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1.
Dental press j. orthod. (Impr.) ; 25(6): 19-25, Nov.-Dec. 2020. graf
Artigo em Inglês | LILACS-Express | LILACS, BBO - Odontologia | ID: biblio-1154054

RESUMO

ABSTRACT Introduction: Teeth frequently fail to erupt and situations arise that prevent the canines from reaching the occlusal plane. Objective: Discourse about the three situations in which the canine does not reach the occlusal plane, and remains unerupted; and at the same time, point how to make a safe diagnosis of alveolodental ankylosis - one of the three causes -, based on tomography. Conclusions: Ankylosis occurs in impacted teeth by atrophy of the periodontal ligament, including the epithelial rests of Malassez. The tomographic signs of alveolodental ankylosis in unerupted canines are the interruption of hypodense periodontal space, discontinuity of the lamina dura and its continuity with the root surface, which gradually loses its regular shape.


RESUMO Introdução: Muitas vezes, a erupção falha, e ocorrem situações que impedem que os caninos cheguem até o plano oclusal. Objetivos: Discorrer sobre quais as três situações nas quais o canino não chega até o plano oclusal, permanecendo não irrompido e, ao mesmo tempo, destacar como se diagnosticar com segurança uma dessas três causas, a anquilose alveolodentária, a partir da tomografia. Conclusões: A anquilose em dentes não irrompidos ocorre pela atrofia do ligamento periodontal, incluindo os Restos Epiteliais de Malassez. Os sinais tomográficos de uma anquilose alveolodentária em caninos não irrompidos são a interrupção do espaço periodontal hipodenso, a descontinuidade da lâmina dura e a sua continuidade com a superfície radicular, que, gradativamente, perde sua regularidade.

2.
Orthod Fr ; 91(1-2): 47-55, 2020 06 01.
Artigo em Francês | MEDLINE | ID: mdl-33146132

RESUMO

In their daily practice, orthodontists and pedo- dontists have a common aim which is to ensure a functional establishment of the permanent denture. Due to the increase of eruption defects/failures with no clear obstacles, the doctor may encounter some difficulties to elaborate a diagnosis or even feels helpless when in need to define and put in motion a correct therapeutic strategy. The primary failure of eruption (PFE) is an extensively studied disease that has to be distinguished from an ankylosis during the diagnosis to improve the patient care. A thorough research of scientific literature has been achieved in order to keep our knowledge on the subject up to date and to develop the diagnosis further on primary failure of eruption. The exploitation of scientific data as well as the use of imagery and genetics, provided us with helpful elements for the primary failure of eruption diagnosis. It also allows the pedodontist and the orthodontist to avoid an unsatisfactory patient care who will be informed prior to the start of the treatment.


Assuntos
Ortodontistas , Anquilose Dental , Criança , Humanos , Dente Molar , Erupção Dentária
3.
Am J Orthod Dentofacial Orthop ; 158(1): 114-125, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32600748

RESUMO

Impaction and an abnormal eruption of a second molar occur because of a lack of retromolar space, premature eruption of the mandibular third molar, and ankyloses. The prognosis must be carefully considered when extracting a damaged permanent tooth. In addition to extraction for orthodontics, this enables the establishment of an effective force system to align the impacted tooth. A 21-year-old woman exhibited maxillary anterior crowding, deviation of the maxillary midline, and deeply impacted mandibular second molars bilaterally. The molar relationship was Class II. The cephalometric analysis demonstrated a skeletal Class I relationship (ANB angle, 1.4°); maxillary and mandibular incisors were lingually inclined. Cone-beam computed tomography images indicated that root resorption, caries, and periodontitis were absent in all mandibular molar. Mandibular second premolars were extracted to relieve crowding and achieve Class I molar relationships. The second molars moved mesially on both sides, and there were no signs of ankylosis. We used improved super-elastic nickel-titanium alloy wire (ISW) to upright the mesioangular second molars. We heat-treated the anterior portion of the ISW, including the first molar area, to increase wire stiffness; the posterior portion of the ISW, including the impacted second molar area, remained untreated to ensure that its super-elasticity was preserved. We alleviated crowding, corrected the maxillary midline, and created ideal occlusion with Class I relationship. This case shows that the alignment of a deeply impacted tooth with a heat-treated ISW, combined with voluntary adjustment of wire stiffness, can be a simple and useful treatment option for adult patients.


