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1.
Eur Arch Paediatr Dent ; 19(5): 379-385, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30194610

RESUMO

BACKGROUND: Dental trauma is very common among children. Crown fractures represent the majority of dental trauma in the permanent dentition. Complicated crown-root fractures require a multidisciplinary approach, for long-term success. CASE REPORT: The multidisciplinary treatment of a traumatised permanent upper incisor of an 11-year-old patient that sustained a complicated crown root fracture, while under active orthodontic treatment is presented. The pulp was widely exposed and therefore endodontic treatment was necessary. However most of the crown (and part of the coronal part of the root as well) had been fractured and the tooth could not be properly isolated for an aseptic procedure. METHODS: Orthodontic extrusion was decided and it was achieved using a custom-made, intra-canal wire loop that was cemented in the root canal and attached to the patients' orthodontic fixed appliances. RESULTS: The remaining tooth structure was successfully extruded coronally and following endodontic treatment (under proper rubber dam isolation [RDI]), root canal obturated using the cold gutta-percha technique (in order to avoid further trauma to the periodontal ligament, if a warm obturation technique was chosen) and subsequently restored under RDI. At the 7-years follow-up, no signs of clinical or radiographical inflammation were evident. CONCLUSIONS: A custom wire loop as an anchoring site is an easy-to-adopt-and-perform option for such cases. Cold gutta-percha obturation techniques should be opted for root canal obturation to avoid further trauma to the periodontal ligament.


Assuntos
Endodontia/métodos , Incisivo/lesões , Extrusão Ortodôntica/instrumentação , Fraturas dos Dentes/terapia , Criança , Seguimentos , Guta-Percha , Humanos , Incisivo/diagnóstico por imagem , Masculino , Radiografia Dentária , Obturação do Canal Radicular/métodos , Coroa do Dente/lesões , Fraturas dos Dentes/diagnóstico por imagem , Raiz Dentária/lesões
3.
Am J Orthod Dentofacial Orthop ; 154(1): 55-64, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29957320

RESUMO

INTRODUCTION: Orthodontic extrusion of impacted maxillary canines requires careful biomechanical planning and the use of physiologic force. The aim of this study was to evaluate the time needed for orthodontic extrusion of impactions of different severities, using a device that can predictably apply forces under 0.6 N. METHODS: Twenty-two patients who were consecutively treated were selected retrospectively, and a total of 30 impacted canines were studied. Indexes of impaction were used to measure severity on pretreatment panoramic radiographs. Statistical analysis was used to detect interactions between treatment time, complexity of impaction, age, and sex. RESULTS: Treatment time was highly dependent on the patient's age; the shortest treatment time was observed in 11- to 12-year old patients. On the other hand, the severity of impaction had no effect on treatment time. CONCLUSIONS: Applying physiologic force with the proposed device resulted in a short treatment time, which depended on the patient's age more than the impaction complexity. Few complications were associated with use of this device. Future prospective studies are needed to replicate these findings and confirm the recommended use of this device.


Assuntos
Dente Canino , Extrusão Ortodôntica/instrumentação , Dente Impactado/terapia , Adolescente , Adulto , Criança , Estudos de Coortes , Desenho de Equipamento , Feminino , Humanos , Masculino , Maxila , Extrusão Ortodôntica/métodos , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
4.
Am J Orthod Dentofacial Orthop ; 153(2): 195-203, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29407496

RESUMO

INTRODUCTION: Orthodontic treatment of palatally impacted maxillary canines raises many difficulties; to minimize complications, careful planning of orthodontic extrusion and the use of physiologic force are crucial. The aim of this study was to quantitatively evaluate a simple and reproducible system for orthodontic extrusion of impacted canines that can provide the correct amount of force. METHODS: Ten specimens were constructed, consisting of a cantilever made with a 0.6-mm or 0.7-mm stainless steel wire modeled around a transpalatal bar with 3, 5, or 7 loops in the shape of a helical torsion spring. A mechanical testing machine was used to measure the force produced by the cantilever at 3, 6, 9, 12, and 15 mm of activation. RESULTS: The force values ranged from 1.24 ± 0.13 N for the 0.7-mm wire with 3 loops to 0.48 ± 0.04 N for the 0.6-mm wire with 7 loops. The forces measured for the 0.6-mm wire with 3 loops and the 0.7-mm wire with 7 loops were similar at 15 mm of deflection. CONCLUSIONS: The proposed system has a simple and robust design, is easy to construct and manage, and can provide the desired amount of force by changing the wire diameter and number of loops.


