The mandibular second premolar is one of the most frequently impacted teeth. The recommended treatment is to extract the second primary molar with or without removing the bone along the eruption path, to uncover the tooth surgically and move it into the arch by orthodontic treatment. The purpose of this article is to review the principles of case management of soft tissue impacted second premolars mandibular and to illustrate their potential to respond well to the treatment. Although the scope of treatment may depend on a varying range of factors, this case report demonstrates the inherent potential for good treatment outcome in cases of soft tissue impactions.
This document discusses functional appliances used in orthodontic treatment. It describes the advantages and disadvantages of functional appliances, how they work to produce orthopedic, dentoalveolar and muscular changes, different types of functional appliances including activators and Frankel regulators, and guidelines for use and patient instruction.
Effects of drugs on orthodontic treatmentumairshoukat5
Dr. Umair Shoukat Ali presented on orthodontic tooth movement and factors that affect it. Orthodontic tooth movement is a biological response to forces applied to the teeth. Continuous light forces produce the most desirable tooth movement with minimal harm. Heavier forces can result in necrosis and delayed movement. Tooth movement is regulated by chemicals like prostaglandins and leukotrienes that influence bone remodeling. Many drugs can also impact orthodontic treatment by altering these chemical pathways and affecting the rate of bone turnover. NSAIDs decrease tooth movement while corticosteroids increase it. Systemic factors like hormones and vitamins also influence the speed of orthodontic tooth movement. Close coordination with physicians is important when patients are
The document discusses Bjork's concept of jaw rotation during growth. It summarizes Bjork's landmark longitudinal study from 1951-1969 that used metal implants to track sites of growth and resorption in the mandible. Bjork observed that the mandible undergoes a downward and backward rotation during growth, with greater growth occurring posteriorly than anteriorly. He classified mandibular rotation patterns into forward and backward types based on the center of rotation. The study provided insights into mandibular growth mechanisms and implications for orthodontic treatment planning.
This document discusses the management of open bite malocclusions. It begins by defining open bite and classifying it as either skeletal or dental in nature. Skeletal open bite is caused by excessive vertical growth of the jaws while dental open bite is due to reduced incisor height. Common etiologies of open bite include thumb sucking habits, tongue thrusting, and abnormal skeletal growth patterns. The document outlines various treatment approaches for different open bite classifications and etiologies.
This document provides an overview and instructions for Carey's analysis and Lundstrom analysis. Carey's analysis involves measuring the arch length and comparing it to the tooth material to determine if extractions are needed. It can indicate if a premolar extraction or first molar extraction is required based on the discrepancy. Lundstrom analysis divides the dental arch into segments and measures the tooth widths to calculate the net discrepancy. Both methods help assess dental arch perimeter and tooth size to determine appropriate treatment planning.
RAPID MAXILLARY EXPANSION VS SLOW MAXILLARY EXPANSIONShehnaz Jahangir
This document provides an overview of rapid maxillary expansion (RME) vs slow maxillary expansion (SME). It discusses the historical perspective of maxillary expansion, articulation and ossification of the midpalatal suture, indications and contraindications for expansion, classifications based on activation and support, examples of RME and SME appliances, activation protocols, and the biomechanical aspects and effects of RME on skeletal and dental structures. Key differences between RME and SME include the rate of activation (rapid vs slow) and appliances used (tooth-borne vs tissue-borne).
1. Arch space analysis methods estimate tooth size and jaw size relationships. Space analysis compares available space to required space for proper tooth alignment.
2. Methods are classified by tooth size estimation method, arch length estimation method, developmental stage, and estimation/digitization method.
3. Common methods include measurements from radiographs, prediction tables using erupted tooth sizes, and combinations of methods. Nance analysis accounts for space changes between deciduous and permanent dentitions.
This document discusses functional appliances used in orthodontic treatment. It describes the advantages and disadvantages of functional appliances, how they work to produce orthopedic, dentoalveolar and muscular changes, different types of functional appliances including activators and Frankel regulators, and guidelines for use and patient instruction.
Effects of drugs on orthodontic treatmentumairshoukat5
Dr. Umair Shoukat Ali presented on orthodontic tooth movement and factors that affect it. Orthodontic tooth movement is a biological response to forces applied to the teeth. Continuous light forces produce the most desirable tooth movement with minimal harm. Heavier forces can result in necrosis and delayed movement. Tooth movement is regulated by chemicals like prostaglandins and leukotrienes that influence bone remodeling. Many drugs can also impact orthodontic treatment by altering these chemical pathways and affecting the rate of bone turnover. NSAIDs decrease tooth movement while corticosteroids increase it. Systemic factors like hormones and vitamins also influence the speed of orthodontic tooth movement. Close coordination with physicians is important when patients are
The document discusses Bjork's concept of jaw rotation during growth. It summarizes Bjork's landmark longitudinal study from 1951-1969 that used metal implants to track sites of growth and resorption in the mandible. Bjork observed that the mandible undergoes a downward and backward rotation during growth, with greater growth occurring posteriorly than anteriorly. He classified mandibular rotation patterns into forward and backward types based on the center of rotation. The study provided insights into mandibular growth mechanisms and implications for orthodontic treatment planning.
This document discusses the management of open bite malocclusions. It begins by defining open bite and classifying it as either skeletal or dental in nature. Skeletal open bite is caused by excessive vertical growth of the jaws while dental open bite is due to reduced incisor height. Common etiologies of open bite include thumb sucking habits, tongue thrusting, and abnormal skeletal growth patterns. The document outlines various treatment approaches for different open bite classifications and etiologies.
This document provides an overview and instructions for Carey's analysis and Lundstrom analysis. Carey's analysis involves measuring the arch length and comparing it to the tooth material to determine if extractions are needed. It can indicate if a premolar extraction or first molar extraction is required based on the discrepancy. Lundstrom analysis divides the dental arch into segments and measures the tooth widths to calculate the net discrepancy. Both methods help assess dental arch perimeter and tooth size to determine appropriate treatment planning.
