Orthodontic Conundrums Part 3: Indications for the loss of a lower incisor

Naeem I Adam; Minnie Lyons-Coleman; Adam Jowett; Trevor Hodge

doi:10.12968/ortu.2021.14.2.72

Orthodontic Conundrums Part 3: Indications for the loss of a lower incisor

Orthodontic Update ◽

10.12968/ortu.2021.14.2.72 ◽

2021 ◽

Vol 14 (2) ◽

pp. 72-79

Author(s):

Naeem I Adam ◽

Minnie Lyons-Coleman ◽

Adam Jowett ◽

Trevor Hodge

Keyword(s):

Clinical Relevance ◽

Orthodontic Treatment ◽

Treatment Plan ◽

Clinical Scenario ◽

Lower Incisor ◽

Highly Effective ◽

Extraction Pattern ◽

Final Article ◽

Dental Professionals

The final article in our series on orthodontic conundrums considers the extraction of a single lower incisor as part of a wider orthodontic treatment plan. This is a relatively uncommon approach; however, when used in the appropriate clinical scenario, it can be highly effective. Extraction of a lower incisor may be required to provide space for alignment of the teeth and serve as a pragmatic way to facilitate treatment while preserving posterior units. This article explores some of the possible orthodontic indications and contraindications for extraction of a lower incisor. CPD/Clinical Relevance: In certain clinical situations, extraction of a lower incisor has significant advantages. Dental professionals should be aware of this extraction pattern and its limitations.

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Temporary Anchorage Device as an Innovative Alternative for Unilateral Arch Mesialization in Medical Application

Biointerface Research in Applied Chemistry ◽

10.33263/briac112.88258835 ◽

2020 ◽

Vol 11 (2) ◽

pp. 8825-8835

Keyword(s):

Orthognathic Surgery ◽

Orthodontic Treatment ◽

Root Resorption ◽

Treatment Plan ◽

Medical Application ◽

Medical Intervention ◽

Lower Incisor ◽

Temporary Anchorage Devices ◽

Special Approach ◽

Maxilla And Mandible

Like any other medical intervention, orthodontic treatment has, in addition to its benefits, also associated risks and complications that are sometimes caused by wrongful treatment objectives. Correction of previous orthodontic malpractice is always a challenging problem in orthodontics. The present study aimed to introduce an innovative approach for total arch mesialization. In this study, the treatment course of a 25-year-old woman dissatisfied with her previous improper orthodontic treatment plan and unnecessary extraction of the upper and lower right first premolar teeth. Maxillary and mandibular dental midline deviation was evident concurrent with asymmetric dental arches and excessive gingival display a smile. The proposed corrective treatment plan consisted of right side temporary anchorage devices assisted total arch mesialization in both maxilla and mandible, followed by orthognathic surgery at the end. The patient’s final occlusion and facial profile improved significantly after the second treatment. The result was determined to be stable over a 1-year period. No significant evidence of root resorption was detected. Overbite decreased from 95% to 25%. Yaw correction was completely accomplished, and the final lateral cephalometric analysis after orthognathic surgery showed skeletal cl I relationship, normal proclination of upper and lower incisor teeth, and no evidence of periodontal complication and loss of vitality in the mandibular and maxillary teeth. The unilateral mesialization approach used in the current study prevented invasive therapies such as dental implants employing a special approach, which is less aggressive and more durable for the patient and revealed successful results with minimum side effects.

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Managing the Transition to Edentulousness Using Partial Transitional Dentures for First Time Prosthodontic Patients: Addressing Unrealistic Expectations – A Case Report

Journal of Oral & Dental Health ◽

10.33140/jodh/01/01/00001 ◽

2017 ◽

Vol 1 (1) ◽

Keyword(s):

Case Report ◽

Treatment Outcomes ◽

Treatment Planning ◽

Clinical Relevance ◽

Treatment Plan ◽

Sequential Treatment ◽

Aesthetic Result ◽

Abutment Teeth ◽

First Time ◽

Unrealistic Expectations

Aim: The aim of this report is to describe the management of a prosthodontic patient expressing unrealistic expectations with respect to the transition to edentulousness. Objectives: To outline (1) the diagnosis and explicit expectations of the patient on presentation (2) considerations made during treatment planning to address the wishes of the first time prosthodontic patient (3) a sequential treatment plan utilizing transitional partial removable dentures to manage the change to edentulousness (4) functional and aesthetic result achieved. Results: Delivery of immediate removable partial dentures retaining key abutment teeth in upper and lower arches was a viable prosthodontic solution in the transition to edentulousness of a patient expecting unrealistic treatment outcomes. Conclusions: Addressing impractical expectations and devising a treatment plan amenable to both clinician and patient is difficult. Strategies to manage these wishes in prosthodontic dentistry can include transitional partial dentures. Clinical relevance: Practitioners who encounter similar situations may consider this report valuable.

