Retenciones múltiples. Reporte de un caso / Multiple retention. Case report

RESUMEN La retención dentaria es común encontrarla en la clínica de ortodoncia, los caninos maxilares son los de mayor solicitud de tratamiento por su importancia estética. Sin embargo, no es frecuente la retención de dientes temporales. Su etiología no está bien definida pero se considera de carácter multifactorial. Se presentó una paciente del sexo femenino de 12 años y medio de edad, con ausencia de 15 y 13, presencia de 53 y mesogresión del 16. Al examen radiográfico se observó retención de 55, 15 y 13, este último en transposición incompleta con el 12. Después de un profundo análisis se decidió exéresis del 55 y alineación al arco dentario de 15 y 13, mediante colocación de un dispositivo, con el empleo del sistema de cementado directo en el acto quirúrgico. Se estableció una oclusión funcional y estética aceptable, con particular cuidado de la integridad de los dientes vecinos y sus tejidos blandos. Las retenciones constituyen maloclusiones dentarias complejas y de difícil pronóstico y tratamiento, más aún cuando son múltiples. Se requiere de estudio y tratamiento multidisciplinario (AU).

ABSTRACT It is common to find teeth retention in Orthodontics clinic; maxillary canines, due to their esthetical importance, are the ones the patients ask to be treated more frequently. Nevertheless, temporary teeth retention is not frequent. Its etiology is not clear, but it is considered multifactorial. The authors present the case of a female patient, aged 12 years and a half, without 15 and 13 teeth, presence of 53 and mesogression of 16. At the radiographic examination, the retention of 55, 15 and 13 was found, and also the incomplete transposition of 13 and 12. After deeply analyzing the case, the orthodontists decided the removal of 55 and aligning 15 and 13 to dental arch, placing a device with the system of direct cementing at the moment of the surgery. It was established a functional occlusion and an acceptable esthetics, particularly caring for the neighboring teeth and their soft tissues. Retentions are complex dental malocclusions, of difficult prognosis and treatment, mainly when they are multiple. They require study and multidisciplinary treatment (AU).

Orthodontic traction of impacted canines: Concepts and clinical application

ABSTRACT Orthodontic traction of impacted canines stands as a major challenge for Orthodontics. It is a relatively frequent clinical complaint which management, more often than not, requires a multidisciplinary approach. Surgical exposure of the impacted canine, and the complex orthodontic mechanics applied to align the tooth back into the arch, may frequently lead to complications involving supporting tissues, not to mention the long treatment time and high costs imposed to patients. In face of that, it is worth highlighting the relevance of early diagnosis as to intervene efficiently and as soon as possible. This paper presents a review of the main concepts involving prevalence, etiology and classification of impacted canines, and describes the different clinical management options that would help solve the problem. It illustrates the topic by presenting a treatment delivered to a 13 year 7 months old male patient, suffering from a Class II, division 2, left subdivision, malocclusion, associated to a deep bite and a prolonged retention of a primary upper canine caused by the impaction of the permanent tooth. Corrective orthodontic therapy was associated to a rapid maxillary expansion and to the use of a high pull headgear. Impacted canine was submitted to orthodontic traction and correctly positioned back into the arch. This approach proved to be efficient in meeting both functional and aesthetic goals.

