scholarly journals Expediting the Irksome - the Cortical Approach: A Case report

Author(s):  
Pujan Acharya ◽  
Charanjeet Singh Saimbi ◽  
Khushbu Adhikari ◽  
Bikash Kumar ◽  
Sita Niure

Corticotomy assisted orthodontic treatment is a promising interdisciplinary approach, which has offered solution to many limitations in the orthodontic therapy. The procedure involves the alveolar decortication in the form of cortical grooves and perforations performed around the teeth that are to be moved. In this case report, a 17 year old male under fixed orthodontic therapy with a complaint of delayed protraction of mandibular second molars underwent corticotomy procedure. The decortication was done followed by elevation of buccal and lingual flaps. After 2 weeks of the surgical procedure, orthodontic tooth movement was initiated.

2020 ◽  
Vol 1 (2) ◽  
pp. 91-105
Author(s):  
Mohd Zambri Mohamed Makhbul ◽  
Izrawatie Mardiana Shapeen ◽  
Wan Nurazreena Wan Hassan

A 26-year-old man with an aggressive periodontitis sought for orthodontic treatment to improve the appearance of his smile. He presented with generalised anterior spacing, missing lowerleft central incisor and deep traumatic bite. He was treated successfully with a combination of orthodontic and periodontal treatment. After 18 months of orthodontic treatment and follow upby the periodontist, his alignment of teeth was improved, a stable occlusion was achieved, and occlusal trauma was prevented. As a result, the patient’s smile appearance and selfconfidence were improved. Orthodontic tooth movement is not only to correct the alignment of his teeth but also to improve the bone level especially at the anterior region. This case report shows the successful treatment outcome in aggressive periodontitis patient which requires good collaboration between the orthodontist and the periodontist.


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Rajesh Gyawali ◽  
Bhagabat Bhattarai

Aggressive periodontitis is a type of periodontitis with early onset and rapid progression and mostly affecting young adults who occupy a large percentage of orthodontic patients. The role of the orthodontist is important in screening the disease, making a provisional diagnosis, and referring it to a periodontist for immediate treatment. The orthodontist should be aware of the disease not only before starting the appliance therapy, but also during and after the active mechanotherapy. The orthodontic treatment plan, biomechanics, and appliance system may need to be modified to deal with the teeth having reduced periodontal support. With proper force application and oral hygiene maintenance, orthodontic tooth movement is possible without any deleterious effect in the tooth with reduced bone support. With proper motivation and interdisciplinary approach, orthodontic treatment is possible in patients with controlled aggressive periodontitis.


2021 ◽  
Vol 11 (2) ◽  
pp. 521
Author(s):  
Simina Chelărescu ◽  
Petra Șurlin ◽  
Mioara Decusară ◽  
Mădălina Oprică ◽  
Eugen Bud ◽  
...  

Background: The crevicular fluid analysis represents a useful diagnosis tool, with the help of which noninvasive cellular metabolic activity can be analyzed. The aim of the study is to investigate comparatively IL1β and IL6 in the gingival crevicular fluid of clinically healthy adolescents and young adults during the acute phase of orthodontic treatment. Methods: Gingival crevicular fluid was collected from 20 patients (aged between 11 and 28) undergoing orthodontic treatment. Measurements were taken before (T0) and after 24 h after distalization forces were activated (T1). IL1β and IL 6 were analyzed using Elisa tests. The statistical tests used were two-sided t tests. Results: Between the two time periods there was a significant raise both in the crevicular fluid rate (0.57 µL at T0 vs. 0.95 µL at T1, p = 0.001) and in IL1β levels (15.67 pg/µL at T0 vs. 27.94 pg/µL at T1, p = 0.009). We were able to identify IL6 only in a third of the sites. There is a significantly increased level of ILβ at T1 in adolescents, more than in young adults (42.96 pg/µL vs. 17.93 pg/µL, p = 0.006). Conclusions: In the early stage of orthodontic treatment, the periodontal tissues of adolescents are more responsive to orthodontic forces than those of young adults.


