Indications for autotransplantation Autotransplantation is defined as the transplantation of embedded, impacted or erupted teeth from one site into extraction sites or surgically prepared sockets in the same person. 3 Autotransplantation has been used to replace missing teeth and teeth of poor prognosis. 4-10 The etiology of tooth agenesis is largely unknown. Vastardis 11 presented supporting evidence of a genetic etiology for tooth agenesis. He also reported the most frequently absent teeth are third molars followed by mandibular second premolars. 11 There are reports of associations of tooth agenesis and other congenital tooth anomalies to certain malocclusions. 12 The treatment plan for missing teeth cases should be based on a comprehensive evaluation of the age, occlusion, and space requirements of the patient as well as the size and shape of the adjacent teeth. 13 If extraction has been planned in the maxilla for the correction of crowding or reduction of a overjet, a maxillary premolar may be transplanted to the second premolar site in the mandible (Fig 1). In most cases, the tooth or teeth to be extracted due to caries or periodontal disease are the first molars. In this case, transplantation of third molars to the first molar site may be considered. 4,6,10 Maxillary incisors are the teeth most frequently involved in trauma. Zachrisson 14 reported autotransplantation of the developing mandibular second premolar to the avulsed maxillary incisors. Autotransplantation may provide a simplified and faster treatment option for patients with ectopically positioned teeth. The optimal treatment for ectopically positioned
Objectives:
To evaluate the condyle-fossa relationship in adolescents with various skeletal patterns using cone-beam computed tomography (CBCT).
Materials and Methods:
CBCT images obtained in 120 adolescent patients were used for this study. The patients were divided into 3 groups according to 3 criteria: (1) age (early, middle, and late adolescence); (2) facial height ratio or Jarabak quotient (hyperdivergent, normodivergent, and hypodivergent); and (3) ANB classification (Class I, Class II, and Class III). Temporomandibular joint space (TMJS: AS, anterior space; SS, superior space; PS, posterior space; MS, medial space; LS, lateral space), width and depth of the condyle (MLT, mediolateral thickness; APT, anteroposterior thickness), articular slope (ArS) and vertical height of the fossa (VHF) were measured and compared using CBCT.
Results:
Differences in condyle-fossa relationships were not significantly different between male and female adolescents, but were significantly different (P < .05) between left and right sides. The mean values showed no statistical differences according to age and skeletal pattern. Most measurements in the sagittal view showed that SS was the greatest, and the mean ratio of AS to SS to PS was 1.00 to 1.27 to 1.19, respectively. The mean values of coronal MS and LS were not significantly different.
Conclusions:
There were almost no statistical differences in the TMJS in adolescents across various factors except between left and right sides.
Objective: The purpose of this research was to use cone-beam computed tomography (CBCT) images to evaluate dental and skeletal changes in upper and lower jaws after treatment with Schwarz appliances.Materials and Methods: 28 patients with Angle Class I molar relationships and crowding were randomly divided into two groups – 14 non-expanded and 14 expanded patients. 3D-Rugle CBCT software was used to measure various reference points before treatment (T0) and during the retention period of approximately 9 months after 6 to 12 month expansion (T1). Cephalometric and cast measurements were used to evaluate treatment in both groups. To test whether there were any significant differences between the control and treatment groups at T0 and T1, the Mann-Whitney U-test was used. Results: The dental arch (including tooth root apices) had expanded in the upper and lower jaws. Alveolar bone expansion of up to 2 mm apical to the cementoenamel junction (CEJ) was detected. The midpalatal sutures were separated in some cases and subsequent expansion was observed at the inner surface of the nasal cavity at the inferior turbinates. However,no significant (P > 0.05) difference was observed in the inter-width of the mandibular bodies, zygomatic bones, nasal cavity in the middle turbinate region, condylar heads, or antegonial notches. In mandibular and maxillary cast measurements, arch crowding and arch perimeter showed statistically significant changes in the expansion group. The mandibular width values demonstrated no significant changes as measured from a point 2 mm apical to the CEJ, whereas the maxillary width values demonstrated significant changes as measured from a point 2 mm apical to the CEJ. Conclusions: This study indicates that the Schwarz appliance primarily affects the dento-alveolar complex, while it has little effect on either the mandibular bodies, any associated structures including the maxillary midpalatal suture and the inter-width of the nasal cavity in the middle turbinate region. In addition, the center of rotation of the mandibular and maxillary first molar was observed apical to the root apex.
Clinicians agree that tooth agenesis regardless of gender or race becomes more prominent in recent societies. The congenital absence of one or more maxillary lateral incisors is a challenge to effective treatment planning for the restorative dentist. The one-sided orthodontic approach of moving canines mesially to eliminate restorative procedures also leads to compromise. Adult patients presenting with malocclusions, missing lateral incisors, and anterior crowding, who request esthetic solutions without proper orthodontic treatment will get compromised results. The avoidance of establishing a stable occlusion, proper alignment and proper axial inclination of the teeth compromises esthetic and periodontal results. Evaluation of anterior smile esthetics must include both static and dynamic evaluations of frontal and profile views to optimize both dental and facial appearance. This article presents how orthodontics is related with other specialties in treating congenitally missing lateral incisor. One case is used to illustrate how orthodontic treatment is progressed in collaboration with other specialists.
CLINICAL SIGNIFICANCEPatients with missing teeth, crowding, midline deviation, unesthetic gingival contours, or other restorative needs may require the interaction between different specialists. For the successful treatment of orthodontic-restorative patients, interdisciplinary team management is vital.
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