RESUMO O tracionamento de caninos impactados representa um dos grandes desafios da Ortodontia. Trata-se de um problema clínico relativamente frequente, cujo tratamento muitas vezes requer uma abordagem multidisciplinar. A exposição cirúrgica do canino impactado e a complexa mecânica ortodôntica aplicada para alinhar o dente na respectiva arcada podem, com frequência, levar a complicações nos tecidos de suporte, sem mencionar o longo tempo de tratamento e os custos elevados para o paciente. Por isso, vale a pena ressaltar a importância dos diagnósticos precoces, para que a interceptação do problema seja feita o mais cedo possível e de maneira eficaz. O presente trabalho apresenta uma revisão dos principais conceitos envolvendo a prevalência, etiologia e classificação dos caninos impactados, e descreve os vários tipos de abordagem clínica para a resolução do problema. Ao final, ilustra o tema com a apresentação de um tratamento realizado em um paciente de 13 anos e 7 meses de idade, portador de má oclusão de Classe II, divisão 2, subdivisão esquerda, associado a mordida profunda, que apresentava retenção prolongada de um canino superior decíduo, devido à impacção de seu sucessor permanente. O tratamento ortodôntico corretivo foi associado à expansão rápida de maxila e ao uso de aparelho extrabucal de tração cervical. O canino impactado foi tracionado ortodonticamente e posicionado corretamente na arcada. Essa abordagem foi eficiente para atingir as metas funcionais e estéticas propostas.

Interdisciplinary management of an impacted dilacerated maxillary central incisor

ABSTRACT Introduction: Tooth dilacerations are dental anomalies characterized by an abrupt deviation in the longitudinal axis of a tooth. They may occur either in the crown, between the crown and root, or in the root. Although not so common, impacted maxillary incisors exhibiting root dilaceration pose a diagnostic and treatment challenge to the clinician. Description: This case report describes the management of a horizontally impacted and dilacerated maxillary central incisor in a 12-year-old girl. Cone-beam computed tomographic scans were used to accurately localize the position of the dilacerated tooth, and to assess the extent of root formation and degree of dilaceration present in the root. Treatment included surgical exposure and orthodontic traction, followed by root canal treatment and apicoectomy. Results: Through a meticulously planned interdisciplinary approach, the impacted dilacerated central incisor was properly aligned and demonstrated good stability after the long-term follow-up. Conclusion: Taking into consideration the concerns and expectations of the patient, communicative feedback between the oral surgeon, orthodontist and endodontist helped achieving successful esthetic, structural and functional outcome in the present case.

RESUMO Introdução: as dilacerações dentárias são anomalias caracterizadas por desvio acentuado no eixo longitudinal de um dente. Elas podem ocorrer na coroa, entre a coroa e a raiz, ou na raiz. Apesar de não serem muito comuns, os incisivos superiores impactados apresentando dilaceração radicular representam um desafio para o clínico, quanto ao diagnóstico e tratamento. Descrição: o presente relato de caso descreve o tratamento de um incisivo central superior impactado horizontalmente e com dilaceração, em uma menina com 12 anos de idade. Tomografias computadorizadas de feixe cônico foram utilizadas para localizar com precisão a posição do dente dilacerado e avaliar o grau de formação e de dilaceração da raiz. O tratamento incluiu exposição cirúrgica e tração ortodôntica, seguida de tratamento do canal radicular e apicectomia. Resultados: por meio de uma abordagem interdisciplinar meticulosamente planejada, o incisivo central impactado com dilaceração foi devidamente alinhado e demonstrou boa estabilidade em acompanhamento de longo prazo. Conclusão: levando-se em consideração as preocupações e expectativas da paciente, a comunicação interativa adotada entre o cirurgião oral, ortodontista e o endodontista ajudou na obtenção de resultados estéticos, estruturais e funcionais satisfatórios no presente caso.

Tracción de canino maxilar izquierdo impactado con botón bondeable, ligadura metálica y cadena elastomérica / Traction of left maxillary impacted canine with bondeable button, metal ligature and elastomeric chain

Se presenta una paciente con 13 años y 7 meses de edad, el motivo de consulta fue "un colmillo en el paladar"; es clase I molar bilateral, clase I canina derecha con el canino infantil 53, clase II canina derecha, clase I canina izquierda, clase I esquelética, normodivergente, tiene apiñamiento dental moderado superior e inferior leve, mordida cruzada anterior de canino superior derecho, diente 23 impactado, acortamiento radicular en los incisivos centrales y segundos premolares inferiores. El tratamiento consistió en la extracción de dientes temporales 53 y 63, alineación nivelación, tracción quirúrgica del diente 23, cierre de espacios, detallado, retención. La retención se llevó a cabo mediante retenedores "Hawley" superior con "Fingers" en los dientes 23 y 13 e inferior. El tiempo de tratamiento activo fue 1 años 2 meses.

