ABSTRACT
RESUMEN: La situación de gran competitividad profesional que estamos experimentando actualmente exige la necesidad de una demanda formativa cada vez mayor, que deriva en la "superespecialización" de los odontólogos/ estomatólogos. Por ello, la asociación entre diversos "especialistas" cada vez es más común con el fin de proporcionar al paciente un tratamiento global y de calidad dirigido a satisfacer sus necesidades asistenciales. El objetivo del presente artículo es presentar el tratamiento multidisciplinar, de un paciente con una transposición del canino definitivo con el incisivo lateral derecho temporal, y su rehabilitación con un implante osteointegrado.
ABSTRACT: Dentistry nowadays is a very competitive field; that is why the amount of professionals that look for an academic training on specific topics is increasing. The importance of permanent communication with other professionals during the planning stage is the key for a successful treatment. The objective of this clinical case is to present a multidisciplinary work, focused on dental rehabilitation of a patient with an agenesis of the permanent right incisor in the maxillary bone and its treatment.
Subject(s)
Humans , Female , Adult , Tooth Eruption, Ectopic/therapy , Dental Implants , Cuspid , Platelet-Rich Fibrin , Incisor/abnormalities , Patient Care Team , Tooth Eruption, Ectopic/rehabilitation , Bone Regeneration , Osseointegration , Anodontia/rehabilitation , Anodontia/therapyABSTRACT
UNLABELLED: Autotransplantation of immature teeth has good survival rates, and has benefits over ossointegrated implants in the growing child, but is very technique sensitive. Spiral CT imaging has been previously used in adult patients to enable computer-aided prototyping to produce a surgical template of the donor tooth, further increasing success rates. CASE REPORT: The case presented describes management of a 9-year-old girl with the combination of hypodontia affecting the upper lateral incisors as well as a severely ectopic maxillary canine. Cone beam CT was used in combination with computer-aided prototyping to produce a surgical template of an immature mandibular second premolar. The surgical template was used to prepare the transplant site before the donor tooth was extracted, greatly reducing the time from extraction to implantation. By 6 months posttransplant the tooth was clinically sound, and continued root development and laying down of dentine was visible radiographically. DISCUSSION: This paper demonstrates the use of a novel technique to aid the surgical procedure of autotransplantation of immature premolar teeth. The use of autotransplantation in this case allowed the difficult situation of two missing units in the upper left quadrant to be reduced to one unit, while retaining symmetry in the upper arch. Compared to previous studies, the use of cone beam CT to create a 3D prototype reduced radiation dose compared to spiral CT and drastically reduced the extra-oral time of the donor tooth from extraction to transplantation.
Subject(s)
Anodontia/therapy , Bicuspid/transplantation , Models, Anatomic , Surgery, Computer-Assisted , Tooth Eruption, Ectopic/rehabilitation , Anodontia/complications , Bicuspid/diagnostic imaging , Bicuspid/growth & development , Child , Cone-Beam Computed Tomography , Cuspid/abnormalities , Female , Humans , Incisor/abnormalities , Maxilla , Models, Dental , Tooth Eruption, Ectopic/complicationsABSTRACT
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.
