ABSTRACT
BACKGROUND: Dental implants are sometimes initially placed in a wrong position leading to esthetic damage, which is difficult to solve with prosthetics. Moreover, implants placed in the anterior sector, like ankylosed teeth, are frequently found in a wrong position over time with infraocclusion because of continuous anterior alveolar growth. Different treatments have been proposed to manage the consequences of malpositioned dental implants. CASE PRESENTATION: This paper describes a surgical and orthodontic new procedure that can be used to relocate an implant in a wrong position: the Orthodontic Bone Stretching technique (OBS), which involves deep partial osteotomies combined with heavy orthodontic forces. The applied force facilitates esthetic rehabilitation with a movement towards the occlusal plane and can modify the implant axis and the gingival line alignment. This relocation is made possible thanks to a bone stretching phenomenon in the surgical area without immediate mobilization or repositioning of an alveolar segment. Three cases with the need for implant repositioning are presented here and were treated with the OBS technique. CONCLUSION: In the three cases presented, implant relocation was successfully performed with the OBS technique and the prosthetic crown was modified to improve esthetic results.
Subject(s)
Dental Implants , Tooth Ankylosis , Dental Implantation, Endosseous/adverse effects , Dental Implants/adverse effects , Esthetics, Dental , Humans , Maxilla/surgery , Osteotomy , Tooth CrownABSTRACT
Using implant to replace a tooth is a well known treatment. However, the practitioner must keep in mind that osteointegrated implants behave like ankylosed teeth, and their evolution does not follow the alveolar processes of the adjacent teeth during growth. This growth decreases after 20 years, but remains present. This can lead to infraposition functionally and aesthetically failure for the implant therapy. Risk factors, like patient's age, sex and shape of the face must be evaluated. Most palatal implant positioning and use of screwed prosthetic tooth can permit the infraposition treatment during years of aging.
Subject(s)
Dental Implants , Facial Bones/growth & development , Skull/growth & development , Adolescent , Child , Esthetics , Humans , Risk Factors , Time FactorsABSTRACT
Different treatments have been proposed to manage the consequences of ankylosed teeth. This clinical report, which includes several different clinical conditions, describes an orthodontic bone-stretching procedure that can be used to relocate ankylosed teeth. The orthodontic bone-stretching technique involves only partial osteotomies, without the mobilization or repositioning of the alveolar segment, combined with orthodontic forces. The applied force facilitates tooth movement to the occlusal plane and can modify the axis of the ankylosed tooth. This relocation is possible because of a bone-stretching phenomenon in the surgical area. In all of the cases, relocation of the ankylosed teeth was successfully performed and the gingival margins were corrected to improve the esthetic results.
Subject(s)
Tooth Ankylosis/therapy , Adolescent , Combined Modality Therapy , Cone-Beam Computed Tomography , Humans , Incisor , Male , Maxilla , Orthodontics, Corrective/methods , Osteogenesis, Distraction/methods , Osteotomy/methods , Radiography, Panoramic , Tooth Ankylosis/diagnostic imagingABSTRACT
Ankylosed anterior teeth are associated with infraclusion and can lead to a concomitant significant esthetic defect. After a review of the techniques used move these teeth into the arch, this article describes a new technique to restore occlusion and improve esthetics, or to prepare the case for either a prosthetic or implant treatment, Orthodontic Bone Stretching (OBS). This technic combines partial corticotomy and orthodontic treatment and produces bone stretching. After 8 to 12 weeks of force application, the ankylosed teeth are repositioned into occlusion or, if extraction is necessary, the bone crest is at a level consistent with a prosthetic or implant treatment. OBS technique can be adapted to implant infraclusion, or the vertical regeneration of atrophied ridge.
