Gingival recession refers to the exposure of the tooth's surface by an apical shift of the gingiva. The aim of this paper is to present a clinical case of an adult patient with a skeletal Class I and clinically deep gingival recession in the mandibular left central incisor. A preadjusted appliance with 0.022 in × 0.028 in slot was placed in both arches. Rectangular arches were used, with the addition of root lingual torque, specifically in the left lower central incisor. Class II and vertical intermaxillary elastics were used throughout the active treatment to obtain intercuspation of the posterior teeth. The orthodontic movement with the application of a localized biomechanics system of forces into the mandibular left central incisor delivered good dental and functional occlusion and, mainly, gingival and periodontal health. The follow-up showed stable results with the periodontium within normal limits and an improved occlusal interdigitation.
Aim The purpose of this article is to report on the five-year follow-up of a case involving treatment of gingival recession with a subepithelial connective tissue graft prior to orthodontic tooth movement. Background Gingival recession has a global prevalence that varies from 3 to 100 perpcent depending on the population studied and the method of analysis. In addition, the frequency of recession seems to be positively correlated with age. Planned orthodontic tooth movement is not necessarily an etiological factor for gingival recession, so long as it does not move the tooth out of its alveolar process. When the tooth is shifted without adequate biomechanical control, bone dehiscence can develop, and the recession can occur as a consequence of the orthodontic treatment. Case Description A 19.6-year-old female patient was referred for orthodontic treatment due to severe anterior-inferior dental crowding and a mandibular right lateral incisor in linguoverson and 4.0 mm of gingival recession on the labial surface. Normal gingival architecture was restored with a subepithelial connective tissue graft used to cover the 4.0 mm defect, after which orthodontic treatment repositioned the malposed incisor into its correct occlusal alignment. Individualized torque was applied to the mandibular right central incisor during the orthodontic treatment. The patient was reevaluated five years after completion of the orthodontic treatment. Results At the five-year recall appointment, the patient exhibited normal tooth alignment and generalized normal gingival architecture; however, 2 mm of gingival recession was noted on the graft site. Summary This case demonstrated that periodontal surgical correction of facial gingival recession with a subepithelial graft may be performed prior to initiating orthodontic treatment. Clinical Significance The interdisciplinary association between orthodontics and periodontics contributes to good prognosis and acquisition or maintenance of the periodontal tissue health, masticatory function, esthetics, and patient satisfaction. The subepithelial connective tissue graft placed prior to the orthodontic movement showed satisfactory results five years after completion of the orthodontic treatment. Citation Tanaka OM, Avila ALR, Silva GM, Añez MCG, Taffarel IP. The Effects of Orthodontic Movement on a Subepithelial Connective Tissue Graft in the Treatment of Gingival Recession. J Contemp Dent Pract [Internet]. 2010 December; 11(6):073-079. Available from: http://www.thejcdp. com/journal/view/volume11-issue6-tanaka
Transmigrated mandibular canines increase treatment complexity in terms of both anchorage and biomechanical planning, posing challenges for both Orthodontists and Oral Surgeons. This case report presents the orthodontic treatment in a 12-year-old girl patient, with transmigrated and impacted mandibular right canine positioned horizontally below the apices of the mandibular incisors. The mandibular deciduous right canine was extracted followed by the traction of the transmigrated permanent canine. Eruption was properly guided, and the correct position of the tooth was orthodontically guided into its normal position in the arch. The patient’s occlusion was significantly improved with good aesthetic outcome, functional occlusion, and a stable result after 1.5 years of follow-up.
Aim: The aim is to report a case of impacted maxillary right canine successfully positioned into the occlusion line. Background: Although the treatment of choice for an impacted canine is a combined surgical-orthodontic approach, there are differences in technique. The preorthodontic uncovering and autonomous eruption technique is a safe and predictable option for the treatment of palatally impacted maxillary canines in adolescents and adults as is the orthodontic creation of a space before minimal surgical exposure, the bonding of a small attachment (an eyelet), full-flap closure, and immediate traction. Although the mechanical management of impacted teeth is a routine task for most orthodontists, certain types of impaction can be frustrating. Case description: An 18-year-old adult patient presented for clinical examination with a mobile maxillary right deciduous canine, the absence of a maxillary right permanent canine, Angle Class I malocclusion, an overjet of 2.0 mm, an overbite of 3.0 mm, and rotated canine and left maxillary central and lateral incisors. Cephalometric measurements revealed a skeletal Class I relationship as well as upright maxillary incisors (1. NA = 18º) and mandibular incisors (1. NB = 16º, IMPA = 80º). The facial profile was concave. Clinically, a constricted maxillary arch was observed, and the patient had a nail-biting habit. Conclusion: The canine was aligned, leveled and positioned in the occlusion line. The aesthetic, functional and periodontal results remained stable in the retention phase. Clinical significance: Various treatment strategies are available to treat impacted maxillary canines. The surgical, periodontal, and orthodontic considerations in the management of impacted canines must be clearly explained to the patient.
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