2016 ◽  
Vol 4 (2) ◽  
pp. 65
Author(s):  
Sneha Dani ◽  
Savitha A.N ◽  
Kenneth Tan ◽  
Anand Naik ◽  
Charan Chhatrala ◽  
...  

Objective: In recent years, advances in technique as well as a growing public interest in developing and maintaining a healthy and attractive smile, has resulted in a greater understanding of the interrelationships between periodontics and orthodontics. The primary objective of periodontal therapy is to restore and maintain the health and integrity of the attachment apparatus of teeth. In adults, the loss of teeth or periodontal support can result in pathological teeth migration involving either a single tooth or a group of teeth. This may result in the development of a diastema, incisal proclination, rotation with collapse of the posterior occlusion.Materials and methods: This case report is of a 32 year old female patient who reported with swollen gums, generalized spacing between the teeth and extruded upper anterior tooth. Periodontal therapy followed by fixed orthodontic therapy was planned.Results: At the end of 2 years a stable healthy periodontium was established that was both functional and esthetic.Conclusion: Adjunctive orthodontic therapy is often necessary for successful restoration of periodontal health. On the other hand, successful orthodontic treatment will depend on the periodontal preparation before and after treatment and the maintenance of periodontal health throughout all phases of mechano-therapy.


2021 ◽  
Vol 22 (5) ◽  
pp. 2388
Author(s):  
Masaru Yamaguchi ◽  
Shinichi Fukasawa

The aim of this paper is to provide a review on the role of inflammation in orthodontically induced inflammatory root resorption (OIIRR) and accelerating orthodontic tooth movement (AOTM) in orthodontic treatment. Orthodontic tooth movement (OTM) is stimulated by remodeling of the periodontal ligament (PDL) and alveolar bone. These remodeling activities and tooth displacement are involved in the occurrence of an inflammatory process in the periodontium, in response to orthodontic forces. Inflammatory mediators such as prostaglandins (PGs), interleukins (Ils; IL-1, -6, -17), the tumor necrosis factor (TNF)-α superfamily, and receptor activator of nuclear factor (RANK)/RANK ligand (RANKL)/osteoprotegerin (OPG) are increased in the PDL during OTM. OIIRR is one of the accidental symptoms, and inflammatory mediators have been detected in resorbed roots, PDL, and alveolar bone exposed to heavy orthodontic force. Therefore, these inflammatory mediators are involved with the occurrence of OIIRR during orthodontic tooth movement. On the contrary, regional accelerating phenomenon (RAP) occurs after fractures and surgery such as osteotomies or bone grafting, and bone healing is accelerated by increasing osteoclasts and osteoblasts. Recently, tooth movement after surgical procedures such as corticotomy, corticision, piezocision, and micro-osteoperforation might be accelerated by RAP, which increases the bone metabolism. Therefore, inflammation may be involved in accelerated OTM (AOTM). The knowledge of inflammation during orthodontic treatment could be used in preventing OIIRR and AOTM.


2018 ◽  
Vol 7 (2) ◽  
pp. 47-51
Author(s):  
Neeta Aryal ◽  
Mao Jing

Introduction: Root resorption is the loss of apical root tissue leading to the shortness of root which is often evident in orthodontic tooth movement. Proper management during orthodontic treatment however can minimize this undesirable outcome. The present article attempts to review the etiology of root resorption, methods of diagnosis, and strategies for prevention.Materials & Method: A scoping review was done with the purpose to carry out the narrative integration of the relevant evidences on root resorption and orthodontic treatment from the published literatures. The resulting papers were studied and reviewed thoroughly for the key explanation of root resorption in orthodontic patients. A total of 41 published research articles were reviewed.Discussion: According to the literatures root resorption is common iatrogenic outcome in orthodontic treatment. Biological, mechanical, and combined biological and mechanical factors result in external root resorption. Though most clinicians diagnose root resorption by conventional radiography, researches have clearly shown that CBCT is the promising tool. The clinicians need to counsel orthodontic patients and their parents that the root resorption might be a potential consequence of the treatment lasting for long time. In case of severity; it is essential to reassess the patient and minimize the underlying cause. It is necessary to understand the role of orthodontist in preventing root resorption


