Interdisciplinary approach for the treatment of periodontally compromised malpositioned anterior teeth: a case report

Today many adult patients with periodontal disease demonstrate positioning of teeth that comprise their ability for proper mechanical tooth cleaning of approximal tooth surfaces. With adequate combined periodontal-orthodontic treatment it is possible to re-establish a healthy and well-functioning dentition. However, while orthodontic treatment can realign periodontally affected teeth, esthetic appearance may be compromised by gingival recession due to alveolar bone dehiscences or fenestrations in combination with a thin gingival biotype. This article reports an interdisciplinary (periodontic, orthodontic, restorative) approach for the treatment of a periodontally compromised patient with anterior dental malalignment. Periodontal therapy, including periodontal plastic surgery to obtain root coverage as well as orthodontic treatment by means of a miniscrew implant anchorage were used to achieve stable periodontal conditions and successful esthetic and functional final results

Single tooth torque correction in the lower frontal area by a completely customized lingual appliance

Abstract Background Aim of this study was to analyze the efficacy and precision of the completely customized lingual appliance (CCLA) regarding the single tooth torque correction. The study also examined external apical root resorptions as possible side effects of torque correction and the changings of the periodontal situation. Methods A case series of three patients were included. The patients showed a single tooth torque problem with a gingival recession and were treated with the CCLA. Plaster casts before and after treatment and plaster casts of the set up were scanned and superimposed. Deviations between the two plaster casts were analyzed at different points of interest. Changes of the gingival recession were compared before and after treatment. Relative root resorptions were measured by the orthopantomograms. Treatment times were assessed by the records of the patients. Results were presented descriptively. Results The mean change of the most apical part of the root reached by the orthodontic treatment was 1.8 ± 0.3 mm. The largest deviation between set up and final model was measured on the occlusal surface of the tooth 36 with 0.8 mm. Most measurement points showed a deviation of 0.5 mm or less. The depths of the gingival recession showed a significant reduction of 4.7 mm. The widths of the gingival recession were reduced by 1.1 mm. The average relative root resorption of the corrected teeth was 2.7 ± 1.5%. The average treatment time was 13.8 ± 4.5 months. Conclusions This is the first study showing that the CCLA with its high precision is very effective in correcting single tooth torque problems. Orthodontic torque correction resulted in a significant reduction of gingival recessions and caused only negligible root resorptions

Clinical observations and success rates of palatal implants

Introduction: Anchorage control is a challenge in orthodontics. Implants can be used to provide absolute anchorage.The aim of this study was to evaluate the success rates of palatal implants used for various anchorage purposes.Methods: Thirty-four palatal implants were placed in 33 patients. In the adults (n = 9), the implants (n = 9) were placed in the median palatal suture. In the adolescents (n = 24), the implants (n = 25) were placed in the paramedian region. The implants were used to support a transpalatal arch, a modified distal jet appliance, or a modified hyrax screw. An implant was considered successful if it could be used as planned throughout the orthodontic treatment. The patients were asked to evaluate their pain perception after placement and explantation procedures.Results: Three implants failed early (during the waiting period before orthodontic loading, within 3 months after placement). During the orthodontic loading period, no implants were lost. No statistically significant correlations were found between success rate and sex, age, primary stability, placement site (median or paramedian), implant size, or palatal depth. Pain perception after surgery was acceptable. The success rate of the palatal implants in this study was 91%.Conclusions: Palatal implants are a reliable method of providing absolute anchorage control in a variety of patients for different indications. They can be loaded both directly and indirectly.info:eu-repo/semantics/publishe