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Hedmo C, Lindsten R, Josefsson E. Evaluation of the aesthetics and clinical findings in patients with missing maxillary lateral incisors treated with a 10-year interval. Eur J Orthod 2024; 46:cjae018. [PMID: 38656537 PMCID: PMC11041049 DOI: 10.1093/ejo/cjae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
INTRODUCTION The most common treatment approaches for patients missing maxillary lateral incisors are implant replacement (IT) and orthodontic space closure (SC). Treatment techniques change and improve over time, and it is of interest to know if improvements differ between the methods. AIM To compare the aesthetic outcome and other clinical findings in patients with one or two missing maxillary lateral incisors who were treated with a 10-year difference in time, with either orthodontic space closure or implant replacement. MATERIAL AND METHODS A total of 88 patients were included in the study. Forty-four patients treated between 2011 and 2018 were included as the latter cohort (LC). The LC was compared to the early cohort (EC; n = 44), treated between 2001 and 2008. A total of 132 teeth was analysed: 62 teeth in the EC (28 teeth in IT cases and 34 teeth in SC cases) and 70 teeth in the LC (34 teeth in IT cases and 36 teeth in SC cases). Long-term clinical and aesthetic outcomes were evaluated. RESULTS An improvement over time was found in crown length, BoP, papilla, the inclination of incisors, and overall appearance in IT cases and in crown colour and overbite in SC cases. A deterioration over time was found in crown length and BoP among the SC cases. CONCLUSION Among the IT cases, an improvement in outcomes was noted over time. When comparing SC cases the colour of the crown and overbite had improved, while crown length and BoP had deteriorated over time.
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Affiliation(s)
- Cecilia Hedmo
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden
| | - Rune Lindsten
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden
| | - Eva Josefsson
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden
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Soiron C. A 10-year-old boy with class II oligodontia treated with buccal fixed appliances and agenesis space closure of the four second premolars: Case report No. 230075 - Titularisation Collège Européen Orthodontie (CEO), European College of Orthodontics. Int Orthod 2024; 22:100872. [PMID: 38613862 DOI: 10.1016/j.ortho.2024.100872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 03/17/2024] [Indexed: 04/15/2024]
Abstract
The patient presented in this case report is a 10-year-old boy with hyperdivergent skeletal Class II associated with familial genetic agenesis of the second premolars. The treatment plan chosen was to close the spaces of agenesis using a bimaxillary appliance fixed buccally. The advantages and disadvantages of this treatment option were discussed. The result was stable and made it possible to avoid an implant-prosthetic solution, which would undoubtedly have been more restrictive over time.
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3
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Jiang LB, Yang JW, He DQ. [Multi-disciplinary treatment of oligodontia: a case report]. Zhonghua Kou Qiang Yi Xue Za Zhi 2024; 59:378-382. [PMID: 38548595 DOI: 10.3760/cma.j.cn112144-20231128-00272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Affiliation(s)
- L B Jiang
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - J W Yang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - D Q He
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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4
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Johal A, Amin M, Dean R. The impact of orthodontic treatment on a young person's quality of life, esthetics, and self-esteem in hypodontia: A longitudinal study. Am J Orthod Dentofacial Orthop 2023; 164:813-823.e1. [PMID: 37589644 DOI: 10.1016/j.ajodo.2023.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 08/18/2023]
Abstract
INTRODUCTION This research aimed to evaluate the impact of orthodontic treatment on a young person's oral health-related quality of life, self-esteem, and esthetics concerning hypodontia. METHODS A prospective longitudinal hospital-based study recruited 97 participants with hypodontia, aged 11-18 years. Forty-one participants (42%) originally planned to have space closure and the remainder space opening, with subsequent prosthetic replacement. The following questionnaires were completed before and after orthodontic treatment: the child perception questionnaire, Bristol condition-specific questionnaire for hypodontia (BCSQ), the child health questionnaire, and the Oral Aesthetic Subjective Impact Scale (OASIS). The Wilcoxon and matched pairs t tests approach was applied to compare before and after orthodontic treatment for significant testing (P <0.05). RESULTS Fifteen participants were lost to follow-up, resulting in 82 participants completing orthodontic treatment, with an average age of 13.8 ± 1.71 years. A total of 282 teeth were missing in the sample. Treatment resulted in significantly lower indexes (P <0.001) to overall BCSQ, OASIS, appearance, and how others would treat them. In comparing the 2 subgroups, those treated with space closure had significantly reduced functional limitations (child perception questionnaire), appearance concerns, self-esteem (child health questionnaire), OASIS, and overall BCSQ scores. CONCLUSIONS Orthodontic treatment in participants with hypodontia appears to significantly impact a range of psychological and esthetic scales. In particular, space closure appears to significantly improve the quality of life of participants compared with those undergoing space opening.
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Affiliation(s)
- Ama Johal
- Centre for OroBioengineering, Institute of Dentistry, Queen Mary University of London, London, United Kingdom.
| | - Mandana Amin
- Centre for OroBioengineering, Institute of Dentistry, Queen Mary University of London, London, United Kingdom
| | - Rabia Dean
- Centre for OroBioengineering, Institute of Dentistry, Queen Mary University of London, London, United Kingdom
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5
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Barber S, Jones A, Abigale Patel V, P Ashley M. Involving young people and parents in decision-making for hypodontia. Br Dent J 2023; 235:529-534. [PMID: 37828196 PMCID: PMC10570137 DOI: 10.1038/s41415-023-6328-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/06/2023] [Accepted: 06/11/2023] [Indexed: 10/14/2023]
Abstract
Involving young people and their parents in decisions about their health care is ethically and professionally the right thing to do. Good decision-making relies on informed, value-based deliberation. Providing the right treatment for people with hypodontia is complex, both technically, in terms of the range of options available, and from a communication perspective. Treatment decisions faced by young people with hypodontia can have lifelong implications and the weight of this is felt both by the patient, who may have limited experience of dental treatment and decision-making, and their parents, who act as advocates. It is important that clinicians understand how they can best share the available evidence and their expertise in a way that can be understood and applied. Clinicians also have an important role in facilitating young people to recognise and communicate their own values, expectations, and ultimately, preferences for treatment. This paper outlines the challenges of navigating information sharing and engaging in shared decision-making specific to hypodontia. A scoping review of the literature by the authors was conducted to identify evidence-based advice for discussing uncertainties, risks and increasing engagement in decision-making. This may be useful to both primary and secondary care practitioners involved in decision-making with people with hypodontia.
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Affiliation(s)
- Sophy Barber
- Clinical Lecturer, University of Leeds, UK; Honorary Consultant Orthodontist, Mid Yorkshire NHS Hospitals Trust, UK.
| | - Adam Jones
- Academic Clinical Fellow in Oral Surgery, Leeds Dental Institute, UK
| | | | - Martin P Ashley
- Consultant and Honorary Professor in Restorative Dentistry and Oral Health, University Dental Hospital of Manchester, UK
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6
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Doughty F, Pillai S, Hamill D, Amin N, P Ashley M. A service evaluation of the multidisciplinary team approach to hypodontia. Br Dent J 2023; 235:514-519. [PMID: 37828193 PMCID: PMC10570135 DOI: 10.1038/s41415-023-6385-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Introduction Patients with hypodontia can be seen by a multidisciplinary team clinic (MDT) for treatment planning at the University Dental Hospital of Manchester (UDHM). The MDT consists of orthodontics, restorative dentistry and oral surgery colleagues.Aims and methods A retrospective case-note analysis was conducted on 558 hypodontia patients seen on Manchester Hypodontia Clinic (MHC) between 2016-2022 to assess service utilisation and treatment planning outcomes.Results The average age of patients attending the MHC was 16 (range 8-50). The distribution of mild, moderate and severe hypodontia in the sample was 28%, 37% and 35%, respectively. Most common treatments proposed were fixed appliances, extractions, implants and resin-bonded bridges. Out of 558 patients seen for consultation on the MHC, 365 (65%) were accepted for treatment. The average number of visits for treatment was 15.5 (range: 1-55). The average number of did not attend/was not brought appointments, patient cancellations and hospital cancellations were 0.8, 1.4 and 1.8, respectively.Conclusion Hypodontia patients referred to UDHM are triaged by consultants in orthodontics or restorative dentistry, and if MDT planning is required, they are booked onto the MHC. There are sufficient patients with complex cases of moderate and severe hypodontia to justify a regular MDT hypodontia clinic.
