A piezo surgery with corticotomies and implant placement as part of a multidisciplinary approach to treat malocclusion disorder in an adult patient: clinical report.

Federico Gelpi,Daniele De Santis,Marco Finotti,Simone Marconcini,Francesco Briguglio

doi:10.1186/s40729-015-0021-3

Federico Gelpi, Daniele De Santis + Show 3 more

Open Access

https://doi.org/10.1186/s40729-015-0021-3

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Abstract

This clinical report illustrates a multidisciplinary approach for the rehabilitation of a young adult patient affected by a bilateral edentulous space and an anterior deep bite. The patient required orthodontics and surgical corticotomy and implantology (both performed with a piezo device). A multidisciplinary planning approach, including orthodontics, oral and periodontic surgery, and restorative dentistry, has an important role in the final outcome of treatment. In fact a dental class I occlusion has been established only on the right side. The left side could not be restored to an ideal class I relationship due to the pontic prosthesis. The original collapsed right posterior occlusion was corrected. A stable posterior occlusion was established, and the balancing interference was eliminated. Centric relation and centric occlusion were established at the same vertical dimension of occlusion. The cephalometric analysis and clinical aspect at the end of treatment showed that the patient had improvements in overbite and overjet.Multidisciplinary management, including endodontic and restorative dentistry, periodontics, corticotomy-assisted orthodontics, implants, and prosthetics, was used for a young female patient with multiple missing teeth, anterior deep bite, and a malocclusion with cant of the occlusal plane. The interaction of interdisciplinary specialties and careful treatment planning were required. The patient also benefited esthetically from our effort.

Highlights

In the adult patient, the loss of teeth or periodontal support can cause pathologic migration of a single tooth or group of teeth. This can result in the development of median diastema or general spacing of the teeth with or without incisor inclination, rotation, or tipping of the premolars and molars and collapse of the posterior occlusion with decreasing vertical dimension [1]
The maxillary corticotomy is another available and suggested technique that facilitates orthodontic intrusion. This clinical report illustrates a multidisciplinary approach for the rehabilitation of a young adult patient affected by a bilateral edentulous space
The patient required orthodontics and surgical corticotomy and implantology

Summary

Background

The loss of teeth or periodontal support can cause pathologic migration of a single tooth or group of teeth. The maxillary corticotomy is another available and suggested technique that facilitates orthodontic intrusion This clinical report illustrates a multidisciplinary approach for the rehabilitation of a young adult patient affected by a bilateral edentulous space. Treatment objectives The following treatment objectives were established for this patient: (1) conservative and endodontic treatment in the teeth damaged by caries; (2) reestablishment of the correct occlusal plane; (3) corticotomy surgery (performed with a piezo device) to accelerate orthodonticassisted tooth intrusion, alignment, and tipping; and (4) improvement of mouth posterior function through implant surgery to replace missing teeth (performed with a piezo device). A microsurgical corticotomy was mandatory to assist orthodontic tipping and intrusion of elements 16 and 17 This surgical procedure was performed by a piezo approach (Fig. 9). The cephalometric analysis and clinical aspect at the end of treatment showed that the patient had improvements in overbite and overjet

Discussion

Conclusions