RESUMEN
Conservative treatment of an ameloblastoma often requires an occlusal reconstruction. In this article, we report the successful interdisciplinary treatment of a 14-year-old girl with a unicystic ameloblastoma in the mandible. One year after the marsupialization, enucleation with bone curettage was performed with extraction of the impacted third molar, but the proximal second molar could be maintained. The conservative treatment required long-term use of an obturator, and it caused a total open bite. Additionally, the patient genetically had a Class II malocclusion with severe crowding. Consequently, orthodontic treatment was performed after 4 premolar extractions. There was no recurrence of the ameloblastoma 10 years after the enucleation.
Asunto(s)
Ameloblastoma/complicaciones , Maloclusión Clase II de Angle/complicaciones , Maloclusión Clase II de Angle/terapia , Neoplasias Mandibulares/complicaciones , Neoplasias Mandibulares/cirugía , Adolescente , Ameloblastoma/patología , Ameloblastoma/cirugía , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Mandibulares/patología , Ferulas Oclusales/efectos adversos , Mordida Abierta/etiología , Mordida Abierta/terapia , Obturadores Palatinos/efectos adversos , Diente Impactado/etiología , Diente Impactado/cirugíaRESUMEN
This case report demonstrates the efficient use of implant anchorage in a patient with mesially inclined mandibular molars and an overerupted maxillary molar. A 14-year-old girl had an overerupted maxillary right first molar, possibly because of severely inclined mandibular right molars. Two-step use of miniplate anchorage in the right zygomatic process was proposed. As the first step, the overerupted maxillary first molar was intruded with elastic chains from the miniplate for 10 months. Then the maxillary right molars were distalized by using the miniplate to correct the Class II molar relationship. In the mandible, the first molar was extruded with intermaxillary elastics applied from the miniplate to the molar for 7 months after the uprighting of the mandibular right second molar. The results suggest that the use of 2-step implant anchorage is efficient for intrusion and distalization of maxillary molars and extrusion and uprighting of mandibular inclined molars.