RAPID MAXILLARY EXPANSION VS SLOW MAXILLARY EXPANSIONShehnaz Jahangir
This document provides an overview of rapid maxillary expansion (RME) vs slow maxillary expansion (SME). It discusses the historical perspective of maxillary expansion, articulation and ossification of the midpalatal suture, indications and contraindications for expansion, classifications based on activation and support, examples of RME and SME appliances, activation protocols, and the biomechanical aspects and effects of RME on skeletal and dental structures. Key differences between RME and SME include the rate of activation (rapid vs slow) and appliances used (tooth-borne vs tissue-borne).
1. Arch space analysis methods estimate tooth size and jaw size relationships. Space analysis compares available space to required space for proper tooth alignment.
2. Methods are classified by tooth size estimation method, arch length estimation method, developmental stage, and estimation/digitization method.
3. Common methods include measurements from radiographs, prediction tables using erupted tooth sizes, and combinations of methods. Nance analysis accounts for space changes between deciduous and permanent dentitions.
The document discusses orthodontic diagnosis and treatment planning. It defines diagnosis as identifying and describing a patient's orthodontic problems. Treatment planning involves outlining a strategy to address the problems while maximizing benefits and minimizing risks. It discusses indications for treatment including psychosocial, developmental, functional, and trauma/disease factors. It also addresses distinguishing moderate problems treated in general practice from more complex cases requiring referral to an orthodontic specialist.
Mode of action of functional appliances /certified fixed orthodontic courses ...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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This document provides information on performing a functional examination as part of an orthodontic diagnosis. It discusses examining the postural rest position and maximum intercuspation, as well as the temporomandibular joint, orofacial dysfunction, and various functional movements. Methods for determining and registering the postural rest position are described. Examination of swallowing, tongue posture, speech, lips, respiration, and craniofacial skeletal relationships are also covered to evaluate orofacial dysfunction. The document emphasizes that a functional examination is important for a complete orthodontic diagnosis beyond just a static evaluation of dental relationships.
This document provides an overview of several common cephalometric analyses used in orthodontics, including descriptions of:
- Steiner's analysis from the 1950s, which was one of the first modern analyses and emphasized relationships between measurements.
- Ricketts' analysis from 1961, which characterized skeletal patterns using measurements like Xi point and the facial axis.
- McNamara's analysis from 1984, which derived norms from studies of children, untreated cases, and young adults with good dental features.
- Di Paolo's quadrilateral analysis from 1983, which assesses skeletal structures like maxillary length and facial heights.
Dentoalveolar compensations /certified fixed orthodontic courses by Indian de...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.
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
The Frankel functional regulator is a removable orthodontic appliance developed by Dr. Rolf Frankel to effect changes in the jaw relationship during mixed and early permanent dentition. It consists of upper buccal shields, lower lip pads, and wires. The shields and pads act to change muscle function and guide jaw growth. Indications include Class II malocclusions with a retruded mandible. Contraindications include severe crowding. The appliance aims to correct jaw positions through muscle adaptation and differential tooth eruption guidance between the arches.
Model analysis in orthodontics /certified fixed orthodontic courses by India...Indian dental academy
Welcome to 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.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
This document provides an overview of headgear appliances used in orthodontic treatment. It discusses the evolution of headgear from early designs in the 1800s to modern versions. Headgears are classified based on their use, attachment method, and direction of pull. The key components of facebow headgear are described, including the outer bow, inner bow, junction, and force elements like elastics that connect it to the head cap or cervical strap anchorage. Adjustments to the inner bow are outlined to position the appliance properly during treatment.
This document discusses several orthodontic appliances including the Nance appliance, transpalatal arch, quad helix, lip bumper, and tongue crib. It provides details on the design, indications, mechanisms of action, advantages and disadvantages of each appliance. The document is intended as an educational guide for orthodontic residents, as it is presented by several orthodontists and covers the key aspects of these common fixed functional appliances.
This document provides information on banding instruments and procedures in pediatric dentistry. It discusses the history of bands, various band materials and sizes, advantages and disadvantages of bands, ideal band material requirements, instruments used for banding, and banding techniques. The key points are:
- Bands are thin metal rings placed on teeth, typically molars, to secure orthodontic appliances. Accurate band placement is important for fitting appliances.
- Stainless steel is commonly used due to properties like resistance to tarnish and springiness. Band sizes vary based on tooth type.
- Banding provides strong attachment but risks caries if cement seals fail. Autoclaving is the most reliable steril
Root resorption is a condition characterized by a partial loss of root cementum and dentin.
Root resorption of the deciduous dentition is a physiological process and it is a necessary precursor to the eruption of permanent teeth.
Permanent teeth root resorption is a pathological inflammatory process and it can be affected by several factors
Apical root resorption can be also related to an orthodontic treatment and it can be present during the treatment or at the end of it.
This root resorption is called orthodontically- induced inflammatory root resorption (OIRR) and it is considered a distinct pathologic process.
Patient-related and treatment-related factors are involved in the onset and progression of this root resorption.1. Cemental or surface resorption with remodeling. In this process, only the outer cemental layers are resorbed, and they are later fully regenerated or remodeled. This process resembles trabecular bone remodeling.
2. Dentinal resorption with repair (deep resorption). In this process, the cementum and the outer layers of the dentin are resorbed and usually repaired with cementum material. The final shape of the root after this resorption and formation process may or may not be identical to the original form.
. Circumferential apical root resorption. In this process, full resorption of the hard tissue components of the root apex occurs, and root shortening is evident.
Orthodontic forces applied to the biologic system act similarly on bone and cementum, which are separated by the periodontal membrane. If there are no differences in the biologic behavior of these two organs, both would resorb equally.
Since cementum is more resistant to resorption compared with the more vulnerable bone, applied forces usually cause bone resorption, which leads to tooth movement. However, resorption of the cementum and dentin may also occur
Several theories explaining the resistance of the dental tissues, especially cemental resistance to resorption, exist.
It is documented that the uncalcified mineral tissues, osteoid, precementum, and predentin are resistant to resorption and may initially prevent loss of root tissue.
These layers might contain noncollagenic materials, eg, the cells themselves, that possess potent anticollagenase propertiesAfter extensive research in this field, mainly with tooth replantation models, Andreasen, relates surface resistance to the innermost cellular layer of the periodontal ligament.
This layer supplies the protective mechanism to the root, as well as the potential for a repair.
