Abstract: The present paper reports the treatment of a young adult woman with congenitally missing maxillary lateral incisors who underwent orthodontic treatment for improvement of teeth alignment and occlusal balance previous to dental implant surgery. This treatment also allowed appropriate space for the future lateral incisors crowns. Then, Implants were positioned and prosthetic abutments installed. Ceramic laminates were planned on central incisors in order to improve anterior aesthetics. All-ceramic crowns and laminates were made using lithium dissilicate-based ceramic The multidisciplinary association of orthodontic, implant and prosthetic techniques resulted in successful functional and aesthetic rehabilitation of the case, which was maintained after 1 year follow up. Keywords: Dental agenesis. Dental implants. Ceramic laminates. Esthetic.
Prosthodontic-Orthodontic Treatment Plan with Two-Unit Cantilevered Resin-Bon...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Treatment of Patients With Congenitally Missing Lateral Incisors: Is an Inter...Abu-Hussein Muhamad
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. The available treatment modalities to replace congenitally missing teeth include prosthodontic fixed and removable prostheses, resin bonded retainers, orthodontic movement of maxillary canine to the lateral incisor site and single tooth implants. Dental implants offer a promising treatment option for placement of congenitally missing teeth. Interdisciplinary approach may be needed in these cases. This article aims to present a case report of replacement of bilaterally congenitally missing maxillary lateral incisors with dental implants.
Prosthodontic-Orthodontic Treatment Plan with Two-Unit Cantilevered Resin-Bon...Abu-Hussein Muhamad
Abstract: Congenitally missing lateral incisors create an esthetic problem with specific orthodontic and prosthetic considerations. Selecting the appropriate treatment option depends on many factors, such us the malocclusion, the anterior relationship, specific space requirements, bone volume, root proximity, the condition of the adjacent teeth, and esthetic prediction mainly when the canine must be reshaped.Resin bonded bridges were considered to be doomed owing to their very high decementation rate, have come alive once again because of newer resin based cements. This article will discuss the variety of treatment managements in case of space opening and treated with two 2-unit cantilevered resin-bonded fixed partial dentures supported by the cuspids. This conservative treatment plan was cost-effective without having any significant biological cost. Keywords: Agenesis, Resin- bonded fixed partial denture, interim prosthesis.
Multidisciplinary Approach in the Rehabilitation of Congenitally Maxillary C...Abu-Hussein Muhamad
Objective: This case report describes the multidisciplinary
approach to treat a congenitally missed maxillary canine, how to
improve patient’s smile using orthodontic fixed appliance, endosseous
dental implant, and porcelain veneer to achieve the treatment results of
function and esthetic.
Materials and procedures: Unilateral agenesis of the permanent
maxillary canines in healthy individuals is extremely rare. This
paper presents the case of a female patient diagnosed with congenital
unilateral agenesis of the permanent maxillary canines as well as
occlusal abnormalities in the form of left-side crossbite. To restore the
proper aesthetics and function, interdisciplinary therapeutic treatment
was implemented. In the case presented in this paper, the aim of
oral rehabilitation was to restore a functional balance by obtaining
proper skeletal relationships, creating optimal occlusal conditions and
obtaining arch continuity.
Conclusion: Interdisciplinary treatment combined of orthodontics,
implant surgery, and prosthodontics was useful to treat a nonsyndromic
oligodontia patient. Especially, with the new strategy, implantanchored
orthodontics, which can facilitate the treatmentand make it
more simply with greater predictability.
Pre prosthetic orthodontic implant for management of congenitally unerupted l...Abu-Hussein Muhamad
The maxillary lateral incisor is one of the most common congenitally missing teeth of the permanent dentition. With the advent of implants in the field of restorative dentistry, a stable and predictable fixed prosthetic replacement has become a reality, especially for young adult patients who suffer from congenital absence of teeth. The dual goals of establishment of functional stability as well as enhancement of esthetic outcomes are made achievable by the placement of implants. A multidisciplinary team approach involving the triad of orthodontist, periodontist and restorative dentist will ensure the successful completion of the integrated treatment approach in these patients. The present case report achieved successful implant based oral rehabilitation in a patient diagnosed with congenital absence of bilateral maxillary lateral incisors utilizing a preprosthetic orthodontic implant site preparation for the purpose of space gain.
Prosthodontic-Orthodontic Treatment Plan with Two-Unit Cantilevered Resin-Bon...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Treatment of Patients With Congenitally Missing Lateral Incisors: Is an Inter...Abu-Hussein Muhamad
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. The available treatment modalities to replace congenitally missing teeth include prosthodontic fixed and removable prostheses, resin bonded retainers, orthodontic movement of maxillary canine to the lateral incisor site and single tooth implants. Dental implants offer a promising treatment option for placement of congenitally missing teeth. Interdisciplinary approach may be needed in these cases. This article aims to present a case report of replacement of bilaterally congenitally missing maxillary lateral incisors with dental implants.
Prosthodontic-Orthodontic Treatment Plan with Two-Unit Cantilevered Resin-Bon...Abu-Hussein Muhamad
Abstract: Congenitally missing lateral incisors create an esthetic problem with specific orthodontic and prosthetic considerations. Selecting the appropriate treatment option depends on many factors, such us the malocclusion, the anterior relationship, specific space requirements, bone volume, root proximity, the condition of the adjacent teeth, and esthetic prediction mainly when the canine must be reshaped.Resin bonded bridges were considered to be doomed owing to their very high decementation rate, have come alive once again because of newer resin based cements. This article will discuss the variety of treatment managements in case of space opening and treated with two 2-unit cantilevered resin-bonded fixed partial dentures supported by the cuspids. This conservative treatment plan was cost-effective without having any significant biological cost. Keywords: Agenesis, Resin- bonded fixed partial denture, interim prosthesis.
Multidisciplinary Approach in the Rehabilitation of Congenitally Maxillary C...Abu-Hussein Muhamad
Objective: This case report describes the multidisciplinary
approach to treat a congenitally missed maxillary canine, how to
improve patient’s smile using orthodontic fixed appliance, endosseous
dental implant, and porcelain veneer to achieve the treatment results of
function and esthetic.
Materials and procedures: Unilateral agenesis of the permanent
maxillary canines in healthy individuals is extremely rare. This
paper presents the case of a female patient diagnosed with congenital
unilateral agenesis of the permanent maxillary canines as well as
occlusal abnormalities in the form of left-side crossbite. To restore the
proper aesthetics and function, interdisciplinary therapeutic treatment
was implemented. In the case presented in this paper, the aim of
oral rehabilitation was to restore a functional balance by obtaining
proper skeletal relationships, creating optimal occlusal conditions and
obtaining arch continuity.
Conclusion: Interdisciplinary treatment combined of orthodontics,
implant surgery, and prosthodontics was useful to treat a nonsyndromic
oligodontia patient. Especially, with the new strategy, implantanchored
orthodontics, which can facilitate the treatmentand make it
more simply with greater predictability.
Pre prosthetic orthodontic implant for management of congenitally unerupted l...Abu-Hussein Muhamad
The maxillary lateral incisor is one of the most common congenitally missing teeth of the permanent dentition. With the advent of implants in the field of restorative dentistry, a stable and predictable fixed prosthetic replacement has become a reality, especially for young adult patients who suffer from congenital absence of teeth. The dual goals of establishment of functional stability as well as enhancement of esthetic outcomes are made achievable by the placement of implants. A multidisciplinary team approach involving the triad of orthodontist, periodontist and restorative dentist will ensure the successful completion of the integrated treatment approach in these patients. The present case report achieved successful implant based oral rehabilitation in a patient diagnosed with congenital absence of bilateral maxillary lateral incisors utilizing a preprosthetic orthodontic implant site preparation for the purpose of space gain.
