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INTRODUCTION: Orthodontists often encounter a clinical challenge while dealing with a big space of anterior teeth. Aberrant frenum with congenitally multiple agenesis is a complex case that requires an interdisciplinary approach. The purpose of this paper is to describe the well-synchronized periodontal surgery, orthodontic, and prosthodontic treatment of an aberrant frenum cases with congenitally multiple agenesis. CASE PRESENTATION: A female patient, aged 20, presented with complaints of misaligned, spaced teeth, and several missing teeth. A Class III malocclusion type 1 with a high and hypertrophied maxillary labial frenum was found and diagnosed. A positive blanch test, diastemata, as well as persistent teeth 53, 71, and 81, were detected. Panoramic radiographs confirmed the teeth's agenesis. Orthodontic treatment was performed using the straightwire technique to close the spaces. The frenulum was corrected by a frenectomy utilizing the Z-plasty surgical procedure. Subsequently, prosthodontic treatment involved the fabrication of lucitone dentures to close the remaining space. DISCUSSION: This case alerted periodontists, orthodontists, and prosthodontists that collaboration is essential to intervene in such specific congenital anomalies. An interdisciplinary effort should focus on eliminating the etiology of malocclusion, considering periodontal factors, maintaining dental arch integrity, addressing biomechanical elements, designing appropriate prostheses, ensuring better retention of tooth position, and achieving aesthetic appearance. CONCLUSION: The Z-plasty frenectomy surgery treatment resulted in successful and rapid healing after the operation, with no occurrence of hypertrophic scar formation. The final outcome of orthodontic-prosthodontic treatment was also pleasing for both the patient's aesthetic and functional requirements and the operator's satisfaction.
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OBJECTIVE: Clear aligner treatment (CAT) provides orthodontic patients with a comfortable treatment alternative; however, this device has limited capacity to facilitate tooth movements. Although composite attachment has been proposed to facilitate tooth displacement, some of its aspects, such as aligner thickness, can influence CAT's precision. This work aimed to compare the stress distribution patterns produced by clear aligners with different thicknesses and composite attachment shapes during anterior retraction. MATERIALS AND METHODS: Maxillary models consisting of clear aligners, maxillary teeth, and various attachments to the upper central incisor's labial surface were generated. Three models were built to mimic the retraction of the upper central incisors. Each had a distinct attachment design (rectangular attachment, ellipsoid attachment, and pyramidal attachment) and various aligner thicknesses (0.75, 0.85, 0.95, 1.05, and 1.15 mm). Upper central incisor retraction was accomplished using clear aligners. Finite element analysis was used to examine the built models. Stress distribution pattern was examined. RESULTS: The greater the thickness of the aligner, the higher the stress experienced by the teeth. The 0.75 mm-thick aligner induces the lightest stress with a minimum of 0.0037623 MPa and a maximum of 0.32859 MPa. Meanwhile, the 1.5 mm-thick aligner has the highest stress with a minimum of 0.004679 MPa and a maximum of 0.43858 MPa. The force distribution on rectangular attachments appears evenly distributed. The maximum pressure force on rectangular attachments has a minimum of 0.38828 MPa, which is smaller than the maximum on ellipsoid and pyramidal attachments at 0.40933 and 0.45099 MPa, respectively. CONCLUSION: The best aligner thickness is 0.75 to 0.85 mm for anterior retraction. An aligner with 0.95 mm thickness can still be used when a remarkable amount of tooth movement force is needed; however, this exception is only applicable to a limited number of clear aligner trays. The ellipsoid attachment is the best type of attachment because the resulting force is substantial and evenly distributed.
RESUMO
Background: Orthodontic treatments progress alongside the development of adhesive materials. The present study aimed to determine the antibacterial properties of propolis, a natural product, in a mixture of resin-modified glass ionomer cement by observing the growth inhibition zone of Streptococcus mutans.Methods: This was an in vitro study conducted on 45 samples of adhesive material, which were divided into control group (resin-modified glass ionomer cement bracket adhesive material), two groups of propolis concentrations (15%, and 25%) and duration (0, 15, and 30 days). The antibacterial effect of each sample was evaluated against S. mutans using an agar plate diffusion test. Measurement of the diameter of the growth inhibition zone of S. mutans was carried out. The data obtained were analyzed statisticallyThe significance value of the Kruskal Wallis and Mann-Whitney test was set at p <0.05, while the significance value of the normality and homogeneity test was set at p> 0.05). Datas in this study that were not normally distributed (p = 0.012) but homogeneous (p = 0.110) were analyzed by the Kruskal-Wallis test (p = 0.003) and then the Mann-Whitney test was performed to determine differences in significance between groups. Results: There was a relationship between concentration and duration of propolis to the growth inhibition zone of S. mutans (p=0.003). The addition of 25% propolis concentration inhibited the growth of S. mutans more than the addition of 15% and without propolis (control group). The addition of propolis to resin-modified glass ionomer cement for 15 days was more effective in inhibiting the growth of S. mutans.Conclusion: The addition of propolis to adhesive materials provides an inhibitory effect on the growth of S. mutans, which may be effective in the world of preventive dentistry.
