4 interdisciplinary treatment
TRANSCRIPT
Interdisciplinary Treatment: Integrating Orthodontics with Restorative Dentistry and
Periodontics, Endodontics.
M. ABOULNASER- Orthodontist, BAU, Connecticut, USA.O. SANDID- Orthodontist, D.C.D., D.U.O, C.E.S.B.B,
C.E.S.O.D.F , S.Q.O.D.F, Paris. France.
Plan• A-Orthodontics and Restorative Dentistry• 1 - Consequences of tooth loss• 2- Space management of Microdontia, Management of 'peg laterals'or other diminutive
teeth• 3- Implant site preparation• Orthodontic Intrusion• Orthodontic Extrusion
• B-Orthodontics with Oral Surgery• C-Orthodontics with Periodontics• D-Orthodontics with Pediatric dentistry• E-Orthodontics with Endodontics
A-Orthodontics and Restorative Dentistry
• 1 - Consequences of tooth loss• 2- Space management of Microdontia,
Management of 'peg laterals'or other diminutive teeth
• 3- Implant site preparation
1-Consequences of tooth loss
• Mesial tipping and rotations of distal molars
http://pocketdentistry.com/18-special-considerations-in-treatment-for-adults/
Loss of a lower molar can lead to tipping and drifting of adjacent teeth, poor interproximal contacts, poor gingival contour, reduced interradicular bone, and supra-eruption of opposed teeth. Note the loss of alveolar bone in the area where a
mandibular first molar was extracted
M. ABOULNASER- O SANDID Orthodontics and restorative dentistry
1a-Consequences of tooth loss
• Distal tipping and rotations of mesial teeth
http://www.columbia.edu/itc/hs/dental/D5300/Lecture%2012.DDS.Class2008.20050622.Principles%20of%20Molar%20Uprigh_BW.pdf
M. ABOULNASER- O SANDID Orthodontics and restorative dentistry
1b-Consequences of tooth loss
• Eruption of opposing tooth in edentulous space
LE MAY J-https://www.orthodontisteenligne.com/en/ortho-101-en/adult-orthodontics-4/
Loss of posterior teeth in an adult. On one side (A), the loss of a lower molar allowed the other molars to tip forward. On each side (A and B), the upper molars migrate toward the space below (extrusion).
M. ABOULNASER- O SANDID Orthodontics and restorative dentistry
1c-Consequences of tooth loss
Gingival tissues become folded, and pockets form in the area
M. ABOULNASER- O SANDID Orthodontics and restorative dentistry
1d-Consequences of tooth loss
This photo shows a lower ridge that has lost 60% of its width following an extraction and normal healing. The black arrows indicate where bone is
located (compare the width to the adjacent molar). The red arrows indicate the normal width that should be there.
M. ABOULNASER- O SANDID
http://www.pittsburghdentalimplants.com/dental-implants/effects-of-tooth-loss/
Orthodontics and restorative dentistry
1e-Consequences of tooth loss
Occlusal Interferences and Temporomandibular Joint Disorders
M. ABOULNASER- O SANDID
http://www.dr-adrianbecker.com/page.php?pageId=281&nlid=50
Orthodontics and restorative dentistry
1f-Consequences of tooth loss
Accumulation of plaque in pockets leads to periodontal damage, with loss of gingival attachment and alveolar bone loss
M. ABOULNASER- O SANDID Orthodontics and restorative dentistry
1g-Loss of the mandibular first molar-46
Occlusal interferences - Overerupted 16- Gum pocket 47- Distalization 45- Exaggerated curve of Spee
M. ABOULNASER- O SANDID Orthodontics and restorative dentistry
1h-Tooth loss and ImpactionOrthodontics and restorative dentistry M. ABOULNASER- O SANDID
1i-Uprighting the dental axes
http://pocketdentistry.com/18-special-considerations-in-treatment-for-adults/
Orthodontics and restorative dentistryM. ABOULNASER- O SANDID
1k-Uprighting the dental axes – Mini -Implant
https://www.researchgate.net/figure/26791749_fig7_Fig-7-Patient-2-schematic-illustration-of-biomechanics-for-molar-uprighting-and /
Orthodontics and restorative dentistry M. ABOULNASER- O SANDID
1l-Intrusion of Overerupted Molars using Miniscrews
http://www.jcdr.net/article_fulltext.asp?id=6165
Orthodontics and restorative dentistry M. ABOULNASER- O SANDID
1m-Intrusion of Overerupted Molars using Miniscrews
http://www.jcdr.net/article_fulltext.asp?id=6165
Orthodontics and restorative dentistry M. ABOULNASER- O SANDID
1n-Implant site preparation
Molar Uprighting, with space creation
Orthodontics and restorative dentistry M. ABOULNASER- O SANDID
1p-Missing upper lateral incisors
Kazemi, https://www.facialart.com
Orthodontics and restorative dentistry
IMPLANT SITE PREPARATION
M. ABOULNASER- O SANDID
1q-Missing upper lateral incisorsOrthodontics and restorative dentistry
Closure space
http://www.scielo.br/pdf/jaos/v22n5/1678-7757-jaos-22-05-0465.pdf
M. ABOULNASER- O SANDID
1s- Managing the orthodontic-restorative patient
Early Tooth Loss and Space Maintenance Space regaining: Molar Uprighting and Distalization
Early tooth loss can be a result of traumatic avulsion or extraction of carious or infected teeth, Premature loss of primary teeth can result in a loss of arch length and have a negative effect on
occlusion and alignment, often increasing the need for orthodontic treatment.
Orthodontics and restorative dentistry M. ABOULNASER- O SANDID
2-Multi-disciplinary approach for space management of Microdontia
- A minimal reduction was needed for lateral incisors. - Veneers cemented on lateral incisors. - Definitive composite restorations after finishing and polishing procedures.
M. ABOULNASER- O SANDID
2a-Anterior Space Management
https://www.researchgate.net/figure/235394688_fig1_Figure-2-Occlusal-view-showing-spaces-between-maxillary-central-incisors-and-
between
Occlusal view showing spaces between maxillary central incisors, and between lateral incisors and canines.
Orthodontics and restorative dentistry Management of 'peg laterals'or other diminutive teeth
M. ABOULNASER- O SANDID
2b-Anterior Space Management
https://www.researchgate.net/figure/235394688_fig1_Figure-2-Occlusal-view-showing-spaces-between-maxillary-central-incisors-and-between
Orthodontics and restorative dentistry
Management of 'peg laterals'or other diminutive teeth
M. ABOULNASER- O SANDID
2c-Anterior Space Management
Additional orthodontic treatment is initiated to improve the dental midline and evenly distribute the space around the microdontic lateral incisors
Orthodontics and restorative dentistry
Management of 'peg laterals'or other diminutive teeth
M. ABOULNASER- O SANDID
3-Implant site preparation
Move the roots from implant site, To create space priorimplant placement, the roots of the adjacent teeth should be upright and parallel
Dr Jebin
M. ABOULNASER- O SANDID
3a- Implant site peparation
Molar Uprighting, with space creation
M. ABOULNASER- O SANDID
3c- Implant site preparation
Yvon Roberge, Sylvain Gagnon, Orthod Fr 2008;79:55–57
Implant site preparation : Open Space, Root proximity, Bone quality, implant types…
www.orthofree.com
M. ABOULNASