Unilaterally impacted maxillary central incisor and canine with ipsilateral transposed canine-lateral incisor.

Concurrent impaction and transposition of maxillary anterior teeth is uncommon and poses a challenge for dentists. Early diagnosis and management of eruption disturbances benefits esthetic and functional outcomes. This article describes the treatment of a teenager who had impactions of the left maxillary central incisor and canine as well as ipsilateral canine-lateral incisor transposition. Treatment alternatives and effective orthodontic techniques are delineated. To optimize the treatment results, the impacted maxillary canine was surgically exposed and orthodontically distalized with an innovative cantilever. Subsequently, the deeply impacted maxillary central incisor was uncovered and orthodontically mesialized into the arch. Finally, the displaced maxillary lateral incisor was brought into its normal position. The combined surgical-orthodontic approach resolved a difficult clinical issue and avoided additional restorations. An esthetic, functional outcome was achieved and satisfied the patient.

Orthodontic screws to extrude impacted maxillary canines.

OBJECTIVE: The impaction of maxillary canines is a frequently encountered clinical problem in orthodontic practice. Patients' refusal to participate in long-term treatment or ankylosis of the impacted tooth result in various treatment difficulties. The aim of this study was to evaluate the possible role of mini-screws in the management of unerupted upper canines. PATIENTS AND METHODS: In a series of 63 consecutive patients (27 males and 36 females, age range 14-49 years, mean 22.7 years) with a total of 69 impacted maxillary canines, each impacted tooth was surgically exposed and an attachment bonded. An intraosseous screw with an endosseous body and intraoral neck section was inserted into the premolar-molar interradicular space. Following soft tissue healing, orthodontic traction was initiated. After correction of the canine angulation, the mini-screw was removed and conventional orthodontic therapy completed. RESULTS: Of the 69 canines, 61 (88.41%) were extruded successfully. In the 7 cases that failed, skeletal anchorage spared both patients and clinicians the disappointment of customary long-term, unsuccessful orthodontic therapy. In one patient, the mini-screw was removed because of inflammation and pain before initiating orthodontic traction. CONCLUSION: Our results demonstrate that mini-screw anchorage should be taken into consideration when extrusion of an impacted canine is planned.

Caninos superiores impactados: incidência, etiologia e opções de tratamento / Upper canine impaction: incidence, etiology and treatment choices

Objetivos: Orientar os cirurgiões-dentistas a detectar a retenção dos caninos precocemente e de maneira simples, assim como apresentar as várias formas de tratamento frente a este problema, frisando a cirurgia para o tracionamento ortodôntico que visa trazer o canino retido para a posição correta no arco dentário. Este trabalho consiste na revisão de literatura sobre a retenção de caninos superiores, abordando seu desenvolvimento, sua incidência, etiologia, conseqüências, diagnóstico e as variadas modalidades terapêuticas e suas complicações. Conclusão: O diagnóstico precoce e a conduta preventiva são essenciais para diminuir a incidência de complicações e facilitar o tratamento dos caninos superiores impactados. O tratamento multidisciplinar é mandatório quando se opta pelo tracionamento, para que seja bem planejado e que seja escolhida a melhor técnica para cada caso. O tracionamento a campo fechado é a técnica mais utilizada por apresentar maior número de vantagens.

Objectives: We propose a guideline to help dental surgeon to early diagnosis a canine impaction, emphasizing the orthodontics traction surgery. After this review article concerning many choices of therapy for this disease, we also describe canines impaction, canine development, incidence of impaction, etiology, prognosis, diagnosis and most common surgical techniques and possible complications. Conclusions: Early diagnosis and preventive management are essentials tools to reduce complications, allowing treatment of upper canine impacted. A multidisciplinary treatment is mandatory, when choosing the orthodontic traction in order to have a well planned procedure and select the best surgical technique for each case. The closed eruption technique is prefered because it has more advantages.

The alignment of impacted and ectopic teeth using the Easy-Way-Coil (EWC) System.

BACKGROUND: Teeth that do not spontaneously erupt in the dental arch or are ectopic must normally be surgically exposed. For orthodontic correction a traction device must be attached to the affected tooth over which the already-raised mucoperiosteal flap is lowered to improve the periodontal condition. METHOD: The author has developed a system at his private orthodontic practice for this purpose, and it has proven itself over a 10-year period. A traction spring is fastened to a lingual button that is attached to the etched tooth surface using an adhesive. The appliance is activated by systematically shortening the spring. RESULTS: A total of 103 patients were treated successfully in this way, 45 of whom had presented a unilaterally ectopic canine requiring an average treatment time of 17.8 months from surgical exposure to removal of the fixed appliance. None of the patients suffered inflammatory reactions in the oral mucosa adjacent to the traction spring during the treatment. Two impacted teeth were ankylosed and could not be aligned. CONCLUSION: The EWC-System is clinically a reliable, efficient, easy to use and economical system for the alignment of impacted and ectopic teeth.

Immediate placement of implants in extraction sites of maxillary impacted canines.

BACKGROUND: Treatment of asymptomatic impacted maxillary canines in adults is inevitable when primary canine becomes lost through extraction or exfoliation or when the impacted tooth becomes symptomatic. Treatment alternatives include an orthodontic procedure to bring the unerupted tooth to the dental arch or prosthetic replacement of the missing tooth. The authors describe an alternative treatment that involves immediate placement of implants into extraction sockets of the teeth. CASE DESCRIPTION: A patient with bilateral palatally impacted upper canines chose to have the unerupted teeth removed and replaced with implants and crowns. Two hydroxyapatite cylindrical implants were inserted through the alveolar ridge into the extraction sites. The unfilled areas in the extraction sites, around the dental implants, were packed and covered with demineralized freeze-dried bone allograft in conjunction with a collagen membrane barrier. Six months after implantation, computed tomography revealed complete osseous fill of the extraction defects and no bone loss around the implants. The implants were uncovered, and porcelain-fused-to-metal restorations were fabricated and placed. CLINICAL IMPLICATIONS: This treatment modality avoids the need for conventional preparation of teeth as part of prosthetic reconstruction or prolonged orthodontic treatment aimed at bringing the impacted canine to the dental arch. Combining the implantation with bone augmentation preserved the alveolar bone and shortened the treatment period.

[The occlusal and functional rehabilitation of a lower canine in complete osseous inclusion]. / Recupero occlusale e funzionale di un canino inferiore in inclusione ossea completa.

The aim of this paper is to show an occlusal and functional rehabilitation of a lower canine tooth in total osseous inclusion by means of surgical and orthodontic therapy. This rehabilitation is very important for mastication and for the correct function of the temporomandibular joint.

Ankylosis: an orthodontic problem with a restorative solution.

This case illustrates a restorative approach using adhesive techniques to overcome the aesthetic and functional problems associated with infraclusion of a mandibular canine tooth resulting from ankylosis. In this case a diagnosis of ankylosis was confirmed after 3 months of fixed appliance orthodontic therapy failed to extrude the tooth.

Cleidocranial dysplasia. Case report.

A 29-year-old Caucasian woman who presented with short stature and multiple unerupted supernumerary teeth is described. Radiological investigations of her cranial and skeletal abnormalities revealed cleidocranial dysplasia. Because of the advanced age of the patient and contraindication for orthodontic treatment, only surgical and prosthetic treatment were performed. The characteristics and treatments of this rare autosomal dominant disorder are discussed.