scholarly journals True orthodontic intrusion using three-piece intrusion arch for correcting excessive gingival exposure

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Kavitha Odathurai Marusamy ◽  
Saravanan Ramasamy ◽  
Butchi Raju Akondi ◽  
George Jose Cherackal
Keyword(s):  
Treatment Outcomes ◽  
Treatment Duration ◽  
Treatment Time ◽  
Vertical Dimension ◽  
Treatment Results ◽  
Posterior Teeth ◽  
Orthodontic Therapy ◽  
Anterior Teeth ◽  
Space Closure ◽  
Effective Use

The combination of proclined upper anteriors with high gingival exposure is challenging for the orthodontist. Correction of proclined upper anteriors sometimes leads to deepening of the bite and loss of posterior anchorage resulting in worsening of gingival exposure. Routinely correction of high gingival exposure was done prior to space closure resulting in increased treatment duration. However, application of sound biomechanical strategies can help us overcome these challenges without compromising treatment time. This presentation will describe the meticulous orthodontic biomechanics using a 3-piece intrusion arch to simultaneously correct excessive gingival exposure as well as accomplish space closure. The patient presented with Class I malocclusion with proclined upper anterior teeth, crowding in upper and lower arches and an excessive gingival exposure. Fixed orthodontic therapy was initiated with first premolar extractions and the primary strategies after correcting of the crowding was the effective use of a 3-piece intrusion arch for simultaneous intrusion and retraction of proclined anterior teeth. Biomechanics strategies utilizing the 3 piece intrusion arch effectively aided in closure of spaces, correction of high gingival exposure, intrusion of the upper anteriors and controlling posterior anchorage. All desired treatment outcomes were achieved without prolonging treatment time. Proper biomechanics strategies can effectively bring about true intrusion of the upper anteriors as well as correct the upper incisor proclination without prolonging treatment time. The use of threepiece intrusion arch to achieve orthodontic correction assures the attainment of predictable treatment results. Loss of anchorage is seldom observed because of the tip back moment on the posterior teeth. Another advantage of intrusion mechanics is the control of the vertical dimension.

scholarly journals Orthodontic anterior teeth space closure in an adult with posterior long standing fixed partial denture

2019 ◽  
pp. 01-02
Author(s):  
Vanashree Takane Shirsat ◽  
Siddharth Shirsat
Keyword(s):  
Treatment Time ◽  
Class I ◽  
Partial Denture ◽  
Long Span ◽  
Fixed Partial Denture ◽  
Anterior Teeth ◽  
Total Treatment Time ◽  
Space Closure ◽  
Total Treatment ◽  
Mandibular Teeth

This is a case report of a 40-year-old female patient with chief complaint of spacing in front teeth. Patient exhibited convex profile, incompetent lips, spacing in anterior maxillary and mandibular teeth. She had maxillary posterior long span fixed partial denture and generalised periodontitis. She was diagnosed as Class I malocclusion with proclined and spaced anterior teeth. Treatment objective include space closure, maintaining class I molar and canine relation, achieving ideal overjet and overbite and functional occlusion. Thorough oral prophylaxis was done prior to start of fixed mechanotherapy. The case was bonded (upper canine to canine and full lower arch) with 022 MBT bracket system. Aligning and levelling was done sequentially with 012,016,17x25 Niti wires. One bracket each side was bonded on the maxillary FPD abutment teeth for anchorage. Space closure was achieved using low forces with elastomeric chain on 19x25 SS wire. Total treatment time was 12 months. Ideal overjet and overbite achieved with functional occlusion. Periodontal condition improved and stable results were achieved. Patient is given fixed retention and removable hawleys retainer with tongue crib in upper arch. In the recent years, there has been an increase in number of adults seeking orthodontic treatment and orthodontists quiite often face patients with periodontal disease. Adult patients should follow regular oral hygiene measure in order to maintain periodontal health during and after active orthodontic therapy.

scholarly journals A multidisciplinary approach to restoration of severely worn dentition: a case report

2016 ◽  
Vol 4 (1) ◽  
pp. 27
Author(s):  
A V Sreekumar ◽  
Mohammed Sajeer PC ◽  
Levin Chengappa
Keyword(s):  
Case Report ◽  
Multidisciplinary Approach ◽  
Vertical Dimension ◽  
Treatment Procedure ◽  
Posterior Teeth ◽  
Anterior Teeth ◽  
Anterior Guidance ◽  
Occlusal Vertical Dimension ◽  
Crown Lengthening

