Orthodontic Treatment of Palatally Impacted Canines in Severe Non-Syndromic Oligodontia with the Use of Mini-Implants: A Case Report
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Treatment Process
3.2. Follow-Up
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Measurement | Norm | Deviation | Value |
---|---|---|---|
SNA | 82.0° | ± 3.0 | 82.9° |
SNB | 80.0° | ± 3.0 | 83.6° |
ANB | 2.0° | ± 2.0 | −0.7° |
SNPg | 81.0° | ± 3.0 | 86.0° |
GntgoAR | 122.0° | ± 7.0 | 121.8° |
NL-NSL | 8.0° | ± 4.0 | 3.1° |
ML-NSL | 28.0° | ± 5.0 | 26.2° |
ML-NL | 20.0° | ± 7.0 | 23.1° |
1+:NA | 21.0° | ± 4.0 | 17.2° |
1+:NA (mm) | 3.7 mm | ± 2.0 | 3.2 mm |
1+:NL | 110° | ± 6.0 | 104° |
1−:NB | 24.0° | ± 4.0 | 10.5° |
1−:NB (mm) | 3.8 mm | ± 2.0 | 0.4 mm |
1−:ML | 94° | ± 7.0 | 79.2° |
1−:APg | 1.0 mm | ± 2.0 | −1.4 mm |
1+:1− | 133.0° | ± 8.0 | 153.5° |
UL—“E” plane | −4.7 mm | ± 2.0 | −4.35 mm |
LL—“E” plane | −2.0 mm | ± 2.0 | −4.45 mm |
Treatment Period | Treatment Procedures |
---|---|
October 2017 | PDCs’ surgical exposure—open technique; brackets bonded on PDCs; MIs tomas®-pin SD 06 (Dentaurum, Ispringen, Germany) inserted in the palatal alveolar region; 0.016″ × 0.022″ TMA cantilevers activated in distal and downward direction (50 g) (Figure 6a,b). |
November 2017 | Visible orthodontic movement—exclusion of primary ankylosis (Figure 6c). |
December 2017 | Increased mobility and tenderness of PDCs, dismantlement of cantilevers, button on the buccal side of UL3 (derotation), power chains to move the teeth (Figure 6d). |
January 2018 | Teeth stability improved; 0.017″ × 0.025″ TMA cantilever with activation in downward and buccal directions for UR3, power chain for distal movement and derotation of UL3. |
February 2018 | Button on the buccal side of UR3 (derotation), power chains for distal movements and derotations (Figure 6e). |
April 2018 | Extraction of the upper right deciduous canine due to the collision with movement of UR3; 0.017″ × 0.025″ TMA cantilever activated for buccal movement of UR3 (50 g) (Figure 6f). |
June 2018 | Partial fixed upper SS appliance Equilibrium® 2 0.022″ in Roth prescription (Dentaurum, Ispringen, Germany), 0.016″ NiTi wire, continuous metal ligature to create space for UL3; cantilever activation (Figure 6g). |
August 2018 | Bracket on tooth no. 24; 0.016″ NiTi wire and open coil spring to create space for UL3; extraction of the upper left deciduous canine. |
October 2018 | New MI tomas®-pin SD 08 (Dentaurum, Ispringen, Germany) was inserted in the buccal surface of left alveolar ridge; 0.017″ × 0.025″ TMA cantilever for buccal movement of UL3 (50 g) (Figure 6h). |
November 2018 | Mobility of the buccal alveolar MI, the miniscrew was tightened and left to stabilize for a month; tooth no. 55 was extracted due to progressive reinclusion. |
December 2018 | Buccal alveolar MI was lost and new MI tomas®-pin SD 10 (Dentaurum, Ispringen, Germany) was placed in the IZC; 0.017″ × 0.025″ TMA cantilever with buccal activation for UL3 (50 g). |
February 2019 | Inflammation and submucous abscess in the IZC; MI removal; antibiotic. |
April 2019 | New MI tomas®-pin SD 10 (Dentaurum, Ispringen, Germany) was inserted in the palatal suture and used as a direct anchorage with 0.017″ × 0.025″ SS cantilever and power chain for buccal movement of UL3 (50 g); 0.016” SS wire and bend-out for UR3 (Figure 6i). |
May 2019 | Overcorrection of UR3 transversal relationship, 0.018″ SS wire and bend-out for tooth no. 22, new power chain from cantilever to UL3 for its buccal movement. |
July 2019 | Tooth no. 22 in correct sagittal relationship; MI in the palatal suture used as an indirect anchorage: 0.017″ × 0.025 SS connection wire with tooth no. 24, 0.017″ × 0.025″ cantilever with buccal activation for UL3 (50g); 0.017″ × 0.025″ Cooper NiTi wire (Figure 6j,k). |
March 2020 | The correct position of UL3; tooth no. 24 showed significant mobility; control panoramic X-ray: root resorption of tooth no. 24 (Figure 7); no possibility to conduct control visits on a regular basis due to COVID-19 pandemic—next appointment took place in November 2020. |