Assuntos
Dente Canino/cirurgia , Extrusão Ortodôntica/métodos , Dente Impactado/cirurgia , Análise do Estresse Dentário , Humanos , Maxila , Extrusão Ortodôntica/instrumentação , Fios Ortodônticos
7.
Am J Orthod Dentofacial Orthop ; 151(6): 1148-1158, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28554460

RESUMO

Treatment of palatally impacted and transposed canines is challenging for both orthodontists and oral surgeons. To treat a maxillary canine impaction without risking damage to adjacent teeth, it is necessary to use cone-beam computed tomography for proper localization and treatment planning. In this case report, a palatally impacted canine was initially retracted distally with a microimplant inserted in the palatal slope and then was moved buccally into its ideal position. The patient's occlusion and smile esthetics were significantly improved after orthodontic treatment.


Assuntos
Dente Canino , Procedimentos de Ancoragem Ortodôntica/instrumentação , Extrusão Ortodôntica/instrumentação , Dente Impactado/terapia , Criança , Tomografia Computadorizada de Feixe Cônico , Dente Canino/diagnóstico por imagem , Feminino , Humanos , Radiografia Panorâmica , Dente Impactado/diagnóstico por imagem
8.
Artigo em Inglês | MEDLINE | ID: mdl-28196161

RESUMO

Crown lengthening by forced eruption is usually followed by conventional surgical procedures. The aim of the present study was to evaluate clinical use of Nd:YAG laser fiberotomy in crown lengthening by forced eruption as an alternative to surgery. Patients who needed crown lengthening were enrolled in this prospective case series and underwent forced eruption. Fiberotomy by Nd:YAG laser was performed 2 days after initiation of forced eruption and every 2 weeks afterward to reach optimum clinical crown length. Measurements included sulcus depth (SD), distance between the gingival margin and the acrylic stent (GM-S), distance from the dental tissue to the gingival margin (clinical crown length) (DT-GM), and distance from the top of the alveolar bone crest to the stent (AC-S) at the mesiofacial, midfacial, distofacial, and midlingual surfaces. A total of 20 patients (9 men and 11 women) with a mean age of 35.25 were enrolled. The SD, GM-S, and AC-S did not change significantly after fiberotomy (P = .32, P = .33, and P = .08, respectively). The DT-GM increased significantly following fiberotomy (P = .001). The results of this study showed that the location of the gingival margin and alveolar bone crest remained unchanged following fiberotomy by Nd:YAG laser during forced eruption, and that Nd:YAG laser can be used as a proper method for fiberotomy in such procedures.


Assuntos
Aumento da Coroa Clínica/métodos , Terapia a Laser/métodos , Lasers de Estado Sólido/uso terapêutico , Extrusão Ortodôntica/métodos , Técnicas de Movimentação Dentária/métodos , Adulto , Processo Alveolar/cirurgia , Restauração Dentária Permanente , Feminino , Gengiva/cirurgia , Humanos , Irã (Geográfico) , Masculino , Maxila , Extrusão Ortodôntica/instrumentação , Estudos Prospectivos , Tratamento do Canal Radicular , Dente , Coroa do Dente , Técnicas de Movimentação Dentária/instrumentação
15.
J Dent Child (Chic) ; 83(3): 167-172, 2016 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-28327268

