Orthodontic Treatment of a Case with Maxillary Impacted Canines and Congenitally Missing First Premolars

Depending on their roles in oral functions and smile and face esthetic, impaction of maxillary canines is an important problem that should be treated by a conservative approach. In this case report, orthodontic treatment of a patient (9-year 5- months) with congenitally missing one maxillary premolar on both side and impacted two maxillary canines were introduced. The canines were impacted in different depth and angulations; right canine was almost parallel to occlusal plane. Following the determination of the teeth were not erupting by a panoramic radiograph taken in the sixth month after first application, patient was accepted to fixed orthodontic therapy. Primary canines were extracted. Rotations of upper premolars and molars were corrected and spaces were organized. However no traction was applied to maxillary canines, it was determined that they were erupting in the following panoramic radiograph. When they are fully erupted they were bonded. The treatment finished in three years and seven months time. This case shows the importance of early diagnose of impacted maxillary canines and their ability to erupt by uprighting when their spaces are prepared

Long-Term Follow-Up of Two-Phase Orthodontic Treatment of Class II Malocclusions

Aim:The aim of the study was to investigate the stability of dentoskeletal changes 8 years after treatment with the activator appliance, followed by an edgewise appliance.Subjects and Methods:The study comprised 18 children (10 boys and 8 girls at 12.2±1.4 years of age) with a skeletal Class II pattern and a Class II molar relationship. Pre-treatment (T1) their ANB angles were greater than 4 degrees and overjets greater than 7 mm. Standardized lateral cephalograms were taken in centric occlusion at the start of treatment (T1), at the end of activator treatment (T2), at the end of fixed appliance therapy (T3) and 6.2 years after the removal of the fixed appliances (T4). Ten angular and nine linear cephalometric measurements were determined. A paired-sample t-test was used to evaluate the treatment changes.Results:At the end of active treatment period (T3) the skeletal relationship was improved and there were significant (p=0.000) increases in maxillary and mandibular length (Co-A and Co-Gn) and SNB. The upper incisors were significantly (p=0.023) uprighted and retruded (U1-NA). SNA and ANB angles were significantly (p=0.012, p=0.000 respectively) decreased whereas IMPA and mandibular plane angle (Go-Gn-SN) remained stable. At (T4) the changes were generally in agreement with those T3 at except for a slight return to the original values for SNA and A to N -I FH (mm) measurements.Conclusion:The anteroposterior dentoskeletal changes obtained with the activator appliance followed by fixed edgewise appliances were demonstrated to be stable over 6.2 years

Comparison of prefabricated Ladanyi springs and reverse closing loop in segmental canine retraction

Amaç: Prefabrike Ladanyi springin, elde bükümü yapılmış olan reverse closing loop ile kıyaslanması, ankraj dişler ve kaninler üzerinde meydana gelen değişimleri değerlendirmektir. Gereç ve Yöntemler: Çalışmaya ortalama yaşları 15 yıl 10 ay olan (12 yıl 6 ay-16 yıl 11 ay) 9 kız, 3 erkek toplam 12 hasta dahil edilmiştir. Prefabrike Ladanyi spring hastaların üst çenelerinde sağ segmente, reverse closing loop ise üst çenede sol segmente yerleştirilmiştir. Seanslar 4 haftada bir yapılmıştır. Her hastadan referans telleri yerleştirilerek sefalometrik radyograflar alınmıştır. Periyotlara göre sağ ve sol fark karşılaştırılmasında 2-bağımsız örnek testi Mann-Whitney U analizi, periyotlar arası kıyaslama için Friedman testi kullanılmıştır. Bulgular: Ladanyi spring grubunda 5,87 mm kanin retraksiyonu 1,37 mm molar ankraj kaybı, reverse closing loop grubunda ise 4,16 mm kanin retraksiyonu 0,75 mm molar ankraj kaybı gözlenmiştir. Ladanyi spring grubunda SN düzlemine göre kaninlerde 1,04 mm intruzyon, molarlarda 0,66 mm ekstruzyon gözlenirken reverse closing loop grubunda kanin intruzyon miktarının ortalama 0,20 mm ve molar ekstruzyon miktarının 0,04 mm olduğu tespit edilmiştir. Sonuç: Çalışmamızda Ladanyi spring grubunda kanin retraksiyonu daha hızlı gerçekleşmiştir. Her iki gruptada kanin retraksiyonu sonrasında molar dişlerde ankraj kaybı, SN düzlemine göre kaninlerde intruzyon-molarlarda ekstruzyon ve overjette spontan düzelme gözlenmiştir. Ayrıca kaninlerde distale devrilme, molarlarda meziale devrilme gözlenmiştir. Reverse closing loop ile kanin retraksiyonunun daha yavaş olmasına rağmen, daha kontrollü bir hareket sağlandığı tespit edilmiştir.Background: The purpose of the study is the comparison of the usage effects of prefabricated Ladanyi spring with handmade reverse closing loop, on canines and anchorage teeth. Methods: Patients,average age were 15 years 10 months,9 female-3 male were included in the study. The prefabricated springs of Ladanyi springs were inserted on patients’ right side teeth and reverse closing loops were inserted on patients’ left side. Reference wires installed cephalometric radiographs were taken.In the comparison of the difference according to periods between left and right segments 2 independent sample test Mann-Whitney U analysis has been used. Friedman Test has been used for the comparison of periods. Results: In the Ladanyi spring group 5,87 mm canine retraction 1,37 mm molar anchorage loss and in the reverse closing loop group 4,16 mm canine retraction 0,75 mm molar anchorage loss were observed. In the Ladanyi spring group 1,04 mm canine intrusion 0,66 mm molar extrusion and in the reverse closing loop group 0,20 mm canine intrusion 0,04 mm molar extrusion were observed according to SN plane. Conclusion: Our results showed that canine retraction duration was shorter in the Ladanyi group. After the canine retaction, anchorage loss in the molar teeth, according to SN plane canine intrusion and molar extrusion were noted in both groups. Despite the slower canine retraction movement with the reverse closing loop, it was provide a more controlled movement