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PubMed1989

[Apical root resorption during orthodontic treatment].

Pre- and posttreatment radiographs of 2050 orthodontically treated patients were examined and apical root resorptions of more than 2 mm were identified. 30 patients (211 teeth) were affected. Treatment characteristics and objectives of this group (with severe apical root resorption) were compared to a treated group of 30 patients (with no resorption) to determine clinical risk factors. Extrusion, but especially jiggling and a long treatment period were found to be significantly more frequent in the group exhibiting resorption than in the control group. Pathogenesis of treatment-induced root resorption is discussed in respect to histological results.

Adolescent↗
PubMed2003

Transplantation of a lower bicuspid after traumatic loss of three upper incisors.

BACKGROUND: Prosthodontic and orthodontic procedures have been described for the treatment of patients with traumatic loss of teeth. PATIENT AND METHODS: Both upper central incisors and the upper right lateral incisor had to be extracted in an 8-year-old patient after failure of conservative procedures following a sports accident. The patient was treated on a temporary basis with a space retainer as a substitute for the teeth. Definitive therapy was carried out by transplanting a lower bicuspid germ into the upper arch with subsequent orthodontic gap closure. RESULTS: 8 years after the intervention, the transplanted tooth is still in place. The patient is fully rehabilitated both functionally and esthetically with no discomfort. CONCLUSIONS: The transplantation of bicuspid germs in conjunction with orthodontic gap closure is a valuable alternative to prosthodontic treatment, particularly in the case of loss or aplasia of several teeth.

Adolescent↗
PubMed2003

Apical root resorption after lingual orthodontic therapy.

PURPOSE: Apical root resorptions are among the undesirable side effects of orthodontic therapy. The aim of the present study was to investigate radiologically whether and to what extent resorptions occur in patients treated solely with a fixed lingual appliance, as well as the pathogenetic relevance of the extent and direction of the therapeutically induced apical movement. PATIENTS AND METHODS: The collective comprised 33 female and seven male patients with a mean age of 24.2 +/- 8.4 years. Permanent lower premolars were extracted in five, and permanent upper premolars in 22 patients. In total, 456 upper and lower incisors and canines were assessed. In order to evaluate the relative change in root length and the sagittal and vertical apical movements, pre- and posttherapeutic panoramic radiographs and/or lateral cephalograms were analyzed. RESULTS: After completion of orthodontic treatment the mean root length was 96.3%, corresponding to a resorption rate of 3.7%. The resorption rates of teeth 11, 12 and 21 differed significantly from those of teeth 31, 32 and 43. Upper incisors presented increased mean resorption rates < or = 10%. Only 18% of the 456 teeth analyzed were affected by pronounced resorptions > 10%. 82% of the teeth were resorption-free. A patient-related evaluation revealed that 26 of the 40 patients had no resorptions > 20%, while 14 had between one and four affected teeth. No significant relationship between extent of resorption and parameters such as age, gender, active treatment time, Angle class, or extent and direction of apical movement was recorded. CONCLUSIONS: The results suggest that lingual orthodontic therapy resulted in only slight root resorptions. Pronounced root shortenings were observed in some patients whose individual predisposition may constitute the main risk factor for the occurrence of root resorptions.

Adolescent↗
PubMed2005

Light microscopic and SEM findings after orthodontic treatment--analysis of a human specimen.

AIM: The hard and soft tissue damage caused by orthodontic forces has so far, for obvious ethical reasons, been investigated in animal models primarily. However, the validity of these results as applied to humans remains controversial. The particular value of this study is that the maxilla of a young adult could be analyzed histologically. Thus it was possible to retrospectively study the effects of a routine orthodontic therapy using light microscopy. MATERIAL AND METHODS: The upper jaw of a 24-year-old patient was investigated. He had been in orthodontic treatment with a straight-wire-appliance using superelastic materials for 18 months. Both posterior segments were analyzed in the horizontal plane using the microsection method according to Donath (toluidine blue staining). Both central incisors were analyzed using a scanning electron microscope (SEM). The examination was performed qualitatively and histomorphometrically. RESULTS: 170 lateral root resorptions were found in the nine posterior teeth, while pressure sites and interference areas with the buccal and sinus cortical bone were predominantly affected. However, the extent of root resorption was minimal: mean length 979 +/- 766 microm, mean depth 208 +/- 133 microm. The lateral root erosions presented high repair potential: 55.6% of resorption length, and 28% of the depth were repaired in 76% of all lesions. CONCLUSION: The incidence of detected root resorptions seems high at first. However, the prognosis of the affected teeth is not critically impaired, due to the lesions' minor extent (length, depth) and their high repair capacity.

Adult↗
PubMed2006

The displaced maxillary canine--a retrospective study.

OBJECTIVE: The re-alignment of retained maxillary canines was studied in relation to the degree of displacement in panoramic radiographs, mesiodistal root deviations, length of treatment and side-effects. The aim was then to determine whether the decision between surgical removal and orthodontic re-alignment can be made on the basis of panoramic radiographs alone. MATERIALS AND METHODS: Forty-seven panoramic radiographs with 59 displaced canines were used to determine their distance and inclination to the occlusal plane (similar to the method described by Dausch-Neumann [8]), the position of the crown tip, and the frequency of mesiodistal root deviations. The length of active treatment was recorded and analyzed statistically in relation to the degree of displacement and incidence of root deviation. Finally, pre- and post-therapeutic panoramic radiographs were compared to determine the incidence of root resorptions and marginal bone defects. RESULTS: The mean values for the angle of inclination and the distance of the maxillary canines from the occlusal plane were 57.4 degrees (+/- 14.3 degrees ) and 10.5 mm (+/- 3.8 mm), respectively. In 21 canines, the crown tips projected most frequently between the central and lateral incisors. Twelve canines presented root deviations. Treatment lasted an average of 1.9 years (+/- 0.7 years). No correlation was found between the treatment time and the canine's distance from the occlusal plane (r = 0.03), its angle of inclination (r = 0.06), position of the crown tip (r = 0.12), or root deviation (r = -0.07). Root resorptions were found in nine canines (15.3%) and marginal bone defects in 24 canines (40.7%). CONCLUSION: Fifty-nine retained maxillary canines, some showing extreme displacement, were re-aligned in an average of 1.9 years. There was no correlation between the degree of canine displacement in the panoramic radiographs or the incidence of mesiodistal root deviations and active treatment time. For this reason, the indication to remove displaced maxillary canines should not be taken from panoramic radiographs alone.

Adolescent↗
PubMed1976

Cause and prevention of injuries to teeth and supporting structures during orthodontic treatment.

The present investigations have shown that, although there are definite risks in undertaking orthodontic treatment with fixed appliances, such treatment need not cause any appreciable damage when accepted orthodontic principles are followed in cooperative patients with good oral hygiene and regular fluoride treatment. On the other hand, when these principles are neglected, the damage may be considerable and the benefits from orthodontic treatment questionable. Progressively increasing evidence from preventive dentistry that the bacterial plaque is the single most important causative factor in periodontal breakdown, and is important also in causing dental caries, opens unique possibilities for the orthodontist and his auxiliary personnel with simple means to increase their patient's oral hygiene awareness. This would not only reduce the prevalence and severity of iatrogenic damage, but would increase the long-term benefits of the orthodontic therapy. Orthodontists may thus provide young adults with an improved esthetic facial appearance, a perfectly functioning occlusion, and the desire, interest, and possibilities of maintaining the dentition in this condition for all or most of their lives (Figs. 3 to 5, 12, and 13).

Dental Bonding↗