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Affiliation(s)
- Faye Doughty
- Dental Core Trainee and Academic Clinical Fellow in Oral Surgery, University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, M15 6FH, UK.
| | - Sruthi Pillai
- Dental Core Trainee, University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, M15 6FH, UK
| | - Dylan Hamill
- Dental Core Trainee, University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, M15 6FH, UK
| | - Nadine Amin
- Dental Core Trainee, University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, M15 6FH, UK
| | - Martin P Ashley
- Consultant in Restorative Dentistry, University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, M15 6FH, UK
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7
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P Ashley M. Hypodontia care in the UK: working together to achieve better clinical outcomes. Br Dent J 2023; 235:445. [PMID: 37828157 DOI: 10.1038/s41415-023-6336-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Affiliation(s)
- Martin P Ashley
- Consultant and Honorary Professor in Restorative Dentistry, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester, M15 6FH, UK.
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8
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Pace-Balzan A, Chatzipantelis A, J Dunn K, Charan G, P Ashley M. Restorative dentistry clinical decision-making for hypodontia: complex cases. Br Dent J 2023; 235:489-495. [PMID: 37828181 PMCID: PMC10570138 DOI: 10.1038/s41415-023-6324-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/01/2023] [Accepted: 07/06/2023] [Indexed: 10/14/2023]
Abstract
Hypodontia is a relatively common condition and patients will be seen by both general dental practitioners and specialist dental colleagues. Although hypodontia can be described as mild, moderate and severe, this does not directly correlate with the complexity of treatment required to provide an acceptable outcome. In addition, the complexity of treatment provided by one colleague in the multidisciplinary team may not be the same as for other colleagues.When treatment planning and delivering dental care for these patients, especially those with severe hypodontia, it is useful to recognise the factors that make their care complex and also to follow principles for multidisciplinary treatment planning.
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Affiliation(s)
| | | | | | - Garima Charan
- Restorative Dentistry, Eastman Dental Hospital, London, UK
| | - Martin P Ashley
- Restorative Dentistry, University Dental Hospital of Manchester, UK.
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9
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Orloff C, Rana S, Bassi GS, Ashley MP, I Bomfim D. Restorative dentistry clinical decision-making for hypodontia: managing missing premolar teeth. Br Dent J 2023; 235:483-488. [PMID: 37828180 DOI: 10.1038/s41415-023-6333-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/04/2023] [Accepted: 09/04/2023] [Indexed: 10/14/2023]
Abstract
Hypodontia is a relatively common clinical condition and the second premolar tooth is the most common tooth that fails to develop (excluding third molars). For some patients, no treatment is required, as there is little, if any, consequence of the condition. For other patients, the missing teeth are part of a more complex dental presentation, requiring specialist dental management. This paper describes the clinical decision-making process and explores the options for managing this presentation of hypodontia.
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Affiliation(s)
- Courtney Orloff
- Royal National ENT and Eastman Dental Hospital, London, WC1E 6DG, UK.
| | - Shivani Rana
- Royal National ENT and Eastman Dental Hospital, London, WC1E 6DG, UK
| | - G Steven Bassi
- Royal National ENT and Eastman Dental Hospital, London, WC1E 6DG, UK
| | - Martin P Ashley
- University Dental Hospital of Manchester, M15 6FH, United Kingdom
| | - Deborah I Bomfim
- Royal National ENT and Eastman Dental Hospital, London, WC1E 6DG, UK
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10
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King S, Sood B, Ashley MP. Practical advice for successful clinical treatment with resin-bonded bridges. Br Dent J 2023; 235:503-509. [PMID: 37828183 PMCID: PMC10570136 DOI: 10.1038/s41415-023-6332-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/04/2023] [Accepted: 09/04/2023] [Indexed: 10/14/2023]
Abstract
Resin-bonded bridges are one of the main options for replacing missing teeth for hypodontia patients. This technique offers several advantages for these patients, who are often young, have unrestored abutment teeth, and have had tooth positions optimised by orthodontic treatment. However, the replacement of missing teeth can be challenging due to tooth positions and anomalies of abutment tooth shape and size.These patients are often young adults at the time of restoration, making the minimally invasive nature and predictable long-term success of resin-bonded bridges advantageous over other treatment methods.This paper in the hypodontia themed issue discusses the importance of case selection and gives practical advice for the design and provision of resin-bonded bridges.
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Affiliation(s)
- Stephanie King
- Consultant in Restorative Dentistry, Liverpool University Dental Hospital, Liverpool, UK
| | - Banoo Sood
- Consultant in Restorative Dentistry, Liverpool University Dental Hospital, Liverpool, UK
| | - Martin P Ashley
- Consultant and Honorary Professor in Restorative Dentistry, University Dental Hospital of Manchester, Manchester, United Kingdom.
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11
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Ewbank L, Caldwell S, Needham R. Orthodontic input in the management of hypodontia cases. Br Dent J 2023; 235:463-469. [PMID: 37828177 DOI: 10.1038/s41415-023-6317-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/18/2023] [Accepted: 04/21/2023] [Indexed: 10/14/2023]
Abstract
This article aims to give an overview of the part orthodontics plays in the management of hypodontia cases. Severity of hypodontia varies and some cases can be managed by orthodontics alone. The more complex cases benefit from multidisciplinary care with a combination of orthodontics and restorative treatment. This article sub-divides orthodontic involvement in hypodontia cases into three distinct phases, while providing clinical examples to highlight the management of a variety of cases ranging from simple to complex.
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Affiliation(s)
- Laura Ewbank
- Orthodontic Post-CCST, University of Manchester Dental Hospital, Manchester, UK.
| | - Susi Caldwell
- Orthodontic Consultant, Wythenshawe Hospital, Manchester, UK
| | - Richard Needham
- Orthodontic Consultant, University of Manchester Dental Hospital, Manchester, UK
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12
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Rana S, Orloff C, I Bomfim D, P Ashley M, Bassi GS. The role of the general dental practitioner in the management of the hypodontia patient. Br Dent J 2023; 235:522-524. [PMID: 37828194 PMCID: PMC10630126 DOI: 10.1038/s41415-023-6326-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 10/14/2023]
Abstract
The general dental practitioner (GDP) is usually the first person to suspect that a young patient is affected by hypodontia. The condition occurs rarely in the primary dentition but is relatively common in the permanent dentition. Between the ages of 7 and 12 years, failure of a permanent tooth to erupt as expected will lead the GDP to initiate and then contribute to the ideal management of the patient's condition. This ranges from reassurance and preventive measures to providing aspects of treatment in a long-term management plan, alongside a multidisciplinary specialist team and thereafter, delivery of life-long dental care.
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Affiliation(s)
- Shivani Rana
- Royal National ENT and Eastman Dental Hospital, London, WC1E 6DG, UK
| | - Courtney Orloff
- Royal National ENT and Eastman Dental Hospital, London, WC1E 6DG, UK
| | - Deborah I Bomfim
- Royal National ENT and Eastman Dental Hospital, London, WC1E 6DG, UK
| | - Martin P Ashley
- University Dental Hospital of Manchester, Manchester, M15 6FH, UK.
| | - G Steven Bassi
- Royal National ENT and Eastman Dental Hospital, London, WC1E 6DG, UK
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Ford S, Ashley MP. The dental technician as a member of the hypodontia multidisciplinary team, with practical considerations for anterior restoration design. Br Dent J 2023; 235:498-502. [PMID: 37828182 PMCID: PMC10570133 DOI: 10.1038/s41415-023-6331-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 10/14/2023]
Abstract
Most patients seeking treatment for hypodontia will require prosthetic replacement of their missing teeth. This will be in the form of dentures, bridges and implant restorations. As these are created by one or more dental technicians who supports the clinical team, a close working relationship between these colleagues is likely to improve the quality of treatment outcome. This interaction will usually occur towards the end of the patient's treatment process, when definitive restorations are prescribed. However, appropriately trained and experienced dental technicians should be involved throughout the patient's treatment process as an integral part of the multidisciplinary team approach to effectively manage these patients.This paper describes the contribution of dental technicians to patient care with particular focus on communication between the restorative dentistry clinical team and the dental technician to improve the quality of anterior restorations. As missing maxillary lateral incisor teeth are a common presentation for this patient group, further technical detail relating to planning resin-bonded bridges for replacement of these teeth is included.
