Orthodontic Space Closure

正畸间隙闭合
  • 文章类型: Case Reports
    在此病例报告中提供的患者是一个10岁的男孩,其骨骼过度发散II类,与第二前磨牙的家族遗传变异有关。选择的治疗计划是使用口腔固定的双腋窝矫治器关闭发育不全的空间。讨论了这种治疗方案的优缺点。结果是稳定的,可以避免植入假体溶液,随着时间的推移,这无疑会更加严格。
    The patient presented in this case report is a 10-year-old boy with hyperdivergent skeletal Class II associated with familial genetic agenesis of the second premolars. The treatment plan chosen was to close the spaces of agenesis using a bimaxillary appliance fixed buccally. The advantages and disadvantages of this treatment option were discussed. The result was stable and made it possible to avoid an implant-prosthetic solution, which would undoubtedly have been more restrictive over time.
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  • 文章类型: Journal Article
    使用清晰的矫正器(CA)成功闭合无牙空间受许多因素的影响。CA是量身定制的正畸设备,其可预测性可能具有相关的医学法律意义。这项研究提供了有关CAs缺失磨牙空间闭合(MMSC)和临床病例的范围审查。这项研究旨在强调通过在没有混合支撑的情况下与CA进行中间化来闭合磨牙空间的可行性。遵循PRISMASc审查指南,PubMed上的英语编写的随机/非随机/观察性临床研究,Scopus,搜索了科克伦和丁香花。一个18岁的病人,由于失去了两个第一磨牙,上下缺牙空间,被CA修复(Sorridi®,Sorridisrl,Latina,意大利)没有混合支架和附件。治疗进行了10个月。目前,没有通过仅CA的中介化记录MMSC的研究。现有的文章记录了前磨牙或门牙空间的闭合。左上和左下第二磨牙取代了丢失的第一磨牙,爆发的第三磨牙取代了相邻的牙齿。与拔牙有关的CA在空间闭合中的生物力学作用似乎是临床/医学法律利益的优先事项。我们的案例将注意力转向没有附件/混合支撑的CA的这种运动,这表明,即使是这样一个复杂的治疗可以舒适的病人和安全可预测的专家。
    Successful closure of edentulous spaces with clear aligners (CAs) is influenced by many factors. CAs are tailored orthodontic devices whose predictability may have relevant medico-legal implications. This study presents a scoping review about missing molar space closure (MMSC) with CAs and a clinical case. This study aims to highlight the feasibility of molar space closure by mesialization with CAs without hybrid supports. Following PRISMA Sc-review guidelines, English-written randomized/non-randomized/observational clinical studies on PubMed, Scopus, Cochrane and Lilacs were searched. An 18-year-old patient, with upper and lower edentulous spaces due to the loss of two first molars, was rehabilitated with CAs (Sorridi®, Sorridi srl, Latina, Italy) without hybrid supports and attachments. The therapy was carried out over 10 months. Currently, there are no studies documenting MMSC by mesialization with only CAs. Existing articles document the closure of premolar or incisor spaces. The upper and lower left second molars replaced the missing first molars, and erupting third molars replaced adjacent teeth. The biomechanical effects in space closure with CAs related to extraction cases appear as priorities of clinical/medico-legal interest. Our case turns attention to this movement of CAs without attachments/hybrid supports, indicating that even such a complex treatment can be comfortable for patients and safely predictable for specialists.
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  • 文章类型: Journal Article
    Preorthodontic socket preservation after tooth extraction is intended to enhance favorable dentoalveolar ridge morphology and architecture, and facilitate orthodontic tooth movement (OTM) and extraction space closure. This 13-year-old skeletal Class II case presents a unique opportunity to evaluate and compare the OTM extraction space closure by means of a split-mouth analysis in a single patient. The comprehensive orthodontic-periodontal treatment included nonsimultaneous extraction of the bilateral periodontally compromised mandibular first molars and the eruption of bilateral impacted mandibular canines. While the right post-extraction space underwent a natural healing process, the left one was grafted using 4BONE BCH (hydroxyapatite β-tricalcium phosphate [HA-β-TCP], HA 60%, and β-TCP 40%). The 3-year multidisciplinary treatment approach resulted in Class I relationships on the right side and Class II on the left side, improved facial appearance, and dento-skeletal jaw relationships. However, a 3-mm residual alveolar space remained unclosed on the grafted left-site, along with an unerupted left third molar. This split-mouth comparative analysis of the orthodontic space closure demonstrated a significant clinical difference in the outcome. Preorthodontic placement of HA-β-TCP grafting material on the left segment, proved to be an obstacle for OTM extraction space closure, hindering the establishment of good occlusion.
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  • 文章类型: Case Reports
    This case report presents treatment of a severe localized horizontal bone loss combined with infrabony defects adjacent to pathologically migrated teeth by orthodontic intrusion following a graft of enamel matrix derivative (EMD) without root surface conditioning. The patient was diagnosed with Angle Class II malocclusion, anterior spacing, and pathologically migrated incisors. Graft of EMD mixed with bone materials was applied for periodontal regeneration before orthodontic treatment, and periapical radiographs were taken every 3 months for radiographic evaluation. After closure of anterior spaces by orthodontic treatment, infrabony defects improved dramatically, with a favorable alveolar bone level and periodontal pocket depth.
