Malpositioned Teeth Research Articles

Correction of Malpositioned Tooth with Insufficient Clinical Crown Length

Correction of Malpositioned Tooth with Insufficient Clinical Crown Length

The Challenges of Treating Malpositioned Teeth in Complete and Partial Occlusal Rehabilitations

The Challenges of Treating Malpositioned Teeth in Complete and Partial Occlusal Rehabilitations

Efektifitas Plat Ekspansi dan Simple Spring

Improving occlusion and tooth alignment can be achieved through orthodontic treatment. Orthodontic appliances can also correct crowded teeth, which are common in Indonesia. The aim of this study is to assess the effectiveness of using expansion plates to create space and simple springs to correct the malposition of anterior teeth in the upper and lower jaws, specifically teeth 11, 31, and 41. A 22-year-old female patient with an overjet of 4.2 mm and an overbite of 2.7 mm. First molar relationship on the right and left sides: Angle's Class I. Canine relationship on the right and left sides: Class I. Malposit ion of the patient's individual teeth: 11 (distolabioversion), 15 (mesiopalatotorsion), 23 (mesiolabioversion), 25 (mesiopalatotorsion), 31 (mesiolingualversion), 33 (mesiolabiotorsion), and 41 (distolabioversion). Lateral expansion of 0.85 mm will be performed and tooth malpositions will be corrected using an active plate in the form of a simple spring on teeth 11, 21, 31, and 41. Tooth malpositions on elements 11 distolabioversion (corrected), 31 mesiolingualversion (corrected), and 41 distolabioversion (corrected). During visits 16 to 20, the operator performed retraction by activating a labial arch. There was a change in overjet from 4.2 mm to 3.15 mm. The treatment was effective in correcting the malposition of teeth 11, 31, and 41. The patient exhibited tooth movement mesially towards the labial direction, thus correcting the patient's teeth towards the ideal position.

Treatment of Tooth Relapse Using Removable Orthodontics Appliances

At present, fixed orthodontic appliances treatment is extensively utilized with excellent outcome. Nevertheless, complications frequently arise following the conclusion of orthodontic treatment, predominanly relapse. Relapse refers to repositioning teeth to their pre-treatment state; its progression is stochastic, thereby rendering relapse possible for each individual. Patients who fail to wear retainers consistently will relapse of the affected teeth after orthodontic treatment. Therefore, this case report details the successful treatment of tooth relapse with a removable orthodontic appliance. A 22-year-old female patient complained of irregular alignment of her lower front teeth. The patient received two years of treatment with fixed orthodontics; however, she ceased using retainers regularly after treatment concluded. An objective examination indicated that the teeth in the upper jaw teeth remain in a well-aligned position; however, the lower jaw exhibited that tooth 32 was mesiolabiotorsiversion, tooth 33 was distolinguotorsiversion, tooth 41 was labioversion, tooth 42 was mesiolinguotorsiversion, with an overjet of 3 mm and an overbite of 2 mm. Afterward, the malposition of the lower jaw teeth was corrected with an expansion plate for a removable orthodontic appliance. Following 20 follow-up treatments over five months, the malposition of the lower jaw teeth has been corrected. As a result, it can be deduced that removable orthodontic appliances continue to be efficacious in rectifying mild malposition caused by dental relapse, thereby obviating patients' need to reapply costly fixed orthodontic appliances.

Correction of Maxillary Multiple Diastem and Mandibular Crowding with Removable Orthodontic

