Congenital Absence and Microdontia of Second Premolars: Orthodontics, Implants and Prosthetic Dentistry
Linda Tseng, Chang CH, Roberts WE.
A 31-year-5-month old male presented for orthodontic consultation to evaluate interdental spacing and an anterior deepbite. There were three congenital missing second premolars: lower left (LL), lower right (LR) and upper right (UR) quadrants. The upper left (UL) second premolar was a ected by microdontia and positioned in lingual crossbite. Multiple teeth were tipped and extruded in both arches, so preprosthetic alignment was required to prepare sites to restore the missing and anomalous premolars. Orthodontic alignment and prosthetic site preparation was achieved with a full xed passive self ligating appliance, open coil springs, and early light short Class II elastics (ELSE). Bite turbos were employed to increase the vertical dimension of occlusion (VDO). Flapless and open-flap surgical procedures were selected according to the soft tissue and bone conditions at each implant site. The implant replacing the LR second premolar was inadvertently oriented to the buccal, so a 15° angled abutment was required to correct the orientation of the preparation prior to restoration with a crown. This severe mutilated malocclusion with an American Board of Orthodontics (ABO) Discrepancy Index (DI) of 26 was treated to a pleasing functional and esthetic result in 26 months. The ABO Cast-Radiograph Evaluation (CRE) score was 27, and the Pink and White dental esthetic index was 3. (Int J Orthod Implantol 2016;43:4-27)
Key words: Interdental spacing, congenitally missing premolars, microdontia, preprosthetic alignment, implant size selection, ap and apless surgical techniques
Space Closure for Congenitally Missing pper Second Premolars with Molar Protraction hrough the loor of the Maxillary Sinus
Chia Wei Liu, Chang CH, Roberts WE.
A 21-year-old male presented with a chief complaint of missing maxillary second premolars. The edentulous spaces were retained as implant sites with band-and-loop fixed space maintainers. Presurgical evaluation, after the space maintainers were removed, revealed caries on the mesial of both rst molars, and inadequate implant sites. The patient opted for orthodontic space closure, which required protracting the upper molar roots through the floor of the maxillary sinus. Routine orthodontic space closure, supplemented with Class III elastics and mandibular buccal shelf bone screws, produced a pleasing result. There was no clinical evidence of root resorption or other complications. This partially edentulous malocclusion, with an American Board of Orthodontics (ABO) Discrepancy Index (DI) of 13 points, was treated to an ABO Cast-Radiograph Evaluation (CRE) score of 19 points in 26 months. (Int J Orthod Implantol 2016;43:32-48)
Key words: Congenital missing premolars, buccal shelf bone screws, maxillary sinus oor, overbite anchorage
Severe ummy Smile, Class II with mm Crowding reated with Invisalign and Miniscrews
Diego Peydro Herrero.
A 27-year-old woman presented with a Class II malocclusion, 8mm of crowding and severe gummy smile. Her motive for the consultation was that she wished to improve her smile aesthetics and to achieve the desired final result without braces. The case was treated by dental arch transversal expansion, creating enough space for the mandible anterorotation and correcting the Class II. Temporary Anchorage Devices (TADs) were used for the Class II elastics, avoiding undesirable upper incisor retroclination. The anchorage also prevented the upper incisors from extruding and the gummy smile from worsening. After 16 months of treatment, satisfactory aesthetical and occlusal results were achieved. (Int J Orthod Implantol 2016;43:52-66)
Key words: Invisalign, aligner treatment, gummy smile, Class II division II, severe crowding, TADs (miniscrews)
Conservative Restoration of Interproximal Caries During Active Orthodontic reatment
Sheau Ling Lin, Chang CH, Roberts WE.
Oral health maintenance during orthodontics is essential for achieving desirable clinical outcomes. Common problems, such as caries, pulpitis, periapical pathology and periodontal disease, require correction or at least stabilization prior to commencing active orthodontic treatment. However, it may be difficult to access small carious lesions in a crowded dentition. On the other hand, large carious lesions with pulp involvement and periapical pathology often require endodontic treatment and temporary restorations before the start of orthodontic treatment. Tooth fractures or pathology detected during active treatment may require adjunctive care during the course of orthodontic therapy. (Int J Orthod Implantol 2016;43:70-73)
The “ANG (Anghileri) Technique” : Making Derotation Easy
One of the main goals of the initial phase, when working with passive self-ligating Damon brackets, is to control rotation during alignment. Delays in reaching this goal can slow down the treatment process. (Int J Orthod Implantol 2016;43:76-79)