Chair time saving method for treatment of an impacted maxillary central incisor with 15-month follow-up

Abstract

Maxillary permanent incisors have a major role in facial esthetics. Impaction of them has great adverse effect on smile and causes serious concerns in patient and parents. Physical barriers (e.g., overretained primary teeth, supernumerary teeth, and pathologic lesions), space problems, developmental abnormalities, altered eruption sequence, trauma, palatal clefts, and genetics can act as etiologic factors. Currently, the conventional technique to treatment of impacted teeth consists of a combined orthodontic and surgical approach, to guide the impacted teeth in a constant position and surrounded by normal hard and soft tissues. Treatment is challenging because of some limitations such as patient's age, cooperation, anchorage, and mechanotherapy possibilities. Hence, sophisticated treatment planning is crucial. A 9-year-old girl with horizontally impacted maxillary left central incisor treated with surgical exposure and closed orthodontic forced eruption with 2 × 4 partial setup fixed appliances. Force was applied with 0.014 inch nickel–titanium wire as elastic overlay and handmade ligated bracket. To save chair time in each appointment, the overlay was activated by twisting of ligature wire extensions around it. After 16-month treatment, impacted incisor emerged in oral cavity, with accepted alignment and inclination. Handmade ligated bracket with ligature wire extensions is useful for the treatment of impacted teeth. Due to easy activation of overlay in this method, chair time become short in each appointment.

Efectos adversos en la tracción ortodóncica de piezas impactadas en el segmento anterior de los maxilares: revisión narrativa

“…Un componente riesgoso durante la reabsorción radicular (RR) fue la ubicación del diente afectado, principalmente en los incisivos maxilares (Arriola et al, 2019). Los incisivos centrales superiores impactados tuvo una prevalencia de 0,1 % (Noorollahian & Shirban, 2018). La erupción o la impactación de los dientes anteriores puede efectuarse por factores locales o sistémicos.…”

“…La utilización de las cadenas elastoméricas puede provocar fuerzas diferenciales que crean una tracción directamente en la línea del arco, además, el uso de botones con ojal unido a un alambre o cadenas de ligaduras adheridas a la corona del diente cerca del borde incisal para el máximo control del movimiento, su activación se lleva a cabo, cada 3 semanas (Quirynen et al, 2000). Fuente: Del autor Otras alternativas encontradas fueron el uso de bobinas como: la bobina abierta de Ni-Ti (open coil) proporcionando un espacio adecuado para la tracción ortodóncica (Noorollahian & Shirban, 2018), la bobina pasiva (close coil) de níquel-titanio se utilizó para mantener el espacio en el arco (Pithon, 2022). El uso de bobinas con diferentes cantidades de fuerza con tracción de caninos superiores múltiples en dientes impactados bilateralmente podrían lograrse mediante una activación de 1 mm o 2 mm con un nivel de fuerza de 0,16 N y 0,32 N (Schubert et al, 2016).…”

Multidisciplinary Approach of Impacted Permanent Maxillary Left Central Incisor and Canine

“…12 Orthodontic and surgical exposure are the best choice for impacted teeth management to bring these impacted teeth into proper position because its benefits in long-term esthetic, function, and stability. 2 Before surgical exposure to canine, space must be sufficient to provide access so that orthodontic movements can be immediately applied. 13 In this case the surgical exposure, orthodontic traction and conservative treatment were the best options for the patient.…”

“…Impacted maxillary insicor is the third most commonly impacted tooth. 2 Impaction of them has great adverse effect on smile and causes serious concerns in patient and parents. Physical barriers (e.g., overretained primary teeth, supernumerary teeth, and pathologic lesions), space problems, developmental abnormalities, altered eruption sequence, trauma, palatal clefts, and genetics can act as etiologic factors.…”

<p>Perawatan ortodonti dan bedah open window impaksi gigi insisif permanen pertama rahang atas</p><p>Orthodontic treatment and open window surgery of impacted maxillary first permanent incisor</p>

“…Perawatan gigi impaksi secara open window, dilakukan dengan membuang jaringan keras dan lunak di sekitar permukaan mahkota gigi impaksi, kemudian pada permukaan mahkota gigi yang telah terbuka dipasang perlekatan ortodonti gold chain atau braket ortodontik dan gigi ditarik ke bidang oklusal. 11,12,13 Perawatan gigi impaksi disertai dengan delaserasi akar gigi seringkali menjadi faktor penyulit dalam proses retraksi gigi ke arah bidang oklusal. 5,7,11,14 Pada laporan kasus ini impaksi gigi 11 disebabkan karena adanya adanya odontoma di tepi insisal gigi 11.…”