Assuntos
Anquilose Dental , Dente Impactado , Adulto , Feminino , Humanos , Mandíbula , Dente Molar , Dente Serotino , Níquel , Titânio , Técnicas de Movimentação Dentária , Adulto Jovem
4.
Compend Contin Educ Dent ; 41(5): 264-270; quiz 271, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32369383

RESUMO

The sequelae associated with anterior oral trauma during childhood growth may require a protracted period of clinical management to achieve an optimal foundation for future prosthetic therapy. This article presents two case examples of long-term ridge development and preservation in children after anterior dental and alveolar trauma. These two patients were managed for periods of 11 years, one from age 8 to 19 and the other from age 9 to 20, until they were old enough to receive implantsupported restorations. Two different treatment plans were prescribed based on whether or not the teeth in question were ankylosed. In one case, fractured roots that were not ankylosed were retained; in the other, decoronation of an ankylosed tooth was performed.


Assuntos
Anquilose Dental , Avulsão Dentária , Traumatismos Dentários , Processo Alveolar , Criança , Humanos , Coroa do Dente
5.
Niger J Clin Pract ; 23(5): 631-637, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32367869

RESUMO

Background: Replantation of avulsed teeth is an invasive treatment approach where patient cooperation is required after the risks are explained to the patient or family. Although replantation of an avulsed permanent teeth is an accepted treatment approach, the long-term prognosis of the replanted teeth is still controversial. This report describes the survival of delayed replanted 15 incisors that was stored in unfavorable conditions after avulsion. Materials and Methods: Nine patients, aged 8-12 years, were referred to the Inonu University, Pediatric Dentistry Department with traumatically avulsed incisors. The parents were informed about the possible complications of a delayed replantation. Results: Forty percent of the teeth were splinted with flexible orthodontic wire and composite. The follow-up periods were varied from 24 to 48 months. The mean follow-up periods were 33.3 ± 8 months. 40% of the teeth were retained in the mouth for at least 3 years and contributed to alveolar bone development. In these cases, the most common complication (9 teeth, 60%) was replacement root resorption. Two of the 15 teeth which had wide open apices, continued to the root development. Conclusion: In this study, replanted teeth were retained in the mouth for at least 2 years and contributed to the patient's development. Therefore, this study has shown that delayed replantation of an avulsed tooth for a child is still worthwhile, even in cases of poor prognosis where the tooth had extended extra-alveolar dry storage. We believe that delayed replantation should be done because of its importance for the child's jaw and facial development.


Assuntos
Incisivo/lesões , Avulsão Dentária/cirurgia , Reimplante Dentário , Criança , Dentição Permanente , Feminino , Humanos , Incisivo/diagnóstico por imagem , Incisivo/cirurgia , Masculino , Pais , Radiografia Dentária , Reabsorção da Raiz/etiologia , Reabsorção da Raiz/prevenção & controle , Preservação de Tecido/métodos , Anquilose Dental , Avulsão Dentária/diagnóstico por imagem , Avulsão Dentária/fisiopatologia , Resultado do Tratamento
6.
Gen Dent ; 68(3): 57-61, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32348245

RESUMO

The objective of this clinical case report is to describe the late treatment performed in a 10-year-old patient who suffered a complicated crown fracture associated with luxation of the maxillary left central incisor. The patient-s parents reported that the patient fell and was immediately taken to a hospital, where radiographs, splinting, and suturing were performed and an anti-inflammatory prescription was provided, but no treatment was given for the exposed pulp. The parents and patient sought treatment at a pediatric dentistry clinic 16 days post-trauma. The clinical examination revealed the presence of a left central incisor with a fracture of enamel and dentin involving the pulp, which was necrotic, and a splint extending from the right lateral incisor to the left lateral incisor. However, it was not possible to diagnose the type of luxation that had occurred. The fractured incisor was treated with periodic changes of calcium hydroxide dressing for apexification for 10 months, and the root was subsequently obturated with gutta percha and root canal sealer. The tooth fragment was stored in physiologic solution during this time. After obturation, tooth darkening was observed, and LED-assisted tooth bleaching was accomplished prior to reattachment of the fractured fragment. The tooth was reexamined every 6 months. Two years after the traumatic event, the left central incisor was infraoccluded in relation to the right central incisor. A radiograph confirmed ankylosis of the traumatized tooth. When trauma affects the enamel, dentin, pulp, and supporting tissues, the prognosis can be unfavorable even when late treatment is adequate, especially when a tooth in a growing patient has points of ankylosis.