Crowding and diastema are common malocclusion conditions that occur due to a discrepancy between tooth size and jaw size. The treatment that can be done is based on the severity of the case. Mild cases of malposition can be treated with removable orthodontic appliances. This article aims to show the analysis how an active plate device with a simple spring was used to treat multiple maxillary diastemas and anterior crowding of the mandible. The patient complained that his upper front teeth gap and his lower teeth were crowded. It does not interfere with the appearance, but sometimes open food is tucked between the front teeth. The patient has never used an orthodontic appliance before. Molar relation: Malocclusion Angle class 1 type dental with mild individual tooth malposition. Twenty-two treatment visits were performed. Treatment was carried out using an active plate with a simple spring on teeth 13, interdental 31-41, and 43; retentive components using Adam Clamer on teeth 16, 26, 36, and 46; long labial arch with U loops on the right and left permanent 1st premolar teeth. In the 22nd control, the results showed that teeth 11, 21, and 43 malpositions were corrected, and the diastema was closed on tooth 14 against 13 and tooth 21 against 22. In addition, the width of the diastema on interdental 13-12, 12-11, and 22-23 was reduced to 0.05 mm. An active plate with a simple spring can correct diastema and mild crowding of the anterior teeth

Mandibular Mesiodens: A Case Report of Rare Clinical Entity

Supernumerary teeth are those that are in excess of the normal series. Supernumerary teeth can appear as a single tooth, multiple teeth, unilaterally or bilaterally, and in the maxilla, mandible, or both. The presence of this condition, particularly in the mandibular anterior region, has been reported infrequently. The purpose of this paper is to report and review the occurrence of such a rare combination. A 9-year-old girl presented to the Department of Pediatric and Preventive Dentistry with the chief complaint of a malpositioned tooth in the lower anterior region of the jaw. A supplemental tooth resembling a permanent central incisor was discovered during a clinical examination. The presence of Mesiodens was confirmed by radiographic examination. The mesiodens was extracted, followed by a spontaneous closure of the diastema. This case report revealed that the early detection of mandibular supplemental incisors could facilitate early intervention, a better prognosis, and fewer complications.

Toulouse Lautrec syndrome: Report of a rare clinical entity

Pycnodysostosis, first described by Maroteaux and Lamy in the year 1962, is a rare autosomal recessive disorder. It is a lysosomal storage disease of the bone attributed to the mutation of the gene that is responsible for encoding the enzyme cathepsin K, thereby inhibiting the normal osteoclastic function, making the bones abnormally dense and brittle. We report a case of 30-year-old female herewith, who presented with characteristic features such as short stature, acro-osteolysis, open fontanelles, generalized osteosclerosis, and oral manifestations including grooved palate, malpositioned teeth with increased incidence of dental caries. There is an increased risk of mandibular fractures and osteomyelitis following invasive dental treatments. Thus, early diagnosis helps clinicians to manage patients with minimally invasive procedures preventing complications.

A inter-relação do movimento dentário ortodôntico em pacientes com periodontite e Diabetes mellitus

ABSTRACT Orthodontic tooth movement is a mechanically induced bone remodeling process aimed at aligning malpositioned teeth. Periodontitis is a polymicrobial infection of the supporting tissues of the teeth that results in the destruction of the periodontium. Diabetes Mellitus is a metabolic disorder that contributes to several types of comorbidities and even premature death of an individual. Due to the high demand of diabetic patients with periodontitis and the need for orthodontic therapy to achieve better periodontal health, we aimed to carry out a bibliographic review on orthodontic tooth movement in patients with periodontitis and diabetes mellitus. The search for articles in this literature review took place between February 2022 and March 2023. The articles were researched, selected and extracted through the database: PUBMED, LILACS and GOOGLE SCHOLAR available online, in the range of years between 1990 and 2022. Diabetes and periodontitis may adversely affect bone remodeling in orthodontic tooth movement. However, despite the need for further long-term studies to elucidate the mechanism of orthodontic tooth movement in diabetic patients with a history of periodontitis, the literature suggests that if there is a well-established periodontal-orthodontic therapy associated with the patient’s glycemic control, the treatment will be successful.

