Interdisciplinary (surgical and orthodontic) treatment in a patient with compound odontoma associated with impacted permanent lateral incisor of the mandible – a case report

2018 ◽  
Vol 23 (1) ◽  
Author(s):  
Diana Karolak ◽  
Joanna Lange

Impacted teeth are one of the reasons for orthodontic appointments. Two conditions must be met for the tooth to be considered impacted, i.e. a fully developed tooth that has not erupted on time. The presence of an odontoma in the maxillary bone when the impacted teeth are observed is a particular situation. We present a case of a patient with a compound odontoma located in the anterior part of the mandible and associated with an impacted right lateral incisor, who received interdisciplinary (surgical and orthodontic) treatment. The aim of the study was to present the advances in interdisciplinary (surgical and orthodontic) treatment of the compound odontoma associated with the impacted permanent lateral incisor of the mandible and a review of relevant literature. A literature review covering years 1990-2016 was performed. Medical databases, such as PubMed and Medline, were used. The following keywords were used: “impacted tooth”, “odontoma”, “orthodontic treatment”. Additionally, a manual search of specialist literature on orthodontics and maxillofacial surgery was conducted. Written consent from the subject/subject’s parents/subject’s legal guardians was obtained. Polish- and English-language publications were included. Early diagnosis of odontoma enables less complicated and less expensive treatment. The treatment plan should be tailored to each patient. More research is needed on predicting the behaviour of impacted teeth related to odontomas.

2017 ◽  
Vol 64 (3) ◽  
pp. 131-135
Author(s):  
Ivana Simić ◽  
Tanja Domazet ◽  
Jelena Lečić ◽  
Jelena Ješić

Summary Impacted tooth is a tooth that has failed to reach occlusal plane, with 2/3 of completed root growth. There are various reasons for teeth impaction, however, lack of space for its emergence is considered to be the main reason. The most commonly impacted teeth are lower wisdom teeth, then upper wisdom teeth, upper canines, and less frequently lower premolars. There are only few studies that have addressed the issue of impacted lower premolars, their etiology, prevalence and treatment. The patient (22 years old) visited orthodontst for the lower jaw aesthetic teeth corrections, due to crowding. Ortopantomography analysis revealed impacted lower right second premolar that caused resorption of mesial root of the first molar. The treatment plan included tooth #46 extraction and placing orthodontic brackets on the impacted second premolar. The next step was extrusion of the tooth #45, its introduction to occlusal plane and orthodontic treatment resumption. Orthodontic treatment of impacted teeth with fixed orthodontic appliance provides excellent therapeutic results. The treatment success depends primarily on adequate planning, cooperation and joint work of oral surgery and orthodontic specialists.


2019 ◽  
Vol 72 (5) ◽  
pp. 838-845
Author(s):  
Pavlo I. Tkachenko ◽  
Maryna I. Dmytrenko ◽  
Mykola O. Cholovskyi

Introduction: Impacted teeth is complex anomaly of teeth eruption that requires a balanced approach not only in the differential diagnosis of its forms, but choice of rational methods of treatment. The aim: Optimization of the tactics of orthodontic-surgical treatment of patients with impacted teeth based on the development and implementation of computed tomographic indices (KT) and photometric indices (FM) of opening of surgical access (OSA) to crowns of impacted teeth Materials and methods: The results of treatment of 48 patients with delay of permanent teeth eruption have been analyzed. For an objective assessment of treatment results, a group of 24 (aged from 9 to 19 years old ) was formed. All 24 patients had typical clinical situation. Results: Orthodontic correction of patients envisaged, first of all, the elimination of obstacles in the way of teeth eruption, if necessary to provide space in dental arch and simultaneous treatment of associated bite malocclusions. Surgical exposure of impacted tooth crown was carried out and at the same time a triangular shaped guiding channel was formed, base of channel was at the impacted tooth and its angle finished into the dental arch. Precise dimensions and depth of the channel were preliminary planed on computed tomography slices with 3D reconstruction. Mean values of CT width (7,13±0,54mm), and length (6,42±0,78mm) of OSA and CT index (130,79±8,19%) of OSA to impacted teeth crowns were determined. Conclusion: To improve the quality of diagnosis and optimization of methodological approaches to treatment of patients with teeth impaction, we have proposed CT and FM OSA indices to the crowns of impacted teeth. The developed indices serve as specific reference points for optimization of diagnostic process, for reducing of probability of repeated surgical interventions and choosing the optimal path for instrumental orthodontic treatment of patients with impacted teeth


2013 ◽  
Vol 20 (1) ◽  
pp. 99
Author(s):  
Timothy Soewito ◽  
Darmawan Sutantyo ◽  
Cendrawasih A Farmasyanti

