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.
This case report describes the replacement of congenitally missing bilateral maxillary lateral incisors and a right mandibular premolar with dental implants in a 22-year old female patient. The treatment involved first extracting retained primary canines and using orthodontics to gain space between teeth for implant placement. Implants were then surgically placed and allowed to heal, followed by the placement of abutments and final prosthesis. The treatment achieved excellent esthetic and functional results through an interdisciplinary approach between orthodontics, periodontics, and prosthodontics.
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.
Management of Congenitally Missing Lateral Incisors with Orthodontics and Sin...Abu-Hussein Muhamad
This case report describes the management of a congenitally missing maxillary lateral incisor using an interdisciplinary approach involving orthodontics, bone grafting, dental implant placement, and prosthodontics. Specifically, orthodontic treatment was used to create sufficient space between the central incisor and canine for an implant. A bone graft was then used to augment the alveolar ridge prior to placing a dental implant. After osseointegration, a crown was placed on the implant to replace the missing lateral incisor. Follow up after one year showed successful treatment outcomes with good esthetics, function, and periodontal health.
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.
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.
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
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.
The maxillary lateral incisor is the second most frequently missing tooth. Females are more likely to be affected than males. Agenesis of the maxillary lateral incisor is often associated with other dental anomalies and requires complex multidisciplinary treatment. The two main treatment approaches are space closure using the canine or space opening for a prosthetic replacement, with the decision based on factors like malocclusion, crowding, facial profile, and canine characteristics.
This case report describes the replacement of congenitally missing bilateral maxillary lateral incisors and a right mandibular premolar with dental implants in a 22-year old female patient. The treatment involved first extracting retained primary canines and using orthodontics to gain space between teeth for implant placement. Implants were then surgically placed and allowed to heal, followed by the placement of abutments and final prosthesis. The treatment achieved excellent esthetic and functional results through an interdisciplinary approach between orthodontics, periodontics, and prosthodontics.
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.
Management of Congenitally Missing Lateral Incisors with Orthodontics and Sin...Abu-Hussein Muhamad
This case report describes the management of a congenitally missing maxillary lateral incisor using an interdisciplinary approach involving orthodontics, bone grafting, dental implant placement, and prosthodontics. Specifically, orthodontic treatment was used to create sufficient space between the central incisor and canine for an implant. A bone graft was then used to augment the alveolar ridge prior to placing a dental implant. After osseointegration, a crown was placed on the implant to replace the missing lateral incisor. Follow up after one year showed successful treatment outcomes with good esthetics, function, and periodontal health.
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.
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.
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
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.
The maxillary lateral incisor is the second most frequently missing tooth. Females are more likely to be affected than males. Agenesis of the maxillary lateral incisor is often associated with other dental anomalies and requires complex multidisciplinary treatment. The two main treatment approaches are space closure using the canine or space opening for a prosthetic replacement, with the decision based on factors like malocclusion, crowding, facial profile, and canine characteristics.
Prevalence of Missing Lateral Incisor Agenesis in an Or¬thodontic Arabs Popul...Abu-Hussein Muhamad
This study examined the prevalence of congenital absence (agenesis) of maxillary lateral incisors in 2,200 orthodontic patients of Arab descent in Israel. The researchers reviewed panoramic radiographs from 2006-2013 and found that 24 patients, or 1.1%, had agenesis of one or both maxillary lateral incisors. Specifically, 13 females (54.2%) and 11 males (45.8%) were missing their lateral incisors. This suggests the prevalence of maxillary lateral incisor agenesis in this population is 1.1%, providing data to compare to other studies on tooth agenesis frequencies.
ESTHETIC MANAGEMENT OF CONGENITALLY MISSING LATERAL INCISORS WITH SINGLE TOOT...Abu-Hussein Muhamad
This document discusses the esthetic management of congenitally missing lateral incisors with single tooth implants. It begins with definitions of hypodontia and discusses prevalence and etiology. Treatment involves an interdisciplinary approach between orthodontics and restorative dentistry. Specifically, the paper describes a case study where osseointegrated implants were used to replace missing maxillary lateral incisors. Key steps included orthodontic space opening, implant placement, and prosthetic restoration. The advantages and disadvantages of the single tooth implant approach are summarized.
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.
This document discusses the correction of excessive spaces (diastemata) between anterior teeth. It begins by explaining that diastemata can distort a pleasing smile but not all need correction, as patient needs and expectations must be considered. It then discusses various treatment options for diastema closure including orthodontics alone or with restorative procedures. Key factors that are important to consider include tooth proportions, gingival esthetics, occlusion, and papilla formation. The goal of treatment is to create harmony between the teeth, gingiva, and smile.
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.
The document discusses how the different dental specialties can collaborate to provide treatment for complex dental cases. It provides several examples:
1. Orthodontics can work with other specialties to treat missing teeth through space closure or opening, depending on factors like buccal occlusion and tooth shape.
2. Traumatized or fractured teeth may require orthodontic extrusion before restorative treatment, and tooth transplantation is sometimes used to replace front teeth.
3. Periodontal problems causing tooth drifting can be addressed through orthodontic realignment once disease is controlled.
4. Orthodontics can be used to improve occlusion and eliminate non-working side interferences, and may close anterior
Maxillary lateral incisors are the second most commonly congenitally missing teeth. When they are missing, orthodontic treatment can either open space to replace the tooth with an implant later, or close the space and substitute the canine. Selecting the best option depends on factors like malocclusion and tooth sizes. For opening space, implants are usually placed after growth is complete, so it is important to monitor eruption and implant site development early. Ankylosed primary molars can also affect future implant placement if not addressed. The orthodontist must consider various factors like age, gender, and tooth development when deciding how to manage congenitally missing teeth and ankylosed primary molars in adolescent patients.
