Solutions for atypical problems in the incisors area: a transdisciplinary challenge

Abstract

Introduction: A significant increase in the number of adults in search of orthodontic treatment has raised a new challenge for orthodontists: the need to interact with other specialties to achieve excellent results, particularly when dealing with smile aesthetics and facial balance. Several factors should be considered to respond to their demand: adequate tooth leveling and alignment, individual tooth proportions between adjacent teeth and their contralateral teeth, shape and natural appearance of each tooth and gingival architecture, which should all be in agreement with facial harmony. Maxillary or mandibular incisors congenitally missing or lost due to caries or trauma and tooth-size discrepancies (Bolton) are some of the important aesthetic challenges for an integrated orthodontic treatment. Objectives: This study describes cases that illustrate the clinical challenges of treating the anterior area, as well as the multidisciplinary strategies required for their resolution. Conclusion: The increasingly frequent multidisciplinary orthodontic treatments of complex cases seem to effectively maximize aesthetic and functional results using a combination of procedures conducted by specialists in related areas, such as Surgery, Prosthetics, Implantology, Restorative Dentistry and Periodontics.

Guided bone regeneration in the anterior maxilla after tooth extraction and implant removal with sticky bone and L-PRF membrane in two surgical approaches

“…The maintenance of the alveolar ridge in height and thickness is limited, as the local blood supply decreases with tooth and periodontal loss and there is more accelerated bone atrophy, especially of the thin buccal wall (Ponte, Araújo, Araújo & Castro-Silva, 2019). Some unsatisfactory results in the medium and long term with implants in the esthetic zone may be related to patients with a high smile line, due to the darkening of the gingival margin after rehabilitation, as well as the verticalization of the incisors with aging, whereas the implants seem to become more protrusive (Sobral, 2020).…”