Combined orthodontic and prosthetic therapy special considerations.(52)Abu-Hussein Muhamad
Agenesis, the absence of permanent teeth, is a common occurrence among dental patients. The total incidence of tooth agenesis is about 4.2% among patients that are seeking orthodontic treatment and with the exception of third molars, the maxillary lateral incisors are the most common congenitally missing teeth with about a 2% incidence. The maxillary lateral incisor is the second most common congenitally absent tooth. There are several treatment options for replacing the missing maxillary lateral incisor, including canine substitution, tooth-supported restoration, or single-tooth implant. Dental implants are an appropriate treatment option for replacing missing maxillary lateral incisor teeth in adolescents when their dental and skeletal development is complete. This case report presents the treatment of a patient with congenitally missing maxillary lateral incisor using dental implants. The paper discusses the aspects of pre-prosthetic orthodontic diagnosis and the treatment that needs to be considered with conservative and fixed prosthetic replacement.
Esthetic Evaluation of ImplantsPlaced after Orthodontic Treatment in Patients...Abu-Hussein Muhamad
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the
proper treatment plan. Several treatment options exist for the replacement of congenitally missing lateral incisors.
These options include canine substitution, resin bonded fixed partial dentures, cantilevered fixed partial dentures,
conventional fixed partial dentures and single tooth implants. Depending on which treatment option is chosen, a
specific criterion has to be addressed. Interdisciplinary treatment plays a vital role to achieve an excellent, esthetic
result for a most predictable outcome. This article aims to present a case report of replacement of bilaterally
congenitally missing maxillary lateral incisors with dental implants
Key words: congenitally missing lateral incisor, interdisciplinary treatment, dental impla
ANTIMICROBIAL EFFICIENCY OF INTRACANAL MEDICAMENT AGAINST E. FAECALIS BACTERIA IN INFECTED PRIMARY MOLARS BY USING REAL-TIME PCR: A RANDOMOMIZED CLINICAL TRIAL
Two Treatment Approaches for Missing Maxillary Lateral Incisors: A CaseAbu-Hussein Muhamad
Missing maxillary lateral incisors create an esthetic problem with specific orthodontic and prosthetic considerations. The aim of the present study is to evaluate the clinical success of the transmucosal flapless implant placement and immediate loading of the implants to restore the agenic lateral incisors after completing the orthodontic treatment and during the retention period.
Partial or complete edentulism has multiple implications in relation to function, esthetics and future rehabilitative treatment. This case report illustrates the management of a patient with extreme consequences of partial edentulism in the maxillary arch and total edentulism in the mandibular arch. The main clinical findings were unopposed remaining teeth, over eruption of the remaining teeth, loss of vertical dimension of occlusion, and significant disfigurement of the occlusal plane. Following the diagnostic procedure, a well-coordinated prosthodontic treatment involving liaison with other dental disciplines was indicated. The management involved an innovative combination of fixed and removable prostheses in conjunction with intentional root canal therapy of the remaining natural teeth. Series of provisional prostheses were applied to facilitate the transition to the final treatment.
Key-words: Edentulism, Vertical dimension, Provisional Restoration, Fixed and Removable prosthesis
Quinidine, Albino rats, Pentylenetetrazole, Gap junctionsiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. The available treatment modalities to replace congenitally missing teeth include prosthodontic fixed and removable prostheses, resin bonded retainers, orthodontic movement of maxillary canine to the lateral incisor site and single tooth implants. Implants are a viable option for replacement of congenitally missing lateral incisors and should be considered before the commencement of definitive treatment plan. Early diagnosis, and proper planning can achieve excellent aesthetics. Interdisciplinary treatment plays a vital role to achieve an excellent, esthetic result for a most predictable outcome. This article aims to present a case report of replacement of bilaterally ,congenitally missing maxillary lateral incisors with dental implants .
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. The available treatment modalities to replace congenitally missing teeth include prosthodontic fixed and removable prostheses, resin bonded retainers, orthodontic movement of maxillary canine to the lateral incisor site and single tooth implants. Implants are a viable option for replacement of congenitally missing lateral incisors and should be considered before the commencement of definitive treatment plan. Early diagnosis, and proper planning can achieve excellent aesthetics.
Interdisciplinary treatment plays a vital role to achieve an excellent, esthetic result for a most predictable outcome. This article aims to present a case report of replacement of bilaterally ,congenitally missing maxillary lateral incisors with dental implants .
Unilateral Maxillary Lateral Incisor Agenesis with Mini Implant Prostheses: A...Abu-Hussein Muhamad
Orthodontic management for patients with single or bilateral congenitally missing permanent lateral incisors is a
challenge to effective treatment planning. Over the last several decades, dentistry has focused on several treatment
modalities for replacement of missing teeth. The two major alternative treatment options are orthodontic space
closure or space opening for prosthetic replacements. For patients with high aesthetic expectations implants are one
of the treatment of choices, especially when it comes to replacement of missing maxillary lateral incisors and
mandibular incisors. Edentulous areas where the available bone is compromised to use conventional implants with
2.5 mm or more in diameter, narrow diameter implants with less than 2.5 mm diameter can be successfully used.
This case report deals with managing a compromised situation in the region of maxillary lateral incisor using a
narrow diameter implant.
Congenitally Missing Lateral Incisors; Orthodontic, Restorative, and Implant ...Abu-Hussein Muhamad
This article discusses factors in determining
whether to close an open space or to open enough space for a prosthetic treatment for congenitally missing maxillary lateral
incisors. Further, the importance of a total treatment approach using an interdisciplinary dental specialty team to maximize
function, aesthetics, and oral health is discussed.
Combined orthodontic and prosthetic therapy special considerations.(52)Abu-Hussein Muhamad
Agenesis, the absence of permanent teeth, is a common occurrence among dental patients. The total incidence of tooth agenesis is about 4.2% among patients that are seeking orthodontic treatment and with the exception of third molars, the maxillary lateral incisors are the most common congenitally missing teeth with about a 2% incidence. The maxillary lateral incisor is the second most common congenitally absent tooth. There are several treatment options for replacing the missing maxillary lateral incisor, including canine substitution, tooth-supported restoration, or single-tooth implant. Dental implants are an appropriate treatment option for replacing missing maxillary lateral incisor teeth in adolescents when their dental and skeletal development is complete. This case report presents the treatment of a patient with congenitally missing maxillary lateral incisor using dental implants. The paper discusses the aspects of pre-prosthetic orthodontic diagnosis and the treatment that needs to be considered with conservative and fixed prosthetic replacement.
Esthetic Evaluation of ImplantsPlaced after Orthodontic Treatment in Patients...Abu-Hussein Muhamad
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the
proper treatment plan. Several treatment options exist for the replacement of congenitally missing lateral incisors.
These options include canine substitution, resin bonded fixed partial dentures, cantilevered fixed partial dentures,
conventional fixed partial dentures and single tooth implants. Depending on which treatment option is chosen, a
specific criterion has to be addressed. Interdisciplinary treatment plays a vital role to achieve an excellent, esthetic
result for a most predictable outcome. This article aims to present a case report of replacement of bilaterally
congenitally missing maxillary lateral incisors with dental implants
Key words: congenitally missing lateral incisor, interdisciplinary treatment, dental impla
ANTIMICROBIAL EFFICIENCY OF INTRACANAL MEDICAMENT AGAINST E. FAECALIS BACTERIA IN INFECTED PRIMARY MOLARS BY USING REAL-TIME PCR: A RANDOMOMIZED CLINICAL TRIAL
Two Treatment Approaches for Missing Maxillary Lateral Incisors: A CaseAbu-Hussein Muhamad
Missing maxillary lateral incisors create an esthetic problem with specific orthodontic and prosthetic considerations. The aim of the present study is to evaluate the clinical success of the transmucosal flapless implant placement and immediate loading of the implants to restore the agenic lateral incisors after completing the orthodontic treatment and during the retention period.