Keberadaan kista dapat menghambat perawatan ortodontik konvensional yang diberikan pada pasien. Tujuan artikel ini adalah menyajikan laporan kasus perawatan ortodontik alternatif seorang pasien perempuan berusia 17 tahun dengan kondisi gigi atas berjejal berat dan kista jinak di antara gigi insisivus lateral dan kaninus kiri atas. Setelah menetapkan diagnosis ortodontik, perawatan pertama yang dilakukan adalah pengangkatan kista. Kista dikirim untuk biopsi dan didiagnosis sebagai kista jinak. Orang tua dan pasien memutuskan untuk mencabut gigi insisivus lateral atas setelah mengetahui bahwa gigi insisivus lateral kiri atas nekrosis. Setelah gigi dicabut, bracket ortodontik dipasang di gigi bawah pasien. Tiga bulan kemudian, bracket ortodontik dipasang di gigi atas pasien. Kondisi gigi atas yang berjejal terkoreksi dan kaninus atas menggantikan posisi insisivus lateral. Saat ini, perawatan aktif masih dilanjutkan dan terpasang bracket ortodontik dengan elastik kelas III pada pasien. Kesimpulan artikel ini adalah pendekatan perawatan ortodontik inkonvensional dapat menjadi pertimbangan ketika ditemukan hambatan seperti adanya kista. Pasien dan orang tua harus diberi informasi mengenai konsekuensi perawatan sebelum perawatan dimulai.Unconventional Orthodontic Treatment for Upper Teeth Crowding with Benign Cyst. The presence of a cyst can provide an obstacle to the conventional orthodontic treatment given to the patients. The purpose of this article is to describe a case report of a seventeen year-old girl with a severe crowding of maxilla and presence of benign cyst between lateral incisor teeth and upper left canine treated with an alternative orthodontic treatment plan. After orthodontic diagnosis, the first treatment to be conducted was the removal of the cyst. The cyst was sent for biopsy and diagnosed as non-malignant cyst. The patient and her parents decided to extract upper laterals incisor tooth after knowing that the upper left lateral incisor tooth was necrotic. After the extractions, orthodontic brackets were bonded on the mandible. Then three months later the maxilla was bonded. The upper crowding of teeth condition was resolved very promptly and the upper canines were used to replace the laterals incisor position. Currently, active treatment is still in progress, and the patient has full upper and lower orthodontic brackets with class III elastics. After the treatment so far, it can be concluded that unconventional orthodontic treatment is worth considering when an obstacle such as a cyst is present. Patients and parents must be informed about the consequences of the treatment before active treatment is started.


RSBO ◽  
2016 ◽  
Vol 12 (1) ◽  
pp. 98
Author(s):  
Radamés Bezerra Melo ◽  
Yuri Edward de Souza Damasceno ◽  
Celio Armando Couto da Cunha Junior ◽  
Igor Vasconcelos Pontes

Introduction: The dentigerous cyst, also called a follicular cyst is an odontogenic cyst that develops in association with crown of an impacted tooth, predominantly in mandibular third molars of young patients. The Odontoma is a ectomesenquimal tumor of unknown origin that are more considered developmental malformations (harmatomas) than benign neoplasms. Occasionally, the dentigerous cyst is associated with odontoma. Objective: The article aims to report a case of surgical treatment of dentigerous cyst associated with compound odontoma and unerupted tooth in anterior region of the mandible. Case report: A male patient, 17 years of age, without systemic changes, was sent to the Center for Dental Specialties of Horizonte, Ceará, Brazil, specialty of Oral and Maxillofacial Surgery, for diagnosis and treatment of oral lesions visualized after periapical radiographic examination to determine failed eruption of element 42. Observing the periapical radiograph it was possible to visualize radiopaque lesion suggestive of a compound odontoma and a cystic capsule in association with the element 42. A panoramic radiographwas requested and it was planned a surgical removal of odontoma with curettage of bone cavity and removing the cystic capsule and element 42. There were no significant postoperative complications, the suture removal was performed 7 days after surgery where it was possible to observe a good healing, no swelling and no paresthesia. Conclusion: The treatment of choice is surgical excision of the lesions with the tooth associated to the cyst, it should be performed with proper planning, avoiding injury to vital structures and should not be delayed in order to avoid possible occlusion sequelae.