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Affiliation(s)
- Stephen Ford
- Lead Dental Technician, University Dental Hospital of Manchester, Manchester, UK
| | - Martin P Ashley
- Consultant and MAHSC Honorary Professor in Restorative Dentistry and Oral Health, University Dental Hospital of Manchester, Manchester, United Kingdom.
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J Patel N, P Beddis H, K Dhaliwal H, Durey K, Lowney C. Restorative dentistry clinical decision-making for hypodontia: retained primary molars. Br Dent J 2023; 235:477-482. [PMID: 37828179 DOI: 10.1038/s41415-023-6318-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/13/2023] [Accepted: 04/15/2023] [Indexed: 10/14/2023]
Abstract
Primary molar teeth that are retained beyond their exfoliation pose a clinical decision-making challenge for dental teams. The retention of these teeth may be due to absence of a permanent successor. As a result, careful planning is required to determine if retention or extraction is necessary. This article aims to discuss the prevalence of retained primary molars, assessment and treatment planning considerations, from both orthodontic and restorative perspectives.
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Affiliation(s)
- Nimit J Patel
- Speciality Trainee in Restorative Dentistry, Leeds Dental Institute, Clarendon Way, Leeds, LS2 9LU, UK.
| | - Hannah P Beddis
- Consultant in Restorative Dentistry, Leeds Dental Institute, Clarendon Way, Leeds, LS2 9LU, UK
| | - Harmeet K Dhaliwal
- Consultant Orthodontist, Leeds Dental Institute, Clarendon Way, Leeds, LS2 9LU, UK
| | - Kathryn Durey
- Consultant in Restorative Dentistry, Leeds Dental Institute, Clarendon Way, Leeds, LS2 9LU, UK
| | - Cian Lowney
- Consultant Orthodontist, Leeds Dental Institute, Clarendon Way, Leeds, LS2 9LU, UK
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Dolan S, Calvert G, Crane L, Savarrio L, P Ashley M. Restorative dentistry clinical decision-making for hypodontia: peg and missing lateral incisor teeth. Br Dent J 2023; 235:471-476. [PMID: 37828178 PMCID: PMC10570134 DOI: 10.1038/s41415-023-6330-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 10/14/2023]
Abstract
Peg-shaped and missing lateral incisor teeth are common features for patients affected by hypodontia. While improvements in dental appearance may be a strong motivating factor for these patients, providing dental treatment to improve the clinical condition and achieve an acceptable and stable outcome can be complex and lengthy.For patients affected by hypodontia, discussion and consideration of various approaches to their individual treatment are best achieved in a multidisciplinary team environment. This allows debate of options and joint agreement between at least orthodontic and restorative dentistry specialist colleagues, based largely on clinical factors, towards a treatment plan that is acceptable to the patient. As most patients with this lateral incisor form of hypodontia are initially treated as teenagers and young adults, there is also an understanding that treatment outcomes will have lifelong maintenance and resource implications to consider.This paper identifies and discusses the key clinical features that influence the treatment planning process for a patient with either missing or peg lateral incisor teeth. These will often involve consideration of whether to open or close the lateral incisor spaces and whether to restore or replace a peg lateral incisor tooth. The process should be patient-centred, evidence-based, and aim to minimise the lifelong treatment burden, retaining options for future maintenance and retreatment.
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Affiliation(s)
- Sean Dolan
- Post DCT Fellow, Glasgow Dental Hospital and School, Department of Restorative Dentistry, Glasgow, G2 3JZ, UK
| | - Gareth Calvert
- Consultant in Restorative Dentistry, Glasgow Dental Hospital and School, Department of Restorative Dentistry, Glasgow, G2 3JZ, UK
| | - Lynnsey Crane
- Consultant in Restorative Dentistry, Glasgow Dental Hospital and School, Department of Restorative Dentistry, Glasgow, G2 3JZ, UK
| | - Lee Savarrio
- Consultant in Restorative Dentistry, Glasgow Dental Hospital and School, Department of Restorative Dentistry, Glasgow, G2 3JZ, UK
| | - Martin P Ashley
- Consultant in Restorative Dentistry, University Dental Hospital of Manchester, Manchester, M15 6FH, UK.
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Hasan HS, Elkolaly MA, Marya A, Venugopal A. Interdisciplinary orthodontics-implants management of a challenging hypodontia case complicated by a class II division 2, bimaxillary retroclination. Int Orthod 2023; 21:100783. [PMID: 37295169 DOI: 10.1016/j.ortho.2023.100783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/14/2023] [Accepted: 05/15/2023] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The case in this study had moderate hypodontia, with both lower lateral incisors and the lower-left second premolar missing. A Class II division 2 relationship with severe crowding in the upper arch and a traumatic deep bite over a skeletal I base complicated the occlusion. MATERIALS AND METHODS The plan was to extract the upper first premolars to relieve upper arch crowding and the lower-left impacted second premolar to preserve the bilateral class I molar relationship. A class I occlusal relationship was achieved through space opening in the lower lateral incisors region and space closure in the upper and lower premolars regions. RESULTS The use of orthodontic screws for bite opening and anterior segment retraction, in conjunction with bi-metric slot size selection in bracket prescription, was effective in controlling incisor inclination and interincisal angle. The use of an implant fixture before beginning the finishing stage allowed for a reduction in total treatment time and facilitated the provision of the final prosthesis before debonding the case. As a result, the patient was able to receive a satisfactory occlusion on the day of debonding. CONCLUSION This case of moderate hypodontia was successfully resolved by combining space closure and space opening effectively. To solve the arch problems in such Class II division 2 cases with severe crowding, extractions were required. To complete the case, this was combined with intrusive and retractive mechanics. In hypodontia cases, implants are an excellent choice for both aesthetics and functional restoration.
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Affiliation(s)
- Hasan Sabah Hasan
- Orthodontic Department-Azadi Dental Center, Hawler-Ministry of Health, Erbil, Iraq; Orthodontic Department, Privet Specialized Dental Clinic, Erbil, Iraq.
| | | | - Anand Marya
- Orthodontics Department, Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
| | - Adith Venugopal
- Department of Orthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
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Goodrum E, Johal A. The quality and reliability of the Internet as a source of information for hypodontia patients. J Orthod 2023; 50:268-275. [PMID: 36628988 DOI: 10.1177/14653125221145705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The aim of this study was to determine the quality, reliability and usability of information on the Internet regarding hypodontia. METHOD A survey of patients with hypodontia revealed seven key search terms favoured by patients: Hypodontia; Congenitally missing teeth; Missing teeth; Gaps in teeth; Cure of missing teeth; Information on missing teeth; and Treatment of missing teeth. These were entered into four search engines: Google; Ask; Wikipedia; and NHS Choices. Relevant websites were assessed for their overall demographics, author type, country of origin and rank within the search engine. They were then analysed using five validated assessment tools. Intra-examiner reliability was assessed, and statistical analysis of the data was undertaken. RESULTS Good intra-examiner reliability was observed. A total of 48 websites were included for analysis from an initial 1718. There was no relationship between the ranking of a website on a search engine and the quality of information it contained. When medical search terminology was used, it resulted in websites of better quality than layperson search terms. Most websites were produced by general dental or specialist dental practices but the quality of these was poorer than those developed by private companies and medical organisations. The country of origin was primarily the USA and UK; however, this had no relationship to website quality. Overall, the majority of websites scored poorly for the validated tools and none scored well across multiple tools. A statistical analysis showed a positive relationship between the LIDA and DISCERN instruments but no other correlation between other validated tools was found. CONCLUSION The quality and reliability of information on the Internet regarding hypodontia is generally poor. There is a need for a reliable online hypodontia resource that can be recommended for patient use.