Assuntos
Anquilose Dental , Avulsão Dentária/complicações , Fraturas dos Dentes/terapia , Criança , Coroas , Humanos , Tratamento do Canal Radicular , Coroa do Dente , Raiz Dentária
7.
Dent Traumatol ; 36(5): 498-504, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32216025

RESUMO

BACKGROUND/AIMS: The diagnosis and treatment of dental trauma are developing rapidly in China. Therapeutic methods used to treat immature avulsed teeth remain a unique challenge in the clinical setting. The aim of this study was to compare the differences in the survival rate and management of avulsed teeth over two distinct periods. MATERIALS AND METHODS: Forty immature permanent avulsed teeth of 34 patients (28 boys, 6 girls) were included in this study between 1 July 2008 and 30 June 2009 (group 1, 17 teeth), and 1 January 2015 and 31 December 2015 (group 2, 23 teeth). The patients' mean age was 8.8 (range 7-11) years. The follow-up period ranged from 1.5 to 10 years (group 1/group 2, 1.5-10/1.5-3 years). Variables such as extra-alveolar time and storage media, stage of root development, splinting type, splinting duration, endodontic treatment and management of complications were studied. The variables were analysed in relation to post-operative pulp outcomes and periodontal healing. RESULTS: Pulp extirpation was performed in 36 teeth within 0-14 weeks (mean: 1.6 + 2.0). The incidence of ankylosis-related (replacement) resorption was 30.5% and that of infection-related (inflammatory) resorption was 22.5%. Pulp survival rate curves differed significantly between the two periods, indicating improvement (P < .05). Splinting type had changed between the study periods to more flexible splints. The use of storage media prior to replantation had also improved. Multivariate Cox proportional hazard regression showed a cumulative survival rate of 82.5% at 3 years and 29.4% at 10 years. CONCLUSION: A significant improvement was observed in the management and prognosis of avulsed teeth between 2008 and 2015.


Assuntos
Reabsorção da Raiz , Anquilose Dental/terapia , Avulsão Dentária/terapia , Pequim , Criança , China/epidemiologia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Reimplante Dentário , Resultado do Tratamento
8.
Int J Oral Sci ; 12(1): 7, 2020 02 21.
Artigo em Inglês | MEDLINE | ID: mdl-32080164

RESUMO

Primary molar ankylosis with infraocclusion can retard dental arch development and cause dental asymmetry. Despite its widespread prevalence, little is known about its molecular etiology and pathogenesis. To address this, RNA sequencing was used to generate transcriptomes of furcal bone from infraoccluded (n = 7) and non-infraoccluded (n = 9) primary second molars, all without succeeding biscuspids. Of the 18 529 expressed genes, 432 (2.3%) genes were differentially expressed between the two groups (false discovery rate < 0.05). Hierarchical clustering and principal component analysis showed clear separation in gene expression between infraoccluded and non-infraoccluded samples. Pathway analyses indicated that molar ankylosis is associated with the expression of genes consistent with the cellular inflammatory response and epithelial cell turnover. Independent validation using six expressed genes by immunohistochemical analysis demonstrated that the corresponding proteins are strongly expressed in the developing molar tooth germ, in particular the dental follicle and inner enamel epithelium. The descendants of these structures include the periodontal ligament, cementum, bone and epithelial rests of Malassez; tissues that are central to the ankylotic process. We therefore propose that ankylosis involves an increased inflammatory response associated with disruptions to the developmental remnants of the dental follicle and epithelial rests of Malassez.


