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1.
Am J Orthod Dentofacial Orthop ; 159(3): 305-311, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33641814

RESUMO

INTRODUCTION: The early diagnosis and interception of potential maxillary canine impaction is the most desirable approach for correcting their path of eruption. However, there is still a lack of evidence regarding the effect of rapid maxillary expansion (RME) on labially impacted canines. This study aimed to investigate the age-related effect of RME on labially impacted maxillary canines in order to reduce the risk of their impaction in the mixed dentition and to examine the proper timing of interceptive treatment. METHODS: All patients aged 7-10 years were treated with an RME appliance using the same protocol. The distance to the occlusal plane, axis to the midline, and distribution in different sectors-depending on the patients' age-were evaluated for maxillary canines before and after treatment on panoramic radiographs in order to detect changes in the position of the impacted canines. These geometric measurements in the impacted canines were also validated by observing the nontreated canines at each age. RESULTS: Significant differences existed between the impacted canines and the erupted canines in all 3 categories in all age groups. RME treatment modulated the position of the impacted canines in all age groups. Interestingly, a statistically significant difference before and after RME in all categories was detected in patients aged <8 years. A discriminant analysis also showed a positive association of RME treatment with the risk of labially impacted canines. The standardized regression coefficients showed that the angulation of the maxillary canine was the most important predictor for impaction. CONCLUSIONS: Our findings indicate that RME treatment in the early mixed dentition was effective for managing labially impacted maxillary canines. An age of 7-8 years with early mixed dentition might be the most appropriate timing for therapeutic intervention on the basis of RME treatment for buccal canine impaction.


Assuntos
Técnica de Expansão Palatina , Dente Impactado , Estudos de Casos e Controles , Criança , Dente Canino/diagnóstico por imagem , Humanos , Maxila/diagnóstico por imagem , Dente Impactado/diagnóstico por imagem , Dente Impactado/terapia
6.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 54(12): 819-824, 2019 Dec 09.
Artigo em Chinês | MEDLINE | ID: mdl-31874481

RESUMO

The treatment of the impacted teeth is often challenging. During orthodontic treatment of the impacted teeth, unexpected tooth movement may occur for a variety of reasons including inadequate anchorage, inappropriate force vectors, ankylosis of the impacted tooth, traumatic external root resorption in adjacent teeth, and/or bony fenestration. Although cone-beam CT (CBCT) can clearly identify the location of impacted teeth, clinicians should avoid other difficulties before and during the traction of impacted teeth. This article discussed the risk factors during treatment of impacted teeth and presented some reasons of unsuccessful cases.


Assuntos
Ortodontia , Reabsorção da Raiz , Dente Impactado/terapia , Tomografia Computadorizada de Feixe Cônico , Humanos , Fatores de Risco , Técnicas de Movimentação Dentária
8.
Int Orthod ; 17(4): 769-775, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31471240

RESUMO

OBJECTIVE: To investigate video content on YouTube™ related to impacted canine and impacted canine surgery. MATERIALS AND METHODS: In this cross-sectional study, the term "impacted canine tooth" was searched on YouTube™. After excluding duplicates, irrelevant videos, non-English-language videos, no audio-no video contents, sixty-one videos were independently examined by 3 reviewers. Videos were categorized as "not useful", "slightly useful", "moderately useful", and "very useful" by using an 8-point score list for evaluating the value of the videos in providing patients information about impacted canine teeth and surgery. Chi-square test was performed for categorical variables and differences between groups were compared with Kruskal-Wallis. Correlations were analysed using Spearman test. Statistical significance was set P<0.05. RESULTS: Most of the videos, 42.6%, n=26 were uploaded by healthcare professionals [dentists, orthodontists, surgeons] and 29,5%, n=18 were uploaded by laypersons for sharing personal experiences. There were 3 [4.9%] not useful videos, 15 [24.5%] slightly useful videos, 27 [44.2%] moderately useful videos, and 16 [26.2%] very useful videos. There was no significant difference between the viewing rate according to the source of upload [P=0.398>0.05]. There was a significant difference between the interaction index according to the source of upload. This difference was in the laypersons and the others [.033<05]. CONCLUSION: Healthcare specialists should be aware of the content of the video-sharing platforms and direct their patients to correct and reliable e-information resources.