Overview on midline diastema and its unesthetic effects
Presented by : Anamika Thorat
Guided by : Dr. Rehan Khan
Dept. of Pediatric Dentistry
SDDCH PBN
ORTHODONTIC TREATMENT OF PERIODONTALLY DAMAGED TEETH - AN INTERDISCIPLINARY A...Abu-Hussein Muhamad
This document describes an interdisciplinary case involving orthodontic treatment of a patient with periodontal damage. The patient had a deep periodontal pocket and bone loss around tooth 26. Guided tissue regeneration (GTR) and a bone graft were used to regenerate the defect before orthodontic treatment. Orthodontic treatment was then performed to align the teeth. The periodontal therapy and bone regeneration prior to orthodontics helped to improve the periodontal health and allowed for successful orthodontic treatment.
This document discusses various factors to consider when planning dental treatment, including periodontal health, tooth structure, gingival display, and facial proportions. A comprehensive diagnosis is needed to develop an optimal treatment plan. When placing crowns, margins are preferably not subgingival but may need to be for aesthetic reasons, so overhangs should be avoided. Laser crown lengthening can provide a comfortable option for improving aesthetics in front teeth when surgical lengthening alone is insufficient.
This document discusses autotransplantation of teeth in children with mixed dentition. It provides background on the timing of primary and permanent tooth eruption. Autotransplantation involves surgically moving a tooth from one site to another in the same person and can be useful for replacing teeth lost to decay or other issues. Success requires careful patient selection based on oral health, a suitable donor tooth with partially formed roots, and adequate bone support at the recipient site. The procedure aims to provide esthetic and functional tooth replacement without the need for 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.
This document discusses who needs orthodontic treatment. It provides three main reasons for orthodontic treatment: 1) To improve dental aesthetics, 2) To correct occlusal function, and 3) To eliminate malocclusions that could damage long-term dental health. It examines various types of malocclusions that may benefit from treatment, such as large overjets which increase risk of dental trauma. Indices like IOTN are used to assess orthodontic treatment need based on aesthetics and dental health. Not all irregularities need treatment, and treatment should only be carried out if it provides clear benefit to the patient.
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.
- The most important part of orthodontic treatment is the patient assessment, which includes both extra-oral and intra-oral examinations.
- The extra-oral examination is conducted first and assesses the skeletal pattern, soft tissue form, and presence of habits to determine treatment options.
- Key aspects of the extra-oral examination include evaluating the skeletal pattern in three dimensions, assessing the soft tissue profile, and examining the vertical and transverse dimensions.
- Extractions for orthodontic purposes have always been controversial, as some believe all teeth can be aligned without extractions while others believe extractions are sometimes necessary to treat malocclusions.
- Factors like a patient's medical history, oral hygiene, dental health, and the quality of their teeth affect whether extractions are recommended.
- While premolars are most commonly extracted, other teeth may be extracted depending on the specifics of the malocclusion and what is needed to achieve the best possible alignment and occlusion.
This document summarizes several journal articles related to sensors for managing xerostomia or dry mouth in patients with maxillofacial prostheses. The first article describes a new technique for fabricating a dental prosthesis with an embedded sensor that detects dry mouth and releases artificial saliva in response. Subsequent articles evaluate different types of sensors for measuring tongue pressure and oral moisture levels, and explore relationships between oral dryness and medical treatments like radiation therapy. The final article discusses the development of a 3D printed sensor for selectively detecting ammonium ions in artificial saliva mixtures.
This document provides an overview of maxillofacial prosthetics. It begins with classifications of maxillofacial prostheses and indications for their use. Common techniques are described, including removable and fixed prostheses. Defects are classified based on etiology such as congenital, developmental, or acquired. Prostheses are also classified as intraoral, extraoral, or combined. Materials and fabrication techniques are discussed. The document provides context and definitions for maxillofacial prosthetics.
This document discusses impacted and unerupted maxillary incisors. It provides information on prevalence, causes such as supernumerary teeth or odontomes, and classifications of delayed eruption. For management, it recommends examining patient history, radiographs, and surgical exposure techniques. Surgical exposure can be open, involve an apically repositioned flap, or use a closed eruption procedure. Factors like position, angulation, and amount of attached gingiva determine the best exposure technique. Orthodontic treatment may involve space creation, surgical exposure with orthodontic alignment, or tooth removal and space management. Complications of orthodontic treatment include relapse, non-compliance, root resorption,
The management of congenitally missing lateral incisors h rosenbergnatalie_archer
The document discusses several treatment options for managing congenitally missing lateral incisors including canine substitution, tooth-supported restorations, and single tooth implants. It provides criteria for determining the appropriate treatment including the patient's malocclusion, facial profile, characteristics of the canine tooth, and gingival display. The ideal treatment is considered the most conservative option that satisfies individual esthetic and functional needs.
This document provides an overview of developmental disturbances that can affect the oral and maxillofacial region, including teeth, soft tissues, and bone. It discusses disorders related to the number, size, shape, and structure of teeth which can be due to genetic and environmental factors. Specific conditions covered include anodontia, supernumerary teeth, micro/macrodontia, impaction, gemination/fusion, dens invaginatus, taurodontism, amelogenesis imperfecta, dentinogenesis imperfecta, and dentin dysplasia. Radiographic and microscopic features are presented along with typical clinical presentations and treatments.