SPACE SEARCH FOR MINOR CROWDING CASES WITH EXPANSION PLATE IN PATIENTS WITH A HISTORY OF ANTIDEPRESSANT DRUG CONSUMPTION

Introduction: Gaining space in malocclusion cases using expansion plate removable orthodontic appliances. Depression is a mental health disorder that is treated with antidepressants. There is a correlation between a history of long-term antidepressant medication use and orthodontic treatment. Case: A 21-year-old female patient with a history of antidepressant medication complained of slightly advanced maxillary front teeth and crowded mandibular front teeth. Clinical examination revealed the first permanent molar relation Angle Class I modified Dewey type 2 malocclusion with malposition of individual teeth. Arch discrepancy analysis showed a space deficiency of 4 mm in the maxilla and 2.85 mm in the mandible. Case Management: The first stage used a removable orthodontic appliance for maxillary and mandibular expansion plates to obtain space deficiency. The expansion results showed that the maxillary dental arch was successfully expanded by 4.52 mm and the mandibular by 4 mm. Discussion: The slow-type expansion plate functions to expand the dental arch. Conclusion and Suggestion: Expansion plate removable orthodontic treatment effectively gains space in patients with a history of antidepressant drug use. Patients' cooperativeness in wearing the appliance influences the expansion plate removable orthodontic appliance treatment result.

Epidemiological and CBCT characterizations of odontomas: A retrospective study of 87,590 subjects.

This study aimed to assess the epidemiological and three-dimensional (3D) radiological characterizations of odontomas, as well as the spatial relationship between odontomas and gubernaculum tracts (GT). We retrieved the cone-beam computed tomography (CBCT) data of 87,590 patients. Dentition, location, type, diameter of the odontomas, width of the dental follicle (DF), the spatial relationship between the odontoma and GT, and the influence on adjacent teeth were evaluated. Significant differences were found in age, dentition, location, Max/Min diameter, width of DF, impaction, retention, and root bending of adjacent teeth among different spatial relationships between the odontoma and GT (all p < 0.05), as well as in age, type and size, absence, impaction, malposition, and retention of adjacent teeth among different locations of odontomas (all p < 0.05). Compared to the odontomas without impaction, those with impaction had larger diameter (p < 0.05 in all directions). This statistically significant association was consistent for odontomas with malposition, while no similar result was observed in the maximum diameter. Our findings provide the preliminary data for clinicians to comprehensively understand the incidence, radiographic characterizations and symptoms of odontoma in Chinese population.

Aligners, can my child use them too?

This is a frequently asked question. The answer depends on various factors, with cooperation being among the most essential. As a parent, you must ask yourself if you can rely on your child to wear aligners correctly for most of the day. If the answer to this question is yes, then clear aligners may be a better choice than traditional braces. There are three major benefits of clear aligners in children: 1. Greater comfort, aligners are less voluminous than traditional braces and more likely to prevent irritation, mouth ulcers and other discomfort that derives from the movement of the orthodontic wire or braces. 2. Better hygiene, as their removal during meals and tooth cleaning manoeuvres makes home oral hygiene easier. 3. Better aesthetics, thanks to the transparency of the plastic replacing the metal. However, a certain degree of caution is advised to those who are considering this treatment option. Although aligners allow us to start resolving certain tooth malpositions (which can cause periodontal and aesthetic problems or increase the severity of damage in the event of trauma), and to improve alignment and minor crowding at an early age, it must not be forgotten that the intervening period for changing the definitive position of individual teeth is still the period of permanent teeth. It is important to consider whether a child has a dental or skeletal problem. In cases where a child's problem is exclusively dental, the aligner may be one of the tools used. In cases of skeletal problems, the literature advises against the aligner, as it is not the right instrument at this stage of development. The literature in some cases refers to aligners as the universal remedy, valid for every malocclusion, presenting them as a panacea for all orthodontic problems of very young patients. It is necessary to remain open to the innovations that the market offers us and that can improve our daily clinic, and aligners can be a valid support in this regard, but, as dentists, we should always keep a critical and open eye on treatments with an evidence-based rationale. As with all other orthodontic appliances, aligners must be evaluated on a case-by-case basis, keeping in mind that they are one of the tools in the hands of the clinician. When the clinical situation makes it possible and when both the child's requirements and the parent's expectations are fulfilled, it is certainly worth considering clear aligners as a viable route in the family-child's orthodontic treatment, making it as simple and convenient as possible. Lastly, we should remember the concept of efficiency regarding an orthodontic treatment, which depends on its cost/benefit ratio, with the former being understood in a biological sense and in terms of its impact on the life of the patient and their family with respect to duration, cooperation required, discomfort induced by the equipment used and frequency of check-ups. The latter should obviously be considered in terms of results obtained in relation to the pre-established treatment goals. A consideration that we should always keep in mind: let us never forget that is the orthodontist who treats the patient, not the appliance!