The cementoblasts, fibroblasts, osteoblasts, endothelial, and perivascular cells are included in this layer
However, continuous pressure will eventually lead to resorption of these areas
Root resorption occurs when pressure on the cementum exceeds its reparative capacity and dentin is exposed, allowing multinucleated odontoclasts to degrade the root substance.
Acc to Rudolph ,Resorption typically attacks the root tip and
This document provides information about cephalometrics in orthodontics, including:
- A definition of cephalometrics and brief history of its development in the 1930s.
- The key equipment used in cephalometric radiography and various reference planes used in analysis.
- The main uses of cephalometrics, including diagnosis, treatment planning, monitoring treatment progress, research, and more.
- Sources of error in cephalometric analysis related to projections, landmark identification, and measuring systems.
- Details on specific cephalometric analyses techniques like Downs, Steiner, Ballard conversion, and Pi analysis.
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
Schwarz analysis divides the evaluation into craniometry (skeletal) and gnathometry (dental) using reference lines and planes. Craniometry assesses the skeletal base and profile using angles like J angle, F angle, and TMJ position. Gnathometry evaluates the dentition using angles like B angle, gonial angle, and axial tooth inclinations. Linear measurements include anterior cranial base, ascending ramus, maxillary base, and soft tissue thickness. The analysis provides metrics to assess the skull, jaws, dentition, and facial profile.
1. Orthodontic tooth movement occurs through remodeling of the alveolar bone in response to prolonged mechanical forces on teeth. Bone resorbs on the pressure side and forms on the tension side of the periodontal ligament.
2. Physiologic tooth movements include eruption, drift, and minor movements during mastication. Eruption occurs through growth of the root and forces from the periodontal ligament.
3. When forces are within physiologic limits, tooth movement occurs through frontal resorption on the pressure side and bone formation on the tension side. Excessive forces cause hyalinization and undermining resorption.
Rakosi's analysis is an important diagnostic tool for planning functional appliance therapy. It involves analyzing three divisions: 1) the facial skeleton, 2) the jaw bones, and 3) the dentoalveolar relationship. Key measurements of the facial skeleton include saddle, articular, and gonial angles which provide information about cranial base orientation and mandibular positioning. Measurements of the jaw bones like SNA, SNB, and inclination angle describe the maxillary and mandibular skeletal bases. Dentoalveolar measurements such as upper and lower incisor angles indicate incisor inclinations. Rakosi's analysis provides a comprehensive evaluation of skeletal, dental, and soft tissue structures for orthodontic
Lateral cephalometric analysis of hard tissuesMalikAshim
The document provides an overview of the Downs analysis method for lateral cephalometric analysis. It describes Downs analysis as evaluating skeletal and dental patterns based on angular and linear measurements compared to normal ranges. The skeletal analysis examines facial angle, angle of convexity, A-B plane, mandibular plane angle, and Y-axis. The dental analysis looks at occlusal plane cant, interincisal angle, incisor-occlusal plane angle, incisor-mandibular plane angle, and maxillary incisor protrusion. Downs developed normal ranges for each measurement based on a sample.
The mandibular second premolar is one of the most frequently impacted teeth. The recommended treatment is to extract the second primary molar with or without removing the bone along the eruption path, to uncover the tooth surgically and move it into the arch by orthodontic treatment.
The purpose of this article is to review the principles of case management of soft tissue impacted second premolars mandibular and to illustrate their potential to respond well to the treatment. Although the scope of treatment may depend on a varying range of factors, this case report demonstrates the inherent potential for good treatment outcome in cases of soft tissue impactions
This document describes the case of a 16-year-old girl with an impacted mandibular second premolar. The tooth was impacted horizontally near the lingual sulcus and covered by gingiva. Orthodontic treatment using aligners and open coil springs created space. The impacted tooth was then surgically exposed using a closed exposure technique and attached to the archwire using a button and chain. Over months of orthodontic forces, the tooth was moved into position in the dental arch. The document reviews principles of managing impacted second premolars and concludes that with adequate treatment, even severely impacted teeth can erupt into functional occlusion.
The document discusses orthodontic diagnosis and treatment planning. It defines diagnosis as identifying and describing a patient's orthodontic problems. Treatment planning involves outlining a strategy to address the problems while maximizing benefits and minimizing risks. It discusses indications for treatment including psychosocial, developmental, functional, and trauma/disease factors. It also addresses distinguishing moderate problems treated in general practice from more complex cases requiring referral to an orthodontic specialist.
Mode of action of functional appliances /certified fixed orthodontic courses ...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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This document provides information on performing a functional examination as part of an orthodontic diagnosis. It discusses examining the postural rest position and maximum intercuspation, as well as the temporomandibular joint, orofacial dysfunction, and various functional movements. Methods for determining and registering the postural rest position are described. Examination of swallowing, tongue posture, speech, lips, respiration, and craniofacial skeletal relationships are also covered to evaluate orofacial dysfunction. The document emphasizes that a functional examination is important for a complete orthodontic diagnosis beyond just a static evaluation of dental relationships.
This document provides an overview of several common cephalometric analyses used in orthodontics, including descriptions of:
- Steiner's analysis from the 1950s, which was one of the first modern analyses and emphasized relationships between measurements.
- Ricketts' analysis from 1961, which characterized skeletal patterns using measurements like Xi point and the facial axis.
- McNamara's analysis from 1984, which derived norms from studies of children, untreated cases, and young adults with good dental features.
- Di Paolo's quadrilateral analysis from 1983, which assesses skeletal structures like maxillary length and facial heights.
Dentoalveolar compensations /certified fixed orthodontic courses by Indian de...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.
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
The Frankel functional regulator is a removable orthodontic appliance developed by Dr. Rolf Frankel to effect changes in the jaw relationship during mixed and early permanent dentition. It consists of upper buccal shields, lower lip pads, and wires. The shields and pads act to change muscle function and guide jaw growth. Indications include Class II malocclusions with a retruded mandible. Contraindications include severe crowding. The appliance aims to correct jaw positions through muscle adaptation and differential tooth eruption guidance between the arches.