RESUMO

Impaction of permanent maxillary central incisors is a rare condition that can affect esthetics and oral function. The etiology of impaction is multifactorial and may be related to embryologic reasons, hereditary factors, mechanical obstacles, and pathologic elements, such as the presence of supernumerary teeth. The purpose of this report is to discuss the case of a 10-year-old patient who presented an impacted permanent maxillary right central incisor due to a supernumerary tooth. Surgical removal of the supernumerary tooth and orthodontic traction of the impacted central incisor by the closed eruption technique were performed. After 12 months, the permanent maxillary right central incisor was adequately positioned in the arch. The multidisciplinary treatment allowed the functional and esthetic rehabilitation to happen in a short period of time, thus reducing the patient's psychological impact caused by the lack of an anterior tooth.


Assuntos
Incisivo/cirurgia , Maxila/cirurgia , Extrusão Ortodôntica/métodos , Dente Impactado/cirurgia , Dente Impactado/terapia , Dente Supranumerário/cirurgia , Dente Supranumerário/terapia , Brasil , Criança , Aparelhos de Tração Extrabucal , Humanos , Incisivo/anormalidades , Incisivo/diagnóstico por imagem , Incisivo/patologia , Masculino , Maxila/patologia , Aparelhos Ortodônticos , Braquetes Ortodônticos , Extrusão Ortodôntica/instrumentação , Fios Ortodônticos , Radiografia Dentária , Retalhos Cirúrgicos/cirurgia , Erupção Dentária/fisiologia , Técnicas de Movimentação Dentária/métodos , Dente Impactado/diagnóstico por imagem , Dente Impactado/etiologia , Dente Supranumerário/complicações , Dente Supranumerário/diagnóstico por imagem
16.
Eur J Paediatr Dent ; 17(4): 310-314, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28045320

RESUMO

BACKGROUND: This study reports a case in which a severely impacted lower first molar was recovered with a combined orthodontic therapy and minimally invasive oral surgery with special focus to patient's aesthetic demands. CASE REPORT: A 12-year- old female patient was complaining delayed eruption of mandibular right first molar. Radiographic exam showed a severe tooth impaction with a close relationship between tooth roots and mandibular nerve. As the patient refused full arches orthodontic treatment, a partial orthodontic approach was projected. During treatment, temporary miniscrews were placed in both upper and lower arches, in order to allow dental movement with maximum anchorage. After a 24 month-therapy the tooth was extruded, so the appliance and the miniscrews were removed. CONCLUSION: The present case shows that severe tooth impaction can be resolved with a combined partial orthodontic- minimally invasive surgical treatment.


Assuntos
Parafusos Ósseos , Dente Molar , Extrusão Ortodôntica/métodos , Dente Impactado/terapia , Criança , Feminino , Humanos , Extrusão Ortodôntica/instrumentação , Radiografia Panorâmica , Dente Impactado/diagnóstico por imagem , Resultado do Tratamento
19.
Am J Orthod Dentofacial Orthop ; 148(4): 587-98, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26432314

RESUMO

INTRODUCTION: In this study, we evaluated root and alveolar bone development in unilateral osseous impacted immature maxillary central incisors by cone-beam computed tomography before and after closed-eruption treatment, in comparison with naturally erupted contralateral immature maxillary central incisors. METHODS AND RESULTS: The study included 30 patients, 20 boys and 10 girls, with a mean age of 8.44 ± 1.20 years (range, 6.5-11.2 years). After treatment, the root lengths of both the impacted maxillary central incisors (10.66 ± 2.10 mm) and the contralateral maxillary central incisors (11.04 ± 1.76 mm) were significantly greater than their pretreatment values (6.67 ± 1.94 and 9.02 ± 2.13 mm, respectively). The root canal widths of the incisors decreased significantly after treatment. From the posttreatment cone-beam computed tomography images, the ratio of exposed root length to total root length and the thickness of the alveolar bone at 1 mm under the alveolar crest and at the apex were calculated to evaluate alveolar bone development. Impacted immature maxillary central incisors differed significantly from contralateral immature maxillary central incisors in labial exposed root length, labial ratio to total root length, and lingual alveolar crest. Clinical crown height was higher (statistically but not clinically) for the impacted incisors (9.87 mm) than for the contralateral incisors (9.37 mm). CONCLUSIONS: Impacted immature incisors grew to the same stage as did erupted contralateral incisors after closed-eruption treatment. Both incisor types had some alveolar bone loss, and thin alveolar bone surrounded the roots.


