Pulp Revascularization After Autotransplantation of the Mandibular Canines With Partially Resected Roots: Report of 5 Cases With Follow-ups Between 26 and 80 Months.

INTRODUCTION: Transmigrated (migrated through the midline) mandibular canines constitute a treatment challenge. Advanced transmigration can be successfully treated by autotransplantation. In developing canines, pulp revascularization is typical after transplantation. On the contrary, the pulp of teeth with completed apex formation does not undergo revascularization. In this case, root canal treatment becomes compulsory and decreases the success of autotransplantation. The aim of this observational retrospective study was to evaluate whether partial resection of the root (performed during the autotransplantation of mature canines) would enable revascularization of the pulp after the surgery. METHODS: Five transmigrated mandibular canines with complete apex formation before the surgery were evaluated. During the autotransplantation surgery, the resection of 2 to 4 mm of the root apex was performed to open the path for revascularization of the pulp after surgery. The transplanted teeth were observed during healing after the surgery for the presence of pulp obliteration. Clinical and radiographic examinations were performed. RESULTS: All treated canines survived the minimum observation period of 2 years (ranging from 26 to 80 months, mean: 55 months) without pulp healing complications. The survival was 100%, and the success was 80%. In one canine, the external cervical root resorption was diagnosed and treated 1 year after the surgery. At the final examination, transplanted canines presented radiographic features of pulp obliteration, normal mobility, and healthy periodontal tissues. CONCLUSIONS: The surgical protocol proved to be successful in promoting revascularization to maintain pulp vitality, in all cases. The outcomes confirm that autotransplantation, combined with the resection of the root, constitutes a valid treatment for mature ectopic canines.

Duration of the pubertal growth spurt in patients with increased craniofacial growth component in sagittal and vertical planes-retrospective and cross-sectional study.

OBJECTIVES: The aim of the study is to assess the skeletal age at the onset and end of the pubertal growth spurt and determine its duration in four growth type groups: (1) normodivergent skeletal Class I (I N), (2) normodivergent skeletal Class III (III N), (3) high-angle skeletal Class III (III H) and (4) high-angle skeletal Class I (I H). MATERIALS AND METHODS: Two hundred thirteen subjects were selected from 2163 examined files. The cervical vertebral maturation stage was recorded by means of Baccetti's method. The sagittal and vertical skeletal relations were evaluated according to Steiner analysis with Kaminek's modification. The duration of the pubertal growth spurt was calculated from the difference between the means of the chronological age related to CS3 and CS4 maturation stages. RESULTS: The shortest lasting pubertal growth spurt was observed in group I N (1.1), followed by group III N (1.6). Major differences between arithmetic means CS4-CS3 were seen in groups I H and III H (2.3 and 2.7, respectively). CONCLUSIONS: The following tendency was observed in the duration of the pubertal growth spurt: I N < III N < I H < III H. This tendency has statistical significance only in high-angle patients in comparison with normodivergent skeletal Class I. CLINICAL RELEVANCE: Knowledge on the longer pubertal growth spurt in high-angle patients compared to patients with normal anteroposterior and vertical relationships can be useful in the selection of an appropriate therapeutic method and a treatment time.

Assessment of the duration of the pubertal growth spurt in patients with skeletal open bite : A cross-sectional study.

PURPOSES: The objectives were to assess the skeletal age of patients with skeletal open bite and to estimate and compare the mean chronological age related to CS3 and CS4 (cervical stage, CS) and the duration of the pubertal growth spurt (PGS). METHODS: Orthodontic records of 145 patients were analyzed in this retrospective cross-sectional study. The study group comprised 104 patients with skeletal open bite (angle between cranial base plane line [NS] and mandible base plane line [ML] > 39° according to Steiner), whereas the control group comprised 41 patients with normal anteroposterior and vertical measurements. Skeletal age was assessed using the 6­stage CVM (cervical vertebral maturation) method according to Baccetti. Quantitative variables were characterized by means of the arithmetic mean and standard deviation. The PGS duration was calculated as the difference between the means of the chronological ages related to CS3 and CS4. RESULTS: In the study group, the arithmetic means related to CS3 and CS4 were 11.12 and 13.54 years, respectively; the duration of the PGS was 2.42 years. In the control group, the arithmetic means related to CS3 and CS4 were 10.71 and 11.82 years, respectively; the duration of the PGS was 1.11 years. CONCLUSIONS: In patients with skeletal open bite, the duration of PGS is longer but it occurs at a similar chronological age compared to patients with normal anteroposterior and vertical measurements. The PGS in males begins later than in females. Knowledge on the longer growth spurt in patients with skeletal open bite compared to patients with normal anteroposterior and vertical relationships can be useful in the selection of an appropriate therapeutic method and also provides information about the possibility of a longer and thus more effective orthopedic approach directed at positive change in the vertical growth pattern during intense bone remodeling.

Patient with asymmetric multiple hypodontia treated with autotransplantation of 2 premolars.

Tooth autotransplantation is performed in patients with congenitally missing teeth and those with traumatic tooth loss. We report a course of edgewise treatment of a girl with multiple congenitally missing teeth and residual features of ectodermal dysplasia, who was treated with autotransplantation of 2 premolars with developing roots. She was 8 years old at the beginning of the treatment. No signs of inflammation, root resorption, or pulp symptoms were observed during the 2.5 years of edgewise treatment after autotransplantation. Cervical external root resorption was detected 31 months postoperatively in 1 transplanted tooth (maxillary first premolar), and the same problem occurred in the other transplanted tooth (mandibular second premolar) 2 years later. Root canal treatment was immediately undertaken and resulted in inhibition of further pathology. Consequently, the survival of both transplanted teeth was achieved. The orthodontic treatment that included intervals related to diagnosis and treatment of root resorption of the transplanted premolars is described in detail.

Duration of the pubertal peak in skeletal Class I and Class III subjects.

OBJECTIVE: To estimate and compare the duration of the pubertal growth peak in Class I and Class III subjects. MATERIALS AND METHODS: The data examined consisted of pretreatment lateral cephalometric records of 218 skeletal Class I or Class III subjects (93 female and 125 male subjects) of white ancestry. The duration of the pubertal peak was calculated from the average chronological age intervals between stages CS3 and CS4 of the cervical vertebral maturation in Class I vs Class III groups (t-test). RESULTS: In skeletal Class I subjects, the pubertal peak had a mean duration of 11 months, whereas in Class III subjects it lasted 16 months. The average difference (5 months) was statistically significant (P < .001). CONCLUSIONS: The growth interval corresponding to the pubertal growth spurt (CS3-CS4) was longer in Class III subjects than in subjects with normal skeletal relationships; the larger increases in mandibular length during the pubertal peak reported in the literature for Class III subjects may be related to the longer duration of the pubertal peak.