Tooth avulsion, or the complete displacement of a tooth from its socket, is a serious dental injury that can lead to complications if not treated properly. The patient, a 13-year-old girl, had her two front teeth avulsed after a bicycle accident. Her teeth were replanted but later became mobile and were extracted. Dental implants were placed but required soft tissue grafting due to insufficient bone and tissue. Pink porcelain crowns were ultimately used to improve esthetics. Dental hygienists play an important role in educating patients on proper oral hygiene to promote the long-term success of replanted or implanted teeth.
THE ART AND SCIENCE OF TREATMENT PLANNING ON ORTHODONTIC EXTRUSIONAbu-Hussein Muhamad
Traumatized anterior teeth with subgingival fractures of crown are a challenge to treat. This paper reports the man¬agement of subgingival fractures of crown of the maxillary central incisor in an 29 year old female. The technique described here involves the use of fixed appliance, post and core with a loop fabricated on it for retention of fixed appliance.
Keywords: Fracture, Tooth, Root Extrusion, Crown Fracture.
Pre-Prosthetic Orthodontic Implant for Management of Congenitally Unerupted L...Abu-Hussein Muhamad
The maxillary lateral incisor is one of the most common congenitally missing teeth of the permanent
dentition. With the advent of implants in the field of restorative dentistry, a stable and predictable fixed
prosthetic replacement has become a reality, especially for young adult patients who suffer from congenital
absence of teeth. The dual goals of establishment of functional stability as well as enhancement of esthetic
outcomes are made achievable by the placement of implants. A multidisciplinary team approach involving the
triad of orthodontist, periodontist and restorative dentist will ensure the successful completion of the integrated
treatment approach in these patients. The present case report achieved successful implant based oral
rehabilitation in a patient diagnosed with congenital absence of bilateral maxillary lateral incisors utilizing a
preprosthetic orthodontic implant site preparation for the purpose of space gain.
Keywords: Preprosthetic, interdisciplinary treatment, implant placement
The document discusses treatment options for untreatable traumatized anterior maxillary teeth in young patients to preserve the alveolar ridge for future dental implants. It notes that dental implants are contraindicated during childhood, requiring a 8-10 year waiting period for growth to cease. For future implants, it is essential to ensure continuous growth of the alveolar process in width and height from time of injury until skeletal maturity. Some treatment options discussed to achieve this include orthodontic extrusion of the root remnant with a temporary crown, autogenous tooth transplantation, and maintaining ankylosed teeth in place to prevent ridge resorption and space closure. The goal is to preserve the alveolar ridge until after skeletal maturity
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
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.
Pre prosthetic orthodontic implant for management of congenitally unerupted l...Abu-Hussein Muhamad
The maxillary lateral incisor is one of the most common congenitally missing teeth of the permanent dentition. With the advent of implants in the field of restorative dentistry, a stable and predictable fixed prosthetic replacement has become a reality, especially for young adult patients who suffer from congenital absence of teeth. The dual goals of establishment of functional stability as well as enhancement of esthetic outcomes are made achievable by the placement of implants. A multidisciplinary team approach involving the triad of orthodontist, periodontist and restorative dentist will ensure the successful completion of the integrated treatment approach in these patients. The present case report achieved successful implant based oral rehabilitation in a patient diagnosed with congenital absence of bilateral maxillary lateral incisors utilizing a preprosthetic orthodontic implant site preparation for the purpose of space gain.
This study evaluated 14 cases of autogenous maxillary canine transplantation in young patients. Impacted or partially erupted maxillary canines were extracted and immediately transplanted to prepared recipient sites. Two years later, 12 cases showed normal mobility and lamina dura formation on radiographs, indicating successful transplantation. Two cases showed inflammatory resorption, increased mobility, and widening of the periodontal space, indicating unsuccessful transplantation. Autotransplantation of impacted or partially erupted maxillary canines can be a viable alternative to other treatments like orthodontics or dental implants when patient selection criteria are met and proper surgical technique is followed.
Tooth avulsion, or the complete displacement of a tooth from its socket, is a serious dental injury that can lead to complications if not treated properly. The patient, a 13-year-old girl, had her two front teeth avulsed after a bicycle accident. Her teeth were replanted but later became mobile and were extracted. Dental implants were placed but required soft tissue grafting due to insufficient bone and tissue. Pink porcelain crowns were ultimately used to improve esthetics. Dental hygienists play an important role in educating patients on proper oral hygiene to promote the long-term success of replanted or implanted teeth.
THE ART AND SCIENCE OF TREATMENT PLANNING ON ORTHODONTIC EXTRUSIONAbu-Hussein Muhamad
Traumatized anterior teeth with subgingival fractures of crown are a challenge to treat. This paper reports the man¬agement of subgingival fractures of crown of the maxillary central incisor in an 29 year old female. The technique described here involves the use of fixed appliance, post and core with a loop fabricated on it for retention of fixed appliance.
Keywords: Fracture, Tooth, Root Extrusion, Crown Fracture.
Pre-Prosthetic Orthodontic Implant for Management of Congenitally Unerupted L...Abu-Hussein Muhamad
The maxillary lateral incisor is one of the most common congenitally missing teeth of the permanent
dentition. With the advent of implants in the field of restorative dentistry, a stable and predictable fixed
prosthetic replacement has become a reality, especially for young adult patients who suffer from congenital
absence of teeth. The dual goals of establishment of functional stability as well as enhancement of esthetic
outcomes are made achievable by the placement of implants. A multidisciplinary team approach involving the
triad of orthodontist, periodontist and restorative dentist will ensure the successful completion of the integrated
treatment approach in these patients. The present case report achieved successful implant based oral
rehabilitation in a patient diagnosed with congenital absence of bilateral maxillary lateral incisors utilizing a
preprosthetic orthodontic implant site preparation for the purpose of space gain.