Prevalence of Missing Lateral Incisor Agenesis in an Or¬thodontic Arabs Popul...Abu-Hussein Muhamad
This study examined the prevalence of congenital absence (agenesis) of maxillary lateral incisors in 2,200 orthodontic patients of Arab descent in Israel. The researchers reviewed panoramic radiographs from 2006-2013 and found that 24 patients, or 1.1%, had agenesis of one or both maxillary lateral incisors. Specifically, 13 females (54.2%) and 11 males (45.8%) were missing their lateral incisors. This suggests the prevalence of maxillary lateral incisor agenesis in this population is 1.1%, providing data to compare to other studies on tooth agenesis frequencies.
ESTHETIC MANAGEMENT OF CONGENITALLY MISSING LATERAL INCISORS WITH SINGLE TOOT...Abu-Hussein Muhamad
This document discusses the esthetic management of congenitally missing lateral incisors with single tooth implants. It begins with definitions of hypodontia and discusses prevalence and etiology. Treatment involves an interdisciplinary approach between orthodontics and restorative dentistry. Specifically, the paper describes a case study where osseointegrated implants were used to replace missing maxillary lateral incisors. Key steps included orthodontic space opening, implant placement, and prosthetic restoration. The advantages and disadvantages of the single tooth implant approach are summarized.
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.
This document discusses the correction of excessive spaces (diastemata) between anterior teeth. It begins by explaining that diastemata can distort a pleasing smile but not all need correction, as patient needs and expectations must be considered. It then discusses various treatment options for diastema closure including orthodontics alone or with restorative procedures. Key factors that are important to consider include tooth proportions, gingival esthetics, occlusion, and papilla formation. The goal of treatment is to create harmony between the teeth, gingiva, and smile.
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.
The document discusses how the different dental specialties can collaborate to provide treatment for complex dental cases. It provides several examples:
1. Orthodontics can work with other specialties to treat missing teeth through space closure or opening, depending on factors like buccal occlusion and tooth shape.
2. Traumatized or fractured teeth may require orthodontic extrusion before restorative treatment, and tooth transplantation is sometimes used to replace front teeth.
3. Periodontal problems causing tooth drifting can be addressed through orthodontic realignment once disease is controlled.
4. Orthodontics can be used to improve occlusion and eliminate non-working side interferences, and may close anterior
Maxillary lateral incisors are the second most commonly congenitally missing teeth. When they are missing, orthodontic treatment can either open space to replace the tooth with an implant later, or close the space and substitute the canine. Selecting the best option depends on factors like malocclusion and tooth sizes. For opening space, implants are usually placed after growth is complete, so it is important to monitor eruption and implant site development early. Ankylosed primary molars can also affect future implant placement if not addressed. The orthodontist must consider various factors like age, gender, and tooth development when deciding how to manage congenitally missing teeth and ankylosed primary molars in adolescent patients.
Overview on midline diastema and its unesthetic effects
Presented by : Anamika Thorat
Guided by : Dr. Rehan Khan
Dept. of Pediatric Dentistry
SDDCH PBN
ORTHODONTIC TREATMENT OF PERIODONTALLY DAMAGED TEETH - AN INTERDISCIPLINARY A...Abu-Hussein Muhamad
This document describes an interdisciplinary case involving orthodontic treatment of a patient with periodontal damage. The patient had a deep periodontal pocket and bone loss around tooth 26. Guided tissue regeneration (GTR) and a bone graft were used to regenerate the defect before orthodontic treatment. Orthodontic treatment was then performed to align the teeth. The periodontal therapy and bone regeneration prior to orthodontics helped to improve the periodontal health and allowed for successful orthodontic treatment.
This document discusses various factors to consider when planning dental treatment, including periodontal health, tooth structure, gingival display, and facial proportions. A comprehensive diagnosis is needed to develop an optimal treatment plan. When placing crowns, margins are preferably not subgingival but may need to be for aesthetic reasons, so overhangs should be avoided. Laser crown lengthening can provide a comfortable option for improving aesthetics in front teeth when surgical lengthening alone is insufficient.
This document discusses autotransplantation of teeth in children with mixed dentition. It provides background on the timing of primary and permanent tooth eruption. Autotransplantation involves surgically moving a tooth from one site to another in the same person and can be useful for replacing teeth lost to decay or other issues. Success requires careful patient selection based on oral health, a suitable donor tooth with partially formed roots, and adequate bone support at the recipient site. The procedure aims to provide esthetic and functional tooth replacement without the need for 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.
This document discusses who needs orthodontic treatment. It provides three main reasons for orthodontic treatment: 1) To improve dental aesthetics, 2) To correct occlusal function, and 3) To eliminate malocclusions that could damage long-term dental health. It examines various types of malocclusions that may benefit from treatment, such as large overjets which increase risk of dental trauma. Indices like IOTN are used to assess orthodontic treatment need based on aesthetics and dental health. Not all irregularities need treatment, and treatment should only be carried out if it provides clear benefit to the patient.
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.
- The most important part of orthodontic treatment is the patient assessment, which includes both extra-oral and intra-oral examinations.
- The extra-oral examination is conducted first and assesses the skeletal pattern, soft tissue form, and presence of habits to determine treatment options.
- Key aspects of the extra-oral examination include evaluating the skeletal pattern in three dimensions, assessing the soft tissue profile, and examining the vertical and transverse dimensions.
- Extractions for orthodontic purposes have always been controversial, as some believe all teeth can be aligned without extractions while others believe extractions are sometimes necessary to treat malocclusions.
- Factors like a patient's medical history, oral hygiene, dental health, and the quality of their teeth affect whether extractions are recommended.
- While premolars are most commonly extracted, other teeth may be extracted depending on the specifics of the malocclusion and what is needed to achieve the best possible alignment and occlusion.
This document summarizes several journal articles related to sensors for managing xerostomia or dry mouth in patients with maxillofacial prostheses. The first article describes a new technique for fabricating a dental prosthesis with an embedded sensor that detects dry mouth and releases artificial saliva in response. Subsequent articles evaluate different types of sensors for measuring tongue pressure and oral moisture levels, and explore relationships between oral dryness and medical treatments like radiation therapy. The final article discusses the development of a 3D printed sensor for selectively detecting ammonium ions in artificial saliva mixtures.
This document provides an overview of maxillofacial prosthetics. It begins with classifications of maxillofacial prostheses and indications for their use. Common techniques are described, including removable and fixed prostheses. Defects are classified based on etiology such as congenital, developmental, or acquired. Prostheses are also classified as intraoral, extraoral, or combined. Materials and fabrication techniques are discussed. The document provides context and definitions for maxillofacial prosthetics.
This document discusses impacted and unerupted maxillary incisors. It provides information on prevalence, causes such as supernumerary teeth or odontomes, and classifications of delayed eruption. For management, it recommends examining patient history, radiographs, and surgical exposure techniques. Surgical exposure can be open, involve an apically repositioned flap, or use a closed eruption procedure. Factors like position, angulation, and amount of attached gingiva determine the best exposure technique. Orthodontic treatment may involve space creation, surgical exposure with orthodontic alignment, or tooth removal and space management. Complications of orthodontic treatment include relapse, non-compliance, root resorption,
The management of congenitally missing lateral incisors h rosenbergnatalie_archer
The document discusses several treatment options for managing congenitally missing lateral incisors including canine substitution, tooth-supported restorations, and single tooth implants. It provides criteria for determining the appropriate treatment including the patient's malocclusion, facial profile, characteristics of the canine tooth, and gingival display. The ideal treatment is considered the most conservative option that satisfies individual esthetic and functional needs.
This document provides an overview of developmental disturbances that can affect the oral and maxillofacial region, including teeth, soft tissues, and bone. It discusses disorders related to the number, size, shape, and structure of teeth which can be due to genetic and environmental factors. Specific conditions covered include anodontia, supernumerary teeth, micro/macrodontia, impaction, gemination/fusion, dens invaginatus, taurodontism, amelogenesis imperfecta, dentinogenesis imperfecta, and dentin dysplasia. Radiographic and microscopic features are presented along with typical clinical presentations and treatments.
This document discusses different approaches to treating congenitally missing maxillary lateral incisors, including closing the space, opening the space for implant placement, or no treatment. It focuses on the approach of orthodontically opening the space, outlining various mechanics that can be used such as open coil springs, T-loops, and bonded buttons to properly align and upright surrounding teeth and open the space to the ideal width of 6mm. Maintaining the space with a retainer until implant placement is also addressed.
This document provides details on the anatomy and morphology of the permanent maxillary lateral incisor. It describes the tooth's location in the dental arch, chronology of development, dimensions, morphological features on each surface of the crown and root, as well as how it differs from the maxillary central incisor. Key traits of the lateral incisor include its rectangular crown shape, prominent marginal ridges, deep lingual fossa, and more rounded mesioincisal and distoincisal line angles compared to the central incisor.
Local Factors_Etiology of Malocclusion - Dr. Nabil Al-ZubairNabil Al-Zubair
The document discusses various local factors that can contribute to malocclusion, including anomalies in tooth number, size and position. It covers conditions like hypodontia (missing teeth), supernumerary teeth, early loss of primary teeth, and retained primary teeth. These dental anomalies can impact the developing permanent dentition and cause issues like crowding, spacing, and displacement or rotation of teeth. The early loss of primary teeth in particular may have minimal effects if incisors are lost, but can cause space loss or centerline shifts if canines are prematurely lost.
Anomalies of tooth formation & eruptionTariq Hameed
The document discusses several anomalies and abnormalities that can occur in tooth formation and eruption. Supernumerary teeth are extra teeth that develop in addition to the normal number. Hypodontia is a congenital absence of one or more teeth. Abnormalities can also occur in tooth size, shape, structure and formation. Some examples provided include taurodontism, dens invaginatus, amelogenesis imperfecta and dentin dysplasia. Many conditions are genetic or due to disruptions during tooth development and may require monitoring or treatments like extractions or root canals.
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.
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.
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
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
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.
This case report describes the management and follow-up of two cases of young patients with complicated crown fractures involving the permanent teeth. Both cases were treated with partial pulpotomy using the Cvek technique, which involves amputating 2 mm of the exposed pulp tissue. Resin restoration and reattachment of the tooth fragments were also used. Follow-ups between 6-25 months found both treatments to be successful based on an absence of symptoms, pathology on x-rays, and maintained pulp vitality. Partial pulpotomy is an effective treatment for complicated crown fractures in young teeth that preserves pulp vitality and functions.
This case report discusses the treatment of a patient with congenitally missing upper lateral incisors. There were two treatment options considered: opening the spaces for prosthetic replacement or closing the spaces via canine substitution. The parents chose to close the spaces orthodontically. Fixed appliances were used to retract the canines into the lateral incisor spaces and extract mandibular premolars to relieve crowding. After treatment, the canines were reshaped to resemble lateral incisors. The final result had a Class I occlusion and improved esthetics. The report evaluates considerations for treating missing lateral incisors cases.
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.
This study analyzed the position and angulation of 300 maxillary central incisors using cone beam imaging to provide data to help clinicians achieve good esthetic results for immediate dental implants. The thickness of buccal and palatal bone and apical bone height were measured. Incisors were classified according to their position (buccal, midline, palatal) and angulation (toward buccal, anterior to A point, parallel to alveolus). Most incisors were positioned buccally. Recommendations for implant placement based on tooth classification aim to maintain adequate buccal bone thickness and prevent complications.
Orthodontic correction prior to autotransplantation of impacted permanent max...Fa Nasir
1) The patient, a 19-year-old Malay male, was missing his upper left lateral incisor and canine which were impacted.
2) Orthodontic treatment using fixed appliances was used to correct crowding, spacing issues, and midline shift to create room for transplantation of the impacted teeth.
3) Autotransplantation of the impacted lateral incisor and canine was selected as the treatment approach and deemed to be a good alternative to prosthodontics given the patient's age.
The management of impacted canines is important in terms of esthetics and function. Clinicians must formulate treatment plans that are in the best interest of the patient and they must be knowledgeable about the variety of treatment options. When patients are evaluated and treated properly, clinicians can reduce the frequency of ectopic eruption and subsequent impaction of the maxillary canine. The simplest interceptive procedure that can be used to prevent impaction of permanent canines is the timely extraction of the primary canines. This procedure usually allows the permanent canines to become upright and erupt properly into the dental arch, provided sufficient space is available to accommodate them. In the present article, an overview of the incidence and sequelae, as well as the surgical, periodontal, and orthodontic considerations in the management of impacted canines is presented.
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.
The main purpose of our study is to present the corrective movement of impacted canines using various surgical-orthodontic techniques Materials and method: 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. For this study we used only the batch of patients who presented upper impacted canine. Depending on the clinical status, we used the following surgical techniques: repositioned flap, gingival translation flap, window flap method and local mesh application. After surgery for 39 patients we considered that canine traction with an orthodontic device was necessary in order to obtain a vertical position of the teeth. The orthodontic systems used were: fixed orthodontics, with a Titanium Button with chain by Watted (Dentaurum). Results and discussion: We used the repositioned flap for 39patients with deep impacted canines in order to uncover the teeth and to bond an auxiliary orthodontic device, the gingival translation flap for 27 patients with superficial impacted canines: 10cases with apical translation and 2 with lateral and apical translation. The window flap was used for 22 patients with palatal impaction. After surgery all patients continued orthodontic treatment in order to correct every dental malposition and to obtain a neutral occlusion with esthetical, functional and stabile results.
2007 daher tratamiento no quirurgico en un adulto con clase iiimarangelroque
This case report describes the nonsurgical treatment of a 43-year-old man with a Class III malocclusion. Treatment options included orthognathic surgery, nonextraction treatment, premolar extractions, and mandibular incisor extraction. The patient opted for nonsurgical treatment, which included maxillary expansion and extraction of a mandibular central incisor. Over 2 years of treatment with braces and a facemask, the crossbite was corrected and a good occlusion with normal overjet and overbite was achieved through advancement of the maxilla and retraction of the mandibular incisors.
2007 daher tratamiento no quirurgico en un adulto con clase iiimarangelroque
This case report describes the nonsurgical treatment of a 43-year-old man with a Class III malocclusion and crossbite. Treatment options included orthognathic surgery, nonextraction treatment, premolar extractions, and mandibular incisor extraction. The patient opted for nonsurgical treatment, which included maxillary expansion and extraction of a mandibular central incisor. Over 2 years of treatment with braces and a facemask, the crossbite was corrected and a good occlusion was achieved without the need for surgery.
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
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
Fixed and removable orthodontic appliance application for class III malocclus...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.
An Interdisciplinary Approach for Improved Esthetic Results in the Anterior M...Abu-Hussein Muhamad
This document describes a case study of an interdisciplinary approach used to treat a maxillary midline diastema. A 42-year-old woman presented with uneven spaces between her front maxillary teeth, asymmetrical tooth positioning, and malocclusion. An evaluation determined tooth size discrepancies and improper clinical crown lengths were contributing factors. The treatment plan involved initial orthodontic treatment using brackets and springs to align the teeth. This was followed by porcelain laminate veneers to further improve esthetics. The veneers required only minimal tooth preparation and provided conservative, esthetic results. Through this coordinated orthodontic and restorative approach, the interdental spaces were closed and a pleasing smile was achieved to satisfy
Similar to Two Treatment Approaches for Missing Maxillary Lateral Incisors: A Case (20)
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.
This document provides guidance on how to write and publish a scientific paper in 3 steps:
1. Plan adequate time for writing a high-quality paper that will be accepted for publication. Previous studies show lack of time is the top reason papers are not published.
2. Carefully review the instructions for authors on the target journal's website and adhere strictly to formatting requirements. Ignoring guidelines is a common reason for rejection.
3. The paper should have key sections - an informative abstract, introduction establishing the study's purpose and novelty, thorough methods section, clear results, and conclusions tying it all together. Following best practices increases the chances of successful publication.
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.
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
“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.
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.
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5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
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Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
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Mercurius is named after the roman god mercurius, the god of trade and science. The planet mercurius is named after the same god. Mercurius is sometimes called hydrargyrum, means ‘watery silver’. Its shine and colour are very similar to silver, but mercury is a fluid at room temperatures. The name quick silver is a translation of hydrargyrum, where the word quick describes its tendency to scatter away in all directions.