Model analysis in orthodontics /certified fixed orthodontic courses by India...Indian dental academy
Welcome to 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.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
This document provides an overview of headgear appliances used in orthodontic treatment. It discusses the evolution of headgear from early designs in the 1800s to modern versions. Headgears are classified based on their use, attachment method, and direction of pull. The key components of facebow headgear are described, including the outer bow, inner bow, junction, and force elements like elastics that connect it to the head cap or cervical strap anchorage. Adjustments to the inner bow are outlined to position the appliance properly during treatment.
This document discusses several orthodontic appliances including the Nance appliance, transpalatal arch, quad helix, lip bumper, and tongue crib. It provides details on the design, indications, mechanisms of action, advantages and disadvantages of each appliance. The document is intended as an educational guide for orthodontic residents, as it is presented by several orthodontists and covers the key aspects of these common fixed functional appliances.
This document provides information on banding instruments and procedures in pediatric dentistry. It discusses the history of bands, various band materials and sizes, advantages and disadvantages of bands, ideal band material requirements, instruments used for banding, and banding techniques. The key points are:
- Bands are thin metal rings placed on teeth, typically molars, to secure orthodontic appliances. Accurate band placement is important for fitting appliances.
- Stainless steel is commonly used due to properties like resistance to tarnish and springiness. Band sizes vary based on tooth type.
- Banding provides strong attachment but risks caries if cement seals fail. Autoclaving is the most reliable steril
Root resorption is a condition characterized by a partial loss of root cementum and dentin.
Root resorption of the deciduous dentition is a physiological process and it is a necessary precursor to the eruption of permanent teeth.
Permanent teeth root resorption is a pathological inflammatory process and it can be affected by several factors
Apical root resorption can be also related to an orthodontic treatment and it can be present during the treatment or at the end of it.
This root resorption is called orthodontically- induced inflammatory root resorption (OIRR) and it is considered a distinct pathologic process.
Patient-related and treatment-related factors are involved in the onset and progression of this root resorption.1. Cemental or surface resorption with remodeling. In this process, only the outer cemental layers are resorbed, and they are later fully regenerated or remodeled. This process resembles trabecular bone remodeling.
2. Dentinal resorption with repair (deep resorption). In this process, the cementum and the outer layers of the dentin are resorbed and usually repaired with cementum material. The final shape of the root after this resorption and formation process may or may not be identical to the original form.
. Circumferential apical root resorption. In this process, full resorption of the hard tissue components of the root apex occurs, and root shortening is evident.
Orthodontic forces applied to the biologic system act similarly on bone and cementum, which are separated by the periodontal membrane. If there are no differences in the biologic behavior of these two organs, both would resorb equally.
Since cementum is more resistant to resorption compared with the more vulnerable bone, applied forces usually cause bone resorption, which leads to tooth movement. However, resorption of the cementum and dentin may also occur
Several theories explaining the resistance of the dental tissues, especially cemental resistance to resorption, exist.
It is documented that the uncalcified mineral tissues, osteoid, precementum, and predentin are resistant to resorption and may initially prevent loss of root tissue.
These layers might contain noncollagenic materials, eg, the cells themselves, that possess potent anticollagenase propertiesAfter extensive research in this field, mainly with tooth replantation models, Andreasen, relates surface resistance to the innermost cellular layer of the periodontal ligament.
This layer supplies the protective mechanism to the root, as well as the potential for a repair.
The cementoblasts, fibroblasts, osteoblasts, endothelial, and perivascular cells are included in this layer
However, continuous pressure will eventually lead to resorption of these areas
Root resorption occurs when pressure on the cementum exceeds its reparative capacity and dentin is exposed, allowing multinucleated odontoclasts to degrade the root substance.
Acc to Rudolph ,Resorption typically attacks the root tip and
This document provides information about cephalometrics in orthodontics, including:
- A definition of cephalometrics and brief history of its development in the 1930s.
- The key equipment used in cephalometric radiography and various reference planes used in analysis.
- The main uses of cephalometrics, including diagnosis, treatment planning, monitoring treatment progress, research, and more.
- Sources of error in cephalometric analysis related to projections, landmark identification, and measuring systems.
- Details on specific cephalometric analyses techniques like Downs, Steiner, Ballard conversion, and Pi analysis.
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
Schwarz analysis divides the evaluation into craniometry (skeletal) and gnathometry (dental) using reference lines and planes. Craniometry assesses the skeletal base and profile using angles like J angle, F angle, and TMJ position. Gnathometry evaluates the dentition using angles like B angle, gonial angle, and axial tooth inclinations. Linear measurements include anterior cranial base, ascending ramus, maxillary base, and soft tissue thickness. The analysis provides metrics to assess the skull, jaws, dentition, and facial profile.
1. Orthodontic tooth movement occurs through remodeling of the alveolar bone in response to prolonged mechanical forces on teeth. Bone resorbs on the pressure side and forms on the tension side of the periodontal ligament.
2. Physiologic tooth movements include eruption, drift, and minor movements during mastication. Eruption occurs through growth of the root and forces from the periodontal ligament.
3. When forces are within physiologic limits, tooth movement occurs through frontal resorption on the pressure side and bone formation on the tension side. Excessive forces cause hyalinization and undermining resorption.
Rakosi's analysis is an important diagnostic tool for planning functional appliance therapy. It involves analyzing three divisions: 1) the facial skeleton, 2) the jaw bones, and 3) the dentoalveolar relationship. Key measurements of the facial skeleton include saddle, articular, and gonial angles which provide information about cranial base orientation and mandibular positioning. Measurements of the jaw bones like SNA, SNB, and inclination angle describe the maxillary and mandibular skeletal bases. Dentoalveolar measurements such as upper and lower incisor angles indicate incisor inclinations. Rakosi's analysis provides a comprehensive evaluation of skeletal, dental, and soft tissue structures for orthodontic
Lateral cephalometric analysis of hard tissuesMalikAshim
The document provides an overview of the Downs analysis method for lateral cephalometric analysis. It describes Downs analysis as evaluating skeletal and dental patterns based on angular and linear measurements compared to normal ranges. The skeletal analysis examines facial angle, angle of convexity, A-B plane, mandibular plane angle, and Y-axis. The dental analysis looks at occlusal plane cant, interincisal angle, incisor-occlusal plane angle, incisor-mandibular plane angle, and maxillary incisor protrusion. Downs developed normal ranges for each measurement based on a sample.