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Affiliation(s)
- Emma Goodrum
- Oral Growth & Development (Orthodontics), Institute of Dentistry, Bart's and The London School of Medicine & Dentistry, Queen Mary College, London, UK
| | - Ama Johal
- Oral Growth & Development (Orthodontics), Institute of Dentistry, Bart's and The London School of Medicine & Dentistry, Queen Mary College, London, UK
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Bashir R, Azami N, Uribe F, Safavi KE. A biological orthodontic approach for multiple missing teeth: Tooth substitutions and autotransplantation. J Clin Orthod 2023; 57:436-445. [PMID: 37778117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Affiliation(s)
- Rehana Bashir
- College of Dentistry, University of Nebraska Medical Center, Lincoln, NE
| | - Niloufar Azami
- Division of Orthodontics, University of Connecticut School of Dental Medicine, Farmington, CT. azami@uchc. edu
| | - Flavio Uribe
- Division of Orthodontics, University of Connecticut School of Dental Medicine, Farmington, CT
| | - Kamran E Safavi
- Division of Endodontology, University of Connecticut Health Center, Farmington, CT
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19
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Hedmo C, Lindsten R, Josefsson E, Davidson T. A cost analysis of orthodontic space closure and implant treatment in patients missing maxillary lateral incisors with a long-term perspective. Eur J Orthod 2023; 45:468-474. [PMID: 37071917 DOI: 10.1093/ejo/cjad008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
OBJECTIVE Few studies within orthodontics present both economic and clinical findings. Missing maxillary lateral incisors is a frequently occurring anomaly. The treatment alternatives most used are orthodontic space closure and prosthetic replacement of the missing tooth. Our aim is to compare the total societal costs of orthodontic space closure (SC) and implant therapy (IT) in patients missing maxillary lateral incisors. METHODS Records of 32 patients treated with SC (n = 18) or IT (n = 14) due to missing maxillary lateral incisors were retrieved from the archives. Direct costs and indirect costs in the short- and long-term were analysed using a cost analysis with a societal perspective up of to 12 years post-treatment. RESULTS Comparing cases treated with SC and IT, the difference in direct short-term costs for treatment is €735.54, whereas SC is the least costly. There is no difference between SC and IT in short-term parent loss of productivity, long-term loss of productivity, costs for transportation, or direct long-term costs. A difference was found between SC and IT-in favour of SC-when comparing patients' loss of productivity (P = 0.007), short-term societal costs (P < 0.001), long-term societal costs (P = 0.037), and total societal costs (P < 0.001). LIMITATIONS There is a limited number of patient records. Local factors such as subsidies, urban versus rural areas, taxes, etc. can influence monetary variables, so the transferability to other settings may be limited. CONCLUSION Patients treated with SC have a lower total societal cost compared to patients treated with IT. There was a difference in productivity loss for patients between SC and IT; however, concerning other indirect parameters and direct long-term costs, there was no difference between the two treatments.
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Affiliation(s)
- Cecilia Hedmo
- Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Rune Lindsten
- Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Eva Josefsson
- Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Thomas Davidson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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20
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Nadolinski M, Schlenz MA, Rahman A, Krämer N, Schulz-Weidner N. A comparative retrospective study on the prevalence and therapeutic treatment of dental agenesis between healthy children and children with systemic disease or congenital malformation. BMC Pediatr 2023; 23:322. [PMID: 37355575 PMCID: PMC10290303 DOI: 10.1186/s12887-023-04138-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 06/17/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND Dental agenesis (DA) in the permanent dentition is one of the most common dental anomalies, with a prevalence up to 2-10%. Therefore, the aim of this retrospective study was to investigate the prevalence and therapeutic treatment of DA in healthy children (HC) compared to children with systemic disease or congenital malformation (SD/CM). METHODS Out of 3407 patients treated at the Department of Paediatric Dentistry of the Justus Liebig University Giessen (Germany) between January 2015 and December 2020, a total of 1067 patients (594 female, 473 male) aged between 4.5 and 18 years were included in this study due to DA. Besides the patients' general medical history and therapeutic treatments, panoramic radiographs were analysed. RESULTS In contrast to the HC group with 9.7% DA, the SD/CM group showed a significantly higher prevalence of DA (19.8%; p < 0.05). The latter group was further classified into children with ectodermal dysplasia (4.4%), down syndrome (8.2%), cleft lip and palate (4.4%), intellectual disability/developmental delay (16.4%), and other genetic/organic diseases without intellectual disability (45.9%). Regarding therapeutic treatments, the HC group (59.5%) was significantly more often treated with an orthodontic gap opening compared to the SD/CM group (42.6%; p < 0.05), followed by orthodontic gap closing 36.5% in the HC group and 22.9% in the SD/CM group (p < 0.05), whereas no treatment was predominantly performed in the SD/CM group (37.7%) compared to the HC group (4%; p < 0.05). Furthermore, 50% in the SD/CM group required general anaesthesia for therapeutic treatment (vs. 8.1% in the HC group; p < 0.05). CONCLUSIONS Children with SD/CM suffered more often from DA compared to HC that underlines multi- and interdisciplinary treatment of utmost importance. Furthermore, due to intellectual disability, common treatment methods can be complicated by insufficient compliance. This fact underlines the importance of an early attempt to establish the necessary cooperation enabling children with SD/CM to receive therapy.
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Affiliation(s)
- Mirja Nadolinski
- Dental Clinic, Department of Paediatric Dentistry, Justus Liebig University, Schlangenzahl 14, 35392 Giessen, Germany
| | - Maximiliane Amelie Schlenz
- Dental Clinic, Department of Prosthodontics, Justus Liebig University, Schlangenzahl 14, 35392 Giessen, Germany
| | - Alexander Rahman
- Hannover Medical School, Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
| | - Norbert Krämer
- Dental Clinic, Department of Paediatric Dentistry, Justus Liebig University, Schlangenzahl 14, 35392 Giessen, Germany
| | - Nelly Schulz-Weidner
- Dental Clinic, Department of Paediatric Dentistry, Justus Liebig University, Schlangenzahl 14, 35392 Giessen, Germany
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21
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Kratochvilova L, Dostalova T, Schwarz M, Macek M, Marek I, Malíková M, Míšová E. Ectodermal dysplasia: important role of complex dental care in its interdisciplinary management. Eur J Paediatr Dent 2022; 23:140-146. [PMID: 35722846 DOI: 10.23804/ejpd.2022.23.02.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
AIM Despite the fact that ectodermal dysplasia (ED) is a rare disease, it is often seen in a tertiary clinic. ED affects ectodermal tissues such as skin, hair, teeth, nails, and sweat glands. Patients usually have sparse light hair, deformed nails, and dry skin. They suffer from dental abnormalities such as oligodontia (absence of 6 or more teeth) or complete anodontia; salivation can also be affected. The absence of teeth can be the overriding problem for both patients and their parents, and lead to substantial social ostracisation. This study aims to summarise the facts about the disease, especially dental treatment options based on data drawn from a representative Czech cohort. MATERIALS The present article summarises the facts about ectodermal dysplasia (ED) in a cohort of 13 patients, where the following were evaluated: clinical manifestations of ED, pathogenic variants detected in selected candidate genes and dental treatment options from child removable dentures to fixed crowns and implants insertion. Three cases are described in detail and demonstrate approaches for different age groups. CONCLUSION Early diagnosis and active cooperation between the geneticist and dentist will facilitate cooperation with parents and patients and assure secondary prevention. It is preferable that the geneticist understands dental treatment options and can discuss these with patients/parents.