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  • 文章类型: Case Reports
    BACKGROUND: Facing a patient with a morphological or numerical disorder of the lateral upper incisors (mainly pegged or missing incisor), the orthodontist has to choose between two treatment options : either spatial planning for a prosthetic restoration, or space closure with substitution of the lateral incisors by canines; the choice depends on the clinical context we are faced with. Each treatment option has its advantages and disadvantages and it is hard to tip the balance in one direction or another.
    METHODS: This article illustrates the rationale for therapeutic management of space closure, in a patient with skeletal class III, with hypoplastic and peg-shaped upper lateral incisors.
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    文章类型: Case Reports
    BACKGROUND: The present case report describes the orthodontic treatment and long-term follow-up of an adult female patient (27 years) who was diagnosed with a mild Class III malocclusion characterised by an anterior and lateral open bite and three periodontally-compromised first permanent molars.
    OBJECTIVE: The aim of treatment was to provide an acceptable aesthetic and functional occlusion while, at the same time, improving the periodontal prognosis.
    METHODS: The patient was treated with fixed orthodontic appliances utilising direct and indirect skeletal anchorage derived from two mini-screws placed in the palate and one mandibular buccal mini-screw.
    RESULTS: The objectives of good aesthetics, a functional occlusion, a healthy periodontium and a balanced profile were achieved. The total treatment time was 31 months, which comprised 13 months of maxillary fixed labial appliances and 25 months of mandibular fixed labial appliances. The three-year follow-up records showed stability of the Class ILL correction.
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  • 文章类型: Case Reports
    This article presents the application of laser welding technique to fabricate an orthodontic mini-implant provisional restoration in missing area after limited orthodontic treatment. A 15-year-old boy case is presented. Two-piece orthodontic C-implant was placed after regaining space for missing right mandibular central incisor. Due to angular deviation of implant, customized abutment was required. Ready-made head part was milled and lingual part of customized abutment was made with non-precious metal. Two parts then were laser welded (Master 1000, Elettrolaser Italy, Verona, Italy) and indirect lab composite (3 M ESPE Sinfony, St. Paul, MN, USA) was built up. The patient had successful result, confirmed by clinical and radiographic examinations. Before the patient is ready to get a permanent restoration later on, this provisional restoration will be used. This case shows that a two-piece orthodontic C-implant system can be used to maintain small edentulous space after orthodontic treatment.
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  • 文章类型: Case Reports
    Multiple idiopathic external root resorption is a rare pathological condition usually detected as an incidental radiographic finding. External root resorption of permanent teeth is a multifactorial process related to several local and systemic factors. If an etiological factor cannot be identified for root resorption, the term \"idiopathic\" is applied. This report presents a case of multiple idiopathic apical root resorption. The condition was found in a young female patient seeking orthodontic treatment due to malocclusion. This kind of resorption starts apically and progresses coronally, causing a gradual shortening and rounding of the remaining root. Patients with this condition are not the ideal candidates for orthodontic treatment; however, the aim of this report is to describe an unusual case of idiopathic root resorption involving the entire dentition, and to present the orthodontic treatment of this patient. It describes the progress and completion of orthodontic therapy with satisfactory end results.
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    文章类型: Case Reports
    BACKGROUND: Fusion is defined as the union between dentine and/or enamel of two normally separated teeth. Gemination is the cleavage of the forming dental germ to produce two partial teeth. The distinction between the conditions is often determined by the number of teeth present. However, this can be confused if supernumerary teeth are considered.
    OBJECTIVE: The present case report describes the treatment of a patient who presented with dental fusion and macrodontia involving both upper central incisors. Besides the central incisors displaying characteristics of macrodonts, tooth 21 also showed aspects of fusion.
    METHODS: Management consisted of the extraction of 11 and 21 and orthodontic mesialisation of the maxillary dentition. Treatment was planned in two phases and at the end of the orthodontic phase, the upper anterior teeth were to be reshaped using composite resin.
    RESULTS: Orthodontic space closure is a treatment option in the clinical management of an extracted maxillary central double and/or macrodontic tooth. As no permanent teeth were absent, it was presumed that the fusion of 21 occurred with a supernumerary tooth.
    CONCLUSIONS: Multidisciplinary treatment following the extraction of maxillary central incisors is reported with special attention to the orthodontic and restorative considerations required to improve the aesthetic outcome.
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  • 文章类型: Comparative Study
    BACKGROUND: The aim of this study was to provide clinical indications for the correct management of appliances in space closure treatment of patients with agenesis of the upper lateral incisors.
    METHODS: Virtual setup for space closure was performed in 30 patients with upper lateral incisor agenesis. Tip, torque and in-out values were measured and compared with those of previous authors.
    RESULTS: In the upper dentition, the tip values were comparable to those described by Andrews (Am J Orthod 62(3):296-309, 1972), except for at the first premolars, which require a greater tip, and the first molars, a lesser tip. The torque values showed no differences except for at the canines, where it was greater, and the in-out values were between those reported by Andrews and those by Watanabe et al. (The Shikwa Gakuho 96:209-222, 1996) (except for U3 and U4).
    CONCLUSIONS: The following prescriptions are advisable: tip 5°, torque 8° and in-out 2.5 for U1; tip 9°, torque 3° and in-out 3.25 for U3; tip 10°, torque -8° and in-out 3.75 for U4; and tip 5°, torque -8° and in-out 4 for U5. Andrews\' prescription is suitable for the lower jaw, except for at L6. It is also advisable to execute selective grinding (1.33±0.5 mm) and extrusion (0.68±0.23 mm) on the upper canine during treatment, and the first premolar requires some intrusion (0.56±0.30 mm).
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