Assuntos
Informação de Saúde ao Consumidor , Dente Canino , Mídias Sociais , Dente Impactado , Estudos Transversais , Humanos , Ortodontia , Educação de Pacientes como Assunto , Dente Impactado/terapia , Gravação em Vídeo
9.
Am J Orthod Dentofacial Orthop ; 156(3): 355-364, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474265

RESUMO

INTRODUCTION: The aim of this work was to analyze data of patients with failed or delayed eruption of first and second permanent molars, to assess the effectiveness of the treatment methods used. METHODS: Epidemiologic and clinical data of 125 patients (mean age 14.08 ± 4.04 years) with 197 affected molars (30 first and 167 second molars) were retrospectively analyzed. The treatment outcome was known in 161 molars after patient drop-out (20 patients with 36 molars). The cases were categorized into 8 groups according to the choice of treatment: orthodontic uprighting, surgical-orthodontic uprighting, surgical uprighting, surgical repositioning, surgical exposure, first or second molar extraction, third molar extraction, or removal of pathologic conditions. RESULTS: The overall treatment outcome was positive in 141 molars (87.6%). It was positive in all cases treated with orthodontic uprighting (7 molars), surgical exposure (10 molars), surgical uprighting (38 molars), and surgical repositioning (8 molars), but it was significantly lower for surgical-orthodontic uprighting (34/48 molars, 70.8%). The positive outcome was significantly lower for inclusion (52/68 molars, 76.5%) than for early-diagnosed condition (11/11 molars, 100%) and retention (78/82 molars, 95.1%), and for total bone crown coverage (21/28 molars, 75.0%) than for osteomucosal or mucosal crown coverage (120/133 molars, 90.2%). CONCLUSIONS: This study demonstrates that an early diagnosis results in a better outcome regardless of the treatment used, with the number of cases with a positive outcome being higher in younger patients.


Assuntos
Dente Molar/patologia , Anormalidades Dentárias , Erupção Dentária , Técnicas de Movimentação Dentária/métodos , Dente Impactado/terapia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Itália , Modelos Logísticos , Masculino , Dente Molar/cirurgia , Dente Serotino/cirurgia , Estudos Retrospectivos , Dente Impactado/diagnóstico , Dente Impactado/cirurgia , Resultado do Tratamento , Adulto Jovem
10.
Am J Orthod Dentofacial Orthop ; 156(3): 391-400, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474269

RESUMO

INTRODUCTION: Orthodontic traction of a maxillary impacted canine (MIC) increases the orthodontic treatment time. Therefore, the objective of this study was to evaluate the influence of MIC characteristics and factors associated with orthodontic treatment on the duration of active orthodontic traction. METHODS: This follow-up and retrospective study included 45 MICs orthodontically tractioned into the occlusal plane with the use of a standardized protocol. MIC characteristics, including type, sector, side, location, height, and complexity of impaction, as well as α and ß angles and canine root length and area were measured. Likewise, factors associated with orthodontic treatment, including sex, age, malocclusion, premolar extractions, previous incisor root resorption, ANB, APDI, and SNA angles, and PNS-ANS distance were also evaluated. The statistical analysis included multiple linear regressions to estimate the influence of all variables on the duration of traction (α = 0.05). RESULTS: Sex had significant influence (P = 0.027) on the time of traction; in female patients, the time was 2.05 months more than in male patients. Bilateral impaction treatment increased the time by 2.74 months compared with unilateral cases (P = 0.001). Traction of bicortically centered impacted canines increased the duration of traction by 2.85 months (P = 0.001). Finally, the traction time increased in 2.35 months (P = 0.046) when the impaction sectors were 4 or 5 (close to the midline). CONCLUSIONS: The duration of active orthodontic traction of MIC is mainly influenced by sex, bilateral type, bicortically centered location, or when MIC is located in sector 4 or 5 close to midline, increasing the traction time by some months.


Assuntos
Dente Canino/cirurgia , Maxila/cirurgia , Ortodontia Corretiva/métodos , Dente Impactado/complicações , Dente Impactado/terapia , Adolescente , Dente Canino/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Incisivo , Masculino , Má Oclusão/classificação , Má Oclusão/terapia , Maxila/diagnóstico por imagem , Procedimentos Cirúrgicos Bucais , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Aparelhos Ortodônticos Fixos , Ortodontia Corretiva/instrumentação , Avaliação de Processos e Resultados em Cuidados de Saúde , Planejamento de Assistência ao Paciente , Radiografia Dentária , Estudos Retrospectivos , Reabsorção da Raiz/complicações , Fatores Sexuais , Fatores de Tempo , Erupção Dentária , Raiz Dentária/anatomia & histologia , Raiz Dentária/diagnóstico por imagem , Dente Impactado/diagnóstico por imagem , Dente Impactado/cirurgia , Tração , Resultado do Tratamento
11.
Am J Orthod Dentofacial Orthop ; 156(2): 275-282, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31375238

RESUMO

This case report describes the interdisciplinary treatment of an ectopic horizontally placed maxillary right central incisor with severe root dilaceration. The root was distally angulated and entrapped by the root of the maxillary right lateral incisor. The initial force system was aimed at an occlusal displacement and applied to the crown. During the second phase, a button was cemented onto the apex of the impacted tooth. A force from the apex to a temporary anchorage device in the palate moved the root toward the midline. Finally, a root canal and an apectomy were performed and the central incisor could be moved to its ideal position. The treatment generated a normal height of the alveolar bone and an ideal occlusion with a healthy periodontium.