Severe caries, attrition  and developemental anomalies  of anterior teeth lead to loss of anterior guidance. This in turn causes attrition of posterior teeth and loss of occlusal vertical dimension of  occlusion. To gain the space for esthetic rehabilitation in these cases is challenging task. The required space can be achieved by crown lengthening and increasing the vertical dimension of occlusion within physiologic limits. We hereby have presented a case report showing the treatment procedure of a patient with severly worn dentition in a simple and systematic multidisciplinary approach to improve the function as well as aesthetics, that also remains in harmony with the entire gnathostomatic system.

scholarly journals A multidisciplinary approach to restoration of severely worn dentition: a case report

2016 ◽  
Vol 4 (2) ◽  
pp. 63
Author(s):  
A V Sreekumar ◽  
Mohammed Sajeer P C ◽  
Levin Chengappa
Keyword(s):  
Case Report ◽  
Multidisciplinary Approach ◽  
Vertical Dimension ◽  
Treatment Procedure ◽  
Posterior Teeth ◽  
Developmental Anomalies ◽  
Anterior Teeth ◽  
Anterior Guidance ◽  
Occlusal Vertical Dimension ◽  
Crown Lengthening

Severe caries, attrition  and developmental anomalies  of anterior teeth lead to loss of anterior guidance. This in turn causes attrition of posterior teeth and loss of occlusal vertical dimension of  occlusion . To gain the space for esthetic rehabilitation in these cases is challenging  task. The required space can be achieved by crown lengthening and increasing the  vertical dimension of occlusion within physiologic limits..We, hereby have presented a case report showing the treatment procedure of a patient with severely worn dentition  in a simple and systematic multidisciplinary approach to improve the function as well as aesthetics , that also remains in harmony with the entire gnathostomatic system.

scholarly journals Treating Bimaxillary Protrusion and Crowding with the Invisalign G6 First Premolar Extraction Solution and Invisalign Aligners

2018 ◽  
Vol 8 ◽  
pp. 219-224 ◽  
Author(s):  
Ronny K. P. Lie Ken Jie
Keyword(s):  
Case Report ◽  
Orthodontic Treatment ◽  
Treatment Approach ◽  
Clinical Findings ◽  
Treatment Results ◽  
Anterior Crowding ◽  
Premolar Extraction ◽  
Anterior Teeth ◽  
Space Closure ◽  
Bimaxillary Protrusion

In cases requiring extraction of four first premolars, ensuring maintenance of adequate posterior anchorage and proper inclination of the teeth adjacent to the extraction sites during space closure can be difficult. The Invisalign G6 first premolar extraction solution has been developed to specifically address these problems. This case report describes the treatment of a 30-year-old woman whose main concerns were related to her protrusive and malaligned anterior teeth. Clinical findings revealed, among others, bimaxillary anterior protrusion and moderate-to-severe anterior crowding. A treatment approach involving extraction of the four first premolars was chosen, followed by orthodontic treatment with the Invisalign G6 first premolar extraction solution and Invisalign aligners. At the completion of 19.5 months of aligner treatment, the patient’s anterior teeth were retracted and uprighted, resulting in an improvement in her lip profile. Normal overjet and overbite were also achieved along with alleviation of the anterior crowding. The patient was extremely happy with the treatment results.

scholarly journals Comprehensive approach to simultaneous molar intrusion and canine retraction in the treatment of Class II anterior open bite using miniscrew anchorage

2020 ◽  
Vol 25 (3) ◽  
Author(s):  
Kaori Shirasaki ◽  
Yoshihito Ishihara ◽  
Hiroki Komori ◽  
Takashi Yamashiro ◽  
Hiroshi Kamioka
Keyword(s):  
Treatment Duration ◽  
Class Ii ◽  
Open Bite ◽  
Prolonged Treatment ◽  
Anterior Open Bite ◽  
Posterior Teeth ◽  
Canine Retraction ◽  
Maxillary Molars ◽  
Anterior Teeth ◽  
Molar Intrusion