The mandibular second premolar is one of the most frequently impacted teeth. The recommended treatment is to extract the second primary molar with or without removing the bone along the eruption path, to uncover the tooth surgically and move it into the arch by orthodontic treatment.
The purpose of this article is to review the principles of case management of soft tissue impacted second premolars mandibular and to illustrate their potential to respond well to the treatment. Although the scope of treatment may depend on a varying range of factors, this case report demonstrates the inherent potential for good treatment outcome in cases of soft tissue impactions
This document describes the case of a 16-year-old girl with an impacted mandibular second premolar. The tooth was impacted horizontally near the lingual sulcus and covered by gingiva. Orthodontic treatment using aligners and open coil springs created space. The impacted tooth was then surgically exposed using a closed exposure technique and attached to the archwire using a button and chain. Over months of orthodontic forces, the tooth was moved into position in the dental arch. The document reviews principles of managing impacted second premolars and concludes that with adequate treatment, even severely impacted teeth can erupt into functional occlusion.
The purpose of this article is to review the principles of case management of soft tissue impacted second premolars mandibular and to illustrate their potential to respond well to the treatment. Although the scope of treatment may depend on a varying range of factors, this case report demonstrates the inherent potential for good treatment outcome in cases of soft tissue impactions
Therapy concept for Surgical Uprighting of the Impacted Second Mandibular MolarAbu-Hussein Muhamad
This document discusses surgical techniques for uprighting impacted mandibular second molars. It describes exposing the impacted tooth and extracting the third molar to create space. The impacted second molar is then surgically rotated and elevated into position between the first molars. Outcomes are best when roots are one-third developed. Uprighting is preferred over extraction or transplantation and provides better long-term prognosis than other options. Combined orthodontic and surgical treatment allows precise positioning of the uprighted molar.
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.
ORTHODONTIC TREATMENT OF AN IMPACTED MAXILLARY CENTRAL INCISOR COMBINED WI...Abu-Hussein Muhamad
Impaction of maxillary permanent incisors is not a frequent case in dental practice, but its treatment is challenging because of these teeth importance to facial esthetics Management by a combination of orthodontics and surgery produces a satisfactory result. The surgical exposure and orthodontic traction of impacted central incisor after surgical exposure of impacted maxillary central incisor teeth is presented in this case report.
Key words: Impacted tooth, Maxillary incisors orthodontics, tooth movement
Dr. Ahmed M. Adawy, Professor Emeritus, Dep. Oral & Maxillofacial Surgery. Former Dean, Faculty of Dental Medicine
Al-Azhar University. Impacted teeth can be defined as those prevented from eruption at the expected time due to physical barrier. The etiology, frequency of impactions are given. Classification systems are based on the depth, angulation, and available space. Complications associated with lower third molar impaction are discussed and methods of treatment are explained. Comparison between maxillary third molar and mandibular one is given. Upper canine is the second most commonly impacted tooth after third molars. It form the foundation of an esthetic smile. The management of impacted canine is interdisciplinary management comprises of a team of an orthodontist, oral surgeon, and periodontist.
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
Treatment concept by Watted for a controlled alignment of palatally impacted ...Abu-Hussein Muhamad
It is known that maxillary canines remain impacted more often than the mandibular canines, and the inclusion can be
buccal or palatal. The treatment focuses mainly on the exposure and on the orthodontic realignment of the impacted
tooth. There are situations when canines erupt spontaneously after their surgical discovery. The present paper has the
purpose of approaching aspects related to impacted upper permanent canines by a literature review, including
localization and treatment conducts.
Key words: Impacted canine, periodontal, surgical-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
Titanium Button With Chain by Watted For Orthodontic Traction of Impacted Max...Abu-Hussein Muhamad
This document summarizes a study that evaluated the outcome of using a titanium button with chain by Watted for orthodontic traction of 82 impacted maxillary canines in patients between 2006-2013. Following surgical exposure of the impacted teeth, an orthodontic traction hook with a titanium button and chain was bonded to each tooth. All teeth were successfully erupted with few complications. Forced orthodontic eruption using a well-bonded orthodontic traction hook and ligation chain in conjunction with surgery resulted in predictable orthodontic eruption of impacted maxillary canines.
A 65-year-old patient presented with a chronic infection related to an impacted lower third molar. Despite recommendations for removal, the patient refused treatment, resulting in progression of the deep bone infection and a pathologic fracture of the jaw. Factors such as age, medical comorbidities, proximity to adjacent structures, and risk of damage during surgery are considered when determining if an impacted third molar should be removed. Surgical extraction involves raising flaps, removing bone, dividing and extracting the tooth, and closing the wound. Postoperative care may include antibiotics, analgesics, and steroids. Complications can be intraoperative such as nerve injury, fracture, or bleeding, or postoperative like pain, swelling, and infection.
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 po
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The document discusses the surgical anatomy of the mandibular third molar region. It describes the thick lateral bone and convex alveolar process medially. The mylohyoid ridge continues posteriorly towards the third molar. Behind the third molar is the retromolar triangle, bounded by lingual and buccal crests. Lateral to this is the retromolar fossa. The retromolar canal and foramen, present in around 25% of individuals, transmits neurovascular branches through this region. The inferior alveolar canal contains the inferior alveolar nerve and vessels below the third molar area.
11.Mathew P, Rahul VCT, Mullath A, David J, Tiwari H. An unusual case of Ectopic Eruption of Supernumerary Mandibular Molar tooth in Coronoid. Int J Oral Health Med Res 2017;4(5):51-54.
- The intra-oral examination assesses oral health, individual tooth positions, and inter-occlusal relationships. This, along with the extra-oral examination, allows for formulation of a treatment plan.
- Careful examination of the lower arch first is important, followed by the upper arch, as the lower arch often determines treatment for the upper. Tooth positions, crowding, rotations, and occlusal relationships are evaluated.
- Dental health is the most important factor, as active dental disease precludes orthodontic treatment due to risks of decalcification and accelerated bone loss during tooth movement. Treatment options depend on the degree of occlusal discrepancy and patient motivation/dental health.