Assuntos
Perfilação da Expressão Gênica , Ligamento Periodontal , Anquilose Dental/genética , Anquilose Dental/patologia , Adolescente , Criança , Cemento Dentário/patologia , Feminino , Humanos , Masculino , Má Oclusão/etiologia , Má Oclusão/genética , Má Oclusão/patologia , Dente Molar/patologia , Análise de Sequência de RNA , Técnicas de Movimentação Dentária , Dente Decíduo/patologia
9.
Dent Traumatol ; 36(2): 108-116, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31631495

RESUMO

BACKGROUND/AIMS: Ankylosis and subsequent tooth loss is a serious complication following tooth avulsion and replantation. The aim of the study was to evaluate the risk of ankylosis of human teeth replanted after various periods of dry storage prior to replantation. The material originates from a previously reported clinical study of 400 replanted teeth. METHODS: Initial treatment, clinical and radiological examination and follow-up were conducted according to a standardized protocol. PDL was not removed. Follow-up periods ranged from 0.2 to 20 years (mean 5.1 years). The risk of ankylosis was analysed using the Cox regression model including stage of root development, length of dry time and age > 20 years. RESULTS: The risk of ankylosis significantly increased with increasing length of dry time (hazard ratio: 1.22, P = .002) and was significantly higher for teeth with mature root development than for teeth with immature root development (hazard ratio: 2.1 P < .0001). The estimated risks of ankylosis after 900 days for teeth with immature root development were: dry time < 20 minutes: 33.9% (95% confidence interval (CI): 25.4-42.7), dry time 20-40 minutes: 49.6% (95% CI: 37.5-64.8), dry time 40-60 minutes: 54.4% (95% CI: 37.1-71.3) and dry time > 60 minutes: 60.0% (95% CI: 45.0-75.8). The risks for teeth with mature root development were: dry time < 20 minutes: 59.4% (95% CI: 51.6-66.5), dry time 20-40 minutes: 78.3% (95% CI: 69.5-86.2), dry time 40-60 minutes: 81.9% (95% CI: 67.2-92.4) and dry time > 60 minutes: 86.4% (95% CI: 79.7; 92.9). CONCLUSION: The risk of ankylosis rose with increasing length of dry time. However, some teeth may heal without ankylosis even after 60 minutes of dry time. Immature teeth have a lower risk of developing ankylosis. Replantation should therefore always be considered for avulsed teeth.


Assuntos
Reabsorção da Raiz , Anquilose Dental/etiologia , Avulsão Dentária/etiologia , Humanos , Estudos Longitudinais , Reimplante Dentário
10.
Dent Traumatol ; 36(2): 141-150, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31471996

RESUMO

BACKGROUND/AIMS: Decoronation is currently considered the best treatment option for ankylosed teeth and discrepancies in the alveolar bone, particularly in childhood and adolescence. The loss of a front tooth creates aesthetic, functional, and psychological distress in patients and their parents. The aim of this study was to analyze the types of restorations provided after decoronation, their suitability, durability, and follow up until insertion of the final restoration. MATERIALS AND METHODS: A literature review was conducted using Ovid MEDLINE, Embase, and Web of Science to identify eligible articles. English language publications until August 9, 2018, were searched independently and cross-checked by two researchers online, in print, and in press. RESULTS: Of 618 articles screened, 10 included reports on 11 patients with detailed descriptions of 13 provisional restorations. Patients' ages at the time of decoronation were 8-15 years. Seven underwent avulsion and four intrusion. Removable partial denture (nine cases) was the most common restoration. In two cases, the restoration was provisional with a lingual bar with prosthetic crown and in two other cases with an adhesive bridge. Follow up ranged from 3 months to 5 years in nine patients. Two cases were followed until the permanent restoration was placed. CONCLUSIONS: The importance of long-term provisional restorations was disregarded by most authors. A multidisciplinary approach should take into consideration immediate-, mid-, and long-term rehabilitation of the decoronated tooth.


Assuntos
Incisivo , Anquilose Dental , Adolescente , Criança , Coroas , Humanos , Coroa do Dente
11.
J Endod ; 46(2): 192-199, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31813579

RESUMO

INTRODUCTION: Regenerative endodontic procedures (REPs) are aimed to treat apical periodontitis and promote root maturation of immature necrotic teeth. However, REPs are not intended to be a primary indication for treating or arresting external root resorption (ERR). The purpose of this study was to describe REP treatment in the cessation of ERR. METHODS: Four cases (5 teeth) of posttraumatic immature teeth diagnosed with necrotic pulp and apical periodontitis or chronic apical abscess were treated with REPs using plasma-rich fibrin as a scaffold. All the teeth showed ERR and have been followed up to 3 years. RESULTS: This case series shows how REPs arrested ERR. In 3 of the cases, replacement resorption was arrested, thus avoiding complications of ankylosis and the need for decoronation. CONCLUSIONS: In addition to the known advantages of REPs, we show that REPs are a promising treatment modality for arresting ERR, warranting further clinical trials.


