11/28. Treatment of a Class I crowded malocclusion with an ankylosed maxillary central incisor. This article describes a Class I crowded malocclusion with an ankylosed maxillary central incisor that was in infraocclusion and labially displaced. Various treatment alternatives are discussed, and the option of extracting the ankylosed tooth followed by space closure with lateral incisor substitution is developed. ( info) |
12/28. Intentional surgical repositioning of an ankylosed permanent maxillary incisor. Replacement resorption (ankylosis) may be a significant complication after replantation of avulsed permanent incisor teeth. This report explains the aetiology, diagnosis, management and current treatment options in ankylosis and then describes an alternative surgical technique, intentional luxation and repositioning. This technique, in the presence of an acceptable root length, may be a realistic treatment option in adolescence until osseointegrated implants can be considered at the age of 18-20 years. ( info) |
13/28. Management of occlusal and developmental disturbances resulting from an ankylosed maxillary second primary molar: case report. This case report presented the orthodontic management of an ankylosed primary molar. Trauma to the maxillary right second primary molar resulted in the infraocclusion of the affected tooth as well as the mesial tipping of the adjacent first permanent molar and displacement of the permanent successor. After extraction of the ankylosed primary molar, orthodontic therapy was performed to upright the adjacent permanent molar and to gain the lost space of its permanent successor. By the application of orthodontic mechanics, the maxillary right permanent first molar was uprighted and the maxillary right permanent second premolar was brought to its proper position. ( info) |
14/28. Orthodontic fine adjustment after vertical callus distraction of an ankylosed incisor using the floating bone concept. The outcome of vertical callus distraction of a segment of tooth-supporting alveolar process might be functionally and esthetically unsatisfactory because of the unidirectional impact of intraoral distraction devices. In this case report, we describe how, with a shortened consolidation phase and application of the floating bone effect, the tooth-supporting osteotomy segment can be successfully aligned 3 dimensionally. We applied orthodontic force systems that went beyond the unidirectional vector preset by the mechanical properties of the distraction device. ( info) |
15/28. root resorption in dental trauma: 45 cases followed for 5 years. We aimed to: (i) study the prevalence of root resorption after luxation or avulsion injuries on permanent teeth referred to our dental clinic over a 3-year period; (ii) study the relationship between type of injury and resultant type of resorption complication; and (iii) evaluate success of treatment protocols for various resorption complications. We observed 1943 patients with dental trauma, aged between 2 and 26 years, referred to the Accident and Emergency Department of the Dental Clinic, University of Brescia, from 1st September 1997 to 31st December 2001. Of these, 261 permanent teeth had sustained luxation (n = 188) or avulsion (n = 73) injuries. Permanent teeth luxation and avulsion injuries occurred most often in upper incisors (75%) of patients mostly aged 12-21 years, with males more commonly affected than females (68.3% vs. 31.7%). These cases were followed for 5 years, and complications and response to treatment were recorded. root resorption was observed in 45 (17.24%) of these cases. Of the 45 cases with resorption, 9 were associated with luxation injury (20%) while 36 (80%) with avulsion. We distinguished 30 cases of inflammatory root resorption (18 transient and 12 progressive) and 15 cases of ankylosis and osseous replacement. When resorption was recognized, quick and effective treatment could still result in an excellent functional and aesthetic outcome for these teeth. ( info) |
16/28. A customized distraction device for alveolar ridge augmentation and alignment of ankylosed teeth. The purpose of this study was to develop an extraosseous, tooth-supported miniature intraoral device that could produce prosthetically driven bone distraction of small atrophic alveolar ridge segments. Extraosseous distraction requires that the distraction device be anchored to a dental implant previously placed into the ridge according to its anatomic axis. A distractor can also correct the position of implants placed in young patients before skeletal growth is completed. Similarly, it allows the alignment of ankylosed teeth not treatable by orthodontics. The device is made of (1) an engine consisting of an orthodontic micrometric screw; (2) a joint between the implant and the engine, ie, the ball attachment/o-ring system; and (3) an anchorage system to the oral cavity provided by an orthodontic appliance and a mini-implant for possible additional support. Surgery involves an osteotomy of the atrophic alveolar ridge segment, incorporating the implant, from the basal bone; afterward the device can be applied and distraction of the segment can be carried out. Distraction was successfully performed in 3 clinical cases: 2 bone-implant segments and 1 bone-ankylosed tooth segment. All cases were clinically uneventful. This mini-device for osteogenic distraction of small atrophic ridge segments can provide for accurate and precise ridge augmentation, as is required for ideal prosthetic rehabilitation. ( info) |
17/28. Orthosurgical treatment with lingual orthodontics of an infraoccluded maxillary first molar in an adult. The biological mechanism that leads to a cessation in the normal passive eruption of a tooth is unclear, and there are differing views as to whether ankylosis is involved. When infraocclusion of a permanent molar occurs in the permanent dentition, its effects are seen (1) locally, with exaggerated tipping and relative under-eruption of the adjacent teeth; (2) regionally, with overeruption of the opposing tooth or teeth; and (3) farther afield, with deviation of the dental midline to the affected side. Treatment aimed at eliminating these adverse conditions is warranted, and this might involve the skills of both an orthodontist and an oral surgeon. When the condition occurs in an adult, the changes in facial appearance that will be caused by traditional fixed orthodontic appliances might undermine the patient's willingness to accept treatment. This report describes the successful orthosurgical treatment with lingual orthodontics of an infraoccluded maxillary first molar in an adult. The challenges, treatment alternatives, and technical refinements are emphasized. ( info) |
18/28. Case report: severe infraocclusion ankylosis occurring in siblings. AIM: This was to report a rare case of strong familiar tendency of ankylosis of maxillary second primary molars. CASE REPORT: Three Caucasian children, male twins of 8.5 years and a sister of 10 years, were diagnosed as having severely infraccluded maxillary second primary molars with underlying second premolars. In all three cases, the early extraction of the infraoccluded molars and an active treatment with cervical extraoral traction allowed the physiologic eruption of second premolars. Follow-up showed that normal vertical relationship and bone height had been obtained. CONCLUSION: early diagnosis, as well as appropriate treatment and careful follow-up are very important in the presence of severe infraocclusion, when the marginal ridge of affected primary teeth is at or below gingival level. ( info) |
19/28. Interceptive management of eruption disturbances: case report. The aim of the present report is to describe a case of a patient with eruption disturbances of an ankylosed lower primary second molar, delayed development of a maxillary permanent canine associated with an odontoma and a class III dental malocclusion. In such a case the objectives of treatment are: to prevent impaction of the lower second premolar and tipping of the lower first molar; to establish correct anterior overbite and overjet and to control the development of the permanent upper canine. ( info) |
20/28. Treatment of an ankylosed central incisor by single tooth dento-osseous osteotomy and a simple distraction device. When teeth are replanted after being avulsed, the repair process sometimes results in ankylosis. In a growing child, the ankylosed tooth fails to move along with the remaining alveolar process during vertical growth, resulting in a tooth that gradually appears more and more impacted and requires several reconstructive procedures to correct. Ankylosed teeth can, however, serve as anchorage for orthodontic correction of a malocclusion and as a point of force application for a dentoalveolar segment during alveolar distraction osteogenesis. This case report describes the treatment of a 13-year-old girl whose maxillary left central incisor had been avulsed and replanted 5 years earlier. The tooth had become ankylosed, and it was used to provide "free anchorage" during distalization of the maxillary dentition. The underdeveloped alveolar process adjacent to the ankylosed tooth was reconstructed by dento-osseous segment distraction osteogenesis, by using the ankylosed tooth as the point of force application. ( info) |