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Milk Alternatives. What Advice should Dental Professionals be Giving?

Dental Update ◽

10.12968/denu.2021.48.5.359 ◽

2021 ◽

Vol 48 (5) ◽

pp. 359-366

Author(s):

Imran Thalukder ◽

Halima Torofdar ◽

Mechelle Collard

Keyword(s):

Risk Assessment ◽

Clinical Relevance ◽

Sugar Content ◽

Caries Risk ◽

Regular Consumption ◽

Increasing Trend ◽

Form Part ◽

The Uk ◽

Drinking Milk ◽

Dental Professionals

Drinking milk-like fluids made from plant-based materials, such as soya, nuts and peas, is an increasing trend within the population, and regular consumption of these non-dairy alternatives may increase the risk of developing caries. This article focuses on current research relating to caries risk and consumption of milk-like products, and also investigates the sugar content of milk alternatives available in the UK. CPD/Clinical Relevance: Frequent sugar attacks causes caries. Dentists need to be aware of milk and milk alternatives for some may contribute to the development of caries, and this should form part of their caries risk assessment.

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Relationship between Orthodontic Treatment Plan and Goslon Yardstick Assessment in Japanese Patients with Unilateral Cleft Lip and Palate: One-stage vs. Two-stage Palatoplasty

The Bulletin of Tokyo Dental College ◽

10.2209/tdcpublication.2016-0700 ◽

2016 ◽

Vol 57 (3) ◽

pp. 159-168

Author(s):

Takenobu Ishii ◽

Teruo Sakamoto ◽

Munetada Ishikawa ◽

Toshihiko Yasumura ◽

Haruyo Miyazaki ◽

...

Keyword(s):

Orthodontic Treatment ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Treatment Plan ◽

Japanese Patients ◽

Two Stage ◽

One Stage

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Orthodontic Conundrums Part 2: Finishing Cases to a Class III Molar Relationship

Orthodontic Update ◽

10.12968/ortu.2021.14.1.27 ◽

2021 ◽

Vol 14 (1) ◽

pp. 27-31

Author(s):

Naeem I Adam ◽

Adam Jowett ◽

Trevor Hodge

Keyword(s):

Clinical Relevance ◽

Orthodontic Treatment ◽

Class I ◽

Patient Harm ◽

Class Iii ◽

Facial Profile ◽

Clinical Cases

This is the second article in a series on conundrums in orthodontics. A Class I molar relationship is a frequent aim of orthodontic treatment. There are, however, examples where intentionally finishing to a Class III molar relationship is the more pragmatic and preferable option. Pursuing this approach in the appropriate circumstances may, for example, prevent deleterious consequences to the facial profile or avoid the need for further dental extractions. This article explores the indications for finishing cases to a Class III molar relationship with illustrated clinical cases. CPD/Clinical Relevance: Dogmatic attempts to deliver Class I molar relationships, in all cases, without consideration of the consequences, have the potential to cause the patient harm. The orthodontist must then consider all possible options available, including those resulting in a Class III molar relationship.