Successful complete oral rehabilitation of a patient with osteopetrosis with extensive pre-treatments, bone grafts, dental implants and fixed bridges: a multidisciplinary case report

BackgroundOsteopetrosis comprises a group of inherited disorders that are rare and result in abnormal bone structure. Bone remodeling is extremely inhibited because osteoclasts are nonfunctional or lacking. This condition causes overgrowth of bone with disappearance of the bone marrow, leading to aplastic anemia; obstruction of nerve passages in the skull leads to blindness and often hearing impairment. In most cases, osteopetrosis results in oral complications such as tooth deformation, hypomineralization, and delayed or absent tooth eruption. The only curative treatment is hematopoietic stem cell transplantation (HSCT). The main treatment of the oral complications during childhood and adolescence consists in protecting the erupted teeth against caries disease through prophylactic treatment aimed at optimal oral hygiene through frequent regular dental visits throughout life. Many patients with osteopetrosis require major oral rehabilitation to treat complications of the disease. Improved results of HSCT increase the likelihood that dental professionals will encounter patients with osteopetrosis.Case presentationIn this case report, we show that individuals with osteopetrosis who have severe oral complications can be treated successfully if they are treated for osteopetrosis at an early age. The boy had his dental care in pedodontics, and regular multidisciplinary meetings were held for future treatment planning. At the age of 15, he was then referred for rehabilitation. The initial evaluations revealed no further growth in the alveolar bone. The rehabilitation was done stepwise, with extraction of malformed and malpositioned teeth. Initially, the patient received a removable partial denture followed by reconstruction of the width of the alveolar process, titanium implants, temporary fixed bridges, and finally screw-retained titanium–ceramic bridges with titanium frames for the upper and lower jaws.ConclusionsThe three-year follow-up after loading indicated a stable marginal bone level and optimal oral hygiene as a result of frequent professional oral hygiene care. The patient showed no signs of symptoms from the temporomandibular joint and has adapted to the new jaw relation without any functional or phonetical issues.

Elastodontic Appliances for the Interception of Malocclusion in Children: A Systematic Narrative Hybrid Review.

Interceptive orthodontic treatment aims to eliminate factors that prevent the harmonious development of the maxillary and mandibular arches during childhood, and elastodontic appliances (EAs) represent a group of devices with an increasingly important role. This systematic narrative hybrid review (HR) aims to provide an overview of the clinical indications for the use of EAs according to the available evidence and to identify potential research areas for unexplored applications. To assess the available literature on the subject, selective database searches were performed between July 2023 and September 2023. With the assistance of a health sciences librarian, a search strategy that utilized terms related to elastodontic therapy was developed. Embase, Scopus, PubMed, and Web of Science were the databases used. The current literature addressing the usability of EAs is scarce and mostly limited to case reports and case series. After 2168 citations were found through the searches, 13 studies were ultimately included. In this regard, information about the clinical use and effectiveness of EAs are reported in a narrative form, defining specific domains of the application that are clinically oriented, including sagittal and transversal discrepancies, atypical swallowing, teeth malposition, two-phase orthodontics and a lack of teeth retention. Within the intrinsic quality limitation of the available literature, it seems that EAs may represent a promising treatment alternative for managing mild-to-moderate malocclusion in children as an adjuvant therapy to the interruption of spoiled habits.

