Open versus closed surgical exposure of canine teeth that are displaced in the roof of the mouth

Background: Palatal canines are upper permanent canine (eye) teeth that have become displaced in the roof of the mouth. They are a frequently occurring anomaly, present in 2% to 3% of the population. Management of this problem is both time consuming and expensive and involves surgical exposure (uncovering) followed by fixed braces for 2 to 3 years to bring the canine into alignment within the dental arch. Two techniques for exposing palatal canines are routinely used in the UK: one method (the closed technique) involves orthodontically moving the canine into its correct position beneath the palatal mucosa and the second method (the open technique) involves orthodontically moving the canine into its correct position above the palatal mucosa. Objectives: To establish if clinical, patient centred and economic outcomes are different according to whether an ’open’ or ’closed’ technique is employed for uncovering palatal canines. Search strategy: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Oral Health Group’s Trials Register were searched (to 29th February 2008). There were no restrictions with regard to publication status or language. Selection criteria: Patients receiving surgical treatment to correct upper palatally impacted canines.Therewas no restriction for age, presenting malocclusion or the type of active orthodontic treatment undertaken. Unilateral and bilaterally displaced canines were included. Trials including participants with craniofacial deformity/syndrome were excluded. Data collection and analysis: Two review authors independently and in duplicate assessed studies for inclusion. The Cochrane Collaboration statistical guidelines were to be followed for data synthesis

A review of implant provision for hypodontia patients within a Scottish referral centre

Background: Implant treatment to replace congenitally missing teeth often involves multidisciplinary input in a secondary care environment. High quality patient care requires an in-depth knowledge of treatment requirements. Aim: This service review aimed to determine treatment needs, efficiency of service and outcomes achieved in hypodontia patients. It also aimed to determine any specific difficulties encountered in service provision, and suggest methods to overcome these. Methods: Hypodontia patients in the Unit of Periodontics of the Scottish referral centre under consideration, who had implant placement and fixed restoration, or review completed over a 31 month period, were included. A standardised data collection form was developed and completed with reference to the patient's clinical record. Information was collected with regard to: the indication for implant treatment and its extent; the need for, complexity and duration of orthodontic treatment; the need for bone grafting and the techniques employed and indicators of implant success. Conclusion: Implant survival and success rates were high for those patients reviewed. Incidence of biological complications compared very favourably with the literature

Development of a device to simulate tooth mobility

Objectives: The testing of new materials under simulation of oral conditions is essential in medicine. For simulation of fracture strength different simulation devices are used for test set-up. The results of these in vitro tests differ because there is no standardization of tooth mobility in simulation devices. The aim of this study is to develop a simulation device that depicts the tooth mobility curve as accurately as possible and creates reproducible and scalable mobility curves. Materials and methods: With the aid of published literature and with the help of dentists, average forms of tooth classes were generated. Based on these tooth data, different abutment tooth shapes and different simulation devices were designed with a CAD system and were generated with a Rapid Prototyping system. Then, for all simulation devices the displacement curves were created with a universal testing machine and compared with the tooth mobility curve. With this new information, an improved adapted simulation device was constructed. Results: A simulations device that is able to simulate the mobility curve of natural teeth with high accuracy and where mobility is reproducible and scalable was developed

Familial aggregation of maxillary lateral incisor agenesis

In spite of recent developments, data regarding the genes responsible for the less severe forms of hypodontia are still scarce and controversial. This study addressed the hypothesis that agenesis of maxillary lateral incisors (MLIA) is a distinct type of hypodontia, by evaluating its familial aggregation and the occurrence of other types of ageneses or microdontia in probands' relatives. Sixty-two probands with MLIA were identified, and information was collected on 142 first-degree relatives. Relative risk (RR) was calculated and compared by re-assessment of data previously published for the Swedish, Utah, and Israeli populations, for the same trait. A RR of 15 was obtained in the Portuguese, 16 in the Swedish, 12 in Utah, and 5 in the Israeli population. Our results support a significant familial aggregation of MLIA, show that MLIA almost never segregates with other forms of agenesis, and suggest that microdontia of maxillary lateral incisors is part of the same phenotype.The individuals who took part in this study are acknowledged. Carolina Lemos was the recipient of a PhD scholarship (FCT - SFRH/BD/17761/2004) and Teresa Pinho of a PhD scholarship from Instituto Superior de Ciencias da Saude Norte/CESPU. The other authors received no funding from any institution, department, or sponsor, other than salaries from the institutions with which they are affiliated

State of the science on controversial topics: missing maxillary lateral incisors--a report of the Angle Society of Europe 2012 meeting.