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Relationship between orthodontic treatment and gingival health: A retrospective study

European Journal of Dentistry ◽

10.4103/1305-7456.137651 ◽

2014 ◽

Vol 08 (03) ◽

pp. 373-380 ◽

Cited By ~ 19

Author(s):

Fatma Boke ◽

Cagri Gazioglu ◽

Sevil Akkaya ◽

Murat Akkaya

Keyword(s):

Retrospective Study ◽

Orthodontic Treatment ◽

Gingival Recession ◽

Orthodontic Appliances ◽

Lower Incisor ◽

Gingival Health ◽

Fixed Orthodontic Appliances ◽

Significant Difference ◽

Before And After ◽

The Relationship

ABSTRACT Objective: The aim of this retrospective study was to evaluate the relationship between orthodontic treatment and gingival health. Materials and Methods: A total of 251 patients among whom 177 were girls and 74 were boys, recruited from the records pool of the Department of Orthodontics, Faculty of Dentistry, University of Gazi, were included in the study. Patients’ treatments have been completed by postgraduate students during the period between 2006 and 2012. Patients’ folders were analyzed according to their age, treatment time, and the type of orthodontic treatment. Intra-oral photographs were analyzed, and the presence or absence of visible plaque, visible inflammation, and gingival recession were recorded, and incisor inclinations analyzed on lateral cephalometric films, before and after orthodontic treatment. Results: No statistically significant difference was found in patients treated with functional appliances before and after treatment. In patients treated with fixed orthodontic appliances, visible plaque, visible inflammation, and gingival recession showed significant increases after treatment, gingival biotype did not show any significant difference. Positive correlation was found between lower incisor position and gingival recession in patients treated with fixed appliance and extraction. And also cuspids were the teeth with the highest prevalence of gingival recession. Conclusion: Considering the relationship between orthodontic treatment and gingival health, cooperation among patients, orthodontists, and periodontists is important.

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Multi-lobed mesiodens with a palatal talon cusp: a rare case report

Brazilian Dental Journal ◽

10.1590/s0103-64402010000400016 ◽

2010 ◽

Vol 21 (4) ◽

pp. 375-378 ◽

Cited By ~ 6

Author(s):

Nayaka Basavanthappa Nagaveni ◽

Kagathur Veerbadrappa Umashankara ◽

Sreedevi ◽

Bokka Praveen Reddy ◽

Nayaka Basavanthappa Radhika ◽

...

Keyword(s):

Orthodontic Treatment ◽

Rare Case ◽

Clinical Case ◽

Treatment Plan ◽

Radiographic Examination ◽

Supernumerary Tooth ◽

Anterior Teeth ◽

Patient Reported ◽

Rare Case Report ◽

Maxillary Arch

Mesiodens is a midline supernumerary tooth commonly seen in the maxillary arch and the talon cusp is a rare dental developmental anomaly seen on the lingual surface of anterior teeth. This paper presents a rare clinical case of development of talon cusp in a mesiodens with multiple lobes, which interfered with both occlusion and appearance of an 11-year-old patient. During clinical interview, the patient reported difficulty on mastication. Clinical and radiographic examination revealed that a supernumerary tooth with completely formed root was causing an occlusal interference. The supernumerary tooth was diagnosed as multi-lobed mesiodens associated with a palatal talon cusp. The treatment plan consisted in the extraction of the supernumerary tooth followed by orthodontic treatment for diastema closure and tooth alignment.

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Short-Term Orthodontics: Reasons for Treatment and their Associated Risks, Precautions in Patient Selection

Dental Update ◽

10.12968/denu.2020.47.3.231 ◽

2020 ◽

Vol 47 (3) ◽

pp. 231-237

Author(s):

Hassan-Ali Ismail ◽

Sangeeta Misra

Keyword(s):

Patient Selection ◽

Clinical Relevance ◽

Orthodontic Treatment ◽

Care Delivery ◽

Quality Care ◽

Scope Of Practice ◽

Further Training ◽

Short Term ◽

Dental Practitioners ◽

Valid Consent

Short-term orthodontics (STO) is a concept that is being utilized principally on adult patients to correct minor dental irregularities. It is a cosmetically motivated treatment that is being increasingly sought as an alternative to conventional orthodontic treatment (COT). Although general dental practitioners (GDPs) who have completed further training can provide STO, for quality care delivery it is important to know the limitations of the scope of practice. This article aims to discuss the reasons for adults seeking STO, the societal pressures responsible for desiring it, precautions required by GDPs during patient selection and its associated risks. CPD/Clinical Relevance: Most importantly, GDPs should have a good understanding of societal pressures that induce patients' desires to seek STO. Therefore, the dental practitioner can manage patient expectations appropriately. This highlights the challenge that not every patient's desires can be delivered with STO. Furthermore, the article explains the limits and risks of STO which should be thoroughly explained to patients in the process of obtaining valid consent.

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