Restorative considerations in children with congenital dental anomalies

Children with congenital dental manifestations may have to endure challenges due to their abnormal tooth development, altered skeletal growth, compromised masticatory and speech function and poor aesthetics. This may further lead to psychosocial problems. These children may have deficient ridge height and volume in edentulous areas, missing teeth, malformed or malpositioned teeth and often the added complication of xerostomia. These anomalies complicate conventional treatment and have led clinicians to consider alternative restorative treatment options. Recent literature suggests that Osseo integrated implant therapy may be a viable option for children with congenital dental defects. However, studies are scarce, with no standardization of success or survival criteria, and little long-term follow-up results. This paper explores the various restorative options and highlights the need for a multidisciplinary team. approach.

Correction of Central Diastema and Individual Dental Malposition with Removable Orthodontic Appliance

Background: Central diastema refers to an anterior spacing between maxillary central incisors and malposition of the individual teeth refers to the teeth being crowded in the upper and lower jaws. There are many causative factors that contribute to the occurrence of these two cases, such as heredity, frenulum deformity, gender, and bad habit. Removable orthodontic appliances are devices that can be used in cases of mild malocclusion. Objective: The purpose of writing this case report is to show that removable orthodontic appliances are the first choice for dentists. Case: A 23-year-old male patient came to UMY Dental and Oral Hospital (RSGM UMY) complaining that his front teeth had spacing and some irregularly arranged teeth. The patient felt uncomfortable with the condition of the teeth. Patient complaints are felt as early as 3 years ago. One year ago, had already used a removable orthodontic appliance and after the treatment is finished then used a retainer but only for 1 month because the retainer is missing. The case of this patient is class I Angle with central diastema and malposition of individual teeth. Case Management: Treatment is carried out using removable orthodontic appliances. The appliances component uses a simple spring on tooth 31 and 41, retentive component uses Adam’s clasp on teeth 16, 26, 36 and 46. Labial arch with a U loop in between canine and first premolar. Conclusion: The removable orthodontic appliance should be used to correct cases of mild malocclusion such as a central diastema with mild malposition of the individual teeth.

Predictors of complications associated with unerupted maxillary canines: a cone beam computed tomography study.

To detect predictive factors for the occurrence of complications associated with unerupted maxillary canines (C). A total of 83 cone beam computed tomograms (CBCT), made from November 1, 2021 to October 31, 2022, have met the inclusion criteria, whereby 110 unerupted C were detected. Independent variables were: gender, age, and C position. Outcome variables were detected complications: external root resorption (ERR) and dilaceration of adjacent tooth, ERR and dilaceration of C, dentigerous cyst, canine ankylosis, and adjacent teeth malposition. Chi-square test and logistic regression analysis were used to examine the relationship between income variables and detected complications. Vertical position of unerupted C showed as predictor for adjacent tooth dilacerations and malposition. Chance for dilaceration increases 5.5-fold with C position at the middle third of lateral incisor (LI) root, while chance of malposition increases 23.4-fold with its supra-apical position to the LI root, in comparison to the C position occlusal to the LI cemento-enamel junction. Age is a predictive factor for dentigerous cysts, with decreasing the chance of their occurrence 1.5-fold with each additional year of age. Early evaluation of the vertical position and timely treatment of C are decisive steps in preventing complications.

Treatment of deep single RT2 and RT3 antero-mandibular gingival recessions with a combination of surgical techniques: A case series study.

To evaluate root coverage (RC) in deep single antero-mandibular RT2 and RT3 gingival recessions (GR) and to investigate the influence of several factors in RC. Fifteen single antero-mandibular GR with a minimum depth of 3 mm were consecutively treated with a new one-stage technique (laterally positioned flap with a tunnel access and a connective tissue graft). At baseline and at 12-month follow-up, the percentage of mean root coverage (%MRC), the recession reduction (RecRed), complete root coverage (CRC) and the gain of keratinized tissue width (KTW) were assessed. Descriptive, intergroup comparative and correlation analyses were performed. At 12 months, a %MRC of 77.29 ± 21.48% with a mean RecRed of 4.10 ± 1.51 mm was achieved. The %MRC was 84.71 ± 21.08% in RT2, and 62.43 ± 14.17% in RT3. The mean gain of KTW was 2.10 ± 0.89 mm, with a mean gain of 2.0 ± 1.03 mm for RT2 and 2.3 ± 0.57 mm for RT3. CRC was observed in six cases, all of them being RT2. A positive association was found between the %MRC and the initial position of the tooth and of both papillae. This technique might be a valuable approach for the treatment of deep single antero-mandibular RT2 and RT3 recessions, even in malpositioned teeth. A combination of different surgical techniques could provide greater vascularization to the CTG especially in malpositioned teeth in sextant V with a large avascular area to be covered.

