Digital Planning for Mini-Implant Supported Palatal Expander in Open-Bite Treatment

Open bite malocclusion, due to it’s multifactorial etiology, has always been considered a difficult problem to treat. Often associated with transverse maxillary deficiency, this is a real challenge in the field of orthodontics. The traditional approach, for this type of anomaly, in adult patients, is orthognathic surgery and RME (rapid maxillary expansion). There are several approaches to the treatment of adult patients using digital technology. Mini-implant supported palatal expander limits the side effects of the conventional RME and is less invasive compared to orthognathic surgery. Precise and predictable mini-implant insertion, using a customized surgical guide, provides a safe therapeutic approach. This case report combines Cone-beam computed tomography (CBCT), laser scan superimposition, computer-aided design (CAD) and 3D printing in order to design and print a customized surgical guide for orthodontic mini-implant insertion. A CBCT scan was performed to determine the optimal site for mini-implants’ placement. Using the 3Shape Trios Intraoral Scanner the maxilla and the mandible were laser-scanned. Blue Sky Plan 4 software was used to design the surgical guide, and RayWare software was used for printing it. 4 mini-implants were inserted using a safe and predictable technique. The 3D technology represents the future of orthodontics, reducing the risks, chair-side time while providing the best treatment plan for the patient.

Cephalometric Antero-Posterior Parameter Evaluation in Orthodontic Patients with Facial Asymmetries

Aesthetic and functional problems associated with significant facial asymmetry can negatively affect the patient's facial appearance, nutritional and psychosocial development. Therefore, a critical assessment and accurate treatment planning is absolutely necessary. The aim of this study was to evaluate the parameters of PA cephalometric analysis defined by Ricketts and Grummons and establish statistically relevant correlations and their importance in diagnosing orthodontic patients with varying degrees facial asymmetries. The research included facial asymmetry Romanian patients from the Department of Orthodontics and Dento-Facial Orthopedics of UMF "Victor Babes", Timisoara. The PA cephalogram investigations that met the inclusion criteria were digitally analyzed. Dental and skeletal cephalometric parameters described by Ricketts, Grummons and Kappeyne Van De Coppello were collected through linear, angular and volumetric measurements. Statistically significant correlations between the degree of asymmetry and the dimension of the internal structures were observed.Our conclusion is that PAcephalograms are cost effective and useful investigations in identifying and evaluating skeletal and dental imbalances in orthodontic facial asymmetry patients.

Interdisciplinary Orthodontic and Surgical Management of Class III Malocclusion in Adult Patients

The treatment of class III malocclusion differs depending on the age of the patient. In adult patients, alternatives include either orthodontic dentoalveolar compensation treatment or a combined ortho-surgical approach. The aim of this paper is to present the orthodontic and surgical treatment of a 24 year old adult patient with increased anterior face height, a class III skeletal pattern and mandibular asymetry. Previous orthodontic treatment with removable appliances obtained a 1 mm overbite and overjet. Intraorally, class III molar relationship was observed, proclined upper incisors, retroclined lower incisors and a deviated lower midline. The main complaint was facial esthetics which required surgical intevention. After pre-surgical orthodontic preparation the maxilla was repositioned by a Le Fort I osteotomy and the mandible was set back using the Obwegeser-Dal Pont method. Final assesment revealed both functional and esthetic dentofacial results. A combination of orthodontic treatment and orthognathic surgery is often required in adult patients with dental malocclusion and skeletal discrepancies.

Modified Direct Transfer Coping Technique for Making Impression of Closely Placed Implants

The main purpose of the impression is to record and transfer the relationship between implants and to reproduce this relationship as accurately as possible. But, Unplanned placement of the implants may result in close approximation of the implants, thereby posing tough challenge to the restorative dentist, to first accurately record the impression and later on fabricate the prosthesis with satisfactory esthetics and function. This article presents a modified direct impression coping procedure for precise making of impression of closely placed implants which otherwise may be difficult to replicate the exact position of the implants by conventional direct or indirect technique.

Er-Yag Laser Root Preparation During Subepithelial Connective Tissue Graft Procedures.

Areas of gingival recession cause either an esthetic problem and or root sensitivity. Obtaining predictable root coverage has become an important part of periodontal therapy. A deep, long – standing recession promoted by ANUG was treated using subepithelial connective tissue graft technique combined with decontamination of root surface by using Er:YAG laser. Our clinical findigs suggest that this technique is a predictable procedure to treat gingival recession and promote root decontamination.

Socket Shield Technique - A New Approach of Immediate Implant Articles Review

Dental implant restoration is challenging procedure when it involve the esthetics zone, and since implant dentistry is prosthodontically driven procedure, care were practice in restoration of missing teeth in esthetics area which will fulfill the objective. Extraction of teeth leave buccal plate bone unsupported and decrease the blood supply and since this plate is very thin resorption will be expected. Different attempt was done in order to prevent this sequence and create natural emergence profile around dental implant prosthesis. Socket preservation procedures were introduced, however in case of ridge deficiencies, hard and soft tissue augmentation procedures are indicated. Socket shield technique meets the demands of minimal invasion, tissue preservation, and no need of bone substitute materials. And can be applied not only for maintaining buccal contour of an edentulous ridge but also for keeping the inter-implant soft and hard tissue In this review paper we present different articles and case report using socket shield technique as treatment protocols and try to explore different protocol are practice in order to achieve high treatment out come with optimal success.

Implant Anchorage in Orthodontic Retrusion: A Case Report

Mini screws represent a new treatment modality in orthodontic biomechanics. They provide absolute anchorage, no secondary movements and reduced orthodontic treatment time. Futhermore, the surgical procedure for mini implants placement is quite simple and this type of treatment requires no patient compliance. We selected a clinical case in order to emphasize one of the most important indications of the mini implants: retrusion of the upper incisors for a incresed overjet case in a young patient. Two mini implants were placed in order to obtain the correction of the overjet and the retrusion of the anterior teeth. The retrusion was obtained in a reduced period of time using retraction devices on crimpable hooks.

Evaluation of Bacterial Population in the Saliva of Drug Addicts

Background: The human mouth harbors over 700 microbial genera. The large number of them is normal bacteria; few of them are opportunistic pathogens. Objective: The study was aimed to evaluate the bacterial population of drug addicted persons and compare it to that of a normal healthy person. Methods: Five different samples of human saliva; alcohol drunken person, oral moist snuff user, cigarette, hashish and shisha smoker were investigated the involvement of bacteria in them. One sample was collected from normal non-addict person. The bacterial population in drug addictive persons were compared that on normal non-addictive person. Results: The bacteria observed were: Gram negative cocci, mono cocci, streptococci, vibrio, gram negative rod, gram positive staphylococcus, gram positive streptococci and gram-positive rod. Conclusion: The order of bacterial population was; alcohol drunken person<oral moist snuff user ˂ cigarette smoker ˂ hashish smoker ˂ shisha smoker˂ normal non addictive person. From the findings in this study it is concluded that all these drugs have some antibacterial activities.