The droplets have a tendency to conglomerate to one big mass, but on being shaken they fall apart into countless little droplets again. It is used to ignite explosives, like mercury fulminate, the explosive character is one of its general themes.
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In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
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Two Treatment Approaches for Missing Maxillary Lateral Incisors: A Case
1. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 15, Issue 7 Ver. VIII (July. 2016), PP 78-85
www.iosrjournals.org
DOI: 10.9790/0853-150787885 www.iosrjournals.org 78 | Page
Two Treatment Approaches for Missing Maxillary Lateral
Incisors: A Case
Abdulgani Mai*, Abdulgani Azzaldeen, Watted Nezar,Abu-Hussein Muhamad
Abstract
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.
Keywords: Dental implant, lateral incisor, case report.
I. Introduction
Dental agenesis is defined as congenital absence of one or more teeth in primary or permanent
dentition. It is also known as hypodontia and is one of the most frequently encountered of all oral variation that
affects a large population. [1]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.[1,2,3]
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.
Missing maxillary lateral incisors create an esthetic problem with specific orthodontic and prosthetic
considerations. Dental implants are commonly used to replace congenitally missing lateral incisors in young
orthodontic patients . [1,2,3,4]However, an interdisciplinary approach should be observed during the
diagnosis,prognosis, and treatment plan to provide a result with good predictability, reaching the esthetic and
functional expectations of the patient .[1]
In population studies, the most commonly missing tooth, excluding third molars, is the mandibular
second premolar followed by the maxillary lateral incisor . [5]There is a range of reported values for prevalence
of hypodontia due to heterogeneous study designs: sample size, gender distribution of sample, records used to
determine missing teeth and geographic differences reflecting ethnically distinct populations. A meta-analysis
revealed that dental agenesis is 1.37 times more common in females than males . [5]The prevalence of missing
maxillary lateral incisors ranges from 0.95% in an American Caucasian sample to 2% in an Icelandic sample .
A meta-analysis of ten studies, totaling 48274 subjects, found the prevalence of missing maxillary lateral
incisors to be 1.6% . Orthodontists can expect a greater percentage of their patients to present with the chief
complaint of missing maxillary lateral incisors. In one sample of orthodontic patients, missing teeth more
commonly occurred in the maxilla with the maxillary lateral incisors cited to be the most commonly missing
teeth .[5,6] This is likely related to the heightened awareness of the esthetic problem of a missing tooth in the
maxillary anterior region.[6,7]
Dental agenesis has been attributed to genetic and environmental factors. The genetic background is
involved in the majority of cases. In fact, the expression of more than 200 genes is responsible for tooth
development, so a mutation in any of these can arrest this process. Familiar dental agenesis may be inherited in
an autosomal (dominant or recessive) or X-linked (dominant or recessive) pattern. Moreover, both the genotype
and phenotype of dental agenesis, in general, present heterogeneity.39 To date, only the cases of severe dental
agenesis with dominant inheritance and syndromic dental agenesis with recessive inheritance are well known as
the result of specific genetic defects.39 The most common types of dental agenesis maxillary lateral incisors and
premolars are merely identified.[3.8,9]
Brook [10] suggests that most cases of hypodontia have a polygenetic inheritance pattern and that the
risk of relatives having hypodontia will depend on a combination of numerous genetic and environmental
factors. As well as the familial nature of hypodontia, it often presents as an isolated diagnosis with no detectable
family history, which suggests it can occur as a result of a spontaneous genetic mutation. Hypodontia has also
been associated with cleft lip and palate usually localized to the maxillary lateral incisor in the line of the
alveolar cleft. [11.12]
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DOI: 10.9790/0853-150787885 www.iosrjournals.org 79 | Page
Fig.1a-c ;Pretreatment buccal views showed (A) root convergence, (B) a difference in clinical appearance of the
left lateral, and (C) significant crestal width of keratinized tissue.
Hypodontia creates significant challenges to the clinicians in both diagnosis and management.
Comprehensive management often requires a multidisciplinary approach.[12.13,14[
There are different treatment alternatives for patients with a missing lateral incisor because of
congenital reasons . Esthetic and functional problems can arise when an orthodontic space closure is realized
and the canine is moved into the missing lateral incisor’s space.[12.13.14.15]
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.
II. 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. Fig.1a-c
Fig. 2a; After orthodontic therapy, the radiograph did not provide enough diagnostic information to determine if
implants could be placed
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Fig. 2b; Pretreatment radiographs revealed convergent roots for the right canine and right central
The patient is a 17-year-old Arab Israeli girl. Presenting complaints are localized spacing and tilting of
upper canines. She has no previous orthodontic treatment history. The pretreatment extra oral photographs show
a concave facial profile (Fig. 1a-c). The intraoral examination showed a Class I molar relationship of 46 and
Class II molar relationship of 36. All permanent teeth were erupted except maxillary lateral incisors (12 and 22).
Both maxillary canines (13 and 23) had tilted mesially creating spaces distally . 11 was in single tooth crossbite
and a reduced overbite of the 21 was identified. On radiographic examination, 12 and 22 were absent and the
roots of maxillary canines were present distally whereas only crowns were tipped mesially towards 11 and 21
respectively (Fig.2). The inclination of the maxillary incisors was normal, but the mandibular incisors showed a
lingual inclination (Fig. 2a-b). Soft tissue analysis showed protrusive lower lip.
Fig 3a-c; Before implant surgery, the orthodontic brackets were removed, revealing (A) the position of the
centrals, and (B, C) the anatomical variations of the crestal tissue and lack of interdental papilla
Treatment Progress
Orthodontic Part
Conventional fixed appliance (0.022 X 0.028 in) slot were first placed in upper arch and leveling
alignment was started by 0.012 NiTi. Then 0.016 NiTi, 017 X 024 NiTi and 018 SS were installed sequentially.