Assuntos
Incisivo/cirurgia , Técnicas de Movimentação Dentária/métodos , Raiz Dentária/cirurgia , Dente Impactado/cirurgia , Dente Impactado/terapia , Fenômenos Biomecânicos , Criança , Tomografia Computadorizada de Feixe Cônico/métodos , Cavidade Pulpar , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imageamento Tridimensional , Má Oclusão de Angle Classe I/terapia , Maxila/anatomia & histologia , Maxila/diagnóstico por imagem , Maxila/cirurgia , Aparelhos Ortodônticos Fixos , Extrusão Ortodôntica/métodos , Planejamento de Assistência ao Paciente , Tratamento do Canal Radicular , Coroa do Dente , Dente Impactado/diagnóstico por imagem , Resultado do Tratamento
12.
Int Orthod ; 17(4): 634-642, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31451345

RESUMO

OBJECTIVE: The aim of this systematic review was to assess whether interceptive treatment carried out in the mixed dentition period improves the position of Palatally Displaced Canines (PDC). MATERIALS AND METHODS: A systematic search was performed on various computerized databases. A hand search was also performed by reviewing the references within the examined studies and titles of the papers published over the last 30 years on various orthodontic journals. RESULTS: This systematic review analysed eight articles, of which five were Randomized Clinical Trials (RCT) and three were prospective control studies. Qualitative assessment was done for all the eight studies. The effect of interceptive measures such as extraction of primary canine, Rapid Maxillary Expansion (RME), cervical pull headgear and Transpalatal Arch (TPA) on successful eruption of Palatally Displaced Canines was analyzed. CONCLUSION: Interceptive treatment improves the position of PDC and reduces the chances of impaction. Significant changes in success rate depend on diagnosis at early mixed dentition stage. A combination of interceptive measures which includes extraction of primary canine, cervical pull headgear, TPA and RME aided in successful eruption. However, Randomized clinical trials with increased sample size, proper randomization comparing all the interceptive measures along with assessment of other factors such as patient satisfaction, pain experience and cost factor will yield more evidence based conclusions.


Assuntos
Dente Canino , Ortodontia Interceptora/métodos , Erupção Ectópica de Dente/terapia , Dente Impactado/terapia , Bases de Dados Factuais , Dentição Mista , Aparelhos de Tração Extrabucal , Humanos , Maxila , Técnica de Expansão Palatina , Palato , Erupção Dentária , Extração Dentária
13.
Am J Orthod Dentofacial Orthop ; 155(6): 860-870, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31153507

RESUMO

Effective torque control is crucial for the successful treatment of impacted incisors; however, torque control is often a challenge with the use of conventional bracket systems, especially when the adjacent teeth require opposite torque managements. A novel approach of torque control for adjacent anterior teeth is introduced in this case report. A 12-year-old boy had an impacted maxillary right central incisor with the adjacent teeth severely displaced. The treatment plan was to regain space and pull the impacted incisor into the dentition. An upper removable appliance was first used to regain space for the impacted central incisor, followed by a spontaneous eruption of the impacted incisor. Subsequently, fixed appliances were bonded to level and align the dentition. However, the crown of the maxillary right central incisor was found to be tipped lingually, while the maxillary right lateral incisor was tipped labially. Traditional torque control, including torque bend and the use of a Warren spring, were first used for the correction, but they were ineffective due to the overlap of the root apex of the maxillary central incisor and lateral incisor. After the roots were separated with a V-shaped curve, auxiliary brackets were bonded on the gingival one-third areas of the maxillary incisors and canine with nickel-titanium wires used for the torque control. This approach of using the auxiliary brackets and wires was demonstrated to be efficient and effective in the torque control of adjacent anterior teeth with opposite torque control requirements. The final result and the 2-year follow-up records demonstrated the proper torque of anterior teeth and good and stable dental and profile esthetics.


