Interdisciplinary treatment of a mutilated dentition with multiple missing teeth and horizontal impaction of a mandibular third molar using an orthodontic skeletal anchorage and dental implants-Case report.

OBJECTIVE: This case report presents a female adult patient who exhibits poor oral hygiene, a mutilated dentition with multiple missing teeth, and skeletal asymmetry. CLINICAL CONSIDERATIONS: Interdisciplinary treatment was necessary to maintain oral hygiene, treat caries, extract residual roots, and upright a horizontally impacted third molar using a miniplate. Additionally, orthodontic mini-implants were utilized as anchorage to improve sagittal relationship and space closing. Space management was completed with orthodontic treatment, followed by restoration of the multiple missing teeth with dental implants. CONCLUSION: Consequently, an esthetic smile and functional occlusion were achieved by interdisciplinary treatment using orthodontic skeletal anchorage devices and dental implants. CLINICAL SIGNIFICANCE: Missing mandibular first molar spaces were closed with retraction of the anterior teeth and protraction of the mandibular second molars using orthodontic mini-implants. The mandibular right third molar, which should have erupted, was protracted with the second molar, while the horizontally impacted mandibular left third molar was uprighted using a miniplate and was protracted with an orthodontic mini-implant. The missing maxillary lateral incisors were replaced with the maxillary canines, and the maxillary canines were replaced with the maxillary first premolars. The missing maxillary right second premolar and first molar and left first and second molars were successfully restored with dental implants.

Biomechanical and clinical considerations in deep bite treatment using temporary skeletal anchorage devices.

Deep bite is usually treated by intrusion of the anterior teeth, extrusion of the posterior teeth, or a combination thereof. Various traditional methods have been used to correct deep bites, but they can cause negative side effects. Recently, temporary skeletal anchorage devices (TSADs) have been used to intrude the anterior teeth simply and efficiently without side effects. The amount of incisal exposure at rest should be considered as the first factor in determining which tooth segment should be intruded to correct a deep bite. The center of resistance of the anterior teeth should be considered to achieve the proper biomechanics when intruding them. The location of TSADs should be determined to ensure sufficient interradicular bone to achieve the desired tooth movement. Therefore, clinicians should understand the biomechanical and clinical considerations to correct a deep bite using TSADs.

Treatment of Class II malocclusion with bialveolar protrusion by means of unusual extractions and anchorage mini-implant

INTRODUCTION: Patients with dental Class II bialveolar protrusion are generally treated by extracting the four first premolars or two first and two second premolars, and retracting the anterior teeth. This case report describes the treatment of an adult patient with bialveolar protrusion, a Class II canine and molar relationship, and lip protrusion. METHODS: In this patient, the maxillary right second molar (1.7) had to be extracted due to extensive caries. To create sufficient space to retract the anterior teeth, the maxillary right posterior teeth were distalized with a maxillary posterior mini-implant (1.2~1.3 mm in diameter, 10 mm long), which was placed into the maxillary tuberosity area and allowed an en masse retraction of the maxillary anterior teeth. RESULTS: Overall, mini-implant can provide anchorage to produce a good facial profile even without additional premolar extraction in cases of dental Class II bialveolar protrusion with the hopeless second molar. CONCLUSION: The total treatment period was 42 months and the results were acceptable for 34 months after debonding.

INTRODUÇÃO: os pacientes com Classe II e biprotrusão alveolar são, geralmente, tratados com extração de quatro primeiros pré-molares ou dois primeiros e dois segundos pré-molares, e retração dos dentes anteriores. Este relato de caso descreve o tratamento de um paciente adulto com biprotrusão alveolar, relação de caninos e de molares em Classe II e protrusão labial. MÉTODOS: nesse paciente, o segundo molar superior direito precisou ser extraído devido a cáries extensas. Para criar espaço suficiente para retração dos dentes anteriores, os dentes posterossuperiores direitos foram distalizados com um mini-implante posterossuperior (1,2 ~ 1,3mm de diâmetro, 10mm de comprimento), que foi colocado na área da tuberosidade maxilar e permitiu uma retração em massa dos dentes anteriores. RESULTADOS: em geral, mini-implantes podem fornecer ancoragem para produzir um bom perfil facial, mesmo sem extração adicional de molares em casos de Classe II com biprotrusão alveolar. CONCLUSÃO: o período total de tratamento foi de 42 meses e os resultados 34 meses após a remoção do aparelho foram aceitáveis.