Partial or complete edentulism has multiple implications in relation to function, esthetics and future rehabilitative treatment. This case report illustrates the management of a patient with extreme consequences of partial edentulism in the maxillary arch and total edentulism in the mandibular arch. The main clinical findings were unopposed remaining teeth, over eruption of the remaining teeth, loss of vertical dimension of occlusion, and significant disfigurement of the occlusal plane. Following the diagnostic procedure, a well-coordinated prosthodontic treatment involving liaison with other dental disciplines was indicated. The management involved an innovative combination of fixed and removable prostheses in conjunction with intentional root canal therapy of the remaining natural teeth. Series of provisional prostheses were applied to facilitate the transition to the final treatment.
Key-words: Edentulism, Vertical dimension, Provisional Restoration, Fixed and Removable prosthesis
Quinidine, Albino rats, Pentylenetetrazole, Gap junctionsiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. The available treatment modalities to replace congenitally missing teeth include prosthodontic fixed and removable prostheses, resin bonded retainers, orthodontic movement of maxillary canine to the lateral incisor site and single tooth implants. Implants are a viable option for replacement of congenitally missing lateral incisors and should be considered before the commencement of definitive treatment plan. Early diagnosis, and proper planning can achieve excellent aesthetics. Interdisciplinary treatment plays a vital role to achieve an excellent, esthetic result for a most predictable outcome. This article aims to present a case report of replacement of bilaterally ,congenitally missing maxillary lateral incisors with dental implants .
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. The available treatment modalities to replace congenitally missing teeth include prosthodontic fixed and removable prostheses, resin bonded retainers, orthodontic movement of maxillary canine to the lateral incisor site and single tooth implants. Implants are a viable option for replacement of congenitally missing lateral incisors and should be considered before the commencement of definitive treatment plan. Early diagnosis, and proper planning can achieve excellent aesthetics.
Interdisciplinary treatment plays a vital role to achieve an excellent, esthetic result for a most predictable outcome. This article aims to present a case report of replacement of bilaterally ,congenitally missing maxillary lateral incisors with dental implants .
Unilateral Maxillary Lateral Incisor Agenesis with Mini Implant Prostheses: A...Abu-Hussein Muhamad
Orthodontic management for patients with single or bilateral congenitally missing permanent lateral incisors is a
challenge to effective treatment planning. Over the last several decades, dentistry has focused on several treatment
modalities for replacement of missing teeth. The two major alternative treatment options are orthodontic space
closure or space opening for prosthetic replacements. For patients with high aesthetic expectations implants are one
of the treatment of choices, especially when it comes to replacement of missing maxillary lateral incisors and
mandibular incisors. Edentulous areas where the available bone is compromised to use conventional implants with
2.5 mm or more in diameter, narrow diameter implants with less than 2.5 mm diameter can be successfully used.
This case report deals with managing a compromised situation in the region of maxillary lateral incisor using a
narrow diameter implant.
Congenitally Missing Lateral Incisors; Orthodontic, Restorative, and Implant ...Abu-Hussein Muhamad
This article discusses factors in determining
whether to close an open space or to open enough space for a prosthetic treatment for congenitally missing maxillary lateral
incisors. Further, the importance of a total treatment approach using an interdisciplinary dental specialty team to maximize
function, aesthetics, and oral health is discussed.
Congenitally Missing Bilateral Incisors with Single-Tooth Implants: Clinical ...Abu-Hussein Muhamad
Agenesis, the absence of permanent teeth, is a common occurrence among dental patients. The total incidence of tooth agenesis is about 4.2% among patients that are seeking orthodontic treatment and with the exception of third molars, the maxillary lateral incisors are the most common congenitally missing teeth with about a 2% incidence . Esthetically correcting congenitally missing maxillary lateral incisors is a common challenge that every orthodontist and dental team will face, and dentists must consider the treatment options that are most appropriate for each patient.
This paper describes the therapeutic use of osseointegrated implants to replacε congenitally missing upper lateral incisors. Highlighting the importance of the Orthodontic/Restorative interface.
Interdisciplinary Management Of Maxillary Lateral IncisorsAbu-Hussein Muhamad
Abstract: Orthodontic management for patients with single or bilateral congenitally missing permanent lateral incisors is a challenge to effective treatment planning. Over the last several decades, dentistry has focused on several treatment modalities for replacement of missing teeth. The two major alternative treatment options are orthodontic space closure or space opening for prosthetic replacements. For patients with high aesthetic expectations implants are one of the treatment of choices, especially when it comes to replacement of missing maxillary lateral incisors and mandibular incisors. Edentulous areas where the available bone is compromised to use conventional implants with 2,5 mm or more in diameter, narrow diameter implants with less than 2,5 mm diameter can be successfully used. This case report deals with managing a compromised situation in the region of maxillary lateral incisor using a narrow diameter implant. Key words: Orthodontics, Correction of unilateral missing maxillary lateral incisors. Minimal invasive technique, narrow diameter implant
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Managing congenitally missing lateral incisors with single tooth implants Abu-Hussein Muhamad
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. Several treatment
options exist for the replacement of congenitally missing lateral incisors. These options include canine substitution, resin bonded fixed partial dentures, cantilevered
fixed partial dentures, conventional fixed partial dentures and single tooth implants. Depending on which treatment option is chosen, a specific criterion has to be
addressed. Interdisciplinary treatment plays a vital role to achieve an excellent, esthetic result for a most predictable outcome. This paper describes the therapeutic use
of osseointegrated implants to replace congenitally missing upper lateral incisors. Highlighting the importance of the Orthodontic/Restorative interface.
Modern Treatment for Congenitally Missing Teeth : A Multidisciplinary Appro...Abu-Hussein Muhamad
The maxillary lateral incisor is the second most common congenitally absent tooth. There are several treatment options for replacing the missing maxillary lateral incisor, including canine substitution, tooth-supported restoration, or single-tooth implant. Dental implants are an appropriate treatment option for replacing missing maxillary lateral incisor teeth in adolescents when their dental and skeletal development is complete. This case report presents the treatment of a patient with congenitally missing maxillary lateral incisors using dental implants. Finally, the importance of interdisciplinary team treatment planning is emphasized as a requirement for achieving optimal final esthetics
Eruptive abnormalities and their treatment /certified fixed orthodontic cours...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Pre-Prosthetic Orthodontic Implant for Management of Congenitally Unerupted L...Abu-Hussein Muhamad
The maxillary lateral incisor is one of the most common congenitally missing teeth of the permanent
dentition. With the advent of implants in the field of restorative dentistry, a stable and predictable fixed
prosthetic replacement has become a reality, especially for young adult patients who suffer from congenital
absence of teeth. The dual goals of establishment of functional stability as well as enhancement of esthetic
outcomes are made achievable by the placement of implants. A multidisciplinary team approach involving the
triad of orthodontist, periodontist and restorative dentist will ensure the successful completion of the integrated
treatment approach in these patients. The present case report achieved successful implant based oral
rehabilitation in a patient diagnosed with congenital absence of bilateral maxillary lateral incisors utilizing a
preprosthetic orthodontic implant site preparation for the purpose of space gain.
Keywords: Preprosthetic, interdisciplinary treatment, implant placement
Esthetic Management of Congenitally Missing Lateral Incisors With Single Toot...Abu-Hussein Muhamad
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. Several treatment options exist for the replacement of congenitally missing lateral incisors.This case report addresses the fundamental considerations related to replacement of a congenitally missing lateral incisor by a team approach.
Esthetic Management of Congenitally Missing Lateral Incisors With Single Toot...Abu-Hussein Muhamad
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. Several treatment options exist for the replacement of congenitally missing lateral incisors.This case report addresses the fundamental considerations related to replacement of a congenitally missing lateral incisor by a team approach.
