Orthodontic approach to treat complex hypodontia using miniscrews in a growing patient

Abstract

This article reports orthodontic treatment of a case of hypodontia of five premolars in an 11-year-old female patient with a positive tooth size-arch length discrepancy in both dental arches. The patient had a straight profile with balanced facial growth. Setup manufacture revealed the possibility of achieving ideal occlusion by mesializing permanent molars up to 15 mm, in addition to keeping a primary molar in the dental arch. With the aid of absolute anchorage, the proposed mechanics was performed and the occlusion predicted in the setup was achieved, while profile and facial growth pattern were maintained. The use of miniscrews for extensive orthodontic movements was successful. Furthermore, one primary molar was extensively mesialized. The indication of gingivoplasty to correct gingival smile proved effective. This is considered a useful technique for orthodontists.

Hypodontia of mandibular incisors: considerations on the orthodontic treatment

“…It presents a wide variety of manifestations and, depending on the number and location of missing teeth, it may affect the esthetics, mastication, speech and occlusal balance, due to undesirable occlusal contacts caused by the extrusion of antagonist teeth or inclination of teeth adjacent to the affected area, 2 with impact on the quality of life of affected individuals. 3 …”

“… 1 It is known that tooth agenesis, especially the most severe manifestations, contributes to the abnormal occlusion and is frequently associated with anomalies in other teeth, such as alterations of shape, especially peg-shaped teeth or microdontia. 1 , 2 Other common characteristic of hypodontia is the ectopic positioning of adjacent permanent teeth, due to the absence of neighboring teeth to guide the eruption or due to lack of space for eruption. 1 …”

“…The treatment of hypodontia varies according to its complexity, being more critical in young and growing patients, impairing both the psychological aspect and facial development of these individuals, requiring multidisciplinary treatment. 2 , 15 , 16 Even though the agenesis of mandibular incisors is not among the most frequent manifestations of hypodontia, 1 , 8 it represents a complex clinical challenge, since in most cases there is loss of the deciduous tooth, impairing the function and occlusal balance, often leading to deep bite, residual overjet, mandibular midline deviation and positive tooth-size discrepancy due to the tooth absence. 10 …”

Methods of treatment of premolar agenesis: a literature review

“…W przypadku agenezji PM2 w żuchwie do zamknięcia szpar poekstrakcyjnych często rozważane jest zastosowanie zakotwienia szkieletowego (TADs). Pozwala ono uniknąć negatywnych skutków retruzji i retroklinacji zębów siecznych na profil pacjenta, a także ułatwia biomechanikę leczenia ortodontycznego (64). Mikrośruby ortodontyczne stosowane po extractions.…”

Prächirurgische dentoalveoläre sagittale Dekompensation der Klasse III: Planungsgrundlagen und Varianten

“…Liegt dieser primär im Unterkiefer, müsst ggf. an eine En-masse-Mesialisierung mittels Miniplatten in der Mentalisregion[18] gedacht werden. Zudem muss in diesen Fällen das symphyseale Knochenangebot und der Gingivaphänotyp kritisch beurteilt werden.…”