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Congenital absence of maxillary lateral incisors is a frequent clinical challenge which must be solved by a multidisciplinary approach in order to obtain an
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Excess of space in the dental arch is diagnosed as a
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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
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LOW BIRTH WEIGHT. PRETERM BABIES OR SMALL FOR DATES BABIES
Treatment of Extremely Displaced and Impacted Second Premolar in the Mandible
1. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 10 Ver. IX (Oct. 2015), PP 110-117
www.iosrjournals.org
DOI: 10.9790/0853-14109110117 www.iosrjournals.org 110 | Page
Treatment of Extremely Displaced and Impacted Second
Premolar in the Mandible
Muhamad Abu-Hussein1
, Nezar Watted 2
, Omri Emodi 3
, Obaida Awadi4
1
University of Naples Federic II, Naples, Italy, Department of Pediatric Dentistry, University of Athens,Athens,
Greece
2
Clinics and Policlinics for Dental, Oral and Maxillofacial Diseases of the Bavarian Julius-Maximilian-
University, Wuerzburg, Germany
3
Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel
4
Center for dentistry, research and Aesthetics, Jatt/Israel
Abstract: The mandibular second premolar is one of the most frequently impacted teeth. The recommended
treatment is to extract the second primary molar with or without removing the bone along the eruption path, to
uncover the tooth surgically and move it into the arch by orthodontic treatment.
The purpose of this article is to review the principles of case management of soft tissue impacted second
premolars mandibular and to illustrate their potential to respond well to the treatment. Although the scope of
treatment may depend on a varying range of factors, this case report demonstrates the inherent potential for
good treatment outcome in cases of soft tissue impactions.
Keywords: Mandibular Premolar ; Unerupted Tooth; Submerged tooth
I. Introduction
The mandibular second premolar is highly variable developmentally. Agenesis, abnormal tooth germ
position, and distal inclination of the developing tooth are among the reported developmental anomalies[1]. n
addition, the second most frequently impacted tooth was found to be the mandibular second premolar, excluding
third molars, in some populations[1,2].
The mandibular premolars erupt after the mandibular first molar and mandibular canine; thus if the
room for eruption of premolars is inadequate, one of the premolars usually the second premolar remains un-
erupted and chances of getting impacted are more[3]. The prevalence of impacted premolars varies according to
age. The overall prevalence for impaction in adults has been reported to be 0.5% the range being 0.2% to 0.3%
for mandibular premolars.[1,2,3,4]
The main etiological factors for premolar impaction appear to include arch length deficiency, lack of
space, ectopic position of tooth germ, obstacles to eruption such as an ankylosed primary molar, and the
presence of supernumerary teeth or odontomas. Some systemic and genetic factors involved include
cleidocranial dysplasia, osteopetrosis, Down’s syndrome, hypothyroidism, and hypopituitarism [2,4]
Genetic and environmental factors involved in tooth development may be disturbed at any stage of
tooth development[2]. Tooth germ of mandibular second premolar is ideally positioned between roots of second
deciduous molar. Normally the path of eruption follows resorption of roots of deciduous molar with no major
deviations. The mandibular premolars erupt after the mandibular first molar and mandibular canine; thus if the
room for eruption of premolars is inadequate, one of the premolars usually the second premolar remains un-
erupted and chances of getting impacted are more.[5,6]
The overall prevalence in adults has been reported to be 0.5% (the range is 0.1% to 0.3% for
maxillarypremolars and 0.2% to 0.3% for mandibular premolars) [7].
Tooth impaction is frequently observed anomaly of eruption and is often the sole complaint of young
patients visiting dentists.[1] If a tooth has erupted out of the jaw bone but not through the gumline, It is termed
as soft tissue impaction. The impaction of premolar may be caused by loss of space due to early extraction of
deciduous second molars, resulting in the mesial drift of permanent molars and the ectopic position of the tooth
bud, obstacles to eruption such as an ankylosed primary molar, the presence of supernumerary teeth or
odontomas and genetic factors[8]. Various treatment methods have been suggested including observation,
intervention, relocation, and extraction depending on the tooth’s position, depth of the impacted tooth,
relationship with adjacent teeth, and orthodontic treatment.[6,8]
Conservative management with exposure of the crown has been advocated. The majority of reported
cases involved distally impacted premolars in which the long axis was inclined to favour eruption if exposed.
Surgical exposure is unpredictable and best limited to cases with no more than 45° tilting of the long axis from
its normal position[6].
2. Treatment of Extremely Displaced and Impacted Second Premolar in the Mandible
DOI: 10.9790/0853-14109110117 www.iosrjournals.org 111 | Page
The case described below illustrates the inherent potential for even the most unfavorably impacted
mandibular premolars to respond.
II. Case Report:
Medical history and Diagnosis:
A 16 years old girl was referred to our dental clinic- Center for dentistry, esthetics and research, Jatt,
Israel, with the chief complaint of mild pain. Her medical and dental history was not significant. She had no
history of dental extractions or orthodontic treatment. .
The process near lingual sulcus and almost completely covered by gingivae. There was a mesial drift of
first mandibular permanent molar and distal tipping of first mandibular right premolar on the affected side,
leaving about 3-3,5 mm of space for impacted tooth. There was mild crowding in the lower anterior region with
deep bite and mild attrition of lower anterior teeth (FIG. 1, 2).
OPG confirmed the presence of all the permanent teeth, including the third molars. Right mandibular
second premolar was almost horizontally impacted associated with follicular cyst with crown facing towards
first molar. The impacted tooth in close proximity to inferior alveolar nerve canal (FIG. 3, 4, 5).
Treatment:
The treatment begins with orthodontic treatment by using a straight wire appliance (0.022" slot). A
0.012" NiTi arch wire was placed in upper arch first with the objective of correction of deep overbite. Leveling
and aligning was accomplished through sequential change in arch wire from 0.018" ×0.025" heat activated NiTi
to 0.018" × 0.025" SS wire.
After six months appliance was placed in mandibular arch, with 0.014" NiTi arch wire being placed as
the initial archwire. After two months, 0.018” SS wire with NiTi open coil spring was placed between
mandibular 1st
premolar and 1st
molar to create space for the
2nd
premolar. Once adequate space was created, then we're ready for the surgical exposure of the 2nd
premolar.
Before performing the surgical intervention , we should examin the interocclusal clearance of the
opposing dentition , in order to verify that sufficient vertical space exists between the impacted second premolar
tooth ,in the mandible and the opposing maxillary premolar tooth .