Keywords: Preprosthetic, interdisciplinary treatment, implant placement
The document discusses treatment options for untreatable traumatized anterior maxillary teeth in young patients to preserve the alveolar ridge for future dental implants. It notes that dental implants are contraindicated during childhood, requiring a 8-10 year waiting period for growth to cease. For future implants, it is essential to ensure continuous growth of the alveolar process in width and height from time of injury until skeletal maturity. Some treatment options discussed to achieve this include orthodontic extrusion of the root remnant with a temporary crown, autogenous tooth transplantation, and maintaining ankylosed teeth in place to prevent ridge resorption and space closure. The goal is to preserve the alveolar ridge until after skeletal maturity
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
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.
Pre prosthetic orthodontic implant for management of congenitally unerupted l...Abu-Hussein Muhamad
The maxillary lateral incisor is one of the most common congenitally missing teeth of the permanent dentition. With the advent of implants in the field of restorative dentistry, a stable and predictable fixed prosthetic replacement has become a reality, especially for young adult patients who suffer from congenital absence of teeth. The dual goals of establishment of functional stability as well as enhancement of esthetic outcomes are made achievable by the placement of implants. A multidisciplinary team approach involving the triad of orthodontist, periodontist and restorative dentist will ensure the successful completion of the integrated treatment approach in these patients. The present case report achieved successful implant based oral rehabilitation in a patient diagnosed with congenital absence of bilateral maxillary lateral incisors utilizing a preprosthetic orthodontic implant site preparation for the purpose of space gain.
This study evaluated 14 cases of autogenous maxillary canine transplantation in young patients. Impacted or partially erupted maxillary canines were extracted and immediately transplanted to prepared recipient sites. Two years later, 12 cases showed normal mobility and lamina dura formation on radiographs, indicating successful transplantation. Two cases showed inflammatory resorption, increased mobility, and widening of the periodontal space, indicating unsuccessful transplantation. Autotransplantation of impacted or partially erupted maxillary canines can be a viable alternative to other treatments like orthodontics or dental implants when patient selection criteria are met and proper surgical technique is followed.
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 single complete dentures that oppose natural teeth or existing prostheses. It defines a single complete denture and notes the increased difficulty of rehabilitating patients with these dentures due to heavy occlusal forces. Various techniques are presented for modifying the occlusal pattern of opposing teeth, including Swenson's method and Bruce's method. The use of implants to support single dentures is also discussed. Potential complications like tooth wear and denture fracture are covered. The document concludes with two case reports demonstrating the treatment of patients with single complete dentures.
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.
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 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
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. The available treatment modalities to replace congenitally missing teeth include prosthodontic fixed and removable prostheses, resin bonded retainers, orthodontic movement of maxillary canine to the lateral incisor site and single tooth implants. Implants are a viable option for replacement of congenitally missing lateral incisors and should be considered before the commencement of definitive treatment plan. Early diagnosis, and proper planning can achieve excellent aesthetics.
Interdisciplinary treatment plays a vital role to achieve an excellent, esthetic result for a most predictable outcome. This article aims to present a case report of replacement of bilaterally ,congenitally missing maxillary lateral incisors with dental implants .
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.
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. The available treatment modalities to replace congenitally missing teeth include prosthodontic fixed and removable prostheses, resin bonded retainers, orthodontic movement of maxillary canine to the lateral incisor site and single tooth implants. Implants are a viable option for replacement of congenitally missing lateral incisors and should be considered before the commencement of definitive treatment plan. Early diagnosis, and proper planning can achieve excellent aesthetics. Interdisciplinary treatment plays a vital role to achieve an excellent, esthetic result for a most predictable outcome. This article aims to present a case report of replacement of bilaterally ,congenitally missing maxillary lateral incisors with dental implants .
This document discusses autotransplantation of teeth in children. Autotransplantation involves surgically moving a tooth from one location in the mouth to another in the same person. It has achieved high success rates and can be an option for replacing missing teeth in children. Factors that influence success include the health of the patient, stage of root development of the donor tooth, and adequate bone and soft tissue support at the recipient site. Autotransplantation may be indicated for missing teeth, premature tooth loss, eruption issues, or other dental problems and can avoid the need for dental implants.
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.
Management of impacted teeth /certified fixed orthodontic courses by Indian d...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
This document discusses the interface between endodontic and orthodontic treatment. It addresses several topics:
1) How orthodontic tooth movement can affect the pulp and cause inflammation, changes in blood flow, and neural responses. Teeth with mature roots or a history of trauma are more at risk.
2) How orthodontic forces can cause root resorption in a small number of patients, particularly of maxillary incisors. Resorption may be similar in root-filled and vital teeth.
3) That endodontically treated teeth can be moved orthodontically similarly to vital teeth, though replacement resorption or injury to tissues could prevent movement. Maintaining the apical seal
This document provides an overview of a case study on immediate dental implantation conducted by Prof. Pavel V. Kuts at the Dental Prosthetics Department of Bogomolets National Medical University in Kiev, Ukraine. The study involved 35 patients who underwent immediate implantation to replace extracted teeth. Bone substitutes were used to augment the alveolar ridge if needed. Temporary and permanent prosthetics were created. Indications for immediate implantation included dental trauma, chronic periodontitis, ineffective treatment of periodontitis, tooth dystopia requiring extraction, and deciduous teeth without permanent successors. The procedure aimed to minimize trauma and preserve bone during extraction and implantation.