Multidisciplinary approach in the rehabilitation of congenitally missing late...Abu-Hussein Muhamad
Agenesis, the absence of permanent teeth, is a common occurrence among dental patients. The total incidence of tooth agenesis is about 4.2% among patients that are seeking orthodontic treatment and with the exception of third molars, the maxillary lateral incisors are the most common congenitally missing teeth with about a 2% incidence. The maxillary lateral incisor is the second most common congenitally absent tooth. There are several treatment options for replacing the missing maxillary lateral incisor, including canine substitution, tooth-supported restoration, or single-tooth implant. Dental implants are an appropriate treatment option for replacing missing maxillary lateral incisor teeth in adolescents when their dental and skeletal development is complete. This case report presents the treatment of a patient with congenitally missing maxillary lateral incisor using dental implants. The paper discusses the aspects of pre-prosthetic orthodontic diagnosis and the treatment that needs to be considered with conservative and fixed prosthetic replacement.
Congenital absence of maxillary lateral incisors is a frequent clinical challenge which must be solved by a multidisciplinary approach in order to obtain an
esthetic and functional restorative treatment. . Fixed prosthodontic and removable prostheses, resin bonded retainers, orthodontic movement of maxillary
canine to the lateral incisor site and single tooth implants represent the available treatment modalities to replace congenitally missing teeth. This case report
demonstrates the team approach in prosthetic and surgical considerations and techniques for managing the lack of lateral incisors. The aims of this case
report of replacement of bilaterally congenitally missing maxillary lateral incisors with dental implants.
Autotransplantation of Tooth in Children with Mixed DentitionAbu-Hussein Muhamad
Autotransplantation of tooth in children is the surgical movement of a tooth from one place in the mouth to another
in the similar individual. Once thought to be uncertain, autotransplantation has achieved high success rates and is an
outstanding option for tooth replacement in children. Although the indications for autotransplantation are narrow, careful
patient assortment coupled with a suitable method can lead to exceptional esthetic and useful results. One benefit of
this procedure is that placement of an implant-supported prosthesis or other form of prosthetic tooth replacement is
not needed. A review of the recommended surgical technique as well as success rates is also discussed.
Dental auto transplantation is defined as the movement of one tooth or dental germ from one position to another, within the same person . Tooth reimplantation and transplantation have a long and difficult history, since both procedures have been carried out for centuries, but failed due to healing complications. This article provides an overview concept of auto transplantation and considerations for clinical success.
THE ART AND SCIENCE OF TREATMENT PLANNING ON ORTHODONTIC EXTRUSIONAbu-Hussein Muhamad
Traumatized anterior teeth with subgingival fractures of crown are a challenge to treat. This paper reports the man¬agement of subgingival fractures of crown of the maxillary central incisor in an 29 year old female. The technique described here involves the use of fixed appliance, post and core with a loop fabricated on it for retention of fixed appliance.
Keywords: Fracture, Tooth, Root Extrusion, Crown Fracture.
Introduction: Impaction of maxillary canines is a frequently encountered clinical problem in orthodontic therapy. When a preventive approach fails, treatment involves surgical exposure of the impacted tooth, followed by orthodontic traction to guide and align it into the dental arch. The aim of the present report was to demonstrate by case reports of an adult patient with bilateral impacted maxillary canines treated with surgical exposure and orthodontic treatment
Introduction: Impaction of maxillary canines is a frequently encountered clinical problem in orthodontic therapy. When a preventive approach fails, treatment involves surgical exposure of the impacted tooth, followed by orthodontic traction to guide and align it into the dental arch. The aim of the present report was to demonstrate by case reports of an adult patient with bilateral impacted maxillary canines treated with surgical exposure and orthodontic treatment.
Titanium Button With Chain by Watted For Orthodontic Traction of Impacted Ma...Abu-Hussein Muhamad
Abstract: Advances in bonding techniques and materials allow for reliable bracket placement on ectopically positioned teeth. This prospective study evaluates the outcome of forced orthodontic eruption of impacted canine teeth in both palatal and labial positions. Eighty-two impacted maxillary canines in 2200patients were included in the study and were observed for 2006 to 2013 ,in Center for Dentistry research and Aesthetics, Jatt/Israel after exposure. Following exposure by means of a palatal flap or an apically repositioned buccal flap, an orthodontic traction hook, with a Titanium Button with chain by Watted (Dentaurum) attached, was bonded to each impacted tooth using a light cured orthodontic resin cement. A periodontal dressing was placed over the surgical site for a period of time. All teeth were successfully erupted. Complications consisted of: failure of initial bond, at the time of surgery, which required rebonding; premature debonding at the time of pack removal and; debonding of brackets during orthodontic eruption. There was no infection, eruption failure, ankylosis, resorption or periodontal defect (pocket greater than 3 mm) associated with any of the exposed teeth. Forced orthodontic eruption of impacted maxillary canines with a well bonded orthodontic traction hook and ligation chain, used in conjunction with a palatal flap or an apically repositioned labial flap, results in predictable orthodontic eruption with few complications. Key Words: cuspid/surgery; orthodontics, corrective; tooth, impacted/therapy
Clinical Management of Bilateral Impacted Maxillary CaninesAbu-Hussein Muhamad
Introduction: Impaction of maxillary canines is a frequently encountered clinical problem in orthodontic therapy. When a preventive
approach fails, treatment involves surgical exposure of the impacted tooth, followed by orthodontic traction to guide and align it into the
dental arch. The aim of the present report was to demonstrate by case reports of an adult patient with bilateral impacted maxillary canines
treated with surgical exposure and orthodontic treatment.
Material and Methods: A 15year-old female with various degrees of bilateral palatal impaction of maxillary canines were managed
by the described technique.
Results and Discussion: Autonomous eruption of the impacted canines after surgical uncovering was witnessed in all patients
without the need for application of a vertical orthodontic force for their extrusion.
Conclusion: The described method of surgical uncovering and autonomous eruption created conditions for biological eruption of the
palatally impacted canines into the oral cavity and facilitated considerably the subsequent orthodontic treatment for their proper alignment
in the dental arch.
Keywords: Impacted canines; Surgical; Tooth exposure; Orthodontic treatment
Aesthetic Management of Fractured Anteriors: A Case ReportAbu-Hussein Muhamad
Introduction: Coronal fracture of anterior teeth is an important topic for esthetic dentistry. Such fractures may jeopardize esthetics, function, tissue biology
and occlusal physiology, thus endangering tooth vitality and integrity. Coronal fractures resulting from dental trauma most frequently occur to the maxillary
anterior teeth of adolescents and less frequently to mandibular teeth. Adult teeth may also suffer traumatic fracture, although less frequently than for
adolescents.
Case Report: In our case, an economical and time-saving novel technique has been described for direct composite restoration in a young patient with
uncomplicated fractured maxillary anterior tooth.
Conclusion: As restoring a fractured tooth is a complex procedure, this technique can prove as a simple, effective and appropriate technique that will fulfill all
the requirements of dental personnel. This technique can also prove to be easy for inexperienced beginner clinicians without requiring special skills in
providing the patients with direct composite restorations.
Impacted Maxillary Central Incisors: Surgical Exposure and Orthodontic Treat...Abu-Hussein Muhamad
The maxillary permanent central incisor develops early in life and forms part of an aesthetic smile. Disruption of the formation or eruption of the permanent
central incisor has multiple etiological factors. Treatment options depend to some extent on the cause of failure of eruption of the central incisor. Generally,
the earlier treatment is provided, the higher the likelihood of success and the less the complexity. Our results suggest that close monitoring and interdisciplinary
cooperation during the treatment phases led to a successful esthetic result, with good periodontal health and functional occlusion.
Excess of space in the dental arch is diagnosed as a
generalised spacing or a local divergence, often
observed in the maxillary anterior region, as a median
diastema, traumatic loss of central incisors, or
congenital absence of lateral incisors. Furthermore,
spacing is observed in aging individuals, due to
pathological migration of teeth caused by
periodontitis. Finally, adult individuals with partial
edentulous jaws demand pre-prosthetic orthodontic
treatment from functional aspects. Thus, indication for
orthodontic treatment in subjects with spacing of teeth
exists for aesthetic reasons, but also for facilitating
prosthetic restorations with optimal occlusalstability.
