- Email: [email protected]
Removable appliance intrusion for incisal edge discrepancy
access was obtained. Purulent exudate drained from the lateral incisor but not the maxillary canine. Suction was used only on the lateral incisor site. At recall visits after 1, 2, and 4 weeks, the patient had repeat vacuum suction on the lateral incisor. The canine was obturated at 1 week and the incisor at 4 weeks. Clinical symptoms resolved after 3 months, with partial radiographic resolution (Fig 6). Complete radiographic resolution of the periapical radiolucency was achieved at 8 months (Fig 7). Discussion.—Active decompression with a vacuum system was able to address these large periapical lesions. Apical inflammatory fluids were removed without surgery and with minimal invasiveness. The root canal was not exposed to the oral environment, and no special care was required on the patient’s part. The procedure saved time for both the patient and the dentist.
Clinical Significance.—Large, radiolucent periapical lesions associated with heavy drainage are typically treated surgically. Presented is a nonsurgical technique that has proven successful.
Mejia JL, Donado JE, Basrani B: Active nonsurgical decompression of large periapical lesions—3 case reports. J Can Dent Assoc 70:691694, 2004 Reprints available from BR Basrani, Univ of Toronto, Faculty of Dentistry, 348C-124 Edward St, Toronto, ON M5G 1G6; e-mail: [email protected]
Esthetic Dentistry Removable appliance intrusion for incisal edge discrepancy Background.—Intrusive movement is the method chosen to realign anterior teeth with discrepancies of the incisal edges, improve clinical crown length, and achieve marginal bone levels. A method that uses a removable appliance was described.
able arch hook was crimped to the labial arch of the appliance at the tooth’s labial surface. The intrusive force applied was 20 g (Fig 2). The elastic band was to be removed daily. Treatment lasted for 2 months. A lightcurable adhesive resin was used to bond an adapted piece
Case Report.—Woman, 27, had an incisal edge discrepancy between her upper central incisors for which she had undergone orthodontic treatment and extraction of a lower central incisor 10 years earlier. Intraoral examination found the incisal edge of her upper left central incisor to be 0.5 mm lower than the edge of her upper right incisor (Fig 1). She also had incorrect axial crown angulation, with otherwise good occlusion. Overjet measured 3 mm. She was a broadcaster at a local television station, making fixed orthodontic treatment unacceptable. A removable appliance was considered to permit her to take the appliance out when needed. The goal of treatment was tooth intrusion, with no action taken regarding the crown angulation. The Hawley retainer–type removal appliance was constructed, with a button placed on the acrylic base plate near the lingual surface of the left central incisor. In addition, a crimp-
Fig 1.—Intraoral view before treatment. (Courtesy of Arici S: An easy way of intruding an upper central incisor. Br Dent J 197:543544, 2004.)
204 Dental Abstracts
Fig 2.—Removable appliance in the mouth. (Courtesy of Arici S: An easy way of intruding an upper central incisor. Br Dent J 197:543-544, 2004.)
of multistrand wire to the lingual surfaces of the upper incisors, serving as a fixed retainer. She was then referred to a periodontist for a minor gingivectomy performed via electrosurgery to address the crown angulation (Fig 4). Discussion.—The removable appliance, with the labial bow and Adams clasps on the first permanent molars, was able to provide controlled intrusion with no buccal or lingual tipping of the upper left central incisor. The light continuous force (20 g) was maintained during the intrusion movement. Referral to a periodontist permitted correction of the difference between the clinical crown lengths of the upper central incisors, exposing the full crown length of the intruded tooth. Gingivectomy is contraindicated when the attached gingiva is narrow or absent or in the presence of infrabony pockets or thickening of marginal alveolar
Fig 4.—Intraoral view 3 weeks after gingivectomy.(Courtesy of Arici S:An easy way of intruding an upper central incisor. Br Dent J 197:543-544, 2004.)
bone. The bone is not touched during the operation to avoid heat injury, which can be irreparable.
Clinical Significance.—Presented is a technique that uses a removal appliance for correcting an uncomplicated, incisal edge discrepancy.
