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The delayed eruption of an upper central incisor
THE DELAYED ERUPTION OF AN UPPER CENTRAL INCISOR. By MARTIN DEWEY, M. D., D. D. S., KANSAS CITY, Mo.
presenting this case to the readers of this journal, I do so because of I Nsome of the features connected with the case and not because of the difficulty of treatment, or because of the new appliances used. When I first saw the patient, a young man 19 years old, the right upper central incisor was erupting on the labial side of the alveolar ridge, gingivally to a temporary bridge which he was wearing to supply the missing central. The cutting edge of the tooth was all that could be seen. By grinding away the gingival portion of the incisor facing, it was possible to allow the central to erupt to the position shown in Fig. 1, before removing the bridge. At the time the impression was taken, a piece of band material was carefully worked under the lingual side of the tooth and soldered on the labial side. A small tube was also soldered on the labial side of the band for the purpose of attaching a ligature, to pull the tooth occlusally.
Fig. 1.
Fig. 2.
Clamp molar bands were placed on the first upper molars and a sixteengauge alignment wire was used. The regular expansion arch with the threaded ends was used in this case. Very little expansive force was placed in the alignment wire, as there was almost enough room for the left central. The alignment wire occupied a position about even with the gingival border of the normal teeth. The normal incisors and canines were ligated to the appliance in order to support the anterior portion of the alignment wire. A wire ligature was passed through the tube on the band which had been placed on the left central and twisted around the arch. About eight months' time was consumed [n moving the central to the position shown in
Delayed Eruption of Upper Central Incisors.
273
Fig. 2. A retaining appliance was made by soldering a labial wire on the left central band and the ends of the wire bent occlusally to engage the cutting edge on the left central and right lateral. Care must be taken that these wires do not interfere with the occlusion of the lower teeth. There was nothing especially difficult about this case. No X-ray was made. I do not know the cause for the late eruption of the left central. There was plenty of room for the tooth to make its appearance, in fact very little expansion was needed to get the tooth in the dental arch. In a great many cases similar to this, the question has been asked: Will the gingival portion of the gum follow the crown of the tooth? In fact, this patient had been told the crown of the tooth would be long if the tooth was forcibly erupted. It required considerable argument to induce the gentleman to have the tooth brought down to its proper position instead of having it extracted and an artificial tooth inserted. The result, while not quite normal (there is a slight bunching in the lower teeth which the patient would not have corrected), is better than an artificial substitute would be. The "gum line" is normal.
presenting this case to the readers of this journal, I do so because of I Nsome of the features connected with the case and not because of the difficulty of treatment, or because of the new appliances used. When I first saw the patient, a young man 19 years old, the right upper central incisor was erupting on the labial side of the alveolar ridge, gingivally to a temporary bridge which he was wearing to supply the missing central. The cutting edge of the tooth was all that could be seen. By grinding away the gingival portion of the incisor facing, it was possible to allow the central to erupt to the position shown in Fig. 1, before removing the bridge. At the time the impression was taken, a piece of band material was carefully worked under the lingual side of the tooth and soldered on the labial side. A small tube was also soldered on the labial side of the band for the purpose of attaching a ligature, to pull the tooth occlusally.
Fig. 1.
Fig. 2.
Clamp molar bands were placed on the first upper molars and a sixteengauge alignment wire was used. The regular expansion arch with the threaded ends was used in this case. Very little expansive force was placed in the alignment wire, as there was almost enough room for the left central. The alignment wire occupied a position about even with the gingival border of the normal teeth. The normal incisors and canines were ligated to the appliance in order to support the anterior portion of the alignment wire. A wire ligature was passed through the tube on the band which had been placed on the left central and twisted around the arch. About eight months' time was consumed [n moving the central to the position shown in
Delayed Eruption of Upper Central Incisors.
273
Fig. 2. A retaining appliance was made by soldering a labial wire on the left central band and the ends of the wire bent occlusally to engage the cutting edge on the left central and right lateral. Care must be taken that these wires do not interfere with the occlusion of the lower teeth. There was nothing especially difficult about this case. No X-ray was made. I do not know the cause for the late eruption of the left central. There was plenty of room for the tooth to make its appearance, in fact very little expansion was needed to get the tooth in the dental arch. In a great many cases similar to this, the question has been asked: Will the gingival portion of the gum follow the crown of the tooth? In fact, this patient had been told the crown of the tooth would be long if the tooth was forcibly erupted. It required considerable argument to induce the gentleman to have the tooth brought down to its proper position instead of having it extracted and an artificial tooth inserted. The result, while not quite normal (there is a slight bunching in the lower teeth which the patient would not have corrected), is better than an artificial substitute would be. The "gum line" is normal.