110 research outputs found

    Passive archwires for intermaxillary fixation in surgical cases: a clinical report

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    In intraoperative intermaxillary fixation (IMF), bonding a minimally adapted, rectangular, stainless steel, preformed archwire directly to the teeth with a light-cured composite resin can offer many benefits to clinicians and patients. The procedure is easier and less time-consuming than conventional bracket placement, the risk of occlusal interference is reduced and the patient's comfort is increased. With the use of composite resin, the wire fits buccal tooth surfaces accurately, thus creating a completely passive anchor unit. Crimpable hooks can be easily adjusted along the archwire, thus establishing different directions of postoperative elastic traction. Furthermore, this technique eliminates soft tissue injuries and tooth root damage, which are risks associated with the use of miniscrews for IMF. In this clinical report, we describe the case of a 50-year-old man, who required a passive anchor unit to assist IMF before undergoing maxillomandibular advancement to treat severe obstructive sleep apnea syndrome

    Orthodontic extraction of mandibular third molar to avoid nerve injury and promote periodontal healing.

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    Aim: Impacted mandibular third molar extraction is a common procedure in oral surgery, not without risk of nerve injury and periodontal defects on the distal aspect of the adjacent second molar. The "orthodontic extraction" is proposed as a method to avoid mandibular nerve injury during the extraction of a deeply embedded third molar and to prevent or limit such periodontal problems. Material and Methods: A 28-year-old man presented a deeply impacted left mandibular third molar that required extraction. Radiographs revealed a very slight quantity of bone at the distal surface of the adjacent second molar. The third molar was extruded according to the "orthodontic extraction" technique. A 3-month retention phase elapsed to ensure adequate bone maturation and the tooth was finally extracted. Results: No neurological complications occurred. A minimal residual bone defect at the distal surface of the adjacent second molar was detected radiographically both post-operatively and at the 3-year follow-up. Conclusions: Orthodontic extraction makes third molar removal easier and has no neurological risk. This procedure, followed by a 3-month retention phase, appears to be effective in preventing or limiting the development of periodontal problems on the distal aspect of the adjacent second molar

    Onychophagia and post-orthodontic isolated gingival recession: diagnosis and treatment

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    This clinical report describes the diagnosis and the management of isolated-type recession defects of complex etiology in 2 healthy postorthodontic patients. The lesions were confined to 1 mandibular incisor and were associated with an abnormal buccolingual inclination of the affected tooth despite a lingual retainer made with a round stainless steel twisted wire. After careful questioning, it was determined that the recession defects were indirect effects of habitual onychophagia. The concomitant fingernail-biting habit and the lingual bonded retainer led to the indirect development of bone dehiscence and, consequently, gingival recession

    Periodontal healing after 'orthodontic extraction' of mandibular third molars: A retrospective cohort study.

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    In this study we investigated periodontal healing of mandibular second molars following 'orthodontic extraction' of adjacent impacted third molars, under the null hypothesis that there would be no difference in probing pocket depths (PPD) and clinical attachment levels (CAL) at the distal aspect of second molars before and after treatment. A retrospective survey was conducted of 64 patients who consecutively underwent 'orthodontic extraction' of mandibular third molars in close anatomical relationship with the mandibular canal from January 1997 to January 2011. Age, smoking habit, and PPD and CAL at the distal aspect of second molars before and after treatment were recorded. A statistically significant difference was found in PPD and CAL before and after treatment for the overall sample and for the sample classified by age (>25 or ≤25 years), smoking habit (smoker or non-smoker), and type of third molar impaction (horizontal, mesioangular, or vertical). Median PPD and CAL reductions amounted to 6mm and 5mm, respectively. The null hypothesis was rejected and orthodontic extraction proved to be indicated for those impacted mandibular third molars at high risk of a postoperative periodontal defect at the distal aspect of the adjacent second molar

    Double vs Single Primary Teeth Extraction Approach as Prevention of Permanent Maxillary Canines Ectopic Eruption

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    PURPOSE: To compare the effects of extraction of primary maxillary canines and first molars (double extraction approach) vs primary maxillary canines extraction (single extraction approach) in cases of ectopic permanent maxillary canines (PMCs). METHODS: Palatally or centrally displaced PMCs were randomly assigned as follows: single extraction (Group 1=29 patients, 52 canines); double extraction (Group 2=30 patients, 56 canines). PMCs inclination to the midline and to the long axis of the lateral incisor, mesiodistal position of the PMCs crown, and first premolars angulation to the midline were measured on panoramic radiographs at T0 and after 18 months (T1), on average. Between-group statistical comparison was carried out on T0-T1 changes for all the radiographic variables. Eruption/noneruption of the PMCs was also assessed. RESULTS: Group 2 exhibited improvements in PMCs intrabony position among all the examined variables (P<.001), obtaining a greater parallelism between the roots of the PMCs and the adjacent lateral incisors (P<.001). An improved position of the first premolars due to a reduced angulation (P<.001) was also observed. Clinical success rates showed no statistically significant difference. CONCLUSIONS: The double extraction approach proved to be a more effective procedure vs the single extraction approach in improving permanent maxillary canines' intraosseous position

    Individualized orthodontic treatment: The Insignia system.

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    This clinical report presents a case treated by a currently available customized orthodontic treatment system. The use of patient-specific brackets, indirect bonding transfer devices, and customized archwires decreases treatment and chairside time, making orthodontic cases more predictable, accurate, and ef!cient. The need for time-consuming adjustments is greatly reduced, and appliance customization further facilitates the achievement of the final desired occlusion from the first day of treatment

    Interdisciplinary rehabilitation of a root-fractured maxillary central incisor: A 12-year follow-up case report

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    Single-tooth implantation has become a common treatment solution for replacement of a root-fractured maxillary incisor in adults, but the long-term esthetic results can be unfavorable due to progressive marginal bone loss, resulting in gingival recession. In this case report, a maxillary central incisor with a root fracture in its apical one-third was orthodontically extruded and extracted in a 21-year-old female. Implant surgery was performed after a 3-month healing period, and the final crown was placed about 12 months after extraction. After 12 years, favorable osseous and gingival architectures were visible with adequate bone height and thickness at the buccal cortical plate, and no gingival recession was seen around the implant-supported crown. Although modern dentistry has been shifting toward simplified, clinical procedures and shorter treatment times, both general dentists and orthodontists should be aware of the possible long-term esthetic advantages of orthodontic extrusion of hopelessly fractured teeth for highly esthetically demanding areas and should educate and motivate patients regarding the choice of this treatment solution, if necessary

    Inclusione dei canini mascellari permanenti e riassorbimento radicolare degli incisivi: prevenzione e aspetti medico-legali

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    Objectives. To discuss the risk of incisor root resorption in the presence of ectopic eruption of the permanent maxillary canines. Discussion. Early detection of an anomalously positioned maxillary canine is essential. To this end, patients should undergo a comprehensive clinical and radiographic assessment starting at the age 8 years. Results and conclusions. Eruption of the ectopic permanent canines can be facilitated with early extraction of the primary maxillary canines (and possibly the primary first molars). This approach can prevent impaction (which requires more complicated, prolonged, and biologically expensive treatment) and limit the risk of root resorption involving the adjacent teeth (an event that causes irreversible damage and may give rise to medicolegal litigation)

    Failure after closed traction of an unerupted maxillary permanent canine: Diagnosis and treatment planning

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    This report describes the treatment of a 13-year-old girl with unerupted maxillary permanent canines. It illustrates how recognizing an unexpected problem influenced the decision-making process. Despite 6 months of closed- eruption traction, the left canine had not erupted. However, the neighboring teeth were intruded, suggesting a diagnosis of canine ankylosis. When the site was surgically reopened, the wire chain used for the orthodontic traction appeared to be osseointegrated. It was renewed, and traction was applied for another 16 months, and the tooth was successfully brought into the arch. Bone tissue passing through the chain might have prevented forced eruption. In young patients with unerupted maxillary permanent canines, failure of closed traction can be attributed to ankylosis, and this accounts for tooth extraction as the treatment of choice. However, this clinical report suggests that additional measures might be warranted before the definitive diagnosis of ankylosis can be made and the tooth extracted
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