Patient with 13 years and 7 months old, the reason for visit "a fang on the palate" presenting molar class I bilateral, right canine class I with OD 53, right class II canine with 13, left canine Class I, is a class I skeletal, normodivergent, with the adequate overbite and overjet, superior moderate crowding and lower light, cross bite between teeth: canine13 and 43, 23 impacted upper right canine, root shortening 11, 21, 35, 45. Treatment consisted of extraction of primary teeth 53-63, alignment, leveling, surgical traction 23, space closure, detailed, and retention. Retention by upper and lower Hawley retainers with fingers in canine 13 23. The active treatment time was 1 years 2 months.

Root length and alveolar bone level of impacted canines and adjacent teeth after orthodontic traction: a long-term evaluation

Abstract Objective The aim of this retrospective study was to evaluate the long-term effects of orthodontic traction on root length and alveolar bone level in impacted canines and adjacent teeth. Material and Methods Sample consisted of 16 patients (nine males and seven females), mean initial age 11 years and 8 months presenting with unilaterally maxillary impacted canines, palatally displaced, treated with the same surgical and orthodontic approach. Teeth from the impacted-canine side were assigned as Group I (GI), and contralateral teeth as control, Group II (GII). The mean age of patients at the end of orthodontic treatment was 14 years and 2 months and the mean post-treatment time was 5 years and 11 months. Both contralateral erupted maxillary canines and adjacent teeth served as control. Root length and alveolar bone level (buccal and palatal) were evaluated on cone-beam computed tomography (CBCT) images. The comparison of root length and alveolar bone level changes between groups were assessed by applying paired t-test, at a significance level of 5% (p<0.05). Results There were no statistically significant differences in root length and buccal and palatal bone levels of canines and adjacent teeth among groups. Conclusions Impacted canine treatment by closed-eruption technique associated with canine crown perforation, has a minimal effect on root length and buccal and palatal alveolar bone level in both canine and adjacent teeth, demonstrating that this treatment protocol has a good long-term prognosis.

Assessment of low-level laser therapy effects after extraction of impacted lower third molar surgery

Introduction: The aim of this study was to assess the effect of low-level laser therapy [LLLT] on pain, swelling and maximum mouth opening in patients undergoing third molar surgery

Methods: A prospective, randomized double-blind study was undertaken on 44 patients at the Dental School, Ahvaz Jundishapur University of Medical Sciences, in 2015. A low-level laser was randomly applied on one of the two sides after surgery of 15 patients. The experimental side received 18 J/cm2 of energy density, wavelength of 980 nm, and output power of 1.8 W. On the control side, a hand-piece was applied intra-orally, but laser was not activated. In addition, in order to evaluate trismus, 13 patients were treated by unilateral laser therapy and 16 patients did not receive laser therapy at all. The laser was administered intraorally on two points of vestibular and lingual sides at 1 cm from the surgery site, and extraorally at the emergence of the masseter muscle, immediately after surgery, and repeated 24 hours later. The pain, swelling and maximum mouth opening [MMO] were compared between the two groups at 24 hours and a week after surgery

Results: The mean score of pain 24 hours after surgery in the laser therapy group [2.3 +/- 3.5] was significantly lower than the mean score of pain in the drug therapy [4.19 +/- 3.09] [P = 0.036]. Moreover, the mean score of pain at one week after surgery in the laser therapy group [0.13 +/- 2.33] was significantly lower than the drug therapy group [1.43 +/- 2.45] [P = 0.046]. The amount of swelling according to different measurements did not significantly differ between the two groups neither at 24 hours nor at 1 week after surgery

