Abstract
This case report describes a 13-year-old boy with alveolar bony defect resulted from surgical removal of impacted upper canine transposed in the anterior region. The boy had a normal occlusion with malposition of upper central and lateral incisors. The treatment objectives were to align teeth, close spaces by mesial movement of the buccal segments in the upper jaw to repair bone loss. Fixed appliance with palatal root torque was used for the mesial movements, levelling, and alignment of teeth.Orthodontic tooth movement consisted of a sequence of root movement in a direction to increase the thickness of the labial cortical plate of bone, could ensure healthier periodontium. A healthier periodontium prior to space closure ensured repair of alveolar bony defect after surgical intervention. Orthodontic tooth movement should be added to our armamentarium for the repair of alveolar bony defect.
Highlights
Surgical removal of impacted tooth in the anterior region can create an alveolar bone defect
Even when orthodontic forces are applied in the desired direction, it is difficult to produce the amount of root movement required because a large hyalinised layer will be created [2]
It has been reported that slight gentle orthodontic forces from the use of laceback ligature technique is effective in correction of bone deficient alveolar ridge [10]
Summary
Surgical removal of impacted tooth in the anterior region can create an alveolar bone defect. The roots of the upper anterior teeth are close to the cortical bone of the maxilla, which is an area of reduced vascularisation This results in delayed bone remodelling and tooth movement. Palatal root torque is needed during orthodontic movement of the tooth to increase the buccal bone thickness, decrease the risk of bone dehiscence and decrease the risk of gingival recession [4,5]. Application of palatal root torque would increase the thickness of bone at the labial aspect of the incisor (Figure 4). This would reduce the chance of gingival recession as the tooth was brought down to the occlusion.
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