Dental Update ◽  
2021 ◽  
Vol 48 (10) ◽  
pp. 816-820
Author(s):  
Thibault Colloc ◽  
Roderick Morrison ◽  
Mark Burrell ◽  
Colin Larmour

The Aberdeen Royal Infirmary oral and maxillofacial surgery department is involved in the joint planning of cases with the orthodontic and restorative departments of the Aberdeen Dental Hospital to agree an optimal treatment plan for patients, with input from all three specialties. A 7-year-old girl was referred to the orthodontic department by her GDP due to non-eruption of the upper left central incisor. This was related to an associated dentigerous cyst. This presentation illustrates the phases of treatment involving marsupialization of the dentigerous cyst; surgical extraction and orthodontic treatment in order to provide the patient with the optimal outcome for her dentition. A retrospective assessment of the case is presented through photographs and radiological imaging outlining the chronology of the treatment and the outcome of marsupialization of the dentigerous cyst. It highlights this more conservative surgical approach as giving the best chances of preserving unerupted teeth in a younger patient. Marsupialization of a dentigerous cyst associated with UL1 and conservative management of cystic pathology led to preservation and natural mesial eruption of UL3 into the position of UL1. The unerupted UL1 associated with cystic pathology was extracted due to its ectopic position and root dilaceration. Seven years after diagnosis of the dentigerous cyst associated with the unerupted UL1, surgical and orthodontic management has facilitated the for patients tooth to erupt into the UL1 position. Restorative treatment is being planned following orthodontic treatment to restore for patients tooth to simulate the missing UL1. CPD/Clinical Relevance: This case encourages the appropriate referral of young patients with dentigerous cysts to achieve a satisfactory outcome.


2021 ◽  
pp. 1-6
Author(s):  
Mhd. Azhar Ibrahim Kharsa ◽  

Introduction and Purpose: Treatment of impacted teeth in orthodontics is crucially important, as clinician is supposed to manage such cases in his/her daily practice. However, impaction cases can be so complicated especially when other factors interfere within their treatments such as anatomical locations of the impacted teeth, surgical considerations and Orthodontic Traction difficulties. The management of impacted teeth in orthodontic practice varies widely from extraction of the impacted tooth to forced orthodontic eruption. Orthodontic eruption varies between closed or open techniques that must be determined for each case, per se. Materials and Methods: One hundred fifty one impacted teeth cases were followed up, classified by their techniques as to register the results statistically. The approaches for handling the impacted teeth were open forced eruption “as window or APF Apically Positioned Flap”, closed forced eruption, negligence and extraction when indicated. Bonding with Light Cure orthodontic composite was used for all cases of forced eruption. The used Device had been Mini LED, Acteron, Li-ION 3.7V, 2500mAh. Time of Exposure 20 Second. The traction attachments had been either Titanium Button and Chain (Watted) Dentaurum, or conventional Buttons (with ligature wires or elastics). This research discusses the prognosis of impacted teeth, the approaches of the orthodontic forced eruption and when to expose, extract or even “neglect”! The article does not recommend one treatment plan for all cases, in contrary; it urges the reader to search more for innovative solutions whenever such cases come across. Results and Conclusion: It is recommended that the decision regarding orthodontic forced eruption (closed or open), or extraction be based on evaluation of each independent case. In spite of the result of this research that 126 cases of the 151 screened cases had been treated successfully by orthodontic forced eruption, but complications such ankylosis, resorption, eruption failure and periodontal pockets need to be taken into account. Another complication can often be encountered that is bonding failures, especially in closed force eruption. However, the new bonding materials and the improved techniques have helped to overcome such a problem. Finally, the more precise the location and position of the impacted tooth is known, the easier the procedure becomes.


Author(s):  
Seyed Hadi Hosseini ◽  
Zahra Mazareii Fard ◽  
Donya Maleki

Aim: As the patterns of impaction can affect the treatment plan of removing or remaining the impacted tooth, the difficulty of surgery, and the post-surgical complications, this survey aimed for assessment of the mandibular wisdom tooth impaction patterns in terms of angulation and depth in the north population of Iran. Materials and Methods: 196 Panoramic radiographs were gathered from patients attending to the department of oral and maxillofacial surgery of GUMS in 2018-2019. To perform this retrospective study the prevalence of impaction, angulation, and the level of the eruption were assessed. The data were analyzed by SPSS 16. Results: This study found that the most common pattern of impacted mandibular third molars was level B in terms of depth and mesioangular in terms of angulation. Conclusion: The current study notes the importance of determining the angulation and level of wisdom tooth in designing the pre-surgical treatment and in post-surgical complaints


Author(s):  
Emran Hajimohammadi ◽  
Hesam Mikaili Khiavi ◽  
Abbas Naghizadeh Baghi ◽  
Vahid Khalili ◽  
Sheida Zohoori

