Long-term periodontal status of palatally and buccally impacted canines after closed surgical-orthodontic approach.

INTRODUCTION: The aim of this study is to evaluate the periodontal status of palatally and buccally impacted canines exposed with closed technique, and to compare them with the controlateral canines that served as control teeth as well as to compare them each other. METHODS: 28 patients, 14 with unilateral palatally impacted canines and 14 with unilateral buccally impacted canines comprised the subjects of the study. Mean recall observational period was 2 years 4 months ± 1 year 1 month. Closed eruption technique without the tunnel was performed to expose both the palatally and the buccally impacted canines. Six periodontal variables were considered: probing pocket depth (PPD); width of keratinized tissue (KT); gingival thickness (GT); plaque index (PI); gingival bleeding index (GBI); gingival recession (REC). RESULTS: Palatally impacted canines exhibited significant greater PPD on the mesiolingual site compared to their controlaterals (P<0.05). Buccally impacted canines had significant increased KT compared to their contralaterals (P<0.05). Palatally impacted canines had significant greater PPD on the midbuccal site and on all the palatal sites when compared to the buccally impacted canines (P<0.05). CONCLUSION: The changes observed in the periodontal status of impacted canines, although statistically significant, did not reach clinical significance.

Young adult patient with two palatally maxillary impacted canines and forced traction on rigid arches of stabilization. Case report.

OBJECTIVE: Young adult patient treated for impaction of two maxillary canines. METHODS: C.S., 15 years, female. Diagnostic evaluation by clinical and radiographic examinations shows permanent dentition with persistence of 5.3 and 6.3, impaction of 1.3 and 2.3, dento-skeletal Cl I malocclusion, normodivergence of bone bases. Analysis of TC dentalscan confirms the palatal impaction of 1.3 and 2.3. The treatment plan provided an orthodontic-surgical approach for adequate space management in dental arch, evaluation of eruption movements, choice of anchorage device, surgical exposure and application of the brackets. RESULTS: Deciduous canines have been extracted and an edgewise appliance with rigid rectangular full thickness archwires has been used to align the arches and to obtain maximum anchorage during the forced traction. The surgical phase, for exposure of 1.3 and 2.3 respectively, performed an open technique by excisional uncovering and a close technique by a repositioned flap. The case has been finalized for the achievement of the right occlusal keys. CONCLUSION: The possibility to choose the surgical technique depending on the intraosseous position of impacted teeth in association to the edgewise therapy with full thickness arches allows to realize an effectiveness surgical-orthodontic approach for the forced traction of impacted teeth in a favourable position.

Association between mesially displaced maxillary first premolars and early displaced maxillary canines.

AIM: To evaluate the association between the mesially displaced maxillary first premolar (MDP) and the early displacement of the adjacent permanent canine (EDC) before their eruption. MATERIALS AND METHODS: A sample of 1247 subjects in the intermediate mixed dentition stage was assessed for the presence of MDP and EDC. All subjects were divided into two groups: MDP group and noMDP group. For each subject two angular measurements (premolar-occlusal plane η and л premolar-midline angles) were analysed on panoramic radiographs. The chi-square test with Yates correction was performed to compare the prevalence rate of EDC in MDP (MDP-EDC) and noMDP groups. The statistical comparisons for the values of η and л angles between MDP vs noMDP, MDP vs MDP-EDC, and noMDP vs MDP-EDC groups were performed by means of ANOVA with Bonferroni correction. RESULTS: The prevalence rate of EDC in the MDP group was significantly greater than in the noMDP group (66% vs. 12.1%). MDP-EDC group showed a significantly larger л angle than in the MDP group resulting in an increased mesial inclination of displaced premolars. CONCLUSION: MDP can be considered a dental anomaly associated to maxillary canine displacement.

Interceptive management for multiple eruption disturbances: a follow-up evaluation.

AIM: The aim of this report was to show the management of a case with an impacted central maxillary incisor caused by odontoma in a young patient with two mesiodentes in the region of the nasal floor. CASE REPORT: A 9-year-old girl was seen in the Department of Orthodontics of the University of Rome 'Tor Vergata'. Radiographic images showed intraosseous impaction of the maxillary right central incisor due to an odontoma. The treatment plan consisted of three stages: removal of the odontoma; rapid maxillary expansion (RME) in order to improve the intraosseous tooth position; surgical exposure and orthodontic traction of the impacted central incisor to its right position. At the end of the treatment the patient showed stable occlusal, functional, and periodontal results. In our therapeutic strategy the application of RME may improve the intraosseous position of incisor, minimizing space loss and surgical intervention to recover the impacted tooth. A three-year follow-up of the stability and periodontal health showed that the tooth placed in the occlusion maintained both esthetics and function.