Conclusion: Our findings showed that LLLT was useful in reducing pain and could slightly reduce swelling compared to drug therapy in impacted third molar surgery

Use of miniplates as a method for orthodontic anchorage: a case report

ABSTRACT Introduction: Temporary anchorage devices (TADs) have been developed to be used as direct adjuncts in orthodontic treatment and have facilitated treatment of more complex orthodontic cases, including patients with dental impaction. Objectives: This clinical case reports the applicability of TADs in the orthodontic treatment of a patient with impacted mandibular second molars. Surgical and orthodontic procedures related to the use of miniplates were also discussed in this study. Conclusions: The use of temporary anchorage devices, such as miniplates, can be suggested as an alternative to treat patients with impacted mandibular second molars.

RESUMO Introdução: os dispositivos de ancoragem temporária vêm sendo desenvolvidos para uso como coadjuvantes no tratamento ortodôntico. Esses dispositivos facilitam o tratamento ortodôntico de casos mais complexos, incluindo pacientes com dentes impactados. Objetivos: o presente relato de caso reporta a aplicabilidade dos dispositivos de ancoragem temporária no tratamento ortodôntico de um paciente com segundos molares inferiores impactados. Os procedimentos cirúrgicos e ortodônticos relacionados ao uso das miniplacas também são discutidos nesse estudo. Conclusões: o uso de dispositivos de ancoragem temporária, tais como as miniplacas, pode ser sugerido como uma alternativa no tratamento de pacientes com segundos molares inferiores impactados.

Miniplacas como dispositivos de anclaje temporal (DAT) en la verticalización del segundo molar inferior impactado / Miniplates as temporary anchorage devices (TAD) for uprighting the impacted second mandibular molar

La impactación de los segundos molares inferiores permanentes es una patología con una incidencia del 0.03 or ciento a 0.04 por ciento del total de dientes retenidos, que en la mayoría de los casos debido a una posición impredecible del tercer molar, el resultado final es la exodoncia de ambas piezas dentarias.Dentro de los dispositivos de anclaje temporal, existen dos tipos, los minimplantes y las miniplacas. A través de este caso clínico se demuestra la eficiencia de las miniplacas en la verticalización de los segundos molares inferiores impactados sobre otras medidas terapéuticas debido a que su uso es un método predecible, rápido y seguro que no genera efectos secundarios indeseables. Además, estas miniplacas son colocadas a distancia de las piezas dentarias, por lo que no interfiere en los movimientos dentales.

Mandibular second molar impaction is a pathology with an incidence of 0.03% - 0.04% of the total of the impacted teeth due to animpredictible position of the third molar in most cases. As a consequence, where the final result is dental extraction of both teethThere are two types of temporary skeletal anchorage devices minimplants and miniplates. This case shows the miniplate efficiency in thesecond molar verticalization which is a predictible, fast and safe method without any side effects when compared with other treatments.In addition, miniplantes do not interfere with dental movements because they are placed far enough from the teeth.

Diferentes recursos mecanicos para larecuperacion de segundos molares impactados / Different mechanics for uprighting included second molars

Los segundos molares superiores e inferiores con frecuencia erupcionan mesioinclinados o quedan retenidos con esta inclinación debidoa terapias ortodoncicas tempranas como la colocación de arcos linguales, previas a la erupción de estas piezas. De acuerdo al grado deinclinación que presenten se pueden implementar diversas mecßnicas ortodoncicas. En este caso clínico se utilizaron varias de estasmecßnicas y se aprovecha la ocasión para explicar otras mßs disponibles...

Upper and lower second molars frecuently erupt with a mesioinclination fashion or eventually get included due to early orthodontictherapies such as lingual arches placed prior to the eruption of these teeth. According to the inclination degree, different mechanics canbe used. In this case report these mechanics are explained wether they were used in the solution or not...