Dental implants represent one of the most successful treatment modalities in dentistry.
However, failures do occur in the range from 5 to 8% for routine procedures and up to 20% in major grafting
cases after at least 5 years of function . The majority of implant losses may be explained as biomechanically
induced failures, since low primary implant stability, low bone density, short implants and overload have been
identified as risk factors . Hence, achievement and maintenance of implant stability are pre-conditions for a
successful clinical outcome with dental implants.
The review focuses on different methods used to assess implant stability and recent advances in this field.
Aesthetic Management of Fractured Anteriors: A Case ReportAbu-Hussein Muhamad
Introduction: Coronal fracture of anterior teeth is an important topic for esthetic dentistry. Such fractures may jeopardize esthetics, function, tissue biology
and occlusal physiology, thus endangering tooth vitality and integrity. Coronal fractures resulting from dental trauma most frequently occur to the maxillary
anterior teeth of adolescents and less frequently to mandibular teeth. Adult teeth may also suffer traumatic fracture, although less frequently than for
adolescents.
Case Report: In our case, an economical and time-saving novel technique has been described for direct composite restoration in a young patient with
uncomplicated fractured maxillary anterior tooth.
Conclusion: As restoring a fractured tooth is a complex procedure, this technique can prove as a simple, effective and appropriate technique that will fulfill all
the requirements of dental personnel. This technique can also prove to be easy for inexperienced beginner clinicians without requiring special skills in
providing the patients with direct composite restorations
Orthodontic tooth movement is basically a biologic response towards a mechanical force. Osteoclast and osteoblast cells mediate bone resorption and apposition, which eventually produces tooth movement. Researches showed that the rate of orthodontic tooth movement can be altered by certain drugs locally or systemically. The Objective of this article is to discuss the current data concerning the effect of drugs on orthodontic tooth movement.
The multifactorial factors influenc cleft Lip-literature review Abu-Hussein Muhamad
Congenital cleft-Lip and cleft palate have been the subject of many genetic
studies, but until recently there has been no consensus as to their modes of
inheritance. In fact, claims have been made for just about every genetic
mechanism one can think of. Recently, however, evidence has been
accumulating that favors a multifactorial basis for these malformations. The
purpose of the present paper is to present the etiology of cleft lip and cleft palate
both the genetic and the environmental factors. It is suggested that the genetic
basis for diverse kinds of common or uncommon congenital malformations may
very well be homogeneous, whilst, at the same, the environmental basis is
heterogeneous.
Dental implants represent one of the most successful treatment modalities in dentistry.
However, failures do occur in the range from 5 to 8% for routine procedures and up to 20% in major grafting cases after at least 5 years of function . The majority of implant losses may be explained as biomechanically induced failures, since low primary implant stability, low bone density, short implants and overload have been identified as risk factors . Hence, achievement and maintenance of implant stability are pre-conditions for a successful clinical outcome with dental implants.
The review focuses on different methods used to assess implant stability and recent advances in this field
Over time, progressively shorter implants have been placed such that short implants are now available that are less than 6 mm in length. The viability and high success rates seen with short implants can be explained by osseointegration, the macro geometric design of the implant, as well as physics and the distribution of forces. This paper was aimed to review the stability and survival rate of short implants under functional loads. Numerical and clinical studies were reviewed. Keywords: Short dental implants, sinus augmentation, factors affecting bone regeneration in dental implantology
Porcelain laminate veneers are among the most esthetic means of creating a more pleasing and beautiful smile. Porcelain veneers within reason allow for the alteration of tooth position, shape, size and color. They require a minimal amount of tooth preparation, approximately 0.5 mm to 0.7mm of surface enamel reduction. This study describes the use of ceramic veneers without tooth wear, reinforcing the concept that minimally invasive porcelain laminate veneers could become versatile and conservative allies in the fi eld of esthetic dentistry. Keywords: Ceramics, dentin-bonding agents, esthetics
Immediate Restoration of Single Implants Replacing Lateral Incisor Compromis...Abu-Hussein Muhamad
Today, the diagnosis of internal root resorption is significantly improved by the three-dimensional imaging. Furthermore, the CBCT’s superior diagnosis accuracy resulted in an improved management of the resorptive defects and a better outcome of Implant therapy of teeth with internal resorption.Implant has become a wide option to maintain periodontal architecture. Diagnosis and treatment planning is the key factors in achieving the successful outcomes after placing and restoring implants placed immediately after tooth extraction. The purpose of this clinical update is to report on the success and survival of Immediate restoration of single implants replacing right lateral incisor compromised by internal resorption.
Immediate Implant Placement And Restoration With Natural Tooth In The Maxilla...Abu-Hussein Muhamad
Anterior tooth loss and restoration in the esthetic zone is a common challenge in dentistry today. The prominent visibility of the area can be especially distressing to the patient and requires a timely and esthetically pleasing solution. Immediate single-tooth implantation followed by immediate provisionalization is becoming an increasingly desirable treatment that offers numerous benefits over conventional delayed loading. Provisionalization for immediately-placed implants using the patient’s existing tooth can enhance the final aesthetic outcome if certain steps are
followed. If the natural tooth is intact and can be used as a provisional, the emergence profile can be very similar to the preoperative condition. This article outlines a technique to use the patient’s natural tooth after extraction to provisionalize an implant.
“One-Piece” Immediate-Load Post-Extraction Implant In Maxillary Central IncisorAbu-Hussein Muhamad
Abstract: This case report describes extraction of a fractured left maxillary central incisor tooth, followed by immediate placement of an one-piece implant in the prepared socket and temporization by a bonded restoration.
Materials And Methods: The tooth was extracted with minimal hard and soft tissue trauma and without flap reflection. The socket was prepared to the required depth and a Implant was inserted.
Results: The atraumatic operating technique and the immediate insertion of the one-piece Implant resulted in the preservation of the hard and soft tissues at the extraction site.
Conclusion: The “One-piece” dental implant and provisional restoration provided the patient with immediate esthetics, function, comfort and most importantly preservation of tissues. The one-piece implant design resulted in a high cumulative implant survival rate and beneficial marginal bone levels.
Single Visit Replacement of Central Maxillary Using Fiber-Reinforced Composi...Abu-Hussein Muhamad
Fiber reinforced composites are high strength filling materials composed of conventional composites and glass fibres. They exhibit extensive applications in different fields of dentistry. This clinical report present a case where FRC technology was successfully used to restore central maxillary incisor edentulous area in terms of esthetic-cosmetic values and functionality.
Zirconium Dental Implants And Crown for Congenitally Missing Maxillary Latera...Abu-Hussein Muhamad
Zirconia implants were familiarized into dental implantology. Zirconia appears
to be an appropriate implant material due to its low plaque affinity, tooth like color, biocompatibility and mechanical properties. The following a case presentations will show how the acid-etched zirconia Implant can be used to functionally and aesthetically replace congenitally missing left lateral incisor tooth germ in the maxilla, and achieve optimal soft tissues and health.
Surgery of Labially Impacted Canine & Orthodontic Management – A Case ReportAbu-Hussein Muhamad
Maxillary canines are one of the most common teeth that are impacted among patients seeking orthodontic treatment. Depending on the position of these impacted teeth, various surgical techniques have been employed for their exposure. His primary goal of surgical phase is to provide the means for correct position of orthodontic anchorage. Additionally, the technique used must ensure favorable tissue anatomy that will permit long-term maintenance of periodontal health. In the present case, a labially impacted maxillary left canine was surgically exposed using an apically positioned flap. Orthodontic extrusion was carried out further.
Taurodontism is a rare dental anomaly in which the involved tooth has an enlarged and elongated body and pulp chamber
with apical displacement of the pulpal floor. Endodontic treatment of a taurodont tooth is challenge to a clinician and
requires special handling because of the proximity and apical displacement of the roots. The present article describes the
diagnosis and management of hypertaurodontism by endodontic treatment in a left mandibular second molar.
