ABSTRACT
INTRODUCTION: This prospective cohort study aimed to evaluate canine substitution supported by skeletal anchorage as a viable treatment protocol for patients with maxillary lateral incisor agenesis (MLIA) and skeletal Class I or Class III. METHODS: Patients (n = 30) who met the following criteria were recruited: (1) bilateral MLIA or unilateral MLIA with a riziform contralateral incisor with a planned extraction; (2) skeletal Class I or Class III; and (3) dentoalveolar discrepancy in the mandible <5 mm. The archwire sequence routine was administered, combined with a rapid palatal expander, temporary intraoral skeletal anchorage device, and intermaxillary traction with Class III elastics. The results of the cephalometric analyses, peer assessment rating indexes, and the patient's smile self-evaluation using the visual analog scale were compared between initial and final treatments. RESULTS: This study indicated that closing the space in patients with Class I or Class III malocclusion by using temporary intraoral skeletal anchorage devices in the mandible, along with Class III elastics, yielded satisfactory outcomes. Proper occlusion was established by mesialization of the maxillary teeth and correction of the intermaxillary discrepancy, thereby yielding beneficial and significant cephalometric changes after the treatment. The soft tissue profile was maintained when it was harmonious before the treatment and improved posttreatment in patients in whom the profile was initially inharmonious. All occlusions improved, as evidenced by the peer assessment rating index. Smile esthetics were also enhanced after orthodontic treatment for all patients. CONCLUSIONS: Canine substitution may be safely offered to patients with Class I and Class III skeletal pattern and MLIA.
Subject(s)
Anodontia/therapy , Cuspid , Malocclusion, Angle Class III/therapy , Malocclusion, Angle Class I/therapy , Orthodontic Anchorage Procedures/methods , Tooth Movement Techniques/methods , Adolescent , Cephalometry , Child , Combined Modality Therapy , Esthetics, Dental , Extraoral Traction Appliances , Female , Humans , Male , Palatal Expansion Technique , Prospective Studies , Treatment Outcome , Visual Analog Scale , Young AdultABSTRACT
The purpose of this case report is to describe the treatment, including 3-year follow-up records, for a patient with hemifacial microsmia. Treatment included the unusual use of temporary anchorage devices to correct the cant of the occlusal plane. The advantages of distraction osteogenesis are discussed. The successful outcome depended on the collaboration of the orthodontist and the craniofacial surgeon.