The effect of canine disimpaction performed with temporary anchorage devices (TADs) before comprehensive orthodontic treatment to avoid root resorption of adjacent teeth

ABSTRACT Objective: The aim of this study was to evaluate the movement of impacted canines away from the roots of neighboring teeth before full-mouth bracket placement, performed by means of TADs to decrease undesired side effects on adjacent teeth. Methods: The study sample consisted of 34 palatally impacted canines, being 19 in the experimental group and 15 in the control group. In the experimental group, before placement of brackets, the impacted canine was erupted by means of miniscrews. In the control group, after initiation of comprehensive orthodontics, canine disimpaction was performed by means of a cantilever spring soldered to a palatal bar. At the end of treatment, volume of lateral incisors and canine root resorption were measured and compared by means of a CBCT-derived tridimensional model. Visual Analogue Scale (VAS) score, bleeding on probing (BOP) and gingival index (GI) were recorded. Clinical success rate was also calculated. Results: The volume of root resorption of lateral teeth in the control group was significantly greater than in the experimental group (p < 0.001). At the end of treatment, VAS score, GI and BOP were not significantly different between the two groups. Conclusion: Based on our results, it seems that disimpaction of canines and moving them to the arch can be done successfully carried out with minimal side effects by means of skeletal anchorage.

RESUMO Objetivo: o objetivo do presente estudo foi avaliar o uso de dispositivos de ancoragem temporária (DATs) para a movimentação de caninos impactados, afastando-os das raízes dos dentes vizinhos, antes da colagem dos braquetes em todos os dentes, com o objetivo de minimizar os efeitos colaterais indesejáveis nesses dentes adjacentes. Métodos: a amostra consistiu de 34 caninos impactados por palatino, sendo 19 no grupo experimental e 15 no grupo controle. No grupo experimental, antes da colagem dos braquetes, os caninos impactados foram tracionados utilizando-se mini-implantes. No grupo controle, após o início do tratamento ortodôntico, a desimpacção dos caninos foi realizada com uma mola em cantiléver soldada a uma barra transpalatina. Ao fim do tratamento, os valores referentes à reabsorção radicular nos incisivos laterais e caninos foram medidos e comparados por meio de modelos tridimensionais reconstruídos a partir de TCFCs. Foram também registrados os escores relativos à dor sentida pelos pacientes, usando uma escala visual analógica (VAS); além do Índice de Sangramento à Sondagem (ISS) e do Índice Gengival (IG). O índice de sucesso clínico também foi calculado. Resultados: o volume de reabsorção radicular nos incisivos laterais no grupo controle foi significativamente maior do que no grupo experimental (p < 0,001). Ao fim do tratamento, não houve diferença significativa entre os dois grupos quanto aos escores relativos à VAS, ao IG e ISS. Conclusão: esses resultados sugerem que a desimpacção de caninos e a movimentação deles para a arcada dentária podem ser realizadas, com sucesso e com mínimos efeitos colaterais, por meio da ancoragem esquelética.

Supernumerarios / Supernumerary teeth

En este artículo se describen los supernumerarios, las diversas teorías sobre su etiología, su frecuencia y lasalteraciones que pueden producir. Además, se dan pautas para su tratamiento. Los supernumerarios son anomalías del desarrollo que se encuentran con poca frecuencia, del 0,30 por ciento al 3,80 por ciento de la población, pero en pacientes con labio ypaladar fisurado pueden llegar al 28 por ciento. Se los puede definir como dientes adicionales a la serie dental normal. Se los encuentra raramente en ladentición primaria, en esta la distribución por sexo es similar; mientras que en la dentición permanente el sexo masculino prevalece en una proporción de 2 a 1. El mesiodens es el que se encuentra con mayor frecuencia. Constituye, según Shafer y Cols, más del50 por ciento de todos los supernumerarios...

Laser Assisted Periodontal Therapy: A Case Series.