Occulasl consideration for implant supported prostehsi /certified fixed ortho...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
occlusal considerations for Implant supported Prosthesis /certified fixed or...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
This case report describes the prosthodontic rehabilitation of a young patient with ectodermal dysplasia over several years using transitional removable dentures and later fixed implant-supported prostheses. Initially, the patient received interim removable partial dentures at age 14 after extraction of mobile deciduous teeth. At age 15, a conventional overdenture was fabricated. At age 18, a tooth- and bar-supported overdenture was made. Finally, at age 21 after osseointegrated implants were placed, a definitive fixed implant-supported prosthesis was fabricated. The patient was satisfied with the final prosthesis both aesthetically and functionally. Delaying fixed implant treatment until adulthood avoided potential growth-related complications.
This document provides an overview of tooth autotransplantation, including:
1) Tooth autotransplantation involves moving a tooth from one position to another within the same person and has a long history dating back to ancient Egypt.
2) Successful transplantation depends on factors like the developmental stage of the donor tooth root, surgical technique, and periodontal ligament healing at the recipient site.
3) Indications for autotransplantation include replacing teeth lost to dental caries, trauma, agenesis or other pathologies when it can maintain alveolar bone and provide esthetic and functional benefits over alternatives.
Occulasl consideration for implant supported prostehsi/ dentistry jobsIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
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.
A Visual Guide to 1 Samuel | A Tale of Two HeartsSteve Thomason
These slides walk through the story of 1 Samuel. Samuel is the last judge of Israel. The people reject God and want a king. Saul is anointed as the first king, but he is not a good king. David, the shepherd boy is anointed and Saul is envious of him. David shows honor while Saul continues to self destruct.
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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 single complete dentures that oppose natural teeth or existing prostheses. It defines a single complete denture and notes the increased difficulty of rehabilitating patients with these dentures due to heavy occlusal forces. Various techniques are presented for modifying the occlusal pattern of opposing teeth, including Swenson's method and Bruce's method. The use of implants to support single dentures is also discussed. Potential complications like tooth wear and denture fracture are covered. The document concludes with two case reports demonstrating the treatment of patients with single complete dentures.
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.
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 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
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. The available treatment modalities to replace congenitally missing teeth include prosthodontic fixed and removable prostheses, resin bonded retainers, orthodontic movement of maxillary canine to the lateral incisor site and single tooth implants. Implants are a viable option for replacement of congenitally missing lateral incisors and should be considered before the commencement of definitive treatment plan. Early diagnosis, and proper planning can achieve excellent aesthetics.
Interdisciplinary treatment plays a vital role to achieve an excellent, esthetic result for a most predictable outcome. This article aims to present a case report of replacement of bilaterally ,congenitally missing maxillary lateral incisors with dental implants .
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.
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. The available treatment modalities to replace congenitally missing teeth include prosthodontic fixed and removable prostheses, resin bonded retainers, orthodontic movement of maxillary canine to the lateral incisor site and single tooth implants. Implants are a viable option for replacement of congenitally missing lateral incisors and should be considered before the commencement of definitive treatment plan. Early diagnosis, and proper planning can achieve excellent aesthetics. Interdisciplinary treatment plays a vital role to achieve an excellent, esthetic result for a most predictable outcome. This article aims to present a case report of replacement of bilaterally ,congenitally missing maxillary lateral incisors with dental implants .
This document discusses autotransplantation of teeth in children. Autotransplantation involves surgically moving a tooth from one location in the mouth to another in the same person. It has achieved high success rates and can be an option for replacing missing teeth in children. Factors that influence success include the health of the patient, stage of root development of the donor tooth, and adequate bone and soft tissue support at the recipient site. Autotransplantation may be indicated for missing teeth, premature tooth loss, eruption issues, or other dental problems and can avoid the need for dental implants.
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.
Management of impacted teeth /certified fixed orthodontic courses by Indian d...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
This document discusses the interface between endodontic and orthodontic treatment. It addresses several topics:
1) How orthodontic tooth movement can affect the pulp and cause inflammation, changes in blood flow, and neural responses. Teeth with mature roots or a history of trauma are more at risk.
2) How orthodontic forces can cause root resorption in a small number of patients, particularly of maxillary incisors. Resorption may be similar in root-filled and vital teeth.
3) That endodontically treated teeth can be moved orthodontically similarly to vital teeth, though replacement resorption or injury to tissues could prevent movement. Maintaining the apical seal
This document provides an overview of a case study on immediate dental implantation conducted by Prof. Pavel V. Kuts at the Dental Prosthetics Department of Bogomolets National Medical University in Kiev, Ukraine. The study involved 35 patients who underwent immediate implantation to replace extracted teeth. Bone substitutes were used to augment the alveolar ridge if needed. Temporary and permanent prosthetics were created. Indications for immediate implantation included dental trauma, chronic periodontitis, ineffective treatment of periodontitis, tooth dystopia requiring extraction, and deciduous teeth without permanent successors. The procedure aimed to minimize trauma and preserve bone during extraction and implantation.
Occulasl consideration for implant supported prostehsi /certified fixed ortho...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
occlusal considerations for Implant supported Prosthesis /certified fixed or...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
This case report describes the prosthodontic rehabilitation of a young patient with ectodermal dysplasia over several years using transitional removable dentures and later fixed implant-supported prostheses. Initially, the patient received interim removable partial dentures at age 14 after extraction of mobile deciduous teeth. At age 15, a conventional overdenture was fabricated. At age 18, a tooth- and bar-supported overdenture was made. Finally, at age 21 after osseointegrated implants were placed, a definitive fixed implant-supported prosthesis was fabricated. The patient was satisfied with the final prosthesis both aesthetically and functionally. Delaying fixed implant treatment until adulthood avoided potential growth-related complications.
This document provides an overview of tooth autotransplantation, including:
1) Tooth autotransplantation involves moving a tooth from one position to another within the same person and has a long history dating back to ancient Egypt.
