Class II Correction with Microimplant Supported Molar Distalization: A Report of Two Cases.

Introduction: Orthodontic treatment of class II malocclusion with conventional treatment modalities can be challenging for the clinician. The use of microimplants to obtain absolute anchorage has become very popular in recent years especially in noncompliant patients. Microimplants are convenient, save time, and produce good treatment results with no need for patient cooperation. A special approach for class II correction with microimplant supported molar distalization has been developed by the authors and is illustrated through two clinical cases. Description. For each clinical case, 0.022" preadjusted brackets were bonded on both arches except on the maxillary first and second premolars with bands on the first and second molars. After leveling and alignment, a 0.017" × 0.025" stainless steel wire was fitted on the upper arch, and two microimplants were placed bilaterally between the maxillary second premolar and the first molar. Open coil springs were inserted in the upper archwire on both sides and compressed via a steel ligature on sliding hooks to the microimplants pushing distally simultaneously the first and second maxillary molars. En-masse retraction of the maxillary anterior teeth was then carried out on a 0.019" × 0.025" stainless steel closing loop archwire while the posterior segment was anchored to the microimplant with a steel ligature to the first premolar. Results: Class I canine and molar relationship were achieved, and an ideal occlusion was established. Both ANB and FMA angles decreased by 1° due to the counterclockwise rotation effect of the maxillomandibular complex. Skeletal and dental results remained stable three years later. Conclusion: Maxillary molar distalization using coils and buccal microimplants can be regarded as an effective technique in a relatively short time and might be considered a breakthrough in the treatment of class II malocclusions. Microimplants enable the clinician to perform a nonextraction treatment in noncompliant patients who would alternatively be treated only with extractions.

Alveolar Bone and Epithelial Attachment Status following Two Different Closed-eruption Surgical Techniques for Impacted Maxillary Central Incisors.

AIM: Two eruption surgical techniques are commonly described for the treatment of upper impacted central incisors (ICIs): Open and closed. Currently, the closed-eruption surgical technique (CEST) is the most commonly used, as it allows for the best esthetic and periodontal results.The aim of this study was to determine the effect of traction discontinuation on maxillary central incisor sulcal depth and alveolar bone ridge levels compared with contralateral incisors, when CEST is used. MATERIALS AND METHODS: Our study involved 28 unilateral impacted maxillary central incisors treated by CEST. Thirteen teeth were subjected to traction interruption for a month at the time of emergence of the crown, while 15 teeth underwent continuous traction. One year after treatment, periapical digital X-rays, anterosuperior cone beam computerized tomography (CBCT) scanning, and periodontal probing of the ICIs and contralateral central incisors (CCIs) were performed. Student's t-test was used to study whether a statistically significant difference between continuous and interrupted tractions takes place while using the CCI measurements as reference. RESULTS: There was a statistically significant difference between the two techniques only for the following measurements: Mesial probing (p-value 0.039352), labial bone level (p-value 2.58E-08), and palatal bone level (p-value 2.56E-06). LIMITATIONS: A larger sample size and longer term follow-up are needed to draw more robust conclusions. CONCLUSION: A temporary discontinuation during traction of the tooth appears to positively impact treatment outcome on ICIs. CLINICAL SIGNIFICANCE: • The CEST leads to the best periodontal status for ICIs.• The discontinuation of traction at the emergence of the tooth allows the supracrestal fibers to insert into the cement in a proper way.How to cite this article: Sfeir E, Gholmieh M, Skaf Z, Mourad A. Alveolar Bone and Epithelial Attachment Status following Two Different Closed-eruption Surgical Techniques for Impacted Maxillary Central Incisors. Int J Clin Pediatr Dent 2018;11(4):317-322.

Maxillary tooth transposition: A report of two cases.

Among eruption anomalies, tooth transposition is considered the most difficult to manage clinically and represent a real challenge for the clinician. Uncorrected, the results are often both functionally and esthetically unsatisfactory. Treatment of this anomaly varies from acceptance to correction and should take into account aspects, such as age, dental morphology, malocclusion, facial esthetics, stage of root development, position of root apices, and magnitude of the transposition. Acceptance of the transposition is the predominating treatment strategy in case reports in the literature. Our aim in this article is to present two cases with complete maxillary canine first premolar transposition where the transposition was corrected.