Assuntos
Periodontite Periapical , Endodontia Regenerativa , Reabsorção da Raiz , Anquilose Dental , Necrose da Polpa Dentária , Humanos
12.
J Endod ; 45(12S): S52-S56, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31623909

RESUMO

Dental implants are reliable to replace teeth lost because of traumatic dental injury. However, dental implants behave like ankylosed teeth and should not be placed in growing individuals because of the risk of infraposition. This risk may be reduced by ensuring arrested skeletal growth and ideal incisal support. The timing of implant placement may be immediate, early, conventional, or late and is determined by the extent of the trauma, remaining growth, and conditions of the hard and soft tissues. Timing should allow an observation period to properly evaluate the prognosis of concomitantly traumatized neighboring teeth. Orthodontic alignment is often necessary after traumatic dental injury in young individuals to provide symmetric dental conditions around the facial midline, to allow implant placement in the correct 3-dimensional position for the later prosthetic reconstruction, and to ensure sufficient mesiodistal space that leaves a minimum of 1.5 mm of healthy alveolar bone between the future implant and neighboring teeth. Space and stable occlusion should be maintained by bonded retainers and a splint used during the night. A partial prosthesis is usually recommended as a temporary replacement. If a fixed provisional prosthesis is required, it is crucial that it does not interfere with the remaining growth and incisal support and allows proper oral hygiene.


Assuntos
Implantes Dentários para Um Único Dente , Implantes Dentários , Anquilose Dental , Traumatismos Dentários , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Restauração Dentária Temporária , Humanos , Anquilose Dental/terapia , Traumatismos Dentários/terapia
13.
J Dent Res ; 98(12): 1287-1293, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31633460

RESUMO

The discovery of the phenomenon "osseointegration," or functional ankylosis, has led to the development of oral implants with high clinical performance. Consequently, the placement of titanium implants has changed the paradigms of restorative dentistry. Implants are used to prevent placing reconstructions anchored on natural teeth when these are vital and intact. Furthermore, implants are suitable to improve subjective chewing function and to replace missing and strategically important abutments. The osseointegration process is characterized by a predictable sequence of healing events that encompass the formation of woven bone, parallel fibers, and lamellar bone and result in fully functional bone that will remodel throughout life. While the osseointegration facilitates the use of implants as prosthetic abutments, it has to be kept in mind that the peri-implant soft tissue may be subject to biological complications. This, in turn, may result in an infectious process that will jeopardize the osseointegration. Consequently, the monitoring of the peri-implant tissues is an important aspect, and early intervention in situations with peri-implant mucositis is mandatory for the prevention of peri-implantitis. Hence, it is evident that oral implants need lifelong maintenance care if their longevity is to be assured.


Assuntos
Implantes Dentários , Restauração Dentária Permanente/tendências , Osseointegração , Humanos , Peri-Implantite/prevenção & controle , Titânio , Anquilose Dental
14.
J Dent Child (Chic) ; 86(3): 150-153, 2019 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-31645256

RESUMO

Failure of eruption of a permanent first molar is a relatively infrequent clinical condition that affects the normal development of dentition and may cause malocclusion. There are two conditions that might result in failure of eruption: (1) mechanical failure (ankylosis) and (2) primary failure of eruption, with different clinical features and therapeutic approaches for each. It is often challenging for orthodontists and pediatric dentists to establish differential diagnoses of these conditions to ensure a successful treatment outcome. The purpose of this case report is to discuss the diagnosis and treatment of a failure of eruption of a permanent first molar. (J Dent Child 2019;86(3):150-3).


Assuntos
Má Oclusão , Anquilose Dental , Erupção Ectópica de Dente , Criança , Humanos , Dente Molar , Erupção Dentária
15.
Gen Dent ; 67(6): 72-75, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31658030

RESUMO

Dentoalveolar ankylosis, the fusion of a tooth with the alveolar bone, is often associated with primary molars and is the main cause of infraocclusion. This report describes an uncommon case of a severely infraoccluded primary first molar associated with loss of space in the maxilla. After anamnesis and a clinical examination, absence of the primary maxillary left first molar was observed. Periapical radiographs revealed a primary molar completely submerged under the gingiva. Cone beam computed tomography was performed to determine the proximity of the ankylosed tooth to the germ of the permanent successor. Treatment planning included the surgical removal of the ankylosed tooth and placement of a removable space regainer. After 18 months, the maxillary first premolar erupted normally. The careful surgical and interceptive orthodontic planning and cooperation of the patient regarding the use of a removable appliance were essential to the treatment success.