The surgical procedure,itself, can be carried out under local anesthesia .
The surgical method was used here is the closed exposure surgery.
A muco-gingival incision is made and a muco –periosteal flap extending from the first molar to the first
premolar area from the buccal side, the flap at the 2nd
premolar area , is reflected .as to expose the bone
surrounding the impacted second premolar (FIG. 6).
Bone is carefully removed in order to expose the height of the crown of the impacted second premolar tooth .
Then we use the tunneling technique and we attach the tooth with Titanium button with chain by Watted ( FIG.
7, 8a), Soft tissue closure is done in an ordinary fashion , using resorbable or unresorbable sutures. In selected
cases , apically repositioned flaps ,has to be incorporated , in order to better expose the uprighted tooth crown.
After the surgical exposure we start to expose the 2nd
premolar tooth by applying force with lace back
to the arch wire, after a few months of treatment in lower arch, the second premolar was seen clinically in the
mouth (FIG 8 b, c). A bracket was bonded to the erupted premolar for final positioning of the tooth (FIG. 9).
The objectives of eruption of impacted tooth into the occlusion, correction of deep overbite and correction of
midline deviation were achieved. The appliance was removed 18months after initiation of the treatment (FIG.
10, 11, 12)
III. Discussion
Impacted permanent mandibular second premolar are detected quite regularly in the clinical and
radiographic examination of a young dental patient[7].
The orthodontist role in Surgical Orthodontics is presurgical dental decompensation using fixed
mechanotherapy and postsurgical establishment of functional occlusion.[1]
Kokich describes the surgical and orthodontic management of impacted teeth and identifies the position
and angulation of the impacted tooth, length of treatment time, available space and the presence of keratinized
gingival as critical factors that will affect prognosis and treatment
Outcome[9].
Andreasen suggests that surgical exposure with or without orthodontic intervention should be confined
to cases with no more than 45 % tilting and limited deviation from the normal position.[2,10]
Wasserstein and Shalish failed to find a significant correlation between premature loss of mandibular
second primary molar and malposition of mandibular second premolar.[11]
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DOI: 10.9790/0853-14109110117 www.iosrjournals.org 112 | Page
Beckeradvocated that by whichever method space is made, the tooth will normallyerupt with
considerable speed, without further assistance, if teeth are with moderately disturbed axial angulations. If
sufficient space exists or created in the dental arch, impacted mandibular premolar then has a high potential for
selfalignment and eruption without orthodontic intervention[1].
Profitt states that a tooth will erupt into its correct position after obstacles to eruption have been
removed by surgical exposure, but after root formation is completed eruption of tooth rarely occur. Even a tooth
that is aimed in the right direction usually requires orthodontic
force to bring in to position.[12]
Aizenbud et al., have described a case of impacted mandibular second premolar with a tilt of 90
o
which
was surgically exposed after extraction of overlying deciduous tooth followed by its orthodontic extrusion and
alignment.[13]
McNamara & McNamara have described two cases of mandibular Premolar impactions, one in 33-
year-old female where surgical intervention was essential to allow for orthodontic alignment of the tooth.[8]
Jain U. & Kallur, the most common cause of mandibular second premolar impaction is premature loss of
deciduous predecessor. The other causes leading to this problem include, over-retained or infraocclusal and
ankylosed primary molars; ectopic positioning of the developing premolar tooth buds; or pathology such as
inflammatory or dentigerous cysts; extrinsic obstructions, such as supernumerary teeth and odontomas.
Impaction of the premolars may also be associated with, thick and fibrous gingival tissue or with
syndromes such as Cleidocranial dysostosis[14]
Orthodontic treatment with traction of a tooth can be divided into three phases, the first phase
comprises the beginning of orthodontic treatment to surgical exposure of the tooth lasting from two to five
months and varying, depending type of malocclusion and which teeth are involved. The second phase occurs
when starting traction, going to the placement of the tooth in the arch, between 12 to 18 months. The third phase
is when the orthodontic treatment is finalizes with the tooth in the arch. The traction of an unerupted tooth adds
between 10 to 18 months to complete orthodontic treatment time[15].
Before orthodontic forces are applied, it is necessary to make sure that there is enough space for the
tooth to be taken to its desired position in the arch. Also, one must be sure that the correct ostectomy around the
crown is made and that there is no present.[1,2,3]
The researched authors mentioned methods suggested for surgical orthodontic traction and alignment,
the use of mobile or fixed anchorage in the same arch or opposing arch, or the use of magnets with the
removable appliance.[16,17]
The literature is not unanimous referring the amount of force used to traction and some suggest 24-35
gr, others, 40 gr but keeps all forces between 5 and 100 gr. This force must be achieved by means of elastic
spring steel ligature or a device helicoloidal shaped attached to the orthodontic arch.[17]
The current case demonstrates the importance of judicious planning after a thoughtful analysis of the
diagnostic records and stresses the individualistic approach in management of any case. The correct diagnosis
greatly simplified the mechanics and an impacted tooth was allowed to erupt just by relieving it from under the
bulge of the adjacent molar. The case is also unique as it proves that even the impacted teeth have eruption
potential provided the impediment to their natural eruption is identified and managed successfully. Even after 5
years of the normal eruption timing, the tooth demonstrated eruptive movement as soon as the molar that
obstructed its path was corrected. An orthodontic force was added just to reduce the time taken by it to take its
occlusal position after it was visible under the gingiva.
Preventing mandibular premolar tooth impaction is the ideal form of treatment and provides the best
long-term results. With early detection, timely interception, and well-managed orthodontic treatment, impacted
tooth can be allowed to erupt naturally and can be guided to an appropriate location in the dental ar ch.
Management of impacted tooth, by regaining space so as to allow its natural eruption, can offer a better and long
term prognosis with no adverse pulpal or periodontal risk to the tooth and the supporting structure.[17,18]
The authors corroborate themselves citing the sequels and postoperative problems, both surgical and
orthodontic as infection after surgery, ankylosis, bone and gingival recession, resorption of adjacent teeth, the
pulpal obliteration, the darkening of the tooth, root resorption of neighboring teeth, in addition to decreased
bone level between the retained tooth and the neighboring teeth
IV. Conclusion:
Constant interaction and communication among the team members and the patient at all level of
treatment are the keys to the success of the interdisciplinary treatment. . From the literature review and case
presentation clinical-surgical, it can be concluded that:
A).The age of the patient is a important fact to be considered for the success of the treatment.
