Eruption pathway formation in the presence of experimental tooth impaction in puppies.
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In comparison to the straight wire technique the segmental arch approach offers numerous biomechanical and clinical advantages. Three typical examples: controlled tooth movement, en masse space closure and deep overbite correction serve to show the spectrum and the efficiency of the segmented arch technique.
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On the basis of 147 panoramic radiographs of 49 patients, this study investigated the influence of the premature loss of deciduous teeth on the formation of their permanent successors at the time of their eruption. Furthermore the study investigated the eruptive movement of the successor teeth at the time of eruption. In addition to detecting the accelerated emergence of still immature successor premolars, the study also determined that the extraction ot the deciduous molars before the age of eight years delayed the eruption of the permanent successors given the absence of an infected deciduous tooth with abscess formation. In relation to the eruptive movement of the permanent molars due to the premature loss of the second deciduous molar, the study ascertained a mesial movement of the first permanent molars and an accelerated eruption of the second permanent molars.
To align those teeth in the dental arch that cannot erupt or are displaced, they must be surgically exposed. After the traction device is attached, the tooth is again covered with the mucoperiosteal flap to protect the tissues involved. For this reason, the loss of this traction device must be absolutely avoided in order to prevent another surgical intervention. Here at the University of Ulm, we have developed and tested an optimized traction chain for that purpose. The chain is attached to the tooth with a laser-roughened pad applying the acid-etching technique. The chain links serve as fixation elements for traction devices such as elastic ligatures or piggyback archwires. At the same time, one can determine the distance covered by the tooth by the number of the erupting chain links. We demonstrate the clinical application of this traction device in two cases.
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Our findings indicate a cellular basis for the connective tissue remodeling which takes place during physiologic tooth movement. This cell is the fibroblast which is capable of synthesizing and degrading collagen simultaneously and, utilizing this ability, the orderly control of collagen remodeling within the periodontal ligament is possible. It is suggested that this cellular basis of connective remodeling will have a direct significance for orthodontic tooth movement once control mechanisms have been established.
Transseptal fibers are a part of the gingival group of fibers of the periodontal membrane, and they are very tough and resistant. They form a chain from tooth to tooth which, provided that it remains intact and is sufficiently strong to resist displacing muscular pressures, will preserve the contacts between the teeth throughout the arch. If the continuity of the chain is interrupted, the balance of the forces acting upon the teeth on either side of the break is upset and considerable displacements can occur. Maxillary median diastemas are classified as "simple" or "persistent" according to their etiology, and an operation to clear the upper midline suture of transeptal fibers is described as an essential part of the treatment of persistent upper median diastema.
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