[Treatment of an impacted upper cuspid: a different approach].
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Biomedical subjects
Publications and source records attributed to B J Wes.
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Attention is paid to the normal and disturbed eruption of the upper cuspid. Genetic factors seem to play the most important role in impaction or delayed eruption. The dentist needs to be aware of the diagnostic and roentgenological features of this phenomenon.
Delayed eruption of impacted canines in more or less guaranteed by using the modified window technique. A decision for futher treatment can be made afterwards. If orthodontic treatment is required, fixed appliance is recommended for uneventful orthodontic positioning of these teeth.
Prevention of impaction depends in many cases on the knowledge of variations in eruption sequences. However, in case of impaction, spontaneous eruption can be stimulated by exposing the tooth with the modified window-technique. Frequent communications between dentist, orthodontist and oral surgeon are required to determine the right time of intervention.
A review of the treatment of the impacted upper cuspid is presented. A description of a modified exposure technique is given. Up to the present day more than 400 impacted cuspids have been treated with this technique.
Treatment goal of the maxillary impacted cuspid should include health periodontal end results. This clinical and radiographic study reveals in 75% of the cases a satisfying periodontal condition.
A modified technique for reconstruction of the atrophic mandible is presented. The caudal part of the mandible is mobilized through a combined intra-extraoral approach or an entirely extraoral approach. The bone graft is then inserted between the osteotomized fragments. The results in terms of bone resorption are comparable with those of the original method, but the risk of a lesion of the mandibular nerve is substantially reduced. Moreover, supplementary vestibuloplasty is only occasionally necessary.
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