Bimaxillary protrusion with an atrophic alveolar defect: orthodontics, autogenous chin-block graft, soft tissue augmentation, and an implant.
Am J Orthod Dentofacial Orthop
; 147(1): 97-113, 2015 Jan.
Article
em En
| MEDLINE
| ID: mdl-25533077
ABSTRACT
Bimaxillary protrusion in a 28-year-old woman was complicated by multiple missing, restoratively compromised, or hopeless teeth. The maxillary right central incisor had a history of avulsion and replantation that subsequently evolved into generalized external root resorption with Class III mobility and severe loss of the supporting periodontium. This complex malocclusion had a discrepancy index of 21, and 8 additional points were scored for the atrophic dental implant site (maxillary right central incisor). The comprehensive treatment plan included extraction of 4 teeth (both maxillary first premolars, the maxillary right central incisor, and the mandibular right first molar), orthodontic closure of all spaces except for the future implant site (maxillary right central incisor), augmentation of the alveolar defect with an autogenous chin-block graft, enhancement of the gingival biotype with a connective tissue graft, and an implant-supported prosthesis. Orthodontists must understand the limitations of bone grafts. Augmented alveolar defects are slow to completely turn over to living bone, so they are usually good sites for implants but respond poorly to orthodontic space closure. However, postsurgical orthodontic treatment is often indicated to optimally finish the esthetic zone before placing the final prosthesis. The latter was effectively performed for this patient, resulting in a total treatment time of about 36 months for comprehensive interdisciplinary care. An excellent functional and esthetic result was achieved.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Ortodontia Corretiva
/
Implantes Dentários
/
Transplante Ósseo
/
Aumento do Rebordo Alveolar
/
Autoenxertos
/
Gengiva
/
Gengivoplastia
/
Má Oclusão Classe I de Angle
Limite:
Adult
/
Female
/
Humans
Idioma:
En
Revista:
Am J Orthod Dentofacial Orthop
Assunto da revista:
ODONTOLOGIA
/
ORTODONTIA
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Taiwan