Forced eruption with miniscrews; inter-arch [corrected] method with vertical elastics versus intra-arch method using the Derton-Perini technique: two case reports.

INTRODUCTION: Orthodontic preprosthetic treatment is an important feature of interdisciplinary dental therapy in the adult patient. Extrusion can be very useful to obtain successful prosthodontic results. The literature describes different ways to obtain forced dental eruption. Miniscrews represent a step towards resolving the problem of anchorage in orthodontics, including in forced eruption cases. The aim of this study is to report two cases of orthodontic preprosthetic extrusion by means of miniscrews and bone anchorage. We will describe and discuss the indications, orthodontic and surgical technique and the clinical advantages. MATERIALS AND METHODS: In the first reported case, a decayed upper molar was extruded using miniscrews and an inter-arch technique (direct skeletal anchorage), which needs patient compliance to properly position the inter-arch elastics. In the second case, an upper premolar with an oblique corono-radicular fracture underwent forced eruption by means of intra-arch miniscrews (indirect bone anchorage with the "Derton-Perini" technique). Patient compliance was not required. RESULTS: Adequate extrusion of the treated teeth was obtained, with no undesired movement of the neighbouring teeth. Using the "Derton-Perini" technique, we reached our objectives without patient compliance. CONCLUSIONS: Miniscrews for skeletal anchorage proved to be an effective device to obtain extrusion for prosthetic purposes without undesired movements on other teeth and with no need for patient compliance when used in the same arch.

Orthodontic treatment in periodontal patients: a case report with 7 years follow-up.

INTRODUCTION: Tooth flaring of the anterior segment is often unesthetic and therefore a primary reason for combined orthodontic and periodontal treatment in adult patients with periodontal disease. Thus, a multidisciplinary approach is frequently chosen for these patients by a qualified dental team. MATERIALS AND METHODS: A clinical case of an adult patient suffering from chronic periodontitis with horizontal bone loss in the anterior segment and consequent flaring of the anterior teeth is described. A combined approach was chosen, initially to improve and stabilize the periodontal situation via multiple scaling and root planning sessions with additional pharmacological therapy and, finally by orthodontic treatment, to resolve the malocclusion. RESULTS: At the end of treatment, bone resorbtion was stabilized, the vertical bone defect was improved and incisor flaring was absent. Follow-up at 7 years post-treatment confirmed the stability of the orthodontic and esthetic results. CONCLUSIONS: The correct combination of orthodontic and periodontal treatment may contribute efficaciously to eliminate the effects of chronic periodontitis in adult patients, as well as improving esthetic parameters.