Friction in a hybrid system. An in vitro study.

AIM: The aim of this study was to compare the frictional force generated by self-ligating and conventional brackets coupled with stainless steel wires when conventional elastomeric or stainless steel ligatures were applied. METHOD: FOUR TYPES OF BRACKETS WERE SELECTED FOR THE STUDY: one passive self-ligating bracket, two active self-ligating brackets, and one conventional bracket. For each type of bracket one molar tube and two upper premolars were used in combination with three different wires (0.016x0.022, 0.017x0.025 and 0.019x0.025 inch). Testing was performed with an Instron machine. Each bracket/wire combination was tested with conventional elastomeric and stainless steel ligatures. Tests performed with self-ligating brackets were carried out also without conventional ligatures. ANOVA with Tukey's post hoc tests were used to compare the results for the different bracket/wire/ligature assemblies. RESULTS: Active self-ligating bracket/0.017x0.025 inch or 0.019x0.025 inch/stainless steel ligature assemblies showed significantly higher values of frictional forces than conventional bracket for the same combinations. Passive self-ligating brackets showed significantly lower values of friction than conventional brackets for each wire/ligature assembly. CONCLUSIONS: The use of stainless steel ligatures applied on active self-ligating brackets produced significantly higher level of frictional force than in combination with conventional brackets for 0.017x0.025 inch and 0.019x0.025 inch wires.

Supernumerary teeth and mental retardation: the importance of early surgical intervention.

AIM: This paper reported a rare case of hyperdontia in a child of 10 years who revealed a mixed dentition and a light mental retardation. MATERIALS AND METHODS: The therapeutic approach has been based on interdisciplinary cooperation between the pediatric dentist, orthodontist and oral surgeon. TC-Dentascan, with a panoramic and occlusal radiographs revealed the presence of two supernumerary teeth in the premaxillary region and clinical examination showed an abnormality of dentoalveolar complex. Both impacted supernumerary teeth were extracted under general anesthesia. Clinical examination revealed that they appeared two premolars in shape with fully formed crowns and partly formed roots. RESULTS: Three months after the extraction of supernumerary teeth there was a spontaneous eruption of permanent central incisors and left lateral incisor. CONCLUSION: The authors emphasized the importance of removal of supernumerary teeth to eliminate the cause of a delayed eruption of permanent teeth.

A case of an unerupted maxillary central incisor for indirect trauma localized horizontally on the anterior nasal spine.

The present paper emphasizes the importance of early diagnosis of retarded eruption because of trauma and the plan for the surgical management of impacted teeth. The permanent incisor was localized horizontally on the nasal spine and the roots seemed to be in a retarded stage of formation beside of contralateral tooth. The treatment plan consisted in the valuation of the necessity of space to move the impacted incisor in the normal position and the biomechanical approach for the anchorage.

Case report: severe infraocclusion ankylosis occurring in siblings.

AIM: This was to report a rare case of strong familiar tendency of ankylosis of maxillary second primary molars. CASE REPORT: Three Caucasian children, male twins of 8.5 years and a sister of 10 years, were diagnosed as having severely infraccluded maxillary second primary molars with underlying second premolars. In all three cases, the early extraction of the infraoccluded molars and an active treatment with cervical extraoral traction allowed the physiologic eruption of second premolars. Follow-up showed that normal vertical relationship and bone height had been obtained. CONCLUSION: Early diagnosis, as well as appropriate treatment and careful follow-up are very important in the presence of severe infraocclusion, when the marginal ridge of affected primary teeth is at or below gingival level.

Case report: two nasal floor compound odontomas associated with impacted maxillary incisor.

AIM: The purpose of this report is to describe the logical sequence of treatment in a case of a six year old caucasian female patient with two nasal floor compound odontomas, that delayed eruption of a maxillary permanent incisor. TREATMENT: The odontomas were surgically removed. However, as the maxillary incisor did not erupt spontaneously, after a suitable period of observation, an orthodontic treatment approach was adopted. This was to obtain an adequate space for the unerupted tooth and to move it to its normal position. CONCLUSION: Early diagnosis and surgical intervention of supernumeraries is therefore necessary and treatment of an impacted tooth may require an orthodontic appliance.