B). During the clinical and radiographic examinations, it should be observed carefully the location of the tooth,
the amount of bone and teeth adjacent to ascertain whether or not the traction will be possible.
4. Treatment of Extremely Displaced and Impacted Second Premolar in the Mandible
DOI: 10.9790/0853-14109110117 www.iosrjournals.org 113 | Page
c). The most used method to enable the traction of the tooth is the direct bonding of an orthodontic appliance on
the most accessible surface of the tooth.
d). For the mechanics of orthodontic traction is most recommended to install a fixed appliance to offer greater
control and effectiveness of the traction force applied..
References
[1]. Becker A. The orthodontic management of impacted teeth. Martin Dunitz Publications, London, 1988, p. 157
[2]. Andreasen JO. The impacted premolar. In: Andreasen JO, Petersen JK, Laskin DM (eds). Textbook and Color Atlas of Tooth
Impaction; Diagnosis, Treatment and Prevention. Copenhagen: Munksgaard; 1997, p.177-95.
[3]. Peterson LJ. Principles of management of impacted teeth. Contemporary Oral and Maxillofacial Surgery, Mosby, Philadelphia, Pa,
4th ed. USA, 2003, p.185.
[4]. Mariano RC, Mariano Lde C, de Melo WM. Deep impacted mandibular second molar: a case report. Quintessence Int 2006; 37:
773-6.
[5]. Burch J, Ngan P, Hackmar A. Diagnosis and treatment planning for unerupted premolars. Pedi Dent 1994;16:89-95.
[6]. Oikarinen VJ, Julku M. Impacted premolars. An analysis of 10,000 orthopantomograms. Proc Finn Dent Soc 1974; 70(3):95–8.
[7]. Collett AR. Conservative management of lower second premolar impaction. Aust Dent J 2000; 45: 279-81.
[8]. McNamara C, McNamara TG. Mandibular Premolar impaction:2 case reports. J Can Dent Assoc 2005; 71: 859-63.
[9]. Kokich VG, Mathews DP. Surgical and orthodontic management of impacted teeth. Dent Clin North Am 1993; 37(2):181–204.
[10]. Jain U, Kallury A. Conservative Management of Mandibular Second Premolar Impaction. J Scient Res 2011; 4: 59-61.
[11]. Wasserstein A, Shalish M. Adequacy of mandibular premolar position despite early loss of its deciduous molar. ASDC J Dent Child
2002; 69: 254-8, 233-4.
[12]. Profitt WR, Field HW. Contemporary orthodontics, Mosby, 3r ded, 2000, p. 435, 538, 541.
[13]. Aizenbud D, Levin L, Lin S, Michtei EE. A multidisciplinary approach to the treatment of a horizontally impacted mandibular
second premolar: 10-year follow-up. Orthodontics : the art and practice of dentofacial enhancement. 2011;12(1):48-59
[14]. Jain U, Kallury A. Conservative Management of Mandibular Second Premolar Impaction. People’s J Sci Res 2011;4(1):59-62.
[15]. KYUNG-HO, K.; KWANG–CHUI, C.; JI-YEON, L. E. E. et al., Orthodontic traction of impacted tooth.Korean J. Orthod., Seoul,
v. 28, n. 6, p. 991-9, dec., 1998.
[16]. TANAKA, O.; DANIEL, R. F.; VIEIRA, S. W. O dilema dos caninos superiores impactados. Ortodon. Gaúch., Porto Alegre, RS. v.
4, n. 2, p. 123-8, jul.,/dez., 2000.
[17]. Watted N, Abu-Hussein M., Awadi O., Borbély P .; Titanium Button With Chain by Watted For Orthodontic Traction of
Impacted Maxillary Canines ,Journal of Dental and Medical Sciences,2015,14(2);116-127
[18]. D.M. Rubin, D. Vedrenne, and J. E. Portnof, “Orthodontically guided eruption of mandibular second premolar following
[19]. enucleation of an inflammatory cyst: case report,” The Journal of Clinical Pediatric Dentistry, 2002.vol. 27, no. 1, pp. 19–23
Legends:
Fig 1: Clinical Photo in Occlusion shows the area of the missing 2nd
premolar.
Fig 2: Clinical Photo shows the lower arch and the missing 2nd
premolar.
5. Treatment of Extremely Displaced and Impacted Second Premolar in the Mandible
DOI: 10.9790/0853-14109110117 www.iosrjournals.org 114 | Page
Fig 3, 4: OPG x-ray shows the impacted 2nd
premolar associated with follicular cyst.
Fig 5: Lateral cephalogram x-ray.
Fig 6: clinical photo shows the exposure of 2nd
premolar with the tunneling technique.
6. Treatment of Extremely Displaced and Impacted Second Premolar in the Mandible
DOI: 10.9790/0853-14109110117 www.iosrjournals.org 115 | Page
Fig 7: clinical photo shows the button with chain by Watted bonded the 2nd
premolar tooth.
Fig 8 a: OPG x-ray shows the traction of the 2nd
premolar.
Fig 8 b: schematic representation of the initial phase when setting the displaced premolar. the mesialization of
the impacted tooth from the molars was carried out by the pressure spring. This was pressed in the distal
direction.
7. Treatment of Extremely Displaced and Impacted Second Premolar in the Mandible
DOI: 10.9790/0853-14109110117 www.iosrjournals.org 116 | Page
Fig 8 c: schematic representation of the second phase in the adjustment of the impacted premolar. the vertical
movement of the impacted tooth was performed by ligature. This was vertically attached to the main arch and
activated.
Fig 9: clinical photo shows the 2nd
premolar bonded with brackets.
Fig 10: clinical photo at the end of treatment.
8. Treatment of Extremely Displaced and Impacted Second Premolar in the Mandible
DOI: 10.9790/0853-14109110117 www.iosrjournals.org 117 | Page
Fig 11: clinical photo of the lower arch at the end of treatment.
Fig 12: OPG x-ray at the end of treatment.