Objectives\u00a0 <\/b>Traumatic dental injuries represent a major public health problem, poten\u00adtially affecting growth, function and aesthetics of the entire orofacial dis\u00adtrict and impacting oral-health-relat\u00aded quality of life, with relevant social and psychological aspects.<\/p>\n
It is estimated that the 80% of all traumatic dental injuries occurs in children and adolescences within 20 years of age, patients in which implant-positioning is not recom\u00admended, if not contraindicated. Many therapeutic alternatives for these group of patients have been described in literature, going from removable prosthetic appliances to Maryland-bridges and other fixed prosthetic appliances supported by orthodontic miniscrews. All these solutions appear to be temporary, requiring a second treatment once the patient\u2019s growth has ended.<\/p>\n
The aim of this report is to de\u00adscribe the combined orthodontic and prosthetic treatment of a trau\u00admatic dental injury-related upper incisor loss in a young patient.<\/p>\n
Materials and methods\u00a0 <\/b>An 11-year-old boy presented with the loss of the permanent upper left central incisor, complaining chiefly of his unpleasant smile aes\u00adthetic. The complete documenta\u00adtion of the case was collected, in\u00adcluding intra and extraoral photos, dental impressions and a CBCT scan. No agenesis was found, based on a panoramic radiography. Cephalometric analysis showed a normo to hypodivergent path of growth, with skeletal first class and average overjet and overbite.<\/p>\n
He was proposed the mesialization of the entire upper left hemiarch and the prosthetic enhancement of all teeth of the second sextant. The orthodontic treatment lasted four and a half years and did not re\u00adquire skeletal anchorage. Intermax\u00adillary elastics were the main anchor\u00ading system, used asymmetrically to obtain and then finalize the patient\u2019s occlusion.<\/p>\n
At the end of the ortho\u00addontic treatment the patient under\u00adwent the prosthetic treatment: since he could not afford the enhance\u00adment of all upper frontal elements, only the camouflage of element 2.2 in element 2.1 was made, using a ceramic dental veneer.<\/p>\n
Results and conclusions\u00a0 <\/b>The final occlusion was asymmet\u00adric, with molar and canine first class on the right side and molar and ca\u00adnine class two on the left side. Overjet and overbite were main\u00adtained within average values. A mild midline deviation was present, but within clinical acceptability limits.<\/p>\n
Considered the patient\u2019s hypodiver\u00adgent growth path, slightly altered gingival margins and emergence profiles were not seen as repre\u00adsenting a problem. The patient and his parents were both satisfied with the treatment outcome.<\/p>\n
Clinical significance\u00a0 <\/b>Orthodontic space closure can be a valid and definitive therapeutic al\u00adternative in a young patient, not yet suitable for fixed prosthetic appli\u00adances, in case of loss of one or two teeth, especially in the upper ante\u00adrior sextant. A good collaboration between orthodontists and prost\u00adhodontists is needed for the suc\u00adcess of this therapy.<\/p>\n
Per continuare la lettura gli abbonati possono scaricare l’allegato.<\/i><\/p>\n
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