Background & Objective: Impacted teeth are one of the most common reasons for visit- ing dentists and maxillofacial surgeons. During clinical and radiographic examinations and evalu- ations, the dentist sometimes realizes that the patient’s problem is due to the impaction of one or more teeth. Therefore, it is necessary for every dentist to make the necessary and correct decision for the treatment of such teeth. One of the best ways to diagnose impacted teeth is first of all the absence of that tooth in the desired location and clinical evaluation of the patient and secondly to check the radiographic view of the desired area. Impacted teeth can be the source of many prob- lems for various reasons, so in most cases, their extraction is recommended. Knowing how to place the impacted tooth and determining its type and other characteristics of the impaction can help the dentist in choosing the appropriate treatment-surgical method and also prevent complications during surgery. Proper and timely diagnosis of impaction as well as determining its position (buc- cal-palatal-intermediate) in the jawbone can reduce damage to adjacent structures and also affect the treatment plan. Because accurate detection of impacted tooth positions is possible with radiog- raphy, the most accurate radiograph to examine the impacted tooth is cbct images. Therefore, due to possible occlusion injuries and the effect of occlusion pattern on the treatment of these teeth, it is important to study the types of impaction patterns. Therefore, this study was presented with the aim of investigating the impaction pattern of maxillary canine teeth in Ardabil with cbct archive. Materials and Methods: In this descriptive cross-sectional study, CBCT images of 239 patients who met the inclusion criteria were evaluated. Due to the lack of statistics, due to the lack of statistics of maxillary impacted canine teeth in Ardabil, the counting method was used for sampling and stereotypes were identified as maxillary impacted canine teeth as the sample size. The obtained data were analyzed in SPSS24 software. Results: Among the impacted canine teeth studied, 63.2% had palatal, 17.5% buccal and 19.3% had intermediate pattern. Also, 11.2% had damage to adjacent structures and 88.8% had no damage to adjacent structures. Among the types of damage to adjacent structures, 46.9% caused root re- sorption of the first premolars, 34.5% caused root canal resorption, and 18.6% had other damage to adjacent structures. Of these, 50.4% had root curvature and 49.6% had no root curvature, of which 12.1% had severe curvature, 38.7% had mild curvature and 49.2% had severe curvature. Also, the average angle of the incised canine to the lateral incisor was 41.7%. 9% of impacted canine teeth had a root resorption of lateral incisors and 9% did not have a root resorption of lateral incisors. Conclusion: Dentists should treat cases such as maxillary latent canine such as: Examine the occlusion pattern, angle to adjacent teeth, damage to adjacent structures, curvature of the incised canine root, and root resorption of adjacent teeth.


2020 ◽  
pp. 31-36
Author(s):  
P.I. Tkachenko ◽  
I.I. Starchenko ◽  
M.I. Dmytrenko ◽  
M.O. Cholovskyi

Impacted teeth are rather common and complex dentofacial anomaly, which requires a balanced approach not only in differential diagnosis of its specific nosological form, but also in a choice of rational treatment methods. Taking into account the multi-factor nature of conditions formation for delay of teeth eruption, an approach to treatment should be directed towards guiding links of pathogenesis. The aim of the study is to increase effectiveness of surgical and orthodontic treatment of patients with impacted teeth of anterior maxillary region by studying morphological features of mucous membrane over impacted teeth, depending on conditions of their positioning. A group of 21 individuals aged from 15 to 17 years was formed to evaluate objectively the results of our work. Clinical situation in all the patients was the same according to diagnostic criteria as presence of impacted maxillary canines and medium level of vertical depth of impaction (in alveolar process); root formation: completely formed, with deviation of longitudinal axis of impacted tooth from correct axis of eruption from 15º to 45º. During further analysis, clinical subgroups were identified depending on conditions of impacted teeth positioning in vestibular-oral direction. Moderate dystrophic changes in stratified squamous epithelium, moderate sclerotic changes in papillary layer of lamina propria were found based on findings of microscopic structure of mucous membrane over palatal positioning of teeth. During investigation of morphological structure of mucous membrane over labially positioning of impacted teeth, there were phenomena of hyperkeratosis, an increase in the number of intraepithelial lymphocytes, presence of epithelial cells in the basal layer with signs of hydropic degeneration. In papillary layer of lamina propria of mucous membrane, sclerotic changes were observed, which were more pronounced in comparison with palatal positioning of impacted teeth. Complex analysis of results of morphological studies showed that in mucous membrane positioning over impacted teeth there is deterioration with anemia in filling conditions of microcirculatory bed, discirculatory disorders, which leads to formation of ischemic zones and development of dystrophic and sclerotic processes. Morphological features of the structure of mucous membrane over impacted teeth is an important to consider while planning surgical and orthodontic treatment, and to some extent, it is possible to adjust management tactics of such patients, taking into account labial or palatal positioning of impacted teeth.


Sign in / Sign up

Export Citation Format

Share Document