Management of Open Apex in Permanent Teeth with BiodentineAbu-Hussein Muhamad
Biodentine is new calcium silicate based cement that exhibits physical and chemical properties similar to those described for certain Portland cement derivatives. This article demonstrates the use of the newer material, Biodentine as an apical matrix barrier in root end apexification procedure. This case reports present apexification and successful healing with the use of Biodentine as an apical barrier matrix.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Interdisciplinary Management of Congenitally Agenesis Maxillary Lateral Incisors: Orthodontic/Prosthodontic Perspectives
1. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 15, Issue 1 Ver. VIII (Jan. 2016), PP 90-99
www.iosrjournals.org
DOI: 10.9790/0853-15189099 www.iosrjournals.org 90 | Page
Interdisciplinary Management of Congenitally Agenesis
Maxillary Lateral Incisors: Orthodontic/Prosthodontic
Perspectives
Abusalih Ahmet1
, Ismail Hakki Bayraktar2
, Abdulgani Azzaldeen3
,
Chlorokostas Georges4
, Abu-Hussein Muhamad5
*
Al-Quds University, Faculty of Dentistry,Jerusalem,Palestine
Abstract: The present paper reports the treatment of a young adult woman with congenitally missing
maxillary lateral incisors who underwent orthodontic treatment for improvement of teeth alignment and
occlusal balance previous to dental implant surgery. This treatment also allowed appropriate space for the
future lateral incisors crowns. Then, Implants were positioned and prosthetic abutments installed. Ceramic
laminates were planned on central incisors in order to improve anterior aesthetics. All-ceramic crowns and
laminates were made using lithium dissilicate-based ceramic The multidisciplinary association of orthodontic,
implant and prosthetic techniques resulted in successful functional and aesthetic rehabilitation of the case,
which was maintained after 1 year follow up.
Keywords: Dental agenesis. Dental implants. Ceramic laminates. Esthetic.
I. Introduction
Dental agenesis is defined as congenital absence of one or more teeth in primary or permanent
dentition.1It is also known as hypodontia and is one of the most frequently encountered of all oral variation that
affects a large population. Epidemiological studies reveal make that one of the most common congenitally
missing tooth is lateral incisor in maxilla causing esthetic and functional impairments in the affected
individual.[1,2] It might be associated with Non-syndromic systemic problems, syndromic conditions or other
oral anmolaies. Management of missing lateral incisors is a challenging procedure that involves a multi-
disciplinary approach for rehabilitation of impaired esthetics and function. The most common treatment
approaches advocated by the clinicians include regaining of the space of missing tooth followed by prosthetic
replacement, auto transplantation of developing premolar and space closure with substitution of canine.[1,2,3,4]
Several etiological factors have been suggested for the development failure of the permanent tooth germ, thus
leading to its absence, such as: physical obstruction, dental lamina rupture, limitation of space or functional
anomalies. In spite of recent progress, the etiopathogenesis of hypodontia remains largely unknown . There is
evidence that congenital tooth absence can be the result of environmental or hereditary causes, or even of their
interaction .[1,2] The development of human dentition in terms of structure and organization is under genetic
control and involves several factors, therefore it is logical to assume that mutations in some genes encoding
these factors may affect the normal development of teeth and, eventually, may cause their absence.[3] Non-
syndromic hypodontia is more common than the syndromic type. The evidence of a genetic cause for non-
syndromic hypodontia came from the identification of significant family aggregation of MLIA and suggest
microdontia of maxillary lateral incisors as part of the same phenotype, segregating as an autosomal dominant
trait with incomplete penetrance ; however, modes of transmission linked to X-chromosome and of polygenic
or multifactorial type have also been proposed .[1,2,5] Candidate genes in early steps of tooth development
regulation (MSX1, PAX9, AXIN2, TGFa, Activin-b A, LEF1, RUNX2, BMP4, MMP1, MMP20), have been
screened for putative mutations in affected families . Some mutations associated with tooth agenesis have been
identified in humans at the MSX1 And PAX9 genes. Nevertheless, these genes might be fundamentally
implicated in the odontogenesis of posterior teeth [5] . Lammi et al., (2004), reported that a nonsense mutation
in the AXIN2, an essential component of the WNT/b-catenin pathway, caused familial oligodontia with a severe
phenotype. In addition to oligodontia, those authors also found that a mutation in AXIN2 predispose the
individual to colorectal cancer.[6] Considering the discrepancy between the high prevalence rate of tooth
agenesis and the relatively small number of reported causative mutations in the PAX9, MSX1, and AXIN2
genes, the genetic contribution to hypodontia/oligodontia seems quite heterogeneous. Environmental and
epigenetic factors as well as genes regulating odontogenesis require further in vivo and in vitro investigation in
order to better explain the phenotypic heterogeneity and to increase our knowledge about the odontogenic
process.[5,6]
Polder et al found in their meta-analysis that dental agenesis differs by continent and gender: The
prevalence for both sexes from Caucasian populations in North America, Europe and Australia ranged from 3,2
2. Interdisciplinary Management Of Congenitally Agenesis Maxillary Lateral Incisors:
DOI: 10.9790/0853-15189099 www.iosrjournals.org 91 | Page
% males and 4,6 % females in North-American to 5,5 % males and 7,6 % females in Australia. The most
affected teeth were the mandibular second premolar followed by the upper lateral incisor and the upper second
premolar [7,8].
Högberg et al. impressively describe in their study of 1986 that at the age of 9 years children can
realise that they are handicapped. Accordingly psychological help may be necessary, depending on the degree of
aplasia.[9]
Missing lateral incisors as well as peg shaped lateral incisors present the clinician with unique and very
challenging aesthetic demands [2,3,4]. It is helpful to determine from an early stage which final treatment
modality would be utilised. Treatment options include space closure, re-establishment of the space or no
treatment at all[4]. These cases are best identified and managed at an early age and usually require a multi-
disciplinary approach. If implants are utilised it is important to choose an implant system that is versatile so that
any restorative requirement can be addressed. In young patients it becomes important to choose a strong implant
design and a system that offers a cone connection and horizontal offset. With modern treatment modalities a
very satisfactory outcome can now be achieved [2,4,5].
The patient and parents should be counseled about the complexities of this unfortunate anomaly as
soon as it is identified. All the available long-term treatment options need to be discussed as well as the
considerable cost implications of each [4,5].
Most patients are diagnosed with hypodontia between the ages of 6 – 12 years. The general dentist is
well positioned to manage the case and to make necessary referrals at the appropriate stages of development.
Regular consultation visits are thus highly recommended and routine maintenance and restoration of the
dentition is important as part of the overall management of the patients [3,4,5]
Generally, maxillary lateral agenesis is diagnosed at an early stage of childhood. Due to the change
over time is inevitable in biologic systems, the most important treatment decisions must be linked to the long-
term outcome. The results of treatment should preferably be completed when the patients are in their young
teens and should be expected to represent a natural dentition over time [1,2]. It is recommended to delay the use
of prosthetic restorations until skeletal growth is completed [1,3].
Missing maxillary lateral incisors’ conventional space closure is a proper and safe procedure that
obtains satisfactory functional and esthetic long-term results [ 9.10]. This treatment alternative is orthodontically
space closure with the maxillary canine substituting and camouflaging the canine to mimic the appearance of a
lateral inciso. The first premolar tooth can also be reshaped as canine for the durability of esthetics. This
camouflaging may be accomplished by the orthodontist with tooth reshaping and positioning and further
progress may be attained by individual tooth bleaching, resin composite buildups, or laminates accomplished by
restorative dentistry disciplines [10,11 ].