Assuntos
Processo Alveolar/crescimento & desenvolvimento , Incisivo/fisiopatologia , Maxila/crescimento & desenvolvimento , Odontogênese/fisiologia , Extrusão Ortodôntica/métodos , Raiz Dentária/crescimento & desenvolvimento , Dente Impactado/terapia , Perda do Osso Alveolar/diagnóstico por imagem , Processo Alveolar/diagnóstico por imagem , Desenvolvimento Ósseo/fisiologia , Criança , Tomografia Computadorizada de Feixe Cônico/métodos , Cavidade Pulpar/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Incisivo/diagnóstico por imagem , Masculino , Maxila/diagnóstico por imagem , Desenho de Aparelho Ortodôntico , Extrusão Ortodôntica/instrumentação , Ápice Dentário/diagnóstico por imagem , Colo do Dente/diagnóstico por imagem , Coroa do Dente/diagnóstico por imagem , Erupção Dentária/fisiologia , Raiz Dentária/diagnóstico por imagem , Dente Impactado/diagnóstico por imagem
20.
J Craniofac Surg ; 26(7): e592-5, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26468833

RESUMO

OBJECTIVES/INTRODUCTION: This article represents clinical application of spike screw, novel design of miniscrew, for direct anchorage and indirect anchorage in orthodontic treatment. Accompanied by easy placement and removal, the spike screw provides good stability for the orthodontic anchorage. MATERIALS AND METHODS: The spike screw consists of 6 spikes attached to a washer with laser welded stainless-steel hook that is placed by self-drilling fixation miniscrew. The spike screws were applied to correct malocclusions in patients as follows: traction of impacted canines and protraction of posterior teeth as a direct anchorage and correction of midline discrepancy as an indirect anchorage. For orthodontic traction of impacted canines, spike screws were placed in the mandibular labial mucosal area to create extrusive forces. Afterward, it was utilized for the protraction of posterior teeth. In the second case of the indirect anchorage, spike screw was applied on the midpalatal area to correct midline discrepancy that occurred during orthodontic treatment. The extended hook of a washer was prebended along the curvature of the palate and then secured with a mini screw. The extended hook was bonded to maxillary left first molar. RESULTS: In the first case, the spike screw provided adequate anchorage for the vertical traction of horizontally impacted canine. Since the spike screws were placed in the mandibular anterior lesion, the vertical traction force was applied simply with orthodontic elastics. Also, enough distance was achieved for up-down elastics to work by placing the spike screw in the opposite arch. The force of vertical traction was adjusted with selection of size and force of up-down elastics. Later, it was used to provide anchorage for protraction of mandibular molars without changing orientation of the spike screws. In the second case, the spike screw placed in the midpalatal area was attached to the left first molar and worked as an indirect anchorage. The midline discrepancy was resolved by consolidating the spaces to the left with securing the left first molar location. CONCLUSION: The novel design of the spike screw permits clinicians to have minimum invasive and easy placement and removal of the appliance while maintaining a good control over tooth movement with improved stability in various clinical cases.


Assuntos
Parafusos Ósseos , Procedimentos de Ancoragem Ortodôntica/instrumentação , Desenho de Aparelho Ortodôntico , Adolescente , Criança , Dente Canino/patologia , Feminino , Humanos , Miniaturização , Dente Molar/patologia , Procedimentos de Ancoragem Ortodôntica/métodos , Extrusão Ortodôntica/instrumentação , Fechamento de Espaço Ortodôntico/instrumentação , Técnicas de Movimentação Dentária/instrumentação , Dente Impactado/terapia
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