2) Successful transplantation depends on factors like the developmental stage of the donor tooth root, surgical technique, and periodontal ligament healing at the recipient site.
3) Indications for autotransplantation include replacing teeth lost to dental caries, trauma, agenesis or other pathologies when it can maintain alveolar bone and provide esthetic and functional benefits over alternatives.
Occulasl consideration for implant supported prostehsi/ dentistry jobsIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
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.
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2. 2 Journal of Orthodontics
sound during percussion and lack of physiologic tooth
mobility are the clinical signs that could suggest ankylosis.
These clinical signs are more sensitive and more accurate
than radiographically observable changes associated with
the periodontal ligament width, since the area with ankylo-
sis might be too small to be detected on conventional radio-
graphs or it might be located on the buccal or lingual
surface of the root (Andersson et al., 1984). However,
three-dimensional (3D) imaging modalities might provide
a more reliable diagnostic aid, as it is more probable to
visualise the ankylosis on some of the sections acquired
from several projections around the tooth (Shetty et al.,
2014). Besides, the most definitive sign of ankylosis is the
failure of orthodontic tooth movement of the affected tooth
(Sanu and Isiekwe, 2003).
Several treatment modalities have been proposed for the
management of ankylosed teeth including extraction, surgi-
cal luxation, surgical repositioning, restoration and retention
with or without coronal modifications (Alcan, 2006).
Extraction of an ankylosed tooth is a challenging process, as
it usually results in a large vertical defect and compromises
the final aesthetic outcome, while replacing the tooth with
fixed or removable prosthesis. Although implant-supported
restoration is a viable treatment alternative, soft and hard
tissue augmentations are necessary to achieve the optimum
results; however, the success rate of these augmentations is
not 100% (Dolanmaz et al., 2010). Some authors have tried
to break the fusion by surgical luxation and attempt ortho-
dontic tooth movement. However, the repair process after
surgery might lead to the recurrence of ankylosis (Isaacson
et al., 2001). The conventional way of surgical tooth reposi-
tioning was to surgically replace the tooth to obtain sym-
metrical and pleasing aesthetic results. However, there is
always a high risk of necrosis for a small-replaced segment
due to the compromised blood supply. Furthermore, dishar-
mony in the gingival level may occur as the speed of gingi-
val proliferation might fall behind immediate repositioning
of the tooth. This is especially important in cases where
replacing a single traumatised maxillary incisor is the ulti-
mate goal (Dolanmaz et al., 2010).
Recently the technique of distraction osteogenesis (DO)
has been applied for moving multiple or single ankylosed
teeth (particularly central incisors) (Epker and Paulus,
1978; Im et al., 2010; Isaacson et al., 2001; Kinzinger et al.,
2003; Kofod et al., 2005; Medeiros and Bezerra, 1997) and
also to correct a unilateral open bite caused by multiple
ankylosed teeth (Susami et al., 2006). Bone distraction, ini-
tially introduced in 1905 by Codvilla (Codivilla, 1905) and
further explained by Ilizarov (Ilizarov, 1971), was first used
for the treatment of malformities in the peripheral skeleton.
Since the first report of craniofacial distraction osteogene-
sis by Synder et al. in 1973 (Snyder et al., 1973), it has been
successfully used for the treatment of patients with cleft lip
and palate (Liou et al., 2000) and hemifacial micrososmia
(Huisinga-Fischer et al., 2003).
For single tooth movement, a single tooth osteotomy
would be the primary step, which requires a very fine and
precise surgical procedure. Ultrasonic surgery, also known
as piezo, has been recently introduced in the field of oral
surgery to substitute routine burs with the advantage of
fine and precise cuts, minimising the surgical trauma and
a fast tissue healing response (Vercellotti et al., 2005).
After the surgery, the alveolar segment containing the
tooth needs to be moved to an appropriate position.
Various DO devices have been designed and applied for
this purpose (Alcan, 2006; Dolanmaz et al., 2010;
Kinzinger et al., 2003; Kofod et al., 2005). However, most
of the DO devices are expensive, complicated and uncom-
fortable for the patients, and they would only be promis-
ing if the segment could be moved by the application
of another orthodontic appliance such as different types
of temporary anchorage devices (Papadopoulos and
Tarawneh, 2007).
This case report presented the treatment of a 23-year-
old female patient who had a 4-mm infraoccluded central
incisor due to an ankylosis caused by an old head trauma.
The orthodontic treatment included single tooth distrac-
tion osteogenesis with the aid of miniscrews.
Diagnosis and aetiology
A 23-year-old woman was referred to our Ortho-Perio pri-
vate clinic with the request of replacing an ankylosed
infraoccluded right maxillary central incisor with a dental
implant. By then, several dentists had visited her with differ-
ent treatment plans. The patient’s chief complaint was her
malposed tooth with a higher gingival line relative to the
adjacent teeth, which had resulted in an undesirable appear-
ance. She presented with a history of trauma to her front
teeth seven years previously that had led to enamel fracture
associated with teeth 12 and 11. Gradually, symptoms of
pulpal necrosis had developed associated with tooth number
12 and it had been treated by root canal therapy.
Intraoral examination revealed a discrepancy of 4 mm
between the incisal edges of teeth 11 and 21 with relatively
the same amount of discrepancy between those teeth’s gin-
gival contours. Excessive gingival display was also
observed in her smile, which made the uneven gingiva even
more noticeable (Figure 1).
Tooth number 11 had a metallic sound upon percussion
and the absence of normal physiologic mobility. Tooth 11
was asymptomatic without discoloration or any sensitivity
to percussion and palpation. Pretreatment radiographs are
shown in Figure 2.
