Teeth realignment for enhanced posterior single implant restorations.

As the use of dental implants became a widespread and acceptable treatment modality, with an overall good long-term prognosis, treatment concepts changed reciprocally. Nowadays, dental implants are considered routine and are preferred over other modalities such as removable or fixed partial dentures or etched cast restorations supported by neighboring teeth. However, we often find clinical situations that challenge the placement of an implant because of insufficient space. Congenitally missing tooth, loss of a tooth because of periodontal disease, long-lasting extracted sites, or lost tooth structures caused by caries or trauma may give rise to teeth drifting and loss of coronal space that may hamper implant placement. Minimal or minor orthodontic procedures may be used to regain adequate space for implant placement. The 3 clinical cases presented in this article discuss the various considerations and the use of teeth as mediators in small scale orthodontic treatment performed to achieve enhanced results for single implant restorations to replace missing teeth.

Migration following crown-lengthening procedure--a case report.

Periodontal surgery may be accompanied with some postoperative complications such as pain, swelling and sloughing, purulence or infection, transient bacteremia, nerve trauma, and hemorrhage. In general, a resective surgical intervention may implicate reduction in the attachment apparatus. Migration as a postoperative complication has never been addressed in the literature. This paper presents a case report detailing migration of a tooth, following a surgical preprosthetic clinical crown-lengthening procedure, which was repositioned using adjunctive orthodontics with a removable maxillary modified Hawley appliance. It is incumbent upon the dentist to examine meticulously the occlusal status of the teeth prior to a planned surgical intervention and to take measures preventing any possible tooth migration during the healing process. Failure to achieve occlusal and intra-arch stability may lead to undesired tooth movement in the arch postsurgery, affecting future prognosis and complicating any planned prosthetic work.

The use of an existing cast post and core as an anchor for extrusive movement.

PURPOSE: This article describes an original solution for a tooth with an existing cast post and core placed subgingivally. MATERIALS AND METHODS: The tooth was erupted rapidly using a simplified and easy technique that incorporates fiberotomy during the process of movement. RESULTS: The distal finish line of the core, which was subgingival before movement onset, was elevated, allowing the placement of crown margins on sound tooth structure. Clinical evaluation of the tooth after a period of 4 weeks, during which a provisional acrylic resin crown was used for retention, showed no need for corrective surgery, and fabrication of a metal-ceramic crown (Captek) was begun. CONCLUSION: When failing to place crown margins on sound tooth structure, the existence of a cast post and core in such a nonrestorable tooth may serve as an anchor in the process of rapid extrusion. Following the need to respect the biologic width and fulfill the obligatory ferrule effect circumferentially, this extrusive treatment modality was applied to meet high treatment standards.