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Affiliation(s)
- L Kratochvilova
- Department of Stomatology, Charles University, 2nd Medical Faculty and Motol University Hospital, Prague, Czech Republic
| | - T Dostalova
- Department of Stomatology, Charles University, 2nd Medical Faculty and Motol University Hospital, Prague, Czech Republic
| | - M Schwarz
- Department of Stomatology, Charles University, 2nd Medical Faculty and Motol University Hospital, Prague, Czech Republic
| | - M Macek
- Department of Biology and Medical Genetics, Charles University, 2nd Medical Faculty and Motol University Hospital, Prague, Czech Republic
| | - I Marek
- Institute of Dentistry and Oral Sciences, Palacky University, Faculty of Medicine and Dentistry and Faculty Hospital in Olomouc, Olomouc, Czech Republic
| | - M Malíková
- Department of Biology and Medical Genetics, Charles University, 2nd Medical Faculty and Motol University Hospital, Prague, Czech Republic
| | - E Míšová
- Institute of Dentistry and Oral Sciences, Palacky University, Faculty of Medicine and Dentistry and Faculty Hospital in Olomouc, Olomouc, Czech Republic
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22
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Kassisieh S, Bodiroga N, Gousman J. Space closure for congenitally missing lower second premolars using temporary anchorage devices. J Clin Orthod 2022; 56:268-284. [PMID: 35767855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Seuss Kassisieh
- Private Practice of Orthodontics in Scottsdale, Paradise Valley, and Ahwatukee, AZ; Arizona School of Dentistry and Oral Health.
| | | | - Jay Gousman
- Private Practice of Orthodontics in Phoenix, AZ
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23
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Naoum S, Allan Z, Yeap CK, Razza JM, Murray K, Turlach B, Goonewardene MS. Trends in orthodontic management strategies for patients with congenitally missing lateral incisors and premolars. Angle Orthod 2021; 91:477-483. [PMID: 33657211 DOI: 10.2319/092320-809.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To identify changes in orthodontic management strategies in patients with hypodontia seen in 2000, 2010, and 2017/2018 (during a 1-year period). MATERIALS AND METHODS An assessment of the panoramic radiographs of 3701 patients from a Western Australian private practice identified 276 individuals demonstrating hypodontia. The location of missing teeth, age, sex, type of malocclusion, and the management strategies (space closure or opening) for each patient were noted. RESULTS Most hypodontia involved agenesis of three or fewer teeth (90%). Maxillary lateral incisors and mandibular second premolars were the most commonly missing teeth. Female preponderance was noted. When considering treatment, the odds ratio for orthodontic space opening and prosthetic replacement in 2000 was 3.266 (P value = 7e-04; 95% confidence interval [CI], 1.464-4.633) compared with patients seen in 2010 and 1.632 (P value = 7e-04; 95% CI, 0.811-2.434) compared with patients in 2017/2018. For patients demonstrating bilateral absence of maxillary lateral incisors, the odds ratio for orthodontic space opening was 3.185 (P value = 0.0215; 95% CI, 1.182-9.243) compared with counterparts with unilateral agenesis. None of the factors investigated were significantly associated with the types of treatment planned/provided for the patients with missing mandibular second premolars. CONCLUSIONS Maxillary lateral incisors and mandibular second premolars were the most commonly missing teeth. A trend away from space opening and prosthetic replacement toward orthodontic space closure was observed from 2000 to 2017/2018. This may reflect a change in attitude toward prosthetic replacement options and/or greater optimism with biomechanical strategies since the implementation of temporary anchorage devices to assist in space closure.
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24
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Shi YJ, Zuo W, Zhang YY, Sun M, Qian YZ. [Identification of a novel mutation of the PAX9 gene and clinical treatment in a nonsyndromic oligodontia family]. Zhonghua Kou Qiang Yi Xue Za Zhi 2021; 56:207-209. [PMID: 33557508 DOI: 10.3760/cma.j.cn112144-20200427-00235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Y J Shi
- Center of Stomatology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - W Zuo
- Center of Stomatology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Y Y Zhang
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - M Sun
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Y Z Qian
- Center of Stomatology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
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25
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Wilmes B, Schwarze J, Vasudavan S, Drescher D. Maxillary Space Closure Using Aligners and Palatal Mini-Implants in Patients with Congenitally Missing Lateral Incisors. J Clin Orthod 2021; 55:20-33. [PMID: 33822760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
| | - Jörg Schwarze
- Private practice of Orthodontics in Cologne, Germany
| | | | - Dieter Drescher
- Department of Orthodontics, University of Düsseldorf, Düsseldorf, Germany
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26
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Valarelli FP, Cotrin P, Malavasi BDM, De Freitas MR, De Freitas KMS. Treatment of mandibular canine agenesis with bone-anchored protraction of posterior teeth. J Clin Orthod 2020; 54:419-428. [PMID: 32966247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
| | - Paula Cotrin
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru 17012901, Brazil.
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27
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Quinzi V, Panetta G, Filippi P, Rizzo FA, Mancini L, Mummolo S. Autotransplatation of immature third molars as substitutes for congenitally missing second premolars: an alternative solution in a young patient with oligodontia. J BIOL REG HOMEOS AG 2020; 34:155-163. DENTAL SUPPLEMENT. [PMID: 32618173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Auto transplantation of immature donor teeth can be a strategic therapeutic solution in young patients. It is preferable to choose this approach instead of prosthetic restorations because it offers a unique and definitive solution. Orthodontic space closure is not always deemed desirable, especially in non-extraction cases (53,54). Successful auto transplantations allow alveolar growth through eruption of donor teeth together with the adjacent dentition when skeletal and dental development is not yet completed. Auto transplantation of third molars is less well-recognised and less documented. The available literature shows promising success rates. Immature donor teeth are reportedly associated with better outcomes than mature donor teeth. Aim of this case report was to analyse the short-term outcomes of auto transplantation of immature maxillary third molars to replace the missing mandibular second premolars in a 17-year-old healthy female with oligodontia. The surgical procedure was performed as a single step. Left and right lower second deciduous molars (7.5-8.5), close to exfoliation, were extracted. Donor upper third molars with developing root were extracted as a traumatically as possible and immediately placed into the surgically modified recipient sites. They were stabilized by a sectional wire. One year after surgery, the survival of both transplanted teeth was achieved. They showed periodontal health, normal mobility and continuation of root development during the follow-up period. The upper left third molar responded to all success criteria, no signs of ankylosis, root resorption (infection or inflammatory), and pulp necrosis. The upper right third molar had long-standing evidence of not progressive cervical external inflammatory root resorption without any clinical signs. Further research is needed to determine their long-term survival and success rates.
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Affiliation(s)
- V Quinzi
- Department of Life, Health and Environmental Sciences Postgraduate School of Orthodontics University of L'Aquila, L'Aquila 67100, Italy
| | - G Panetta
- Private Practice in Colleferro, Roma 00034, Italy
| | - P Filippi
- Private Practice in Bazzano, L'Aquila 67100, Italy
| | - F A Rizzo
- Department of Life, Health and Environmental Sciences Postgraduate School of Orthodontics University of L'Aquila, L'Aquila 67100, Italy
| | - L Mancini
- Department of Life, Health and Environmental Sciences, University of L'Aquila
| | - S Mummolo
- Department of Life, Health and Environmental Sciences Postgraduate School of Orthodontics University of L'Aquila, L'Aquila 67100, Italy
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Barber S, Bekker H, Marti J, Pavitt S, Khambay B, Meads D. Development of a Discrete-Choice Experiment (DCE) to Elicit Adolescent and Parent Preferences for Hypodontia Treatment. Patient 2019; 12:137-148. [PMID: 30367434 PMCID: PMC6335368 DOI: 10.1007/s40271-018-0338-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective Our objective was to develop and test a discrete-choice experiment (DCE) survey to elicit adolescent and parent preferences for dental care for hypodontia (a developmental condition where one or more teeth fail to develop). Methods This was a mixed-methods study. Participants were adolescents (aged 12–16 years) with hypodontia and their parents and the dentists providing hypodontia care. Stage one entailed attribute development, as follows. (1) Attribute identification: systematic review of hypodontia literature; interviews with adolescents with hypodontia (n = 8) and parents (n = 8); observation of hypodontia clinical consultations (n = 5); environmental scan of hypodontia patient information resources (n = 30); and systematic analysis of social media posts (n = 176). (2) Attribute selection: stakeholder consultation to develop items for a questionnaire; rating and ranking questionnaire for adolescents with hypodontia and parents (n = 18); further stakeholder consultation. Stage two involved the development of the DCE survey, and stage three included the pre-testing using cognitive interviews with adolescents (n = 12) and parents (n = 8) to assess face and content validity. Results The attribute long list included 27 attributes focusing on service delivery and treatment outcome, from which seven ‘important’ attributes were selected for pre-testing. Cognitive interviewing suggested adolescents found the DCE choice tasks challenging to understand; the survey was modified to enhance its acceptability. One attribute was excluded as it showed poor validity with adolescents. Pre-testing suggested DCE choice tasks encouraged thinking and discussion about preferences for treatment. Conclusions Including the target respondent group in all stages of DCE development ensured the final DCE survey was valid and acceptable. DCE methods appear to be a useful tool for exploring joint decision making alongside conventional preference elicitation. Electronic supplementary material The online version of this article (10.1007/s40271-018-0338-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sophy Barber
- Orthodontic Department, Leeds Dental Institute, Clarendon Way, Leeds, LS2 9LU UK
| | - Hilary Bekker
- Leeds Institute of Health Sciences, Level 10 Worsley Building, Clarendon Way, Leeds, LS2 9TJ UK
| | - Joachim Marti
- Institute of Social and Preventive Medicine (IUMSP), Université de Lausanne-CHUV, Route de la Corniche 10, 1010 Lausanne, Switzerland
| | - Sue Pavitt
- School of Dentistry, Level 6 Worsley Building, Clarendon Way, Leeds, LS2 9LU UK
| | - Balvinder Khambay
- School of Dentistry, University of Birmingham, 5 Mill Pool Way, Birmingham, B5 7EG UK
| | - David Meads
- Leeds Institute of Health Sciences, Level 11 Worsley Building, Clarendon Way, Leeds, LS2 9TJ UK
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De Santis D, Pancera P, Sinigaglia S, Faccioni P, Bertossi D, Luciano U, Zotti F, Kumar N, Donadello D, Manuelli M, Lucchese A, Tacchino U, Ricciardi G, Nocini R, Albanese M. Tooth agenesis: part 2. Orthodontic treatment and prosthetic possibilities. J BIOL REG HOMEOS AG 2019; 33:23-28. [PMID: 30966729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Dental agenesis has a great clinical significance due to its frequency during daily practice and the therapeutic problems that can arise from it. This paper will explore all the aspects to consider in order creating a proper multidisciplinary treatment plan: in particular, orthodontic, prosthetic and implantologic therapeutic alternatives are described for the rehabilitation of the different areas of the dental arches. In fact, dental agenesis is a problem that often requires the intervention of specialists from the different fields of dentistry and its treatment must meet aesthetics needs, stomatognathic function and patient satisfaction.