Comparison of pleasant and unpleasant smile characteristics in the perception of the laypeople in an Iranian population

This study aimed to compare the characteristics of pleasant and unpleasant smiles from the perception of laypeople. Two-hundred posed smile photographs were obtained from adult participants with no anomaly, restoration, or severe crowding and spacing in anterior teeth. Photographs were shown to 26 judges to give each photograph a score for attractiveness. Upper and lower quartiles for the most and least rated smiles were determined, and variables including gingival display, smile arc, midline deviation, buccal corridor, smile width, tooth rotation or malposition, diastema, upper and lower vermilion show, and tooth form were measured. Independent-sample t test and Pearson chi-square analysis were used to determine the differences between the pleasant and unpleasant groups for quantitative and qualitative variables, respectively. The linear regression model revealed variables with the most significant impact on the mean score. All quantitative and qualitative variables except tooth form significantly differed between pleasant and unpleasant smile groups (P<0.05). The consonant smile arc was associated with an increase of 12.59% in mean scores compared with the inconsonant smile arc. Each tooth reported with malposition was correlated with a decrease of 9.37% in the scores. In the same way, each 1-mm increase in midline diastema and occlusal cant coincided with a drop of 8.73% and 3.59% in scores, respectively. The results of this study suggested that smile arc, tooth malposition, midline diastema, and occlusal plane canting had the most impact on smile esthetics and should be given priority by orthodontists in the treatment plan of choice.

Prevalence and risk indicators of gingival recessions in Erbil city: a cross-sectional study

Background and objectives: Gingival recession is the migration of the gingival margin toward the apex, causing root exposure. It may affect one (local) or a group of teeth (generalized), affects individuals in all ages. The prevalence of gingival recession is high worldwide. Gingival recession gives rise to numerous problems, like functional and aesthetic concerns to psychological problems. Objective of the study was to estimate prevalence of gingival recession and risk factors in Erbil province. Methods: This cross sectional-study carried out on 989 patients that visited Khanzad Teaching Center for oral health in Erbil city. All participants were evaluated by filling in questionnaires form with a clinical examination by single examiner. Results: Among 989 participants, 70.4% were females and 29.6% were males with mean age of 34.86 ± 10.63 years. Gingival recession seen in about 93.6% of participants. Significant association was detected between educational level and age with gingival recession, but this was not consistent throughout the educational categories as it was (41.7%) in post-graduate, (12%) in college graduate, and (28.8%) in illiterate. No significant association was detected between gingival recession with gender and ethnic group (p = 0.183, and p = 0.327). The risk factors mostly associated with recession were plaque index, periodontal diseases, frenul pull, tooth position, age. Conclusions: Almost all of the examined participants demonstrated gingival recession. Many significant risk factors (Poor oral hygiene, inflammation, trauma, anatomical, tooth malposition) are associated with the presence of gingival recession.

Prosthodontic management of completely edentulous young ectodermal dysplasia patient: A case report

Ectodermal Dysplasia is a hereditary disorder commonly associated with trichodysplasia (abnormal hair), onchodysplasia (abnormal nails), dyshidrosis (abnormal or missing sweat glands) and abnormal dentition. Due to ectodermal dysplasia, for missing, abnormally shaped, and mal-positioned teeth, a wide range of prosthetic options are available for oral rehabilitation. This case report represents prosthodontic rehabilitation of completely edentulous young Ectodermal Dysplasia patient using a characterized complete denture.