November 2020 | 0.019″ × 0.025″ SS wire, torque expression, closure of spaces with power chain. |
March 2021 | Removal of MIs, 0.021″ × 0.025″ TMA wire for torque expression in the upper arch; Fixed lower SS appliance Dentaurum Equilibrium® 2 0.022″ in Roth prescription (Dentaurum, Ispringen, Germany); 0.016″ NiTi wire; elastics 4 ½ oz. from palatal buttons on teeth no. 12 and 22 to the lower arch to correct the anterior crossbite (Figure 6l). |
April–June 2021 | Further alignment of the lower teeth by means 0.017″ × 0.025″ NiTi, and next 0.019″ × 0.025″ SS; intermaxillary elastics 4 ½ oz and offset bends on teeth no. 12 and 22 were used to correct the anterior crossbite; elastic power chains for space closure. |
August 2021 | Open sinus lift surgery with porcine bone-derived grafting material (The Graft™ bone substitute cancellous granules (Purgo Biologics, Seongnam, Republic of Korea) and BioCover™ resorbable collagen membrane (Purgo Biologics, Seongnam, Republic of Korea)) was performed on the right side of the maxilla. |
March 2022 | Two dental implants were placed: tooth no. 14—Axiom® PX 3.4 × 12 mm (Anthogyr, Sallanches, France), tooth no. 15—Axiom® PX 3.4 × 10 mm (Anthogyr, Sallanches, France). |
May–August 2022 | Finishing; control panoramic X-ray (Figure 8); 1st canine relationships and midline consistency; debonding of the brackets; fixed upper and lower retainers’ placement (0.027″ × 0.011″ 8-strand braided SS), tooth no. 24 was not fixed to the retainer due to increased mobility. |
September 2022 | E-max (lithium desilicated ceramic) veneers on upper teeth; individual implant abutments (titanium pre-milled abutments) and implant-supported blocked crowns (zirconia veneered with porcelain using the cut-back technique) on dental implants; removable thermoformable retainer. |
March 2023 | Retention phase: 10-month follow-up. Stability of treatment results; minimal opening of the spaces mesially to teeth no. 34 and 44; proper mobility of tooth no. 24. Bleaching of the lower teeth. |
Measurement | Pretreatment | Posttreatment | Difference |
---|---|---|---|
SNA | 82.9° | 83.4° | 0.5° |
SNB | 83.6° | 85.0° | 1.4° |
ANB | −0.7° | −1.6° | −0.9° |
SNPg | 86.0° | 87.7° | 1.7° |
GntgoAR | 121.8° | 116.3° | −5.5° |
NL-NSL | 3.1° | 4.8° | 1.7° |
ML-NSL | 26.2° | 22.0° | −4.2° |
ML-NL | 23.1° | 17.2° | −5.9° |
1+:NA | 17.2° | 32.1° | 14.9° |
1+:NA (mm) | 3.2 mm | 5.4 mm | 2.2 mm |
1+:NL | 104° | 117.2° | 13.2° |
1−:NB | 10.5° | 13.7° | 3.2° |
1−:NB (mm) | 0.4 mm | −0.1 mm | −0.5 mm |
1−:ML | 79.2° | 85.7° | 6.5° |
1−:APg | −1.4 mm | −1.2 mm | 0.2 mm |
1+:1− | 153.5° | 135.8° | −17.7° |
UL—“E” plane | −4.35 mm | −5.02 mm | −0.67 mm |
LL—“E” plane | −4.45 mm | −3.62 mm | 0.83 mm |
Tooth Number | 13 | 12 | 11 | 21 | 22 | 23 | 24 |
---|---|---|---|---|---|---|---|
Root length before treatment (mm) | 11.5 + 2.1 * | 12.9 | 11.1 | 10.8 | 12.8 | 14.6 | 9.4 |
Root length after treatment (mm) | 11.0 | 12.3 | 10.5 | 9.5 | 10.9 | 12.4 | 8.5 |
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Stasiak, M.; Kołodziejska, A.; Racka-Pilszak, B. Orthodontic Treatment of Palatally Impacted Canines in Severe Non-Syndromic Oligodontia with the Use of Mini-Implants: A Case Report. Medicina 2023, 59, 2032. https://doi.org/10.3390/medicina59112032
Stasiak M, Kołodziejska A, Racka-Pilszak B. Orthodontic Treatment of Palatally Impacted Canines in Severe Non-Syndromic Oligodontia with the Use of Mini-Implants: A Case Report. Medicina. 2023; 59(11):2032. https://doi.org/10.3390/medicina59112032
Chicago/Turabian StyleStasiak, Marcin, Aleksandra Kołodziejska, and Bogna Racka-Pilszak. 2023. "Orthodontic Treatment of Palatally Impacted Canines in Severe Non-Syndromic Oligodontia with the Use of Mini-Implants: A Case Report" Medicina 59, no. 11: 2032. https://doi.org/10.3390/medicina59112032