Assuntos
Anquilose Dental , Técnicas de Movimentação Dentária , Dente Decíduo , Dente Pré-Molar , Humanos , Maxila , Dente Molar , Anquilose Dental/cirurgia
16.
Br J Oral Maxillofac Surg ; 57(8): 793-795, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31375300

RESUMO

We present a 16-year-old boy with a history of ankylosis of the temporomandibular joint (TMJ) who had been treated with a costochondral graft and mandibular distraction. The distraction seems to have caused pulp canal obliteration of the lower right second premolar and lower right first molar on radiographic examination. To our knowledge this is the only reported instance of such damage related to mandibular distraction. We aim to highlight the risks of this complication and the importance of discussing it with patients as part of the process of informed consent.


Assuntos
Anquilose , Cavidade Pulpar/patologia , Osteogênese por Distração , Articulação Temporomandibular , Anquilose Dental , Adolescente , Anquilose/cirurgia , Humanos , Masculino , Mandíbula , Osteogênese por Distração/efeitos adversos , Articulação Temporomandibular/cirurgia
17.
J Craniomaxillofac Surg ; 47(10): 1510-1520, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31420281

RESUMO

PURPOSE: The aim of this retrospective study was to evaluate the short-term and long-term skeletal and soft-tissue stability after MDO with or without genioplasty, as well as the stability of the achieved maximum inter-incisal opening (MIO) in patients with mandibular hypoplasia secondary to TMJ ankylosis. PATIENTS AND METHODS: Twenty patients with mandibular hypoplasia secondary to TMJ ankylosis were managed by a two-stage surgical protocol, gap arthroplasty as the first stage, followed by MDO. The patients were analyzed for skeletal and soft-tissue stability as well as the maintenance of the achieved MIO. Lateral cephalograms were evaluated at four time intervals: pre-distraction (T1), after a consolidation period with or without genioplasty (T2), after one year following consolidation (T3), and at the longest follow-up (T4). Statistical analyses compared the skeletal and soft-tissue changes at different intervals in every group. RESULTS: All the ankylosed joints except three were treated with gap arthroplasty without costochondral graft. The MIO was increased from 8.2 ± 2.1 mm preoperatively to 40.2 ± 1.7 mm postoperatively. After the consolidation period, MIO decreased to 23 ± 6.5 mm. The patients were instructed to restart active physiotherapy after removal of the distractors to regain the pre-distraction MIO, which was maintained during the short-term follow-up. The mean follow-up period was 8.5 ± 1.5 years. At the end of the follow-up, two patients showed recurrence of ankylosis. Cephalometric analysis revealed great improvements in the hard- and soft-tissue structures after MDO with or without genioplasty. Several significant long-term relapses could be observed in all groups; however, they did not reach their pre-operative values. CONCLUSION: TMJ ankylosis leads to severe, multidirectional mandibular hypoplasia, which is significantly corrected with the MDO. The MDO provides a stable short-term improvement in the facial esthetics at the first postoperative year, but a significant relapse occurs during the long term follow-up. Nevertheless, a satisfied facial esthetic is maintained for up to seven to 12 years postoperatively. During the activation period, the MDO minimizes the gained MIO after release of ankylosis, but the MIO is successfully restored with physiotherapy.


Assuntos
Anquilose , Osteogênese por Distração , Artroplastia , Estética Dentária , Seguimentos , Humanos , Estudos Retrospectivos , Articulação Temporomandibular
18.
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1009851

RESUMO

A mordida aberta anterior é uma maloclusão caracterizada por um trespasse vertical negativo entre os dentes anteriores, quando os dentes posteriores estão em oclusão. Ela pode ser desenvolvida através de diversos fatores etiológicos, tais como os hábitos bucais deletérios (sucção de polegar ou chupeta), anquilose dentária, respiração bucal, amígdalas hipertróficas, interposição lingual e anormalidades no processo de erupção. Esses fatores interferem diretamente no crescimento e desenvolvimento normais das estruturas faciais. É uma das maloclusões de maior comprometimento estético-funcional, além das alterações dentárias e esqueléticas, e seu tratamento é constituído de diferentes abordagens, pois depende de suaclassificação e severidade. O objetivo deste trabalho é destacar a importância do diagnóstico e tratamento da mordida aberta anterior, bem como mostrar o que pode causá-la, interferindo no correto funcionamento do sistema estomatognático e bem-estar do paciente