When the patient was referred to the orthodontist at our
office, the following were observed. In the frontal view, the
patient had good facial symmetry with proportionate facial
thirds. In the profile view, she had a relatively straight face
with no anteroposterior discrepancy. Intraorally, she had an
3. Saffar Shahroudi and Golmohammadi 3
Angle Class I molar and canine relationship on both the right
and left sides. Mild crowding was observed in both the upper
and lower dental arches and both arches were symmetric and
ovoid in shape. The patient had a 1-mm overjet with a 0.5-
mm overbite in the region of the left central incisors, while
open bite with no overjet existed in the right central incisor
region, which was due to apically and slightly palatally posi-
tioned maxillary right central incisor (Figure 3).
The lateral cephalometric radiograph showed a
skeletal Class I relationship (SNA = 81.2°, SNB = 78.4°,
ANB = 2.8°), slight vertical growth pattern (GoGn-SN =
34.3°), and the upper and lower incisors had a relatively
normal inclination with their apical bases (upper incisor to
palatal plane = 109.3°, lower incisor to mandibular plane
= 91.4°).
Treatment alternatives
Considering the age of the patient and the fact that no more
pronounced vertical alveolar growth was expected, the
Figure 1. The patient’s smile view. The gingival margin and incisal edge discrepancy of central incisors due to an ankylosed right
central incisor.
Figure 2. Pretreatment pre-apical, panoramic and cone beam computed tomography radiographs.
4. 4 Journal of Orthodontics
following treatment alternatives were discussed with the
patient and her parents:
1. Fabricating a crown restoration on the ankylosed
tooth with pink porcelain glazed onto the gingival
portion to compensate uneven gingiva. The patient
was informed that the aesthetic could be compro-
mised since the pink porcelain cannot be exactly the
same as the adjacent gingiva.
2. Resecting the ankylosed tooth surgically and replac-
ing it with a dental implant which would have required
ridge augmentation before the dental implant therapy.
The patient was informed that the result of ridge aug-
mentation surgery is unpredictable.
3. Breaking the fusion between the root of the anky-
losed tooth and the alveolar bone by surgical luxa-
tion and moving the tooth by orthodontic treatment.
This would have been an aggressive procedure with
low probability of success since the area of fusion
might have been too vast. Moreover, there would
have been a risk of root fracture and tooth re-ankylo-
sis during the orthodontic tooth movement.
4. Segmental osteotomy to mobilise the ankylosed
tooth and move the segment by means of a DO
device. This treatment option could have been more
expensive and less precise compared to orthodontic
tooth movement with the aid of the miniscrew treat-
ment option but was considered as the main alterna-
tive treatment for this patient. Finally, the last option
was chosen for the patient.
Treatment objectives
The established treatment objectives for this patient
included: (1) alignment of the maxillary arch excluding
tooth number 11 to facilitate inserting a heavy base arch
wire; (2) diverging the roots of adjacent teeth (teeth 12 and
21) to make enough space for surgical bone incision to pre-
vent any damage to the mentioned teeth’s roots; (3) seg-
mental osteotomy to mobilise the ankylosed tooth with the
surrounding alveolar bone without the elevation of the pal-
atal mucosa; (4) extruding the ankylosed tooth to the level
of adjacent teeth with the aid of two mini-screws inserted in
mandibular alveolar process; (5) realignment and levelling
of the maxillary dental arch to achieve root parallelism and
appropriate overjet and overbite; and (6) correcting the gin-
gival margin of the anterior teeth to improve the smile
aesthetics.
Treatment progress
The result of the endodontic consultation stated that tooth
11 was vital but since the root canal was obliterated there
was no possibility of root canal therapy. However, further
follow-ups were recommended. Fixed orthodontic treat-
ment was initiated by means of pre-adjusted brackets with
0.018 × 0.022 slots on the upper arch only. The reason that
the treatment was confined to the upper arch was the mild
crowding in the lower arch with a perfect posterior occlu-
sion. On the other hand, the patient desired to decrease her
treatment expenses as much as possible.
Figure 3. Pretreatment facial and intraoral photographs.
5. Saffar Shahroudi and Golmohammadi 5
The teeth were aligned by sequential Nickel-Titanium
(NiTi) archwires to facilitate inserting a heavy stainless-
steel base arch. Positioning the brackets of teeth 12 and 21
was done so that their roots became divergent after align-
ment and provided the necessary space for bone cuts. When
a 0.019 × 0.025-inch stainless-steel rectangular archwire
was inserted and enough space was prepared (five months
later), the ankylosed tooth was bonded and two orthodontic
miniscrews (1.4 mm in diameter and 8 mm in length)
(Dual-top Anchor System 20-G2-010; Guro-Gu, Seoul,
Korea) were placed in the mandibular alveolar process
between the roots of teeth 33 and 32 as well as between
teeth 42 and 43; the patient was subsequently referred for a
single-tooth osteotomy.
Surgical procedure
Under local anaesthesia, the mucoperiosteal (or full thick-
ness) flap was elevated after sulcular incisions extending
from tooth 12 to tooth 21 along with two releasing incisions
at the very distal and mesial sites of the surgical area. An
interdental osteotomy line was made using a piezo electric
device (Piezosurgery®, Mectron Medical Technology,
Carasco, Italy) up to the nasal floor (about 1 mm above the
apex of the ankylosed tooth). The osteotomy was com-
pleted with a fine osteotome to ensure the green stick frac-
ture was made. The fractured segment was then mobilised
by keeping the palatal mucosa in place to maintain the
blood supply. Finally, the flaps were closed to achieve pri-
mary closure of the wound site (Figure 4).
After a latency period of four days to allow for callus
formation, active orthodontic treatment was restarted to
distract the alveolar block containing the ankylosed tooth.