2017 ◽  
Vol 11 (1) ◽  
pp. 466-475 ◽  
Author(s):  
Taísa Boamorte Raveli ◽  
Dirceu Barnabé Raveli ◽  
Kelei Cristina de Mathias Almeida ◽  
Ary dos Santos Pinto

Background: Tipped lower molar over edentulous space is very common in orthodontics practice when adults seek treatment. The segmented arch technique features a predictable force system that provides a controlled release of force that can produce light and continuous tooth movement. Case Description: A female adult patient, who lost a permanent lower first molar, needed correction of the position of her permanent first molar place. Instead of making space for rehabilitation, it was closed after second molar uprighting and a balanced interdigitation was created without prosthetics. The patient was successfully treated with segmented arch technique using root correction spring activated with geometry VI to promote uprighting of a tipped molar and Niti spring coil to promote space closure. Practical Implications: Segmented arch technique is known to provide predictable light and continuous forces, which is very much indicated in adult treatment. There are several things to consider when orthodontically treating adult patients. Their periodontal conditions might not be ideal, less bone apposition may occur, and side effects of orthodontic tooth movement are expected. Thus, a predictable and controlled orthodontic treatment is needed.


1986 ◽  
Vol 89 (4) ◽  
pp. 342-345 ◽  
Author(s):  
Ronald Kaminishi ◽  
W.Howard Davis ◽  
David Hochwald ◽  
Richard Berger ◽  
Christopher Davis

2017 ◽  
Vol 16 ◽  
pp. 1-8
Author(s):  
Noraini Abu Bakar ◽  
Wisam Kamil ◽  
Lina Al Bayati ◽  
Basma Ezzat Mustafa

Introduction: During orthodontic tooth movement, the early response of periodontal tissues to mechanical stress is an acute inflammatory reaction. Mechanical stress from orthodontic appliances is believed to induce cells in the periodontal ligament (PDL) to form biologically active substances, such as enzymes and cytokines, responsible for connective tissue remodeling (Nishijima Y et al 2006). Leptin, a polypeptide hormone has been classified as a cytokine (Zhang et al 1994). Earlier findings concluded that leptin at high local concentrations protects the host from inflammation and infection as well as maintaining bone levels. It has been also suggested that leptin plays a significant role in bone formation by its direct effect on osteoblasts (Alparslan et al 2010). This pilot study aimed to study leptin in saliva and its association with tooth movement during initial orthodontic alignment. Objectives: To determine if there are any differences in saliva leptin level before and after orthodontic alignment. Material and methods: Ten orthodontic patients (7 girls and 3 boys; mean age, 16.76 ± 1.1 years) with crowding (up to 5mm) that required orthodontic fixed appliances, on a non-extraction basis as part of the treatment plan, were recruited in this longitudinal study. Orthodontic study models were constructed at baseline and at 6- weeks after orthodontic treatment commenced. Full fixed orthodontic appliances with initial 0.014” Nickel Titanium archwire placed. The amount of crowding was measured, before and after initial alignment with an electronic digital caliper (Max-Cal, Japan Micrometer Ltd, Tokyo, Japan) with an accuracy of up to 0.01mm. Unstimulated morning saliva sample were collected at all visits, after at least an 8-hour period of fasting and no-toothbrushing. After centrifugation (4000x g;10min), the samples were stored at -25C and tested using Leptin Abnova LEP Human ELISA kit (KA3080) which was subsequently analyzed. Subjects’ periodontal health status was also monitored throughout the study. Ethical approval (ID IREC 262) was received on 7th April 2014 from International Islamic University Malaysia Research Ethics Committee (IREC). Results: Leptin concentration in saliva was significantly decreased in a time-dependant manner (t(9)=8.60, p<0.001), from before orthodontic treatment (7016.45± 425.15 pg/mL) and 6 weeks after bond-up (4901.92±  238.64 pg/mL). Conclusion: Leptin concentration in saliva is decreased during orthodontic tooth movement in initial alignment stage.


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