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Affiliation(s)
- D De Santis
- Section of Oral and Maxillofacial Surgery; Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - P Pancera
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - S Sinigaglia
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - P Faccioni
- DSection of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - D Bertossi
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - U Luciano
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - F Zotti
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - N Kumar
- Postgraduate Medical Institute, Faculty of Medical Science, Anglia Ruskin University, Chelmsford, UK
| | - D Donadello
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - M Manuelli
- School of Dentistry, Department of Orthodontics, Vita-Salute San Raffaele University, Milan, Italy
- Unit of Dentistry, Division of Orthodontics, Research area in Dentofacial Orthopedics and Orthodontics, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Private Practice in Milan, Italy
| | - A Lucchese
- School of Dentistry, Department of Orthodontics, Vita-Salute San Raffaele University, Milan, Italy
- Unit of Dentistry, Division of Orthodontics, Research area in Dentofacial Orthopedics and Orthodontics, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - U Tacchino
- School of Dentistry, Department of Orthodontics, Vita-Salute San Raffaele University, Milan, Italy
- Unit of Dentistry, Division of Orthodontics, Research area in Dentofacial Orthopedics and Orthodontics, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - G Ricciardi
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - R Nocini
- Section of ENT, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - M Albanese
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
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30
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Zanotti G, Gelpi F, Sinigaglia S, Croce S, Tacchino U, Perozeni G, Luciano U, De Santis D. Agenesis: pilot case report by 2.9 mm implant. J BIOL REG HOMEOS AG 2019; 33:61-65. [PMID: 30759977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The agenesis of the upper lateral incisor is one of the most frequent aesthetic-functional problems in dentistry. The reported case concerns a 49 years old male patient with bilateral agenesis of teeth 1.2-2.2 and a root stump of tooth 5.2 temporarily rehabilitated through a Maryland bridge. Without orthodontic treatment, the only solution for implant-prosthetic rehabilitation of tooth 1.2 results therefore in the use of a 2.9 mm diameter implant. The clinical and radiographic control of the implant and the gingival stability at a distance of 1 year gives a positive result both clinically and radiographically. The use of the implant with a 2.9 mm diameter is therefore indicated in extreme cases of limited bone availability.
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Affiliation(s)
- G Zanotti
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - F Gelpi
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - S Sinigaglia
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - S Croce
- Department of Orthodontics, Vita-Salute San Raffaele University, Milan, Italy
- Unit of Dentistry, Division of Orthodontics, Research area in Dentofacial Orthopedics and Orthodontics, IRCC San Raffaele Scientific Institute, Milan, Italy
| | - U Tacchino
- Department of Orthodontics, Vita-Salute San Raffaele University, Milan, Italy
- Unit of Dentistry, Division of Orthodontics, Research area in Dentofacial Orthopedics and Orthodontics, IRCC San Raffaele Scientific Institute, Milan, Italy
| | - G Perozeni
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - U Luciano
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - D De Santis
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
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Finkelstein T, Shapira Y, Pavlidi AM, Schonberger S, Shpack N. Agenesis of Permanent Canines in Orthodontic Patients: Prevalence, Location, Treatment Options and Outcomes. J Dent Child (Chic) 2018; 85:133-138. [PMID: 30869590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose: Tooth agenesis is one of the most common anomalies of the human dentition, found most often in the maxillary anterior region and in the mandibular and maxillary premolar regions. Little information is available on the prevalence and distribution of permanent canine agenesis. The purpose of this retrospective study was to evaluate the prevalence and distribution of permanent canine agenesis in orthodontic patients and describe treatment options and outcomes. Methods: The records of 3,000 consecutively treated patients in the Department of Orthodontics, Tel Aviv University, Tel Aviv, Israel were reviewed. The pre-treatment facial and intraoral clinical photographs as well as panoramic and periapical radiographs were used to detect permanent canine agenesis in both dental arches. The data were recorded according to sex, age, number of missing canines, and their location. Results: Twenty-three patients (0.76 percent), nine males (39 percent) and 14 females (61 percent) had 38 congenitally missing canines. Of these, 22 (58 percent) were missing in the maxilla and 16 (42 percent) were missing in the mandible. Conclusions: The overall prevalence of missing permanent canines in our population was 0.76 percent. The female-to-male prevalence ratio was approximately three to two and more canines were missing in the maxilla than in the mandible.
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Affiliation(s)
- Tamar Finkelstein
- Instructor, in the Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yehoshua Shapira
- Clinical associate professor, in the Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel;,
| | - Aikaterini Maria Pavlidi
- Postgraduate orthodontic student, in the Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shirley Schonberger
- Instructor, in the Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nir Shpack
- Senior lecturer and chair, in the Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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32
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Ali H, Chadwick S. A Technique for Utilizing Ankylosed Teeth for Anchorage. Int J Orthod Milwaukee 2018; 28:35-36. [PMID: 29990398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We present a novel method of reinforcing anchorage by utilizing ankylosed teeth. This technique provides simple solutions in otherwise challenging and complex cases.
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33
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Schneider UE, Moser L, Pellitteri G, Siciliani G. Orthodontic space closure vs. implant-borne crowns in patients with congenitally missing maxillary lateral incisors. J Clin Orthod 2018; 52:284-296. [PMID: 29952765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Ute E Schneider
- Department of Orthodontics, University of Ferrara, Ferrara, Italy; Private Practice of Orthodontics in Bolzano, Italy.
| | - Lorenz Moser
- Department of Orthodontics, University of Ferrara, Ferrara, Italy; Private Practice of Orthodontics in Bolzano, Italy
| | - Giuseppe Pellitteri
- Department of Oral and Maxillofacial Surgery, University of Modena and Reggio Emilia, Italy; Private Practice of Periodontology, Implantology, and Prosthodontics in Bolzano, Italy
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34
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Maheshwari S, Gupta ND, Rathi S, Gauer A. Preprosthetic orthodontics in an adult with multiple anterior edentulous spaces and loss of vertical dimension. J Clin Orthod 2018; 52:297-302. [PMID: 29952766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Sandhya Maheshwari
- Department of Orthodontics and Dentofacial Orthopedics, Dr. Ziauddin Ahmad Dental College, Aligarh, Uttar Pradesh, India
| | - N D Gupta
- Department of Periodontology, Dr. Ziauddin Ahmad Dental College, Aligarh, Uttar Pradesh, India
| | - Shraddha Rathi
- Department of Prosthodontics, Dr. Ziauddin Ahmad Dental College, Aligarh, Uttar Pradesh, India
| | - Aditi Gauer
- Department of Orthodontics and Dentofacial Orthopedics, Dr. Ziauddin Ahmad Dental College, Aligarh, Uttar Pradesh, India.
