The Graz implant supported pendulum, a technical note.

A new, immediately loadable palatal implant with rotational stability and an implant-supported pendulum for patients with dental class II dysgnathia and dental crowding is presented. In seven cases, the treatment goal of distalization of all upper molars without extraction of a single tooth was achieved within 8 months.

An implant to eliminate anchorage loss during molar distalization: a case report involving the Graz implant-supported pendulum.

Based on the philosophy of the pendulum appliance, a new non-integrated implant-supported device is presented, the Graz Implant-Supported Pendulum (GISP). It is designed to distalize maxillary first and second molars in adults. It consists of 2 parts: the anchorage plate, which is fixed to the palatal bone via 4 miniscrews, and the removable part, which is a pendulum-type appliance. A finished clinical case is shown, and experiences with the GISP in comparison with other orthodontic implants are discussed. The system can be loaded 2 weeks after surgical placement, actively distalize maxillary molars consecutively, serve as an active anchor unit, and provide stability against rotational movements.

Distal molar movement using the pendulum appliance. Part 1: Clinical and radiological evaluation.

Intra-arch distal molar movement techniques have recently assumed an important role in clinical orthodontics. In this study, the dental and skeletal effects of the pendulum appliance, applying 200 to 250 g of force to the molars in 13 patients (age range 8 years to 13 years 5 months) were evaluated by means of cephalometric radiographs. The results showed that the pendulum appliance moved the molars distally without creating dental or skeletal bite opening and with little incisor anchorage loss. However, important molar tipping should be taken into consideration when using this appliance.

Distal molar movement using the pendulum appliance. Part 2: The effects of maxillary molar root uprighting bends.

A clinical study was recently undertaken to evaluate the dental and skeletal effects of the pendulum appliance (PA). In the present study, the appliance was modified by incorporating an uprighting bend into the distalizing spring during the second phase of treatment to avoid excessive distal tipping of the maxillary molars. The sample consisted of 20 patients: 8 females and 12 males, mean age 13.11 +/- 1.10 years. Eight of the patients were subjected to a slow rate of maxillary expansion. Measurements were obtained from cephalometric headfilms prior to (T1) and the day of removal (T2) of the PA. Treatment changes were analyzed and compared with the previous study. The PA with uprighting bends led to reduced molar tipping without significantly changing the effects of the PA, with the exceptions of 0.62 mm more anchorage loss of the maxillary incisor edge and increased treatment time. There was no significant difference in anchorage loss between the patients with and without maxillary expansion.

Conservative surgical and orthodontic management of a child with central giant cell granuloma.

Differential diagnosis and treatment modalities of giant cell granulomas have been a controversial matter since Jaffe first distinguished true giant cell tumours (TGCG) from central giant cell granulomas (CGCG). CGCG is a slowly growing and painless tumour usually treated by simple curettage but denotes a strong tendency to recurrence. A case report is presented to describe conservative therapy of CGCG in the maxilla of a young child: surgical enucleation of the tumour at the age of 11 years, though successful, was followed by progressive impaction of the maxillary right permanent canine. Orthodontic treatment aligned the maxillary teeth to accommodate autotransplantation of the impacted tooth. Clinical and radiographic evaluation of the patient 5 years after the initial surgical treatment showed good bony and periodontal healing around the transplanted canine and no recurrence of the CGCG. As the literature shows that distinction of the two tumours is difficult even by histological means, various clinico-pathologic factors involved in prognostic evaluation are discussed.

Unilateral and bilateral corticotomies for correction of maxillary transverse discrepancies.

Surgically-assisted rapid maxillary expansion in adults has been proved effective in overcoming the strong resistance of the maxillary complex after growth is completed, particularly after the second decade of life. The aim of this study was to describe the dental and the skeletal expansion and relapse, as well as the amount of tipping of the two maxillary bones and first permanent molars, during a rapid maxillary expansion procedure combined with unilateral and bilateral corticotomies. The sample consisted of four adult patients, two presenting with bilateral and two with unilateral cross-bite. Records were taken before and after rapid maxillary expansion, at the end of retention and at least 12 months post-retention. In the cases of bilateral cross-bite the same amount of skeletal expansion was observed on both sides. The angular changes measured at the upper first molars indicated important tipping on both sides, which tended to relapse moderately during the retention and post-retention period. Following unilateral surgery, the operated side showed more than twice the amount of skeletal expansion than the non-operated side. The angular changes presented twice as much tipping and relapse on the operated side. The results of this study demonstrate that unilateral cross-bites in adults can be corrected with unilateral corticotomy and rapid maxillary expansion using the contralateral non-operated side as anchorage. Stability appeared satisfactory in all cases.