vendex and Anodontia

The congenitally missing maxillary lateral incisor is the most common agenesis in the anterior region. There are several treatment options for this anomaly, which causes severe deficiencies: orthodontic space closure, tooth-supported restoration, or single-tooth implant. Each of these solutions has a high degree of success if used in the correct situation. An implant-supported restoration with an interdisciplinary approach provides a predictable outcome. This article describes the treatment of a patient with agenesis of the maxillary left lateral incisor. After orthodontic space management, it was decided to restore the tooth with an all-ceramic crown cemented on a zirconia custom abutment, which fractured after only 6 weeks of service. Fractographic analysis revealed that the failure was due to over-reduction of the buccal wall to correct the labial emergence of the implant. Zirconia abutments should be designed with even wall thicknesses of at least 0.8 mm to avoid areas that may compromise functional success.

Topics: Aluminum Silicates; Anodontia; Ceramics; Computer-Aided Design; Crowns; Dental Abutments; Dental Implant-Abutment Design; Dental Implants, Single-Tooth; Dental Materials; Dental Porcelain; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Female; Follow-Up Studies; Humans; Incisor; Maxilla; Potassium Compounds; Torque; Young Adult; Zirconium

The aim of this study was to provide clinical indications for the correct management of appliances in space closure treatment of patients with agenesis of the upper lateral incisors.. Virtual setup for space closure was performed in 30 patients with upper lateral incisor agenesis. Tip, torque and in-out values were measured and compared with those of previous authors.. In the upper dentition, the tip values were comparable to those described by Andrews (Am J Orthod 62(3):296-309, 1972), except for at the first premolars, which require a greater tip, and the first molars, a lesser tip. The torque values showed no differences except for at the canines, where it was greater, and the in-out values were between those reported by Andrews and those by Watanabe et al. (The Shikwa Gakuho 96:209-222, 1996) (except for U3 and U4).. The following prescriptions are advisable: tip 5°, torque 8° and in-out 2.5 for U1; tip 9°, torque 3° and in-out 3.25 for U3; tip 10°, torque -8° and in-out 3.75 for U4; and tip 5°, torque -8° and in-out 4 for U5. Andrews' prescription is suitable for the lower jaw, except for at L6. It is also advisable to execute selective grinding (1.33±0.5 mm) and extrusion (0.68±0.23 mm) on the upper canine during treatment, and the first premolar requires some intrusion (0.56±0.30 mm).

Topics: Anodontia; Bicuspid; Cuspid; Dental Arch; Enamel Microabrasion; Female; Humans; Imaging, Three-Dimensional; Incisor; Male; Maxilla; Molar; Optical Imaging; Orthodontic Appliances; Orthodontic Space Closure; Patient Care Planning; Tooth Movement Techniques; Torque; User-Computer Interface; Young Adult

To evaluate the survival rate of implants placed in the maxillary tuberosity region using the fixed prosthesis in partially edentulous cases.. Of implant-treated patients who visited Kyung Pook National University Hospital, 7 partially edentulous patients (2 male and 5 female; mean age, 52.3 years; range, approximately 43 to 65) were selected according to the following criteria: 1) less than 3-mm thickness alveolar bone reaming at the first molar area and 2) 1 to 2 fixture premolars, with the additional implant at the maxillary tuberosity region. For the control group, patients who had nontuberosity areas were selected. After 1 to 7 years, marginal bone level, fixture mobility, and radiolucency of tuberosity fixtures of the fixed prostheses were evaluated by digital panorama (Starpacs, Infinitt, Seoul, Korea).. None of the fixtures of the tuberosity-installed implants for 1 to 7 years failed. The marginal bone level around the implants of the maxillary tuberosity 1 to 6 years (average 3.4 years) after the final prostheses was approximately 0.6 to 1.3 mm, with an average of 0.94 mm.. The fixture installation at the maxillary tuberosity using the unilateral partially edentulous implant-fixed prosthesis would be a clinically acceptable treatment module.

Topics: Adult; Aged; Alveolar Bone Loss; Anodontia; Dental Implantation, Endosseous; Dental Prosthesis Design; Dental Prosthesis Retention; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Denture, Partial, Fixed; Female; Humans; Jaw, Edentulous, Partially; Kaplan-Meier Estimate; Male; Maxilla; Middle Aged; Molar; Periodontal Splints; Radiography, Panoramic; Retrospective Studies; Torque

A common orthodontic task is to correct anterior tooth position using brackets whose torque, tip and in-out are pre-adjusted. Bracket prescription greatly influences final aesthetics and function. Pre-adjusted orthodontic brackets have in-built prescriptions of torque, tip and in-out which are optimized for average cases. Refinement of tooth position can be achieved by archwire adjustment or archwire auxiliaries. Modifications to bracket position such as inversion can also help achieve individual tooth movements. Planning bracket position must be considered at the outset of treatment to achieve the maximum benefit. A number of clinical scenarios will be discussed including: a Class II division 1 malocclusion with lateral incisors palatally displaced, and another case with absent lateral incisors for space closure. Also, Class III malocclusions with consideration given to: canine angulation; a palatally displaced canine requiring labial movement; absent upper central incisors (space closure), and finally, a Class III case where incisor inclination requires consideration. By using a typodont to illustrate some of the points, this article aims to (1) show how three pre-adjusted orthodontic bracket systems (Andrews, Roth and MBT) vary significantly in their ability to influence tooth position and appearance; (2) inform clinicians how modified bracket position can influence tooth position.

Topics: Anodontia; Biomechanical Phenomena; Cuspid; Humans; Incisor; Malocclusion; Malocclusion, Angle Class II; Malocclusion, Angle Class III; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Space Closure; Orthodontic Wires; Patient Care Planning; Tooth Eruption, Ectopic; Tooth Movement Techniques; Torque