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Abstract
BACKGROUND Hypodontia and hyperdontia are considered to be at opposite ends of the dental development spectrum. Nevertheless, these anomalies may occur concomitantly (hypohyperdontia). CASE REPORT This clinical report describes two case of hypohyperdontia occurring exclusively in the premaxillary region, and the difficulties associated with its diagnosis and management. Following 24 months of follow-up examinations, Case 1 developed a sequential supernumerary tooth in the tooth 35 region. CONCLUSION Cases of hypohyperdontia can occur exclusively in the premaxillary region and may be difficult to diagnose. Multidisciplinary treatment planning is essential to facilitate appropriate management, and long-term follow-up is necessary as sequential supernumerary teeth may develop.
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Affiliation(s)
- L M Bowdin
- Paediatric Dentistry, UWA Dental School, The University of Western Australia, 17 Monash Avenue, Nedlands, WA, 6009, Australia
| | - S Wong
- Paediatric Dentistry, UWA Dental School, The University of Western Australia, 17 Monash Avenue, Nedlands, WA, 6009, Australia
| | - R P Anthonappa
- Paediatric Dentistry, UWA Dental School, The University of Western Australia, 17 Monash Avenue, Nedlands, WA, 6009, Australia.
| | - N M King
- Paediatric Dentistry, UWA Dental School, The University of Western Australia, 17 Monash Avenue, Nedlands, WA, 6009, Australia
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Lameira C, Mestrener SR, Pini N, Salomão FM, Pesqueira AA, Fagundes TC. Conservative Approach for Treatment of Maxillary Lateral Incisor Agenesis With the Deciduous Tooth Retained: 18-Month Follow-Up. Oper Dent 2018; 43:121-127. [PMID: 29337645 DOI: 10.2341/17-015-t] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This case describes a female patient with agenesis of the maxillary right lateral incisor, with her permanent canine in its position and the deciduous canine retained. Additionally, she presented with a maxillary left peg lateral incisor. To solve her functional and esthetic complaints, a multidisciplinary approach involving perio-restorative procedures was proposed. Periodontal surgeries were performed to align the gingival contour, and the restorative approach utilized ceramic veneers. At the 18-month clinical and radiographic follow-up, the treatment outcome was stable, with maintenance of the clinical results achieved and without any sign of deciduous tooth resorption.
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Pirmohamed S, Bomfim DI. Utilising Digital Dentistry for the Management of Patients With Hypodontia of Lateral Incisers. Prim Dent J 2018; 7:50-55. [PMID: 30095883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Management of missing maxillary lateral incisors can involve joint restorative and orthodontic treatment planning and intervention. Digital dental technologies are contributing to better communication and precision of planning both between clinicians and patients and within specialists. This paper outlines the ways in which digital dentistry is facilitating this process with a focus on restoratively-driven treatment planning and delivery.
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Rokaya D, Mahat Y, Sapkota B, Kc Basnyat S. Full Coverage Crowns and Resin-bonded Bridge Combination for Missing Mandibular Anterior Teeth. Kathmandu Univ Med J (KUMJ) 2018; 16:97-99. [PMID: 30631027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Most often the anterior teeth and those that are visible when a patient speaks or smiles are chosen for esthetic restorations. The mandibular anterior fixed bridge often presents problems to the dentist due to the size of the natural teeth and their visibility. In addition, due to high cost factor, many patients are not able to afford fixed partial denture for missing anterior teeth. This article describes a cost effective technique for the restoration of missing mandibular anterior teeth by fabrication of full coverage crowns and resin-bonded fixed bridge combination.
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Affiliation(s)
- D Rokaya
- Department of Dentistry, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - Y Mahat
- Department of Dentistry, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - B Sapkota
- Department of Dentistry, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - S Kc Basnyat
- Department of Dentistry, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
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Kawakami S, Yokozeki M, Horiuchi S, Moriyama K. Oral Rehabilitation of an Orthodontic Patient with Cleft Lip and Palate and Hypodontia Using Secondary Bone Grafting, Osseo-Integrated Implants, and Prosthetic Treatment. Cleft Palate Craniofac J 2017; 41:279-84. [PMID: 15151443 DOI: 10.1597/03-002.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective Complete skeletal and dental reconstruction of the anterior maxilla is of great importance to patients with cleft lip and palate. Accordingly, osseo-integrated implants have been utilized for dental reconstruction after secondary bone grafting. In this report, the orthodontic management of a patient with unilateral cleft lip and plate with associated hypodontia is described. The patient was treated with comprehensive orthodontic treatment in addition to secondary bone grafting, and dental reconstruction was achieved with a combination of osseo-integrated implants and fixed prosthodontic treatment.
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Affiliation(s)
- Shingo Kawakami
- Department of Orthodontics, School of Dentistry, University of Tokushima, Tokushima, Japan
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40
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Abstract
Objective To evaluate the management of alveolar clefts by cleft palate and craniofacial teams in North America. Design An anonymous survey was mailed to 240 American Cleft Palate– Craniofacial Association teams across North America regarding alveolar bone grafting. The questionnaire included multiple questions about each team's approach to alveolar bone grafting and options for the missing tooth. Results Consensus was achieved in three areas: 90% of centers performed secondary alveolar bone grafting, 78% performed grafting between ages 6 and 9 years, and iliac crest donor site was the most popular site (83%). There was no consensus with respect to dental criteria for the timing of grafting, follow-up x-rays, or the use of a grading system for evaluating results. In addition, there was no consensus on the management of the missing tooth. Conclusion There is wide acceptance of secondary bone grafting and there is a consensus for the age of grafting (6 to 9 years) and donor site (iliac crest). The disturbing finding was the lack of postoperative x-ray evaluation of the results. With so much variability in management, the use of a routine, standardized scale to measure postoperative results would allow for better outcome studies in alveolar bone grafting.
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Meros GC, Shoji A, Suzuki S, Paranhos LR, Manfroi R, Claus J, Garcez A. An Alternative Approach for Space Opening in a Bilateral Maxillary Lateral Incisor Agenesis Patient using Miniplates. J Contemp Dent Pract 2017; 18:1198-1205. [PMID: 29208799 DOI: 10.5005/jp-journals-10024-2200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
AIM This case report aimed to present an orthodontic mechanic alternative for space opening in a patient missing maxillary lateral incisors, using miniplates as anchorage, associated with self-ligating brackets. BACKGROUND Dental agenesis affects the population causing esthetic and functional damages. The prevalence of missing maxillary lateral incisors should be considered for its significant rate and negative impact on smile esthetics. CASE REPORT This treatment was chosen based on the presence of balanced facial pattern, large canine anatomy, the need to improve dental occlusion to prevent further wear, and patient's esthetic complaint. To obtain the results, upper third molars were extracted, and two miniplates were installed to distalize the upper arch with no need for patient compliance or auxiliary devices. Self-ligating brackets were used to reduce friction on posterior teeth, thus facilitating movement with light force application. At the end of 19 months, the patient presented with class I good overbite and overjet, and adequate space for implant and prosthetics; also, good facial esthetic was maintained. CONCLUSION When indicated, space opening may provide excellent esthetics and functional results, and even more predictable results when skeletal anchorage miniplates are used to distalize all posterior teeth. CLINICAL SIGNIFICANCE Considering the high level of esthetic and functional compromise caused by dental agenesis, the technique hereby described represents a viable mechanic alternative within orthodontic possibilities.