ABSTRACT Introduction: Anterior open bite is one of the most difficult malocclusions to correct in orthodontic treatment. Molar intrusion using miniscrew anchorage has been developed as a new strategy for open bite correction; however, this procedure still has an important concern about prolonged treatment duration in the patient with anteroposterior discrepancy due to the separate step-by-step movement of anterior and posterior teeth. Objective: This article illustrates a comprehensive orthodontic approach for dentoalveolar open bite correction of an adult patient, by using miniscrew. Case report: A woman 19 years and 5 months of age had chief complaints of difficulty chewing with the anterior teeth and maxillary incisor protrusion. An open bite of -2.0 mm caused by slight elongation of the maxillary molars was found. The patient was diagnosed with Angle Class II malocclusion with anterior open bite due to the vertical elongation of maxillary molars. After extraction of the maxillary first premolars, concurrent movements of molar intrusion and canine retraction were initiated with the combined use of sectional archwires, elastic chains and miniscrews. Results: At 4 months after the procedure, positive overbite was achieved subsequent to the intrusion of maxillary molars by 1.5 mm and without undesirable side effects. Class I canine relation was also achieved at the same time. The total active treatment period was 21 months. The resultant occlusion and satisfactory facial profile were maintained after 54 months of retention. Conclusion: The presented treatment shows the potential to shorten the treatment duration and to contribute to the long-term stability for open bite correction.

scholarly journals Rehabilitation of a Severely Worn Dentition with Partial Lithium-disilicate Glass Ceramic Restorations: A Case Report

2021 ◽  
Author(s):  
Ece İrem Oğuz ◽  
Semih Berksun
Keyword(s):  
Case Report ◽  
Glass Ceramic ◽  
Treatment Options ◽  
Lithium Disilicate ◽  
Vertical Dimension ◽  
Posterior Teeth ◽  
Anterior Teeth ◽  
Occlusal Vertical Dimension ◽  
Ceramic Restorations ◽  
Laminate Veneers

Rehabilitation of worn dentition is a challenging task because several predisposing factors may be included in the pathogenesis. The treatment options and process should be carefully considered based on the clinical condition and patients’ requirements. This case report represents the esthetic rehabilitation of a 68-year-old patient who exhibited severely worn teeth caused by attrition and erosion. After clinical evaluation, 3 mm increase in occlusal vertical dimension was planned with partial lithium-disilicate ceramic restorations as laminate veneers for anterior teeth and vonlays (onlays with veneer extentions) for posterior teeth in maxilla. The adaptation of the patient to the increased occlusal vertical dimension was tested for 1 month by provisional direct composite restorations. As the patient did not show any discomfort, definitive restorations were completed. The patient was satisfied with the esthetics and functionality of her new dentition.

scholarly journals Frictionless segmented mechanics for controlled space closure

2017 ◽  
Vol 22 (1) ◽  
pp. 98-109
Author(s):  
Ildeu Andrade Jr
Keyword(s):  
Specific Treatment ◽  
Posterior Teeth ◽  
Present Case Report ◽  
Anterior Teeth ◽  
Extraction Site ◽  
Space Closure ◽  
Force Systems ◽  
Treatment Objective ◽  
Dentofacial Orthopedics ◽  
Partial Fulfillment

ABSTRACT Extraction spaces may be needed to achieve specific orthodontic goals of positioning the dentition in harmony with the craniofacial complex. However, the fundamental reality that determines the occlusion final position is the control exerted by the orthodontist while closing the extraction spaces. A specific treatment objective may require the posterior teeth to remain in a constant position anteroposteriorly as well as vertically, while the anterior teeth occupy the entire extraction site. Another treatment objective may require the opposite, or any number of intentional alternatives of extraction site closure. The present case report describes a simple controlled segmented mechanic system that permitted definable and predictable force systems to be applied and allowed to predict the treatment outcome with confidence. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) in partial fulfillment of the requirements for Diplomate certification.

scholarly journals Bracket Failure in Orthodontic Patients: The Incidence and the Influence of Different Factors

2022 ◽  
Vol 2022 ◽  
pp. 1-6
Author(s):  
Haris Khan ◽  
Samer Mheissen ◽  
Ayesha Iqbal ◽  
Ali Raza Jafri ◽  
Mohammad Khursheed Alam
Keyword(s):  
Failure Rate ◽  
Treatment Time ◽  
Related Factors ◽  
Posterior Teeth ◽  
Anterior Teeth ◽  
Significant Difference ◽  
Adolescent Patients ◽  
Orthodontic Patients ◽  
Bracket Failure ◽  
Lower Arch