0.016 NiTi, 0.018 NiTi, 0.017 X 0.025 NiTi, and 018 SS were installed in lower arch chronologically. Crossbite
was corrected using fixed orthodontic treatment. The mesially tilted maxillary canines were aligned distally to
create spaces for maxillary lateral incisors. The canines and central incisors were aligned in the dental arch.
(Fig. 1a-c,Fig .3a-c)
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DOI: 10.9790/0853-150787885 www.iosrjournals.org 81 | Page
Surgical Part
After 15 months of orthodontic treatment, exact locations for surgical implant placement were
determined by CBCT 3-D positioning system. 11,5mm implant for 11 and 13mm implant for 21, were placed.
The temporary crowns were inserted while waiting for the healing process. Fig.4.5
Fig.4; A surgical template was derived from the final treatment plan created in the software, which facilitated
(A) the drilling sequence and (B) precise location of placement
Prosthodontic Part
Temporary prostheses were inserted to maintain and prevent vertical space loss of final crown. Final
prostheses were inserted after six months of surgery for the optimal osseointegration and Vacuum form clear
retainer were initially fabricated. Then passive Hawley’s retainers were given for maintenance of final finishing.
Fig. 6,7
Fig.5; After the osteotomies were completed, the implants were placed.
Treatment Results
Post-treatment visit confirmed that patient’s complaints had been addressed. Teeth were esthetically
pleasing. Upper and lower arches were well aligned (Fig.3). Appropriate distallization of canines created spaces
required for implantation of missing maxillary lateral incisors. Posterior occlusion had good overall
intercuspation and was well settled in a Class I molar relationship. Crossbite of mandibular central incisor had
been corrected after which normal overjet and overbite were achieved. Upper and lower dental midlines were
coincident with facial midline. Fig. 7,8
Fig.6; The patient- abutments were placed
5. Two Treatment Approaches For Missing Maxillary Lateral Incisors: A Case
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III. Discussion
Agenesis of teeth can be due to genetic or environmental factors. In non syndromic agenesis, gene
mutations are said to be the cause. The mutations in genes responsible for tooth development are marked as
PAX9, MSX1, and AXIN2.11 Among these, MSX1 is usually related to congenitally missing third molars,
second premolars, maxillary first premolar and incisors.[3,8]
A variety of esthetic problems are associated with maxillary lateral incisor agenesis. This includes
median diastema, spacing between permanent incisor and canine, mesial migration of canines, midline shift in
case of unilateral missing tooth.[1,2] Over-retention of maxillary deciduous lateral incisor and canine,
ectopically erupted canines, absence of canine eminence, asymmetric loss of primary teeth, dental asymmetries
are significant apparent factors that are useful for diagnosing the entity.
Confirmed diagnosis of a missing tooth requires radiograph like periapical view or an OPG. Among them,
tomography is the most reliable method for diagnosing congenitally missing teeth.[1.2,6.9]
Management of missing maxillary lateral incisors is challenging process for re-establishment of esthetics and
function of the affected individuals. The most appropriate approaches as reported in the literature namingly are
i) Regaining of space by orthodontic therapy ii) Autotransplantaion of premolars iii) Orthodontic space
closure.[9,12]
1) Regaining of space by orthodontic therapy: this approach is aimed to provide adequate space for
replacement of missing tooth. Space opening can be achieved by closing the midline diastema and
retracting the ectopically erupted canines. The amount of space required can be determined by application
of golden proportions, measuring the Bolton discrepancy and the missing lateral incisor is then replaced to
the best of its esthetic and functional demand using a variety of alternatives as per patients choice and
socioeconomic status. These include removable denture, fixed cantilever bridge, fiber reinforced composite
fixed partial dentures, resin bonded fixtures, or by implant supported restoration.
2) Autotransplantaion of premolars: Autotransplantaion of premolars at maxillary lateral incisor position is
suggested when 2/3rd root of premolar roots have developed so that autotransplanted teeth can achieve
functional adjustment. The success rates of autotransplantaion range from 79-90% as reported in the
literature. After three months of successful autotransplantaion, the crown of premolar is modified to bear a
resemblance with the maxillary lateral incisor both esthetically and functionally.
3) Orthodontic space closure: It is best indicated for patients presenting a class II malocclusion with
noncrowded lower arch, class I malocclusion with sever crowded upper lower arches where extractions are
required and in cases where upper anterior teeth are proclined. This approach involves orthodontics space
closure by moving the canines to missing lateral incisor place and making contact with central incisors.