Periodontitis is a one of the commonly occurring disease. Various therapies have been used and suggested for its treatment which includes nonsurgical, antimicrobial, and surgical therapy. In the recent years, lasers have been used frequently for periodontal therapy. Lasers have been applied for debridement, reshaping as well as the reduction of bacterial load in the pocket. This case series represent the use of lasers for exposure of impacted teeth, second stage surgery for dental implant, and vestibuloplasty. The surgical procedure with a 810 nm diode laser has been described. The laser-assisted procedures provided excellent results without complications as well as high patient and clinician satisfaction.

An Unusual Single Quadrant Dental Anomaly: A Case Report.

Anomalies of the dentition present real challenges to the dental practitioner. The occurrence of multiple supernumerary teeth in the absence of an associated systemic condition or syndrome is considered as a rare phenomenon. Here, we discuss a case of four supernumerary teeth in one maxillary quadrant with a fusion of supernumerary tooth to maxillary permanent central incisor, which was evident on radiological and clinical examination. Various radiographic views including intraoral periapical radiograph, maxillary occlusal radiograph, orthopantomograph, and cone-beam computed tomographic (CBCT) imaging were done to identify and locate the presence of supernumerary and supplemental teeth. The present case emphasizes the importance of different radiographic views and modalities in correct identification of the dental anomalies and thereby providing a prompt diagnosis and treatment as the exact identification of supernumerary teeth and differentiating it from permanent tooth is of prime importance in treatment planning and management.

Functional approach to a Class II patient with upper first molar impaction.

The lack of the left first molar maxillary and the left second molar maxillary, caused respectively by impaction and agenesis is a very rare case, which determines an important occlusal imbalance and asymmetrical mandible movement. A gnatologic and functional orthodontic approach were planned to improve the retrognathic mandible and the muscular activity using kinesiograph and electromyography.

Four impacted canines in an adult patient: A challenge in orthodontics.

This case report illustrates the management of four impacted canines in an adult patient associated with prolonged retention of the four deciduous teeth. The treatment plan was formulated to extract the lower deciduous teeth, application of the forced eruption with the permanent canines, and extract the upper permanent canines and maintenance of the maxillary deciduous canines. No reshaping of the maxillary deciduous teeth was performed because the patient was satisfied with the results.

Dental transposition of canine and lateral incisor and impacted central incisor treatment: A case report

INTRODUCTION: Dental transposition and impaction are disorders related to ectopic eruption or failure in tooth eruption, which can affect child physical, mental and social development and may be difficult to be clinically solved. METHODS: We describe a case of transposition between the upper left canine and lateral incisor associated with impaction of the central incisor on the same side, in a 12-year-old patient. Conservative treatment involving surgical-orthodontic correction of transposed teeth and traction of the central incisor was conducted. CONCLUSION: The option of correcting transposition and orthodontic traction by means of the segmented arch technique with devices such as cantilever and TMA rectangular wire loops, although a complex alternative, was proved to be esthetically and functionally effective. .

INTRODUÇÃO: transposição e impacção dentárias são distúrbios relacionados à erupção ectópica ou à falha na erupção dentária, que podem afetar o desenvolvimento físico, psíquico e social da criança, e que podem ser de difícil resolução clínica. MÉTODOS: é descrito um caso clínico de transposição entre o canino e o incisivo lateral superior esquerdo, associado à impacção do incisivo superior, do mesmo lado, em uma paciente de 12 anos de idade. Optou-se pela realização de tratamento ortodôntico-cirúrgico conservador, envolvendo a correção ortodôntica dos dentes transpostos e o tracionamento do incisivo central impactado. CONCLUSÃO: a opção pela correção da transposição e tracionamento ortodôntico com a utilização da técnica do arco segmentado com uso de dispositivos como cantiléver e alças em fios TMA retangulares, apesar de ser uma alternativa de execução complexa, mostrou-se efetiva do ponto de vista estético e funcional. .