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Affiliation(s)
- Gladistone C Meros
- Department of Orthodontics, Sao Leopoldo Mandic Dental School and Research Center, Campinas, Sao Paulo, Brazil, Phone: +554699117799 e-mail:
| | - Aline Shoji
- Department of Orthodontics, Sao Leopoldo Mandic Dental School and Research Center, Campinas, Sao Paulo, Brazil
| | - Selly Suzuki
- Department of Orthodontics, Sao Leopoldo Mandic Dental School and Research Center, Campinas, Sao Paulo, Brazil
| | - Luiz R Paranhos
- Department of Dentistry, Federal University of Sergipe, Lagarto Sergipe, Brazil
| | - Rodrigo Manfroi
- Department of Prosthesis, Sao Leopoldo Mandic Dental School and Research Center, Campinas, Sao Paulo, Brazil
| | - Jonathas Claus
- Department of Oral Surgery, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Aguinaldo Garcez
- Department of Orthodontics, Sao Leopoldo Mandic Dental School and Research Center, Campinas, Sao Paulo, Brazil
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42
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Kravitz ND, Miller S, Prakash A, Eapen JC. Canine Bracket Guide for Substitution Cases. J Clin Orthod 2017; 51:450-453. [PMID: 29112502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Neal D Kravitz
- Journal of Clinical Orthodontics; Private Practice of Orthodontics in South Riding, VA.
| | | | - Amit Prakash
- Department of Orthodontics and Dentofacial Orthopedics, People's College of Dental Science and Research Center, Bhopal, India
| | - Jijo C Eapen
- Department of Orthodontics and Dentofacial Orthopedics, People's College of Dental Science and Research Center, Bhopal, India
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43
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Walker CG, King R. Extraction of Gingivally Retained Deciduous Teeth Using Orthodontic Elastics. J Clin Orthod 2017; 51:480. [PMID: 29112506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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44
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Ciarlantini R, Melsen B. Semipermanent replacement of missing maxillary lateral incisors by mini-implant retained pontics: A follow-up study. Am J Orthod Dentofacial Orthop 2017; 151:989-994. [PMID: 28457277 DOI: 10.1016/j.ajodo.2016.12.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 12/01/2016] [Accepted: 12/01/2016] [Indexed: 11/17/2022]
Abstract
Agenesis of maxillary lateral incisors can be treated either by closing the space and substituting the canines for the missing lateral incisors or, in adults, by replacing the missing teeth with fixed prosthetics or implants. This article illustrates a method that can be used for a semipermanent implant replacement of the missing incisors in adult patients. An Aarhus mini-implant was inserted perpendicular to the palatal mucosa of the alveolar process of the edentulous area. A pontic was made at chair side of composite material around a stainless steel wire extending from the mini-implant. This replacement approach allowed for the vertical development of the alveolar process and maintained the bone density and morphology of the alveolar process. Five years after placement, periapical radiographs showed that the alveolar process was following the vertical development related to the eruption of the adjacent teeth, and that the morphology and the bone density were maintained, making the later insertion of a dental implant possible without additional surgical buildup.
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Affiliation(s)
| | - Birte Melsen
- Department of Orthodontics, Klinik für Kieferorthopedie Medizinische Hochshule, Hannover, Germany; Department of Orthodontics, University of Western Australia, Perth, Western Australia, Australia; Department of Orthodontics, Kentucky University, Lexington, Ky.
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45
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Derton N, Lupini D, Cozzani M. Miniscrew-Supported Orthodontic Pseudo-Ankylosis for Mesialization of a Lower Third Molar. J Clin Orthod 2017; 51:290-293. [PMID: 28668944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Nicola Derton
- Private Practice of Orthodontics, Conegliano, Italy; Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Daniela Lupini
- LUdeS Foundation Higher Education Institution, Kalkara, Malta; Department of Medicine, Surgery and Health Sciences, University of Trieste; Private Practice of Orthodontics, Teramo, Italy.
| | - Mauro Cozzani
- LUdeS Foundation Higher Education Institution; Private Practice of Orthodontics in La Spezia, Italy
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46
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Abstract
Patients with hypodontia require a wide range of treatment, ranging from single tooth replacement to the restoration of multiple edentulous spaces in both arches. Treatment should involve an interdisciplinary team, as no dental speciality possesses the range of expertise required to optimally treat this patient population. This paper presents principles of treatment, key factors of assessment and multidisciplinary approaches to management of the hypodontia patient, including contributions from conservative dentistry.
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47
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Al-Ani AH, Antoun JS, Stacknik S, Farella M. Management of missing mandibular second premolars: a review. Aust Orthod J 2017; Spec No:87-98. [PMID: 29709125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Tooth agenesis is the most common developmental dental anomaly and it is frequently associated with other dento-skeletal disturbances, such as structural variations of other teeth, late dental eruption, transpositions and crowding. Except for the third molars, the mandibular second premolars are the most commonly missing teeth. Oral rehabilitation of patients with missing mandibular premolars often requires a multi-disciplinary approach, and usually results in prolonged treatment time and a greater burden of care. An understanding of the aetiology and clinical features of hypodlontia is essential for the planning phase and the outcome of treatment. The purpose of the present review is, therefore, to discuss the aetiology of hypodlontia as well as to evaluate the clinical options available for the treatment of missing mandibular second premolars. An insight into future research directions and their clinical applications will also be discussed.
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48
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Portelli M, Militi A, Nucera R, Cicciù M, Gherlone E, Lucchese A. Orthodontic management of missing lateral incisor by miniscrew-anchored device. Minerva Stomatol 2016; 65:403-411. [PMID: 27362812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Congenitally missing teeth are one of the most common tooth anomalies associated to therapeutic sets of problems. Orthodontists should consider these clinical cases because management often requires an integrated orthodontic and restorative approach. In the present study authors reported a therapy note referred to a 14-year-old male patient affected by missing maxillary lateral incisors, bilateral dental Class II and deep bite, treated in 2009 at the Department of Orthodontics of the University of Messina. An orthodontic treatment has been planned with the aim of distalize maxillary molar and the following opening of the spaces necessary for the prosthetic restoration of missing lateral incisor. For the distalization of maxillary molars has been decided to use a Distal Jet supported by miniscrew (Distal-Screw, American Orthodontics, Sheboygan, WI, USA). After seven months of treatment with distal screw, maxillary molar distalization was completed, obtaining a bilateral molar Class I. A multi-bracket orthodontic appliance was bonded in the upper and lower arch using Empower Brackets (American Orthodontics). Class II molar relationship has been over-corrected to Class I in about seven months. The orientation of the force vector resulted in a tipping and rotation of the first molars, without significant vertical changes. Distal Jet reinforced with screws seems to be effective in molar distalization without any type of side effects. The advantages of this device were the absence of patient compliance, relatively predictable outcomes, favorable esthetics, possibility of different activations in each side.
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Affiliation(s)
- Marco Portelli
- School of Dentistry, Department of Biomedical Sciences, Dentistry and Morphological and Functional Imaging, University of Messina, Messina, Italy -
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49
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Wang J, Teng F, He H, Ding H, Li Y. Esthetic Restoration of Multiple Congenitally Missing Anterior Teeth with Oral Implants: A Clinical Case Report. INT J PROSTHODONT 2016; 29:614-617. [PMID: 27824986 DOI: 10.11607/ijp.4901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Having multiple congenitally missing anterior teeth heavily influences the patient's countenance and pronunciation. There are few reports on the esthetic restoration of such situations with oral implants. This clinical case history report presents a multidisciplinary approach to treat a young woman with multiple congenitally missing anterior teeth using implant-supported prostheses. The treatment steps and clinical implications are discussed.
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50
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Dekterov A. Cost-Effective Management of Patients with Unilateral Congenitally Missing Second Maxillary Premolars. Int J Orthod Milwaukee 2016; 27:11-13. [PMID: 30178935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Two case presentations are utilized to review the cost-effective treatment options in patients with unilateral congenitally missing second maxillary premolars. Once diagnosed, the dentist can either preserve or remove the respective primary molar. Preservation will lead to a tooth-size discrepancy. To limit the size of the second primary molar to the dimension of the contralateralpremolar, and to allow the preservation of alveolar bone, removal of its mesio-distal aspect should be performed. Later on, the primary molar may become infraoccluded or lost, and it will be necessary to do a coronal built-up or a prosthetic replacement respectively. Any type ofprosthetic replacement will significantly increase the total cost of treatment. Clinicians should aim for ideal occlusion and profile and take into account other orthodontic problems and propose the most appropriate treatment plan for each patient.
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