After orthodontic space closure, the crowns of canine and premolars are modified to take esthetic and
functional semblance of lateral incisor. This approach also has an advantage that normal gingival and
alveolar bone architecture can be maintained by mesial movement of teeth into the available space,
prosthetic replacement can be avoided and possibility of third molar impaction is also decreased
However, following this method would result in anterior group functioning during lateral excursions
instead of canine guided occlusion. This occlusal scheme is also acceptable and considered stable by several
school of thoughts .[1,2,4, 6]
Fig.7; The final restorations are indistinguishable from the surrounding dentition, demonstrating good
emergence and re-creation of the interdental papillae
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Each one has its own indications, advantages and disadvantages. Osseointegrated implants may be used
to restore single unit spaces including the congenitally missing maxillary lateral incisor. However, implants are
not indicated in patients for whom a potential for further growth exists since an implant, which does not have
periodontal ligament, cannot erupt and keep pace with dentoalveolar development . Single tooth implants are
likely to be of most use in the adult patients.[1,2,9] Patient selection should be considered carefully keeping in
mind oral hygiene socio-economic background and ability of patient to follow maintenance instructions. The
importance of early diagnosis of missing teeth should not be forgotten, so that a multidisciplinary approach can
be established at an early stage. Preparatory orthodontic treatment may be needed to align teeth, create adequate
space in addition to establish an optimal axial inclination of the teeth adjacent to the proposed implant site. With
proper patient selection and diagnosis, understanding of occlusion, effective communication among operators
and attention to detail, the single tooth restoration can be a predictable esthetic and longlasting restorations .In
this case, alveolar bone was available in maxillary lateral incisor areas in the mesiodistal and coronoapical
dimension; however, there was deficiency in orofacial dimension.[1,2,4, 6.7,9]
Fig.8; The final radiograph confirmed the fit of the abutment-implant-crown interfaces
Implants are commonly used to replace congenitally missing lateral incisors in adolescent orthodontic
patients. However, these restorations are often challenging for the orthodontist, surgeon, and restorative dentist.
In some patients the space across the alveolar crest is too narrow to permit the surgeon to place the implant.
Occasionally the root apices of the adjacent central incisor and canine are in close proximity. In other cases the
ridge thickness could be inadequate and require augmentation. When the orthodontist opens the space, the
papilla heights are adversely affected. Some adolescent patients have altered passive eruption after orthodontic
treatment, which affects the level of the gingivalmargins.[10,11,12,13,14]
For patients with congenitally missing lateral incisors, in addition to over-retained primary teeth,
permanent canines may erupt or drift mesially into the edentulous space. If the space is to be opened
orthodontically for ideal prosthesis, the canines vb will need to be moved distally, which may result in
development of the alveolar ridge in the canine region [ 15,16,17,18]]. In cases where the occlusion and
esthetics of the canine in the lateral position are acceptable, closure of the lateral space by the mesially
positioned canine may be the simplest alternative treatment option.However, in all the above congenital missing
cases we considered space opening followed by fixed prosthesis would be more acceptable on aesthetic point of
view [19,20,21]. Esthetics as well as occlusion must be considered in the final orthodontic positioning of the
teeth adjacent to the edentulous space. To satisfy the "golden proportion" principle of esthetics, the space for the
maxillary lateral incisor should be approximately two-thirds of the width of the central incisor.[9] However, if
the patient is missing only one maxillary lateral incisor, the space required to achieve symmetrical esthetics and
occlusion is primarily dictated by the width of the contralateral incisor [22]. The optimal time for placement of
fixed prosthesis is after the growth of the maxilla, mandible and alveolus is complete. If fixed prosthesis/implant
are placed before growth is complete, the surrounding alveolar bone may continue to develop vertically and
adjacent teeth may continue to erupt. Thus a discrepancy between the gingival margins of the prosthesis and the
natural teeth is created and the prosthesis appears to became submerged. This creates a functional as well as an
esthetic problem [23].
In this case, alveolar bone was available in maxillary lateral incisor areas in the mesiodistal and
coronoapical dimen-sion; however, there was deficiency in orofacial dimension. The patient was refused to have
bone augmentation procedures using either autogenic or synthetic bone grafts because of financial and patient
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related factors . Therefore, implants with 3 mm diameter were used to compensate for horizontal alveolar bone
deficiency. However, to avoid labial fenestration, the implants had to be placed off axis in labial direction. The
relationship of the position between the implant and the proposed restoration should be based on the position of
the implant shoulder, since it will influence the final hard and soft tissue response . The malposition of the
implant shoulder in the coronoapical direction causes soft tissue recession. In this case, location of the implant
shoulders was in coronoapical and mesiodistal dimension in comfort zone. However, in the orofacial dimension
the implant shoulders were in danger zone . The angulation of implants in labial direction was compensated
using angled abutments that were prepared for better emergence profile of the ceramic crowns. Many authors
have also concluded that angled abutments may be considered a suitable restorative option when implants are
not placed in ideal axial positions. Nevertheless, forces applied off axis may be expected to overload the bone
surrounding single-tooth implants, as shown by Papavasiliou et al using finite element analysis. Hence, the
segmental osteotomy may provide an alternative treatment to reposition the severely malposed implants.[25]
Finally, questions commonly arise regarding the appropriate age for implant placement in these young patients.
If not addressed, these issues could compromise the aesthetics of the implant restoration . From an aesthetic and
functional point of view such patients need a combination of orthodontic, prosthetic and restorative care.
In this case, the use of a simple vacuum formed surgical guide template was found to be very cost effective and
accurate for the implant placement.[1,9]
The decision to open or to close absent maxillary lateral incisor spaces remains a challenging task for
most orthodontists. The clinician must balance the advantage of avoiding long-term restorations with the
esthetic limitations imposed by using canines as lateral incisor substitutes. All efforts from the professionals
involved should focus on minimizing the treatment margin of error by developing good coordination among the
multidisciplinary team members, capitalizing on their experience, and consequently achieving an individualized
treatment plan that efficiently meets the patient’s expectations.
IV. Conclusions
Maxillary lateral incisor is among one of the most common congenitally missing teeth that occurs
either due to genetic or environmental disturbances. Management of missing lateral incisors is a challenging and
complex process that involves a multidisciplinary approach in order to restore the esthetics and function.
Emphasis on early diagnosis with a team consultation followed by a timely planned and
well executed inter-disciplinary treatment plan is the ultimate solution for such complex cases.
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