A traction force was exerted from the archwire to the den-
toalveolar block by means of an elastomeric chain while
the patient was asked to wear intermaxillary rubber elastics
(two elastics, each exerting an orthodontic force of 75 g
(2.5 oz, 7.95 mm, 0.31 inch) from the adjacent teeth to the
miniscrews to prevent their intrusion. After a few days, the
results indicated that the amount of force might be not suf-
ficient. Therefore, the patient was asked to apply the elas-
tics directly from the miniscrews to the ankylosed tooth
while a 0.014 NiTi overlay was also added. Since the anky-
losed tooth was positioned palatally relative to the adjacent
teeth, a force vector in the buccal direction should have
been added. Thus, a step-out bend was formed on the base
archwire (Figure 5A and B).
The elastics were changed every day and the patient was
checked every two days to monitor the gradual movement
of the dentoalveolar block. On day 15, the tooth reached an
appropriate level relative to the adjacent teeth. The dis-
tracted block was then fixed by being ligated to the base
archwire and the patient was advised not to bite with her
front teeth. The whole process of healing was completed
without any complications associated with the alveolar dis-
traction. After the consolidation phase (10 weeks) was
elapsed, the fixed orthodontic treatment began with reposi-
tioning the brackets of teeth 12 and 21 to achieve ideal root
parallelism. The remaining spaces were closed using an
elastomeric chain (Figure 5C and D). After 12 weeks, when
Figure 4. Surgical procedure for single-tooth osteotomy and mobilisation of the tooth-containing block.
6. 6 Journal of Orthodontics
an ideal alignment and levelling were achieved, the brack-
ets were debonded and a fixed orthodontic retainer was fab-
ricated by a 0.0175-inch multi-stranded wire on the palatal
surface of the six front teeth. Subsequently, gingivoplasty
on the anterior maxillary teeth was performed in order to
achieve harmonious gingival margins.
Treatment results
The post-treatment facial photographs (Figure 6) and radio-
graphs (Figure 7) showed that the vertical discrepancy
between the two maxillary central incisors was completely
corrected and the anterior aesthetics were also improved.
Correct occlusion of the patient was preserved with a Class
I canine and molar relationship on both sides, although the
fixed orthodontic treatment was just bonded on the upper
jaw. The follow-up pictures after four years confirmed sta-
ble results (Figure 8).
Discussion
In this article, the successful treatment of a patient with
ankylosis and infraocclusion of a previously traumatised
maxillary right central incisor was presented. Among dif-
ferent treatment options that had been proposed for an
ankylosed tooth, decoronation is advantageous in prevent-
ing further vertical discrepancy and preserving bone for
future dental implant (Malmgren, 2013). However, in this
case the ankylosis had occurred seven years beforehand
and the vertical discrepancy had already occurred. Thus, in
the case of replacing the tooth by a dental implant, vertical
ridge augmentation was necessary, which is a technically
sensitive procedure with unpredictable outcomes (Mayne
et al., 2017). One alternative procedure is to move the
ankylosed tooth with its surrounding bone by surgery.
Although there are several reports of successful tooth
movement by segmental surgery, there is always a risk of
necrosis when the segment is too small, such as in single-
tooth osteotomy (Dolanmaz et al., 2010). It has been
reported that alveolar DO could be an effective and reliable
method for the reconstruction of alveolar vertical defects
(Chang et al., 2010; Kim et al., 2010; Ohkubo et al., 2011;
Susami et al., 2006). Therefore, it was the treatment option
of choice for our treatment and, consequently, an intraoral
distractor was required. Kinzinger et al. and Alcan applied
bone-born and tooth-born distractors, respectively (Alcan,
2006; Kinzinger et al., 2003). Alcan believed that since a
tooth-born appliance is attached to the tooth and archwire
rather than the bone, it would be easier to insert and remove
it (Alcan, 2006). However, these distractors could only
work in a linear direction while we needed to reposition the
segment three-dimensionally in both the occlusal and labial
directions. There have been few successful reports of dis-
tracting a tooth-containing segment by orthodontic meth-
ods (Dolanmaz et al., 2010; Im et al. 2010; Ohkubo et al.,
2011). Isaacson et al. (2001) applied continuous step bends
in the base archwire after the surgery, which took more than
four weeks for the segment to reach the ideal vertical
Figure 5. Traction forces to move the tooth-containing bone block in the occlusal and labial directions. (A) Miniscrews were
used as indirect anchorage; (B) miniscrews were used as direct anchorage. (C, D) When the ankylosed tooth reached an ideal
position, the remaining spaces were closed using an elastomeric chain.
7. Saffar Shahroudi and Golmohammadi 7
position. However, it is believed that in DO the segment
should be moved with a higher rate to prevent callus forma-
tion (Alcan, 2006). Mayne et al. (2017) applied intra-arch
elastics for vertical extrusion, which resulted in occlusal
movement of the ankylosed segment, but the lower incisors
were extruded and retroclined as a side-effect of those
elastics. Thus, we needed heavier forces along with a more
powerful anchorage. Recently, few studies have applied
temporary anchorage devices for the DO procedure (Im
et al., 2010; Şenışık et al., 2014). Şenışık et al. inserted a
miniscrew in the ankylosed-tooth-containing segment,
since there had been already a severe replacement root
resorption and most of the root structure had been replaced
Figure 8. Photographs at four-year follow-up.
Figure 6. Post-treatment facial and intraoral photographs.
Figure 7. Post-treatment panoramic and lateral
cephalometric radiographs.
