The presence of supernumerary teeth is not uncommon in the general population. Supernumerary teeth (hyperodontia) appear more in permanent dentition. Supernumerary teeth which are in the premolar region occur more often in the mandible with different shape and size. They might occur singly or in multiples, be erupted or impacted. The reason of hyperodontia is still unknown. There are a lot of theories. Various theories have been suggested to explain the etiology of supernumerary teeth in general including both, the genetic theory and environmental factors.Furthermore, it has been suggested that supernumerary premolar teeth belong to a third (postpermanent) series. Proliferation of dental lamina has been implicated. The presence of supernumerary teeth usually is connected with some disease or syndromes. Treatment of hyperodontia depends on the area where supernumerary teeth occur.This article presents a case report of an 11-year-old girl with hyperodontia of the first premolar, erupted palatinally in the left side of maxilla. This is supplemental tooth that looks like the permanent premolar. The orthopantomogram and 3D radiograph showed a big possibility of concrescence of both premolars. To make a definitive diagnosis and a plan for orthodontic treatment, OPG and 3D radiograph were crucial.
Correct positioning of the canines after their retraction is of great importance for the function, stability and esthetics. Aim: Two case reports were presented to compare the efficiency of two techniques for canine retraction, segmented mechanics using 0.017 x 0.025 TMA T-loop vs sliding straight-wire mechanics usingelastomeric chains. Material and methods: The first case describes orthodontic treatment with 0.017 x 0.025 TMA T-loop whereas the second case describes a 9 mm canine retraction using elastomeric chains. Results: Depending on the type of malocclusion both techniques for canine retraction can be used. Post treatment results showed canine retraction with good anchorage control and no mesial movement of the molars.Conclusion: Both techniques provide an optimum rate of tooth movement and none of the methods can be considered superior in terms of tooth movement or side effects, including rotation, tipping, root resorption, anchorage loss, as well as associated pain.
Early loss of mandibular permanent molars with supraeruption of maxillary permanent molars is a common clinical finding causing functional posterior occlusion problems. Rehabilitation of the stomatognathic system often requires preprosthodontic intervention with molar intrusion which is one of the most difficult movements in orthodontic mechanics requiring efficient anchorage to achieve success.The aim of this study was to present two case reports, with orthodontic mini-implants used for molar intrusion as preprosthetic treatment, reducing the need for prosthetic crown reduction in patients with edentulous space discrepancy. With the aid of chain elastics, the force of intrusion passing through the center of resistance of the tooth, supraerupted maxillary molars were intruded approximately 0.5 mm per month. The intrusive tooth movement maintained the vitality of the intruded teeth and was not aggressive to the periodontal structures, did not cause root resorption and no change of the pulp flow was detected. In contrast to traditional orthodontics, mini-implants were demonstrated to be clinically efficient in providing sufficient anchorage against orthodontic forces. With these devices, using well-controlled magnitude and direction of the force, we reestablished successfully the functional posterior occlusion. By presenting these case reports, we emphasize the versatility of orthodontic mini-implants as a form of temporary anchorage devices (TADs) in the biomechanics of molar intrusion attempted to create interocclusal space for adequate prosthodontic restoration with osseointegrated implants and prosthesis.
RTG projections are essential for diagnosis, treatment plan, follow-up and treatment outcomes. Three-dimensional (3D) cephalometry, which is done using a cone-beam computerized tomography (CBCT) examination, allows more detailed evaluation of the craniofacial hard and soft tissue structures than 2D radiograph. Using 3D analyses in diagnostic and treatment planning in orthodontics is more than necessary in cases with impacted teeth, cleft lip, and skeletal discrepancies requiring surgical interventions. CBCT has come into wider usage in other situations as root resorption, temporomandibular joint (TMJ) morphology and pathology, supernumerary teeth, alveolar boundary conditions and asymmetries; maxillary transverse dimensions and maxillary expansion; vertical malocclusion and obstructive sleep apnoea.The present descriptive study aimed to explore possible applications of 3D technologies during the diagnosis, treatment plan, case monitoring and result assessment in orthodontics including their advantages and disadvantages.Utilisation of 3D technique was more than necessary in diagnostic and treatment planning in this case because of presence of more than one impacted tooth. The fixed appliances, the surgical exposure, cortectomy and orthodontic traction were done. The tooth movement and positioning to the dental arch started six months ago.The impacted tooth is already seen and the treatment continues. The severity of this case is indication for utilization of control 2D and 3D radiographs in manner following the positioning of the central incisor on the appropriate place. 3D technique is less prone to error and can improve the clinicians' workflow.
Deep bite is perhaps one of the most common dental malocclusions seen in children as well as in adults and is very demanding to be treated successfully. A skeletal or dental overbite is caused by genetic or environmental factors, or a combination of both.The ideal overbite in a normal occlusion may range from 2 to 4 mm. Mild deep bite typically requires no correction, unless correction for aesthetic reasons. Severe overbite, considered as a clinical problem may affect the temporomandibular joint, causes periodontal problems and tooth wearing, as well as traumatizing the incisive papilla or interfering with mastication function. Anterior deep bite could be caused by overeruption of upper and/or lower incisors or undereruption of posterior teeth.Correction of deep overbite has always been challenging to orthodontists, especially in adult cases. There are different modalities in orthodontic treatment of this malocclusion. Deep bite correction can be treated with intrusion of incisors, extrusion of posterior teeth, combination of both, and orthognathic surgical modality.The aim of this case report was to present treatment protocol for an adult patient with skeletal deep bite, Class II Division 1 malocclusion and temporomandibular disorder (TMD) managed with conventional orthodontics therapy combined with orofacial myofunctional exercises.The modality of exercise therapy included improvement of proprioception, tonicity and mobility, working with the facial and cervical musculature, as well as with stomatognathic functionsrespiration, mastication, deglutition and speech. The most important thing is to aid long-term retention.
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