Assuntos
Incisivo , Má Oclusão/terapia , Aparelhos Ortodônticos Funcionais , Aparelhos Ortodônticos Removíveis , Dente Impactado/terapia , Cefalometria , Criança , Tomografia Computadorizada de Feixe Cônico , Estética Dentária , Humanos , Incisivo/diagnóstico por imagem , Masculino , Má Oclusão/diagnóstico por imagem , Maxila/diagnóstico por imagem , Radiografia Panorâmica , Dente Impactado/diagnóstico por imagem , Torque
14.
Int Orthod ; 17(2): 249-255, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31040074

RESUMO

OBJECTIVE: To analyse the amount of root resorption of mesially or horizontally impacted mandibular third molars after orthodontic uprighting treatment. MATERIALS AND METHODS: Twenty-four patients with an age range of 20∼26years old who had mesially/horizontally impacted third molars with complete root formation. And those with decayed or missing the mandibular first molar on the same side were selected. The lower third molars were uprighted and the extraction spaces closed. Root resorption was compared with paired t-test. The related risk factors for root resorption were compared with Pearson correlation analysis. RESULT: The average uprighting time was 10.00 months (4∼16months). The study showed that all the impacted third molars were uprighted and got satisfactory outcomes after treatment. Shortening in length of mandibular third molar roots was detected at the end of the treatment, but no statistically significant differences were found (P<0.05). Root resorption was correlated with the duration of uprighting and the distance that root moved. CONCLUSION: Impacted mandibular third molars were uprighted and the amount of root resorption of third molar after treatment was not increased. The duration of uprighting and the distance that root moved influence the degree of root resorption.


Assuntos
Dente Serotino/patologia , Reabsorção da Raiz/etiologia , Técnicas de Movimentação Dentária/efeitos adversos , Dente Impactado/terapia , Adulto , Feminino , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Dente Molar/patologia , Dente Serotino/diagnóstico por imagem , Aparelhos Ortodônticos Fixos , Fatores de Risco , Técnicas de Movimentação Dentária/métodos , Dente Impactado/complicações , Adulto Jovem
16.
Shanghai Kou Qiang Yi Xue ; 28(1): 97-99, 2019 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-31081010

RESUMO

PURPOSE: To analyse the imaging features of odontogenic keratocysts (OKCs) associated with an impacted tooth. METHODS: Clinical and radiological data of 235 cases with OKCs were respectively investigated, with emphasis on imaging features of 36 OKCs, which were associated with an unerupted tooth. RESULTS: In 36 cases of OKCs associated with an impacted tooth, the ratio of male to female was 1.77:1, and molar-ramus was involved in 26 cases (72.22%). OKCs in association with an unerupted tooth occurred mostly in patients ranging from 20 to 30 years (19 cases, 52.8%). There were 27 cases (75%) of unilocular and 9 cases (25%) multilocualr radiolucency. Thirteen cases (36.11%) were related to the crown of the impacted teeth, and the unerupted teeth also were impacted as a result of malposition in which the entire teeth appeared to be enveloped by cysts (15 cases, 41.67%), or adjacent to cyst wall (8 cases, 22.22%). CONCLUSIONS: Radiographically, one of the most imaging features of OKCs in association with an unerupted tooth is that its entire tooth appears to be enveloped by cyst or adjacent to cyst, while pericoronal radiolucencies surrounding an impacted tooth are rarely seen.


Assuntos
Cistos Odontogênicos , Tumores Odontogênicos , Dente Impactado , Feminino , Humanos , Masculino , Cistos Odontogênicos/diagnóstico , Cistos Odontogênicos/terapia , Tumores Odontogênicos/diagnóstico por imagem , Tumores Odontogênicos/terapia , Radiografia , Coroa do Dente , Dente Impactado/diagnóstico por imagem , Dente Impactado/terapia
17.
J Craniofac Surg ; 30(6): 1767-1771, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30950953

RESUMO

Cleidocranial dysplasia is a rare autosomal-dominant condition that affects ossification. The main symptoms of this cleidocranial dysplasia patient include craniofacial abnormalities, hypoplasia of clavicles, narrow thorax, retarded exfoliation of deciduous teeth, retarded eruption of permanent teeth, and multiple impacted supernumerary teeth. The aim of this treatment was to correct the craniofacial abnormalities and provide an adequate functional reconstruction of the occlusion. The patient was treated with a multidisciplinary therapeutic protocol including removal of supernumerary teeth, surgical exposure of impacted teeth, orthodontic, and orthognathic surgery. After 6 years' follow-up, the treatment objectives of acceptable occlusion, normal function, and acceptable profile were achieved.