BACKGROUND: The optimal long-term management of the congenitally missing maxillary lateral incisor continues to cause controversy within the specialty. The Angle Society of Europe meeting 2012 dedicated a day to address some of the current controversies relating to the management of these missing lateral incisors. FINDINGS: The format of the day consisted of morning presentations and afternoon breakout sessions to discuss a variety of questions related to the management of missing lateral incisors. CONCLUSIONS: The consensus viewpoint from this day was that the care of patients with congenitally missing lateral incisors is best achieved through a multi-disciplinary approach. The current evidence base is weak, and further well-designed, prospective trials are needed

Clinical and radiographic evaluation of early loaded narrow diameter implants – 1‐year follow‐up

Objective To evaluate the clinical performance of A stra T ech O sseo S peed™ TX 3.0 S implants using one‐stage surgical procedure and early loading in the anterior region. Material and methods This is a prospective, single arm, multi‐centre study. Patients missing teeth at positions 12, 22 and 32–42 were eligible to enter the study. The implants ( O sseo S peed™ TX 3.0 S ) used in the study were of 3 mm diameter and of different lengths. One‐stage surgery was performed, and healing abutments were used during the 6–10 weeks healing period. Clinical and radiographic examinations were assessed at implant installation, loading and at the 6‐ and 12‐month follow‐up visits. Results Ninety‐seven implants were placed in 69 patients at six different study centres in D enmark, G ermany, I taly, S pain, S weden and the U nited K ingdom. The survival rate was 95.9%. No implants have been lost after loading (100% survival rate after loading). Mean marginal bone loss 1 year after installation was 0.065 mm ( SD  = 1.018). The frequency of bone loss ≥1 mm was 6.6% and 51.3% of the implants demonstrated no bone loss or even bone gain from the surgical visit to the first year follow‐up visit. Mean probing pocket depth and gingival zenith score were stable from crown placement to the 6‐ and 1‐year follow‐up visits. Conclusion Treatment with O sseo S peed™ TX 3.0 S implants is a safe and predictable option in the anterior region where physical space is limited. Minimal marginal bone loss was observed during the first year follow‐up.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/91103/1/clr2254.pd

What is the value of orthodontic treatment?

Orthodontic treatment is as popular as ever. Orthodontists frequently have long lists of people wanting treatment and the cost to the NHS in England was £258m in 2010-2011 (approximately 10% of the NHS annual spend on dentistry). It is important that clinicians and healthcare commissioners constantly question the contribution of interventions towards improving the health of the population. In this article, the authors outline some of the evidence for and against the claims that people with a malocclusion are at a disadvantage compared with those without a malocclusion and that orthodontic treatment has significant health benefits. The authors would like to point out that this is not a comprehensive and systematic review of the entire scientific literature. Rather the evidence is presented in order to stimulate discussion and debate

Unilateral cross bite treated by corticotomy-assisted expansion: two case reports

<p>Abstract</p> <p>Background</p> <p>True unilateral posterior crossbite in adults is a challenging malocclusion to treat. Conventional expansion methods are expected to have some shortcomings. The aim of this paper is to introduce a new technique for treating unilateral posterior crossbite in adults, namely, corticotomy-assisted expansion (CAE) applied on two adult patients: one with a true unilateral crossbite and the other with an asymmetrical bilateral crossbite, both treated via modified corticotomy techniques and fixed orthodontic appliances.</p> <p>Methods</p> <p>Two cases with asymmetric maxillary constriction were treated using CAE.</p> <p>Results</p> <p>In both cases, effective asymmetrical expansion was achieved using CAE, and functional occlusion was established as well.</p> <p>Conclusions</p> <p>Unilateral CAE presents an effective and reliable technique to treat true unilateral crossbite.</p

Chin cup therapy for mandibular prognathism

The purpose of this work was to provide a comprehensive description of craniofacial alteration in the Class III patient in response to orthopedic chin cup treatment. Thirty patients with skeletal Class III malocclusion under treatment with the chin cup appliance, averaging 6 years of age at the start of treatment, were followed longitudinally for a 3-year period. This treatment sample was compared cephalometrically with an analogous untreated Class III sample.The following significant craniofacial alterations were noted in the sample that underwent orthopedic chin cup therapy: 1. 1. A retardation of vertical ramus growth.2. 2. A retardation of vertical development in the posterior aspect of the mandibular body.3. 3. A retardation of vertical development in the posterior maxilla.4. 4. A closure of the gonial angle.5. 5. A distal rotation of the mandibular complex.6. 6. A decreased amount of anteroposterior anterior cranial base growth.7. 7. A redirection of the predominantly horizontal mandibular growth pattern to a more vertical direction.8. 8. A reduction of the maxillomandibular malrelationship toward normative values.9. 9. A production of an Angle Class I dental relationship following the establishment of normal maxillomandibular relations.10. 10. A lack of detectable localized effect on the symphyseal region or incisor position as a direct result of chin cup placement and pressure.11. 11. Development of soft-tissue profile changes in harmony with underlying skeletal changes.While all of the listed alterations are important when analyzed separately, they gain increased importance when considered together. With orthopedic chin cup therapy, there is a change in craniofacial pattern leading to the observed resolution of the Angle skeletal Class III malocclusion. This study thus provides strong support for the use of the orthopedic-force chin cup appliance in the clinical management of young patients with skeletal mandibular prognathism.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/23012/1/0000581.pd