The advantage of space closure using canine substitution is the avoidance of introduction of fixed
partial dentures or implants. The prosthetic replacement with fixed partial dentures necessitates intact tooth
structure removal and both treatment options are typically more expensively. The parents and the patient should
be informed about the damage benefit relation of the course and limited time span of the invasive operative
interventions emphasizing the sacrifice of the sound tooth structures. However, in addressing the esthetic
concerns of the patient in very severe situations, this treatment might be the most successful alternative [3,4,5].
In addition, while the lateral agenesis patient has gummy smile, the treatment choice should be space closure
rather than placing implants [19,11].
In cases with Class 1 skeletal relationships, orthodontic space opening treatment is preferred to
treatment by space closing for maintenance of posterior occlusion [3,4]. Color incompatibility between
maxillary canines and central incisors is also another factor for the decision for or against space opening [3].
There are several methods to determine the width of space is required for missing lateral replacement. The first
one is named the ‘’golden proportion’’, the second one is to use the opposite lateral incisor as reference, the
third method is to use Bolton analysis, the fourth and most appraisable guide for considering the ideal
replacement space is to conduct a diagnostic wax-up [3].
When treatment plan involve creating a space for missing lateral incisor, there are 2 treatment
alternatives: a tooth-supported restoration and a single tooth implant. Nowadays, tooth supported restorations
can be divided into 3 available categories: a resin bonded fixed partial denture (FPD), a cantilevered FPD, or a
conventional FPD [10].
Implants are one of the treatment modalities to take place congenitally missing lateral incisors without
disturbing the adjacent teeth in orthodontic patients [3,5]. An interdisciplinary point of view should be preferred
during the diagnosis, prognosis, and treatment scheme to hinder several potential problems. However, the major
drawbacks of this treatment option are the unpredictable prognosis of dental implant treatment and the
ambiguous ability of meeting the esthetic and functional expectations of a young patient with high esthetic
demand.[12]
The minimum age of the implant patient is more often a concern for maxillary anterior tooth
3. Interdisciplinary Management Of Congenitally Agenesis Maxillary Lateral Incisors:
DOI: 10.9790/0853-15189099 www.iosrjournals.org 92 | Page
Replacement, especially for congenitally missing lateral incisors in terms of skeletal maturation level [13].
During the developmental stage vertical and anteroposterior growth changes are substantial in this area. The
vertical growth of the maxilla exceeds all other dimensions of the growth in this quadrant; therefore premature
implant placement can result in the repetitive need to lengthen the transmucosal implant connection which leads
to poor implant-to-prosthesis ratios and the potential to load magnification [3,14,15].
Brahmin advised that whenever possible, implant placement must be delayed until the 15th years for
girls and 18th for boys. If is placed earlier, it will relatively seem to submerge vertically, because the implant
can not erupt like the adjacent teeth [16]. Additionally, Thilander et al. showed that a predetermined
chronological age may not be guidance for implant placement. According to the authors [17] During post
adolescence, because of a slight continuous eruption of the adjacent teeth, a dental stage, indicating fully erupted
permanent teeth and skeletal maturation completed or almost completed, is not sufficient to hinder infraoclusion
of the implant-supported restoration. Similarly numerous of studies showed that infraocclusion may occur
correspondingly the continuous eruption of adjacent teeth even an implant is placed in adult with skeletal
maturation completed or almost completed [17]. Importantly, Thilander et al. emphasized that the mentioned
infraocclusion with minor degree was seen in patients with good interincisor stability also. In addition, the
osseointegrated fixtures will not be able to be displaced in the transverse and sagittal dimensions during the
growing .
On the other hand, in the literature there are some studies which are advocating implant therapy with
high success rate for the rehabilitation of unilaterally or bilaterally congenitally missing lateral incisor.[17]
The present paper reports the treatment of a young adult woman with congenitally missing
maxillary lateral incisors who underwent orthodontic treatment for improvement of teeth alignment and occlusal
balance previous to dental implant surgery.
Case Report
The initial clinical exam revealed diastema, congenitally missing maxillary lateral incisors with the
canines located in the lateral incisor positions, and the primary maxillary canines still located in their original
positions.These aspects created not only esthetics deficiencies but also maloclussion. Therefore, a
multidisciplinary treatment was suggested to restore both esthetics and function.
Phase 1: Planning
All dental professionals involved in the treatment (orthodontist, periodontist, master ceramist, and
operative dentist) evaluated the clinical case individually to decide which noninvasive procedures were
indicated. Next, the four professionals discussed the prognosis and limitations of the case. The master ceramist
performed a diagnostic wax-up to provide a model of the multidisciplinary treatment. After patient approval, the
conservative treatment was then split into three restorative phase orthodontic, surgical, and restorative.
Phase 2: Orthodontics
Dental implants have become a common method for restoring missing teeth. However, especially upper
lateral incisor implants are esthetically challenging. The orthodontic improvement of the procedure and the final
attendance result of these patients can be accomplished best by positioning the remaining natural dentition in the
anatomically correct location. This treatment should be closely coordinated with the implant placement and the
restorative team. In cases of extensive dento-alveolar and skeletal malformations, occlusion and facial
proportions additionally must be improved by orthognatic surgery and sometimes even by esthetic plastic
surgery.
The orthodontic treatment used the following parameters for evaluation: sagittal relationship between
the dental arches; posterior occlusion; location, shape, and size of the canines; amount of remaining interdental
space; and profile and facial skeletal pattern of the patien.
After orthodontic treatment was finalized, the orthodontic brackets were removed and a removable
appliance was used to replace the missing maxillary lateral incisors. (Fig.1) Fig.2a, b)
Phase 3: Surgical
After 15 months of orthodontic treatment, exact locations for surgical implant placement were
determined by CBCT 3-D positioning system.12mm implant for 11 and 12mm implant for 21, were placed. The
temporary crowns were inserted while waiting for the healing process. (Fig.2c, d) The correct tridimensional
positioning of the implants allowed sufficient amount of bone and gingival tissue, which are extremely
important for maintenance of supporting tissues on buccal side. The suitable palatal implant approach is crucial
on keeping harmonic gingival architecture.(Fig.3a,b)
4. Interdisciplinary Management Of Congenitally Agenesis Maxillary Lateral Incisors:
DOI: 10.9790/0853-15189099 www.iosrjournals.org 93 | Page
Phase IV - Prosthodontic Treatment
Waxing analysis was used to plan minimally invasive ceramic laminates for the central incisors
since their shape need improvements. Minimal wear was performed to ensure direction of insertion and
resistance to the restorative materials (ceramic laminates). During preparation, all angles were rounded using
extrafine tapered-cylinder round-end diamond burs , silicone rubbers , abrasive disks , and felt disks to smooth
the prepared surfaces. Impression of the prosthetic abutments and prepared teeth was performed using
polyvinylsyloxane-based material and retraction cords . The accuracy on coping gingival groove favors
determining cervical finishing for the ceramic laminates, which must be perfectly adapted to tooth enamel. The
ceramic laminates and the prosthetic crowns were made with lithium dissilicate-based ceramic . High fracture
resistance and good aesthetic performance are some of the properties of lithium dissilicate ceramics , what
guided the material choice. All functional and esthetic adjustments should be ideally performed on the mock-up
restoration previous to laminate confection, since thin restorations are delicate pieces that cannot be worn.
Checking of both full crown and ceramic laminates was carefully performed since direction of insertion of the
restorations and fit must be verified before luting. Ceramic laminates can also be influenced by the luting agent
color due its reduced thickness, so testing the luting agent shade before final luting also becomes an important
step. (Fig.4) The internal surfaces of the crowns and laminates were etched with 9.5% hydrofluoric acid for 20
seconds . The surfaces were washed with water and 37% phosphoric acid was applied for 60 seconds followed
by cleaning. The ceramic restorations were silanized with a silane coupling agent actively applied for 1
minute. Etching of enamel was performed with 37% phosphoric acid for 30 seconds followed by application of
a total-etch single component adhesive system . Light-curing resin cement was used to lute the ceramic
laminates. Excess cement was removed with a disposable brush applicator, and each surface was photoactivated
for 60 seconds by a LED-curing unit with 1200 mW/cm2 light output . The full all-ceramic crowns were luted
using self-etching dual cure resin cement according to the manufacturer’s instructions. Occlusal contacts were
marked, and protrusive and lateral movements were checked. (Fig.5) (Fig.6.a,b)
II. Discussion
Missing lateral incisor leads to an obvious asymmetry in the patients smile, shift in the dental midline.