The anterior open bite is a malocclusion characterized by a negative vertical overlap between the anterior teeth when the posterior teeth are in occlusion. It can be developed through several etiological factors, such as deleterious oral habits (thumb sucking or pacifiers), dental ankylosis, mouth breathing, hypertrophic tonsils, lingual interposition, and abnormalities in the eruption process. These factors directly interfere with the normal growth and development of facial structures. It is one of the malocclusions of greater aesthetic-functional impairment, besides the dental and skeletal alterations, and its treatment is constituted of different approaches, as it depends on its classification and severity. The objective of this study is to highlight the importance of diagnosis and treatment of anterior open bite, as well as to show what can cause it, interfering in the correct functioning of the stomatognathic system and the patient's well-being.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Mordida Aberta , Sucção de Dedo , Má Oclusão , Hábitos
19.
Int Orthod ; 17(3): 580-595, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31248808

RESUMO

Despite being one of the most pervasive debilitating skeletal problems in the craniofacial region, surgical-orthodontic management of long-standing asymmetric Class II dentofacial deformities is often a unique challenge posed to the clinicians. This case report describes the encouraging results of systematically sequenced and staged therapeutic approach adopted for successful rehabilitation of an adult patient with asymmetric Class II dentofacial deformity with mandibular micrognathia secondary to unilateral TMJ ankylosis. Concurrent gap arthroplasty and bilateral distraction of mandibular body were performed during the first operation for functional restoration of mandibular movements and correction of mandibular micrognathia and associated asymmetry. After 13 months of post-distraction orthodontic treatment, Le Fort I osteotomy for inferior repositioning and sagittal advancement of maxilla was performed during the second operation, in conjunction with adjunctive alloplastic reconstruction of inferior border of mandible for optimization of facial aesthetics. Postsurgical orthodontic detailing facilitated achievement of stable, balanced interdigitation. The total active treatment period was 29 months. After treatment, both the skeletal disharmony and the functional stability were significantly improved with establishment of functional occlusion. The morphological and functionally acceptable results were reasonably well-maintained during three-year follow-up. The merits of mandibular osteodistraction vs. conventional mandibular orthognathic surgery and the potential advantages of staged surgical approach are discussed.


Assuntos
Anquilose/cirurgia , Deformidades Dentofaciais/reabilitação , Deformidades Dentofaciais/cirurgia , Mandíbula/cirurgia , Micrognatismo/cirurgia , Procedimentos Cirúrgicos Ortognáticos/métodos , Transtornos da Articulação Temporomandibular/cirurgia , Adulto , Anquilose/diagnóstico por imagem , Artroplastia/métodos , Cefalometria , Deformidades Dentofaciais/diagnóstico por imagem , Estética Dentária , Assimetria Facial/diagnóstico por imagem , Assimetria Facial/etiologia , Assimetria Facial/cirurgia , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Avanço Mandibular , Maxila/diagnóstico por imagem , Maxila/cirurgia , Micrognatismo/diagnóstico por imagem , Cuidados Pós-Operatórios , Articulação Temporomandibular , Transtornos da Articulação Temporomandibular/diagnóstico por imagem
20.
J Indian Soc Pedod Prev Dent ; 37(2): 214-217, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31249189

RESUMO

Dentoalveolar ankylosis in growing patients is associated with continuing replacement root resorption, tooth infrapositioning, and the local arrest of alveolar bone growth. While extraction of ankylosed teeth might be associated with bone loss, decoronation of the offending tooth (removal of crown portion and instrumentation of pulp canal to stimulate bleeding) has been suggested as a more conservative approach of bone preservation until definitive implant placement is planned. This is a case presentation of a 14-year-old patient who presented with root resorption in relation to the left maxillary central incisor such that decoronation with a prosthetic tooth replacement was decided as the treatment option.


Assuntos
Anquilose Dental , Avulsão Dentária , Adolescente , Processo Alveolar , Seguimentos , Humanos , Coroa do Dente
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