Assuntos
Displasia Cleidocraniana/cirurgia , Displasia Cleidocraniana/diagnóstico por imagem , Oclusão Dentária , Humanos , Masculino , Erupção Dentária , Dente Decíduo , Dente Impactado/diagnóstico por imagem , Dente Impactado/terapia , Dente Supranumerário , Adulto Jovem
18.
Am J Orthod Dentofacial Orthop ; 155(3): 380-387, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30826041

RESUMO

OBJECTIVES: The early interceptive treatment of palatally displaced canines (PDCs) has for decades been based on their position in panoramic radiographs. In the 1990s, cone-beam computed tomography (CBCT) started to become popular in cases with PDCs. The aims of this prospective study were to evaluate the agreement of PDC sector position and angle to midline between panoramic radiographs and CBCT scans. METHODS: PDC sector and angle to midline were measured in panoramic radiographs and CBCT scans in 58 consecutive patients with 64 PDCs. Kappa with linear weighting was used to assess the agreement between the measurements of PDC sector position and Bland-Altman limits of agreement to assess the agreement between the PDC angular measurements in the 2 methods. RESULTS: PDC sector position and angle to midline had systematically higher values in panoramic radiographs compared with those in the CBCT scans. The agreement of sector position between the methods was fair: weighted kappa 0.36 (95% CI 0.24-0.49). The mean difference in angle was almost 7° (95% CI 5.9°-7.9°) higher in panoramic radiographs compared with CBCT. CONCLUSIONS: Panoramic radiographs overestimate PDC sector and angle to midline position, compared with the use of CBCT scans, but clinically the differences are quite modest. Panoramic radiographs could be considered good enough for rendering PDC position when the need for 3D information is not crucial for treatment planning.


Assuntos
Dente Canino/anormalidades , Dente Canino/diagnóstico por imagem , Radiografia Panorâmica , Erupção Ectópica de Dente/diagnóstico por imagem , Dente Impactado/diagnóstico por imagem , Adolescente , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Maxila/diagnóstico por imagem , Ortodontia Interceptora , Suécia , Erupção Ectópica de Dente/terapia , Dente Impactado/terapia
19.
Am J Orthod Dentofacial Orthop ; 155(3): 421-431, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30826045

RESUMO

Short root anomaly (SRA) is a rare familial dental condition that is often misdiagnosed. Orthodontic treatment of patients with SRA is challenging because it is difficult to diagnose, it may be accompanied by other dental anomalies, and it has been reported to contribute to additional susceptibility to root resorption during orthodontic treatment. In this article, we describe a methodical and evidence-based means of diagnosing and orthodontically managing a patient with SRA. The patient had additional challenges, including impacted and ectopic teeth. An individualized treatment plan that incorporated efficient and effective mechanics led to a well seated occlusion and an esthetic smile.


Assuntos
Extrusão Ortodôntica/métodos , Ortodontia Corretiva/métodos , Erupção Ectópica de Dente/diagnóstico por imagem , Erupção Ectópica de Dente/terapia , Raiz Dentária/anormalidades , Raiz Dentária/diagnóstico por imagem , Dente Impactado/terapia , Adolescente , Cefalometria , Tomografia Computadorizada de Feixe Cônico , Estética Dentária , Feminino , Humanos , Radiografia Panorâmica , Sorriso , Dente Impactado/diagnóstico por imagem
20.
Dental Press J Orthod ; 24(1): 74-87, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30916252

RESUMO

Orthodontic traction of impacted canines stands as a major challenge for Orthodontics. It is a relatively frequent clinical complaint which management, more often than not, requires a multidisciplinary approach. Surgical exposure of the impacted canine, and the complex orthodontic mechanics applied to align the tooth back into the arch, may frequently lead to complications involving supporting tissues, not to mention the long treatment time and high costs imposed to patients. In face of that, it is worth highlighting the relevance of early diagnosis as to intervene efficiently and as soon as possible. This paper presents a review of the main concepts involving prevalence, etiology and classification of impacted canines, and describes the different clinical management options that would help solve the problem. It illustrates the topic by presenting a treatment delivered to a 13 year 7 months old male patient, suffering from a Class II, division 2, left subdivision, malocclusion, associated to a deep bite and a prolonged retention of a primary upper canine caused by the impaction of the permanent tooth. Corrective orthodontic therapy was associated to a rapid maxillary expansion and to the use of a high pull headgear. Impacted canine was submitted to orthodontic traction and correctly positioned back into the arch. This approach proved to be efficient in meeting both functional and aesthetic goals.


Assuntos
Estética Dentária , Má Oclusão , Extrusão Ortodôntica , Dente Impactado , Adolescente , Dente Canino , Dentição Permanente , Humanos , Má Oclusão/terapia , Técnicas de Movimentação Dentária , Dente Impactado/terapia
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