Failure of brackets is a common problem in orthodontics. This affects the treatment time, cost, and compliance of the patient. This study was conducted to estimate the bracket failure rate and the related factors for the long term. Methodology. This ambidirectional cohort study included 150 nonsyndromic orthodontic patients undergoing fixed appliance therapy for the last two years. The same patients were followed for 7 months. Different variables related to bracket failure were evaluated. The available data were analyzed descriptively, and the Kaplan-Meier estimate was used to measure the bracket survival rate from the date of bonding to failure. Results. A total of 180 bracket bond failures in the 150 included patients (52.2% males and 47.8% females) with a median age of 17 years (range 10-25 years). 69% of brackets failures were reported within the first 6 months after bonding. About 58.3% of bracket failure was noticed in adolescent patients before the age of 18 years. The majority of the cohort (81.1%) has good oral hygiene. The failure rate in patients with normal overbite was 41.1%, in decreased overbite cases was 15%, while in deep bite cases the failure rate was 43.9% with a statistically significant difference. Adults show less bracket failure (41.7%) than adolescent patients (58.3%). More bracket failure was noted in the lower arch (55%) than the upper arch (45%), and there were more bond failures posteriorly (61%) than on the anterior teeth (39%). Majority (41.1%) of the bracket failed on round NiTi wires. Conclusion. The bracket failure rate was 6.4%, with most bracket failure occurring in the first 6 months after bonding with individual difference. There was more incidence of bond failure in an increased overbite, adolescents, lower arch, posterior teeth, and lighter alignment wires.

scholarly journals Class I malocclusion with severe double rotrusion treated with first premolars extraction

2014 ◽  
Vol 19 (3) ◽  
pp. 127-138 ◽  
Author(s):  
Ricardo Moresca
Keyword(s):  
Torque Control ◽  
Class I ◽  
Posterior Teeth ◽  
Lower Lip ◽  
Anterior Teeth ◽  
Angle Class ◽  
Space Closure ◽  
Bimaxillary Protrusion ◽  
Maximum Anchorage

Angle Class I malocclusion with bimaxillary protrusion is characterized by severe buccal tipping of incisors, which causes upper and lower lip protrusion. First premolars extraction is recommended to reduce facial convexity as a result of anterior teeth retraction, which keeps canines and first molars in key to occlusion. In order to yield orthodontic results that are compatible with ideal esthetic and cephalometric outcomes, the space closure phase needs to be carried out with overbite and incisors torque control. The majority of cases also requires maximum anchorage of posterior teeth. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO) as a requirement for the title of certified by the BBO.

scholarly journals An updated systematic review on the effectivity of clear aligner therapy

2021 ◽  
Author(s):  
Mahsa Mortazavi ◽  
Mana Naeim ◽  
Amirali Badri ◽  
Reza Sharifi ◽  
Mahboube Hasheminasab
Keyword(s):  
High Risk ◽  
Treatment Outcomes ◽  
Controlled Trial ◽  
Relevant Literature ◽  
Risk Of Bias ◽  
Orthodontic Therapy ◽  
Randomized Controlled ◽  
Anterior Teeth ◽  
Jadad Scale ◽  
Clear Aligner

Introduction: Several studies have evaluated the strengths and weaknesses of Orthodonthic aligners however, the results are still uncertain. In the current study, we aimed to systematically review the literature and provide updates on the efficacy and effectivity of orthodontic therapy using aligners. Methods: PubMed, Web of Science and Cochrane Oral Health Group’s Trials Register databases were systematically searched for relevant literature up to December 2020. All studies reporting aligner therapy in management of dental misalignment were included. The quality was assessed using the methodological index for non-randomized studies (MINORS) criteria and Jadad scale for randomized controlled trials. Results: Of the initial 550 articles, 18 studies were ultimately included representing a total of 637 patients who were treated with clear aligners. Of the 18 studies, 15 had a retrospective design, one was an observational study, one was conducted as a prospective clinical trial,  and one study was a randomized controlled trial. Due to the design and methodology of the studies the quality assessment revealed a high risk of bias. Significant diversity among the outcomes of the studies was observed; however, an underlying consistency was detected within the included studies with regards to the effectivity of aligner therapy in alignment of the anterior teeth, while the pretreatment predictive rates were not significantly different to treatment outcomes. In addition, despite comparable treatment outcomes between aligner therapy and conventional appliance technique, aligner therapy resulted in increased rates of patient satisfaction. Conclusion: Aligner therapy seems to be a viable alternative to conventional orthodontic therapy for correction of mild to moderate malocclusions in non-growing nonextraction patients. However, it should be taken into consideration that due to the high risk of bias, results should be interpreted with caution.

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