Four impacted canines in an adult patient: a challenge in orthodontics.

This case report illustrates the management of four impacted canines in an adult patient associated with prolonged retention of the four deciduous teeth. The treatment plan was formulated to extract the lower deciduous teeth, application of the forced eruption with the permanent canines, and extract the upper permanent canines and maintenance of the maxillary deciduous canines. No reshaping of the maxillary deciduous teeth was performed because the patient was satisfied with the results.

The anterior dental cross-bite: the paradigm of interception in orthodontics / A mordida cruzada anterior: o paradigma da interceptação em ortodontia

OBJECTIVES: To present specific clinical interception procedures instituted to reduce malocclusionseverity on developmental stage. Anterior tooth cross-bite, involving one or two permanent teeth, is acommon form of malocclusion diagnosed in children about 6 years of age. RESULTS ANDDISCUSSION: Various devices can be suggested for single tooth cases, like removable cantilevereddouble-helix apparatus with digital springs, which is one of the most efficient to intercept malocclusion.In the other hand, fixed appliance does not depend on patient’s cooperation and have greater actionpower and liberates more continuous forces. CONCLUSION: Dental anterior cross-bite, involvingone tooth, can be corrected by means of the multi-loop arch wire with a double-helix, even in caseswhere adequate space for alignment is lacking.

OBJETIVOS: Apresentar procedimento de interceptação clínica específica para reduzir aseveridade da má oclusão no estágio de desenvolvimento. O cruzamento anterior, comprometendoum ou dois dentes permanentes, é forma comum de má-oclusão, diagnosticada em crianças emtorno de seis anos de idade. RESULTADOS E DISCUSSÃO: Vários dispositivos podem ser utilizados para casos de cruzamento de um dente apenas, como os aparelhos de duplo hélice emextremo livre, com molas digitais, um dos mais eficientes para interceptar más-oclusões. Poroutro lado, os aparelhos fixos não dependem da colaboração do paciente, tendo maior poder deação e de liberação de forças contínuas. CONCLUSÃO: Os cruzamentos anteriorescomprometendo um dente podem ser corrigidos por meio de arco com dobras múltiplas, comhélice dupla, mesmo em casos onde há deficiência de espaço para o alinhamento.

The effects of orthodontic movement on a subepithelial connective tissue graft in the treatment of gingival recession.

AIM: The purpose of this article is to report on the five-year follow-up of a case involving treatment of gingival recession with a subepithelial connective tissue graft prior to orthodontic tooth movement. BACKGROUND: Gingival recession has a global prevalence that varies from 3 to 100 percent depending on the population studied and the method of analysis. In addition, the frequency of recession seems to be positively correlated with age. Planned orthodontic tooth movement is not necessarily an etiological factor for gingival recession, so long as it does not move the tooth out of its alveolar process. When the tooth is shifted without adequate biomechanical control, bone dehiscence can develop, and the recession can occur as a consequence of the orthodontic treatment. CASE DESCRIPTION: A 19.6-year-old female patient was referred for orthodontic treatment due to severe anterior-inferior dental crowding and a mandibular right lateral incisor in linguoverson and 4.0 mm of gingival recession on the labial surface. Normal gingival architecture was restored with a subepithelial connective tissue graft used to cover the 4.0 mm defect, after which orthodontic treatment repositioned the malposed incisor into its correct occlusal alignment. Individualized torque was applied to the mandibular right central incisor during the orthodontic treatment. The patient was reevaluated five years after completion of the orthodontic treatment. RESULTS: At the five-year recall appointment, the patient exhibited normal tooth alignment and generalized normal gingival architecture; however, 2 mm of gingival recession was noted on the graft site. SUMMARY: This case demonstrated that periodontal surgical correction of facial gingival recession with a subepithelial graft may be performed prior to initiating orthodontic treatment.

A modificação na inclinação axial dos incisivos superiores para a busca da estética, função e estabilidade / Axial inclination change of the upper incisive teeth searching for esthetics, functionality and stability

O presente trabalho propôs relatar o tratamento ortodôntico e restaurador em um paciente adulto apresentando desgaste excessivo dos incisivos superiores e inferiores. A inclinação axial dos incisivos superiores era desfavorável para remodelação com compósito. As correções nas inclinações axiais dos dentes anteriores com a Ortodontia e os procedimentos restauradores com a Dentística propiciaram melhor estética, saúde e função, além de estabilidade dos resultados obtidos. Durante o planejamento do tratamento ortodôntico e antes de se iniciar o tratamento restaurador todos os detalhes operacionais foram ponderados entre os profissionais envolvidos e a decisão final foi definida em concordância com a vontade do paciente. Resultados estéticos e funcionais satisfatórios foram obtidos neste caso clínico tratado interdisciplinarmente.

The current paper focuses the orthodontic and restorative treatment of an adult patient with excessive wear on the incisal edges of upper and lower incisors. He also presented upper incisors in up-righted position. Correction of axial inclination of anterior teeth promoted improvements in esthetics, health, function and also favored the stability of the attained results. Every operational detail must be considered by both orthodontist and restorative dentist during orthodontic treatment planning and prior to any restorative procedure. The treatment plan must be in accordance with the patient’s expectations and the limitation of the case. Favorable esthetic and functional results were achieved in this case report.