Quiste dentígero de gran tamaño que ocupa el seno maxilar y desplaza a tercer y cuarto molares ectópicos a fosa cigomática / Large dentigerous cyst in the maxillary sinus with displacing ectopic third and fourth molars into zygomatic fossa

Presentar un caso de quiste dentígero que invade el seno maxilar asociado a un tercer y cuarto molares ectópicos. Caso clínico: se presenta un caso de quiste dentígero de gran tamaño que invade el seno maxilar en su totalidad, asociado a tercer y cuarto molares, en una paciente de sexo femenino de 14 años. Se realizó la exéresis completa de la lesión mediante un abordaje de Cadwell-Luc. Conclusión: es de suma importancia el diagnóstico temprano de estas patologías a través de un correcto examen clínico y radiológico. En quistes de gran tamaño y de evlución rápida, como es el caso presentado, debemos considerar la posibilidad de una transformación ameloblástica o carcinomatosa en la pared quística. Por esta razón, tendremos que elegir un tratamiento que nos asegurela extirpación total de la lesión y su posterior análisis histopatológico para determinar la conducta por seguir.

Tracionamento ortodôntico-cirúrgico de incisivo superior impactado associado a odontoma: relato de caso clínico / Surgical-orthodontic traction of an impacted maxillary incisor associated with odontoma: a case report

A impacção de incisivos superiores na fase de dentição mista, além de ser um desafio clínico, é uma má oclusão que preocupa os pais e as crianças, haja vista que afeta a estética do sorriso. Nesses casos, o diagnóstico precoce e o tratamento adequado são importantes para a melhor resolução do problema, tanto do ponto de vista funcional quanto psicológico. Um dos fatores etiológicos da impacção dentária é a presença de odontoma no trajeto de erupção do dente permanente. O tratamento ortodôntico-cirúrgico dessa má oclusão promove a erupção, posicionamento e estabilização do dente retido, além da remoção da patologia. Dessa maneira, o objetivo do presente estudo é apresentar um relato de caso clínico da remoção cirúrgica de odontoma e tracionamento do incisivo retido, com a utilização de aparelho ortodôntico removível. O aparelho foi utilizado de início para proporcionar abertura de espaço necessária à erupção do dente retido, sendo, depois, utilizado para tracioná-lo e posicioná-lo adequadamente na arcada. Os procedimentos adotados mostraram-se uma alternativa eficiente para o tratamento de dentes impactados, além de apresentarem baixo custo e boa aplicabilidade.

Tratamiento ortodóntlco quirúrglco de canino maxilar impactado con reabsorción radicular bilateral: reporte de caso / Surgical orthodontic treatment of impacted maxillary canine with resorption bilateral radicular: case report

Los dientes caninos superiores permanentes impactados bilaterales son un problema clínico que puede provocar una serie de secuelas irreversibles como la reabsorción radicular de dientes vecinos. Se describe el caso de una paciente con ausencia clínica de caninos superiores que se encontraban impactados orientados hacia vestibular produciendo reabsorción de los dos tercios de la raices de todos los incisivos superiores, los que fueron extraídos, en el mismo acto se realizó la exposición quirúrgica de los dos dientes caninos y posteriormente la tracción ortodóntica de los caninos impactados, en el maxilar inferior se realizaron extracción de primeras premolares inferiores para compensar las extracciones que se realizaron en el maxilar superior. Ocho meses fueron necesarios para observar clínicamente las piezas impactadas. El tiempo de tratamiento fue de 2 años, al finalizar el tratamiento ortodoncico se realizó una ameloplastía de las cuspides de los caninos para dar forma de incisivos laterales.

The that were impacted oriented vestibular reabsorption producing 2/3 root of the upper incisors, they were extracted, with subsequent surgical exposure and orthodontic traction of the impacted canines in the lower jaw were made first premolars extraction, Camouflaging the alveolar biprotrusion. Eight months were required to observe clinically impacted teeth. The treatment time was 2 years old are ameloplastia cusps of the canines to build incisal edge.