8. 8 Journal of Orthodontics
by alveolar bone. Vertical elastics between the miniscrew
and the lower archwire were used in our case (Şenışık et al.,
2014), the root was intact without any noticeable external
resorption, which left little space for inserting a miniscrew
in the mobilised segment. On the other hand, the lower arch
was not supposed to undergo any fixed orthodontic treat-
ment. Accordingly, it was planned to insert two miniscrews
in the alveolar bone of the anterior mandibular arch and a
bracket was bonded on the ankylosed tooth. The selected
mechanism of force application was intra-arch elastics
between the bonded ankylosed tooth and the miniscrews
followed by interarch power chain between the tooth and
the maxillary base archwire.
There are several considerations in the surgical proce-
dure of the segmental osteotomy. The inter-radicular dis-
tance should be at least 2 mm to leave enough bone width
on both sides and maintain a safe distance from adjacent
roots (Bousquet et al., 2016). The precise surgery for fine
osteotomy is best achieved by slim profile ultrasonic tips
(Vercellotti et al., 2005). The cuts should be parallel or
occlusally divergent and the palatal mucosa should remain
intact to insure adequate blood supply.
The DO protocol that was applied in this case was
mostly according to a study by Kofod et al. (2005) in which
the surgery is followed by a latency period. The duration of
this phase was different in the literature and is in the range
of 0–14 days (Alcan, 2006; Bousquet et al., 2016; Isaacson
et al., 2001). Bousquet et al. started the distraction immedi-
ately after surgery, believing that it would be helpful when
orthodontic force was applied rather than distractors
(Bousquet et al., 2016). Isaacson et al. and Alcan waited for
two weeks and one week, respectively (Alcan, 2006;
Isaacson et al., 2001). Based on the contemporary DO pro-
tocol, we chose a period of four days (Kofod et al., 2005).
According to similar studies, a force of approximately 600
gr was exerted by intraoral elastics and it was gradually
increased by adding an interarch power chain from the
tooth to the step-down bend of the archwire regarding the
fact that the force exerted on miniscrews should not surpass
900 gr (Büchter et al., 2005). Since the rate of the segment’s
movement decreases with time, it is recommended to reach
the ideal position in the minimum possible time.
Accordingly, the fixed orthodontic treatment had already
proceeded up to a heavy base archwire (0.021 × 0.025-inch
stainless steel). During the distraction phase the segment
was remobilised once, under local anaesthesia. The same
procedure was reported in a study by Şenışık et al., albeit
for several times rather than once (Şenışık et al., 2014).
When the segment reached the appropriate position, it
was stabilised by getting ligated to the base archwire for a
consolidation phase. Isaacson et al. (2001) and Medeiros
and Bezerra (1997) recommended six and four weeks,
respectively, and it is believed that microscopic bony con-
nection forms after six weeks. Bousquet et al. (2016) let the
passive archwire remain in place for six months and contin-
ued the orthodontic treatment until the adjacent teeth got
aligned and root parallelism was re-established. Some stud-
ies did overtreatment to compensate for any further vertical
alveolar growth, which is believed to continue to the age of
approximately 18 years, in girls (Riolo, 1974). However,
since our patient was a 23-year-old woman, no overtreat-
ment was required in her case. In fact, it is prudent to post-
pone such treatment until the cessation of alveolar growth.
Although this case was treated successfully with the
maximum possible aesthetic results, clinicians should take
several risk factors into consideration when choosing this
method such as: the possibility of miniscrew loosening;
damage to the adjacent teeth’s roots during the surgical pro-
cedure; insufficient patient’s compliance; single tooth seg-
ment necrosis; and root or crown fracture during distraction
especially in cases that the tooth has got fragile due to inter-
nal root resorption. One concern about this case was that
she had a gummy smile that made achieving a perfect gin-
gival aesthetic more crucial. Moreover, she insisted on one
jaw orthodontic treatment. In spite of these limitations,
proper occlusion was achieved and the final gingival aes-
thetics were established by a minor gingivoplasty six weeks
after debonding.
Conclusion
DO to move a block of alveolar bone containing an anky-
losed tooth could be a viable treatment to align an infraoc-
cluded tooth, especially in the aesthetic region, to gain a
harmonious gingival level. This method could be facilitated
by means of miniscrews and applying orthodontic forces
rather than using complicated DO devices.
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with
respect to the research, authorship, and/or publication of this
article.
Funding
The author(s) received no financial support for the research,
authorship, and/or publication of this article.
ORCID iD
Shima Golmohammadi https://orcid.org/0000-0001-8766-1917
References
Alcan T (2006) A miniature tooth-borne distractor for the alignment of
ankylosed teeth. The Angle Orthodontist 76: 77–83.
Andersson L, Blomlöf L, Lindskog S, Feiglin B and Hammarström L
(1984) Tooth ankylosis: clinical, radiographic and histological assess-
ments. International Journal of Oral Surgery 13: 423–431.
Bousquet P, Artz C, Renaud M and Canal P (2016) Relocation of infra-
positioned ankylosed teeth: Description of orthodontic bone stretch-
ing and case series. Journal of Oral and Maxillofacial Surgery 74:
1914–1925.
Büchter A, Wiechmann D, Koerdt S, Wiesmann HP, Piffko J and Meyer U
(2005) Load-related implant reaction of mini-implants used for ortho-
dontic anchorage. Clinical Oral Implants Research 16: 473–479.
9. Saffar Shahroudi and Golmohammadi 9
Campbell KM, Casas MJ and Kenny DJ (2007) Development of ankylosis
in permanent incisors following delayed replantation and severe intru-
sion. Dental Traumatology 23: 162–166.
Chang HY, Chang YL and Chen HL (2010) Treatment of a severely anky-
losed central incisor and a missing lateral incisor by distraction osteo-
genesis and orthodontic treatment. American Journal of Orthodontics
and Dentofacial Orthopedics 138: 829–838.