Arici S: An easy way of intruding an upper central incisor. Br Dent J 197:543-544, 2004 Reprints available from S Arici, Ondokuz Mayis Univ, Dental Faculty, Orthodontics, Kurupelit, 55139 Samsun, Turkey; e-mail: sarici @omu.edu.tr
Evidence-Based Dentistry Dentistry and the National Health Information Infrastructure Background. The effort to develop a nationwide electronic infrastructure for health care, the National Health Information Infrastructure (NHII), is designed to avoid dangerous medical mistakes, reduce costs, and improve
care. The NHII was described, its potential benefits and drawbacks as well as barriers and risks were outlined, and the steps to be taken by the dental profession to joint NHII were noted.
Volume 50 • Issue 4 • 2005 205
Clinical Significance.—Large, radiolucent periapical lesions associated with heavy drainage are typically treated surgically. Presented is a nonsurgical technique that has proven successful.
Mejia JL, Donado JE, Basrani B: Active nonsurgical decompression of large periapical lesions—3 case reports. J Can Dent Assoc 70:691694, 2004 Reprints available from BR Basrani, Univ of Toronto, Faculty of Dentistry, 348C-124 Edward St, Toronto, ON M5G 1G6; e-mail: [email protected]
Esthetic Dentistry Removable appliance intrusion for incisal edge discrepancy Background.—Intrusive movement is the method chosen to realign anterior teeth with discrepancies of the incisal edges, improve clinical crown length, and achieve marginal bone levels. A method that uses a removable appliance was described.
able arch hook was crimped to the labial arch of the appliance at the tooth’s labial surface. The intrusive force applied was 20 g (Fig 2). The elastic band was to be removed daily. Treatment lasted for 2 months. A lightcurable adhesive resin was used to bond an adapted piece
Case Report.—Woman, 27, had an incisal edge discrepancy between her upper central incisors for which she had undergone orthodontic treatment and extraction of a lower central incisor 10 years earlier. Intraoral examination found the incisal edge of her upper left central incisor to be 0.5 mm lower than the edge of her upper right incisor (Fig 1). She also had incorrect axial crown angulation, with otherwise good occlusion. Overjet measured 3 mm. She was a broadcaster at a local television station, making fixed orthodontic treatment unacceptable. A removable appliance was considered to permit her to take the appliance out when needed. The goal of treatment was tooth intrusion, with no action taken regarding the crown angulation. The Hawley retainer–type removal appliance was constructed, with a button placed on the acrylic base plate near the lingual surface of the left central incisor. In addition, a crimp-
Fig 1.—Intraoral view before treatment. (Courtesy of Arici S: An easy way of intruding an upper central incisor. Br Dent J 197:543544, 2004.)
204 Dental Abstracts
Fig 2.—Removable appliance in the mouth. (Courtesy of Arici S: An easy way of intruding an upper central incisor. Br Dent J 197:543-544, 2004.)
of multistrand wire to the lingual surfaces of the upper incisors, serving as a fixed retainer. She was then referred to a periodontist for a minor gingivectomy performed via electrosurgery to address the crown angulation (Fig 4). Discussion.—The removable appliance, with the labial bow and Adams clasps on the first permanent molars, was able to provide controlled intrusion with no buccal or lingual tipping of the upper left central incisor. The light continuous force (20 g) was maintained during the intrusion movement. Referral to a periodontist permitted correction of the difference between the clinical crown lengths of the upper central incisors, exposing the full crown length of the intruded tooth. Gingivectomy is contraindicated when the attached gingiva is narrow or absent or in the presence of infrabony pockets or thickening of marginal alveolar
Fig 4.—Intraoral view 3 weeks after gingivectomy.(Courtesy of Arici S:An easy way of intruding an upper central incisor. Br Dent J 197:543-544, 2004.)
bone. The bone is not touched during the operation to avoid heat injury, which can be irreparable.
Clinical Significance.—Presented is a technique that uses a removal appliance for correcting an uncomplicated, incisal edge discrepancy.
Arici S: An easy way of intruding an upper central incisor. Br Dent J 197:543-544, 2004 Reprints available from S Arici, Ondokuz Mayis Univ, Dental Faculty, Orthodontics, Kurupelit, 55139 Samsun, Turkey; e-mail: sarici @omu.edu.tr
Evidence-Based Dentistry Dentistry and the National Health Information Infrastructure Background. The effort to develop a nationwide electronic infrastructure for health care, the National Health Information Infrastructure (NHII), is designed to avoid dangerous medical mistakes, reduce costs, and improve
care. The NHII was described, its potential benefits and drawbacks as well as barriers and risks were outlined, and the steps to be taken by the dental profession to joint NHII were noted.
Volume 50 • Issue 4 • 2005 205