In addition the peg shaped lateral incisor further adds to the unsightliness of the smile. There seems to be an
association between hypodontia and malformation of the maxillary laterals which may be reduced in size or
simplified in shape, often becoming peg-shaped. It may even provoke an unfavorable response from others in
society. The canine can drift mesially into an end-on or Class II relation which is functionally
undesirable.[3,4,10,11] Single tooth implants are a good treatment option for replacing the missing teeth
provided that the subject's dental and skeletal development is complete and it has several improvements over
resin bonded prosthesis: preparation of adjacent teeth is not needed; the tooth replacement will function
individually; a conventional oral hygiene technique can be used; preservation and stimulation of existing bone
and soft tissues occur, including recreation of the interproximal papillae; and stability and function are improved
because of the implant supporting the crown.[17.18] When planning for the placement of a single tooth implant,
the orthodontist must ensure adequate space between the crowns and roots. Both the quantity and quality of
alveolar bone must be assessed before implant placement is considered.[16]To accommodate a standard implant
there should be a minimum of 10 mm of inciso-gingival bone and a minimum of 6.0 mm of facial-lingual bone.1
In cases where there is insufficient alveolar bone for implant placement, ridge augmentation may be necessary
in addition to orthodontic repositioning of adjacent teeth.[16] Adequate space for the implant is also required
between the adjacent roots.[17,18,19] The average dental implant fixture is 3.75 mm wide, and 1 to 2 mm of
space is necessary between the fixture and the adjacent roots. Typically, between 6 and 8 mm of bone between
the central and canine roots is recommended. Creating adequate space between the roots must be specifically
addressed since the central and canine roots may be brought into closer proximity when the teeth are initially
aligned orthodontically.[3] To create adequate space for the implant, further orthodontic treatment may be
necessary to move the roots further apart. Space for the coronal restoration must also be assessed. The average
implant platform, which is 4.0 mm wide, requires a space of 1.0 mm mesially and distally between the platform
and the adjacent tooth to facilitate proper healing and the development of a papilla postoperatively.[12,15]Thus,
a minimum of 6 mm of space for the lateral crown is required be based on a comprehensive evaluation of the
age, occlusion, and space requirements of the patient as well as the size and shape of the adjacent teeth [20].
Treatment for children with several congenitally missing teeth is challenging because the growth and
development of the oral structures have to be taken into account.[17,18,19,20]
One of the treatment options is the use of implants [3]. However, because of the residual facial growth
in young patients, infraocclusion of the implant may occur as the implant becomes ankylosed to the alveolar
bone [3]. The other treatment options include maintaining the deciduous teeth, extracting the deciduous teeth
and allowing the space to close spontaneously, prosthetic replacement, and orthodontic space closure [21]. On
5. Interdisciplinary Management Of Congenitally Agenesis Maxillary Lateral Incisors:
DOI: 10.9790/0853-15189099 www.iosrjournals.org 94 | Page
the other hand, if donor teeth are available, autotransplantation is a viable option. If the autotransplanted teeth
do not ankylose, they will promote alveolar growth along with the eruption process [22].
The Esthetic Outcome Of Implant Restorations Are Influenced By Many Variables
Including:[23,24,25,26,27,28]
A. Patient’s expectation and smile line: Patients’ esthetic expectations must be evaluated together with the
smile posture. Previous photographs may assist in determining the natural position of the lip when smiling.
A high smile line poses considerable challenges because the restoration and gingival tissues are thoroughly
displayed. The low smile line is a less critical situation due to the gingival display will be hidden behind the
upper lip.
B. The bony anatomy of the implant site: For successful esthetic restoration, the bony housing must have a
three dimensional foundation that permits placement of an implant in a relatively ideal position. The bone
graft procedure is necessary if the bony anatomy is inadequate. The most crucial dimension remains the
apicocoronal dimension. The patient must understand that the missing hard and soft tissue architecture will
need to be rebuilt so that optimum esthetics can be achieved.
C. Implant position: The implants need to be evaluated in three dimensions: apicocoronal, faciolingual, and
mesiodistal prior to the surgery since these positions will significantly influence the performing gingival
architecture. Placing the implant close to adjacent root creates a great risk of the bone resorption.4 The
surgical and radiographic guide along with a computerized tomography scan is essential to evaluate the
required precision in implant placement, and to determine the proper diameter size and length of implants.
D. Implant Restoration: Successful dental restorations on implant in the esthetic area are usually the result of
close interdisciplinary cooperation between dental clinicians and technicians. The restorations need to be
painstakingly fabricated in the laboratory to mimic the natural translucent appearance. In addition, several
issues such as porcelain natural shade layering techniques, precision of margins, accuracy of framework,
proper dental anatomy, and optimal occlusion are also a principal focus
E. Gingival Biotype: The healthy appearance of the gingiva is a crucial issue. Characteristics of the gingival
soft tissue biotype will play a prominent role in the final planning for the implant.4 A thick gingival biotype
is more favorable since the thin biotype has a delicate soft tissue curtain, and reduced quantity and quality
of keratinized mucosa. Therefore, the thin biotype will require the implant to be placed more palatal and
deeper to allow a proper emergence profile and mask any metal show through.
Restoration of congenitally missing maxillary lateral incisors treatment could include removable partial
dentures, tooth supported restorations, resin bonded fixed partial denture, canine substitution or a single tooth
implant 8.
Space conditions and patient’s age as well as on the patient’s dental, skeletal and occlusal conditions.
should be taken into consideration when selecting the proper treatment for each individual case. Wax set-up
study models are helpful involve the patient in the treatment plan.[3].
Implant supported fixed partial prosthesis is the most conservative way of treatment because of
protection of the supported teeth, preventing of the alveolar bone resorption and esthetic outcomes. In this case
report the patients were evaluated both radiographically and clinically at each appointment.
The appropriate multidisciplinary rehabilitation of congenitally missing lateral incisors with previous
orthodontic treatment, followed by correct tridimensional implant positioning and well fit lateral incisor
implant-supported crowns associated to ceramic laminates on central incisors was effective in successfully
restoring function and aesthetics for the case reported. (Fig.5) (Fig.6.a,b)
III. Conclusion
The importance of communication between interdisciplinary team members increases with the
complexity of the case. When orthodontics is indicated and severe wear or malformation of the dentition also is
present, the intermediate restoration of the anterior teeth may be necessary, thereby requiring communication 3-
dimensionally and precisely between the restorative dentist and orthodontist. It is the practitioner’s or dental
institution’s obligation to explain the limits and risks of extensive orthodontic, restorative, and implant therapy
to other dental professionals so all can mutually agree while planning treatment.
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Lgendes
Fig.1; Patient with missing upper lateral incisors
Fig.2a; X-ray showing minimal space between adjacent teeth- right side
Fig2b; X-ray showing minimal space between adjacent teeth- left side
Fig.2c; A CBCT (Cone Beam CT Scan) done to precisely measure amount of space and bone and perform 3-D
digital work up as simulation
Fig.2d;A digital 3-D model created that shows position of implants and proposed position of the crowns.
Fig. 3a; Implant #7 was placed with a precision guide using our virtual / 3-D work up
Fig. 3bImplant #10 was placed with a precision guide using our virtual / 3-D work up
Fig. 4; after healing and a 3-month period of temporization, final crowns were placed: A terrific new smile for
the patient
Fig.5; New crowns and supporting gum tissue look very natural
Fig.6a; The final X-ray with crown on implant #10
Fig.6b; The final X-ray with crown on implant #7