Codivilla A (1905) On the means of lengthening, in the lower limbs, the
muscles and tissues which are shortened through deformity. Journal
of Bone and Joint Surgery 2: 353–369.
Dolanmaz D, Karaman AI, Pampu AA and Topkara A (2010) Orthodontic
treatment of an ankylosed maxillary central incisor through osteo-
genic distraction. The Angle Orthodontist 80: 391–395.
Epker BN and Paulus PJ (1978) Surgical-orthodontic correction of adult
malocclusions: single-tooth dento-osseous osteotomies. American
Journal of Orthodontics 74: 551–563.
Huisinga-Fischer CE, Vaandrager JM and Prahl-Andersen B (2003)
Longitudinal results of mandibular distraction osteogenesis in hemi-
facial microsomia. Journal of Craniofacial Surgery 14: 924–933.
Ilizarov GA (1971) [Basic principles of transosseous compression and dis-
traction osteosynthesis]. Ortopediia Travmatologiia Protezirovanie
32: 7–15.
Im JJ, Kye MK, Hwang KG and Park CJ (2010) Miniscrew-anchored
alveolar distraction for the treatment of the ankylosed maxillary cen-
tral incisor. Dental Traumatology 26: 285–288.
Isaacson RJ, Strauss RA, Bridges-Poquis A, Peluso AR and Lindauer
SJ (2001) Moving an ankylosed central incisor using orthodontics,
surgery and distraction osteogenesis. The Angle Orthodontist 71:
411–418.
Kawanami M, Andreasen JO, Borum MK, Schou S, Hjerting-Hansen E
and Kato H (1999) Infraposition of ankylosed permanent maxillary
incisors after replantation related to age and sex. Dental Traumatology
15: 50–56.
Kim Y, Park S, Son W, Kim S, Kim Y and Mah J (2010) Treatment of
an ankylosed maxillary incisor by intraoral alveolar bone distraction
osteogenesis. American Journal of Orthodontics and Dentofacial
Orthopedics 138: 215–220.
Kinzinger GS, Jänicke S, Riediger D and Diedrich PR (2003) Orthodontic
fine adjustment after vertical callus distraction of an ankylosed incisor
using the floating bone concept. American Journal of Orthodontics
and Dentofacial Orthopedics 124: 582–590.
Kofod T, Wurtz V and Melsen B (2005) Treatment of an ankylosed central
incisor by single tooth dento-osseous osteotomy and a simple dis-
traction device. American Journal of Orthodontics and Dentofacial
Orthopedics 127: 72–80.
Liou EJ, Chen PK, Huang CS and Chen YR (2000) Interdental
distraction
osteogenesis and rapid orthodontic tooth movement: a novel approach
to approximate a wide alveolar cleft or bony defect. Plastic and
Reconstructive Surgery 105: 1262–1272.
Malmgren B (2013) Ridge preservation/decoronation. Pediatric Dentistry
35: 164–169.
Mayne R, Mayne R, Saranathan S and Spencer K (2017) Single tooth oste-
otomy and distraction in the treatment of an ankylosed central incisor-
a case report. Australasian Orthodontic Journal 33: 280.
Medeiros PJ and Bezerra AR (1997) Treatment of an ankylosed central
incisor by single-tooth dento-osseous osteotomy. American Journal of
Orthodontics and Dentofacial Orthopedics 112: 496–501.
Ohkubo K, Susami T, Mori Y, Nagahama K, Takahashi N, Saijo H,
et al. (2011) Treatment of ankylosed maxillary central incisors by
single-tooth dento-osseous osteotomy and alveolar bone distraction.
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and
Endodontology 111: 561–567.
Papadopoulos MA and Tarawneh F (2007) The use of miniscrew implants
for temporary skeletal anchorage in orthodontics: a comprehensive
review. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology
and Endodontology 103: e6–e15.
Riolo ML(1974) An atlas of craniofacial growth: cephalometric standards
from the University School Growth Study, the University of Michigan.
Ann Arbor, MI: Center for Human Growth and Development,
University of Michigan, pp. 101–216.
Sanu OO and Isiekwe MC (2003) Tooth ankylosis and its orthodontic
implications. Pakistan Oral Dental Journal 28: 87–90.
Schwartz-Arad D, Levin L and Ashkenazi M (2004) Treatment options
of untreatable traumatized anterior maxillary teeth for future use of
dental implantation. Implant Dentistry 13: 120–128.
Şenışık NE, Koçer G and Kaya BÜ (2014) Ankylosed maxillary inci-
sor with severe root resorption treated with a single-tooth dento-
osseous osteotomy, vertical alveolar distraction osteogenesis, and
mini-implant anchorage. American Journal of Orthodontics and
Dentofacial Orthopedics 146: 371–384.
Shetty H, Hegde P, Shetty A and Hegde MN (2014) CBCT Imaging-The
Dentists Third Eye: A Literature Based Review. Indian Journal of
Stomatology 5: 95–101.
Snyder CC, Levine GA, Swasson HM and Browne EZ Jr (1973)
Mandibular lengthening by gradual distraction: preliminary report.
Plastic and Reconstructive Surgery 51: 506–508.
Susami T, Matsuzaki M, Ogihara Y, Sakiyama M, Takato T, Sugawara
Y, et al. (2006) Segmental alveolar distraction for the correction of
unilateral open-bite caused by multiple ankylosed teeth: a case report.
Journal of Orthodontics 33: 153–159.
Vercellotti T, Nevins ML, Kim DM, Nevins M, Wada K, Schenk RK,
et al. (2005) Osseous response following resective therapy with
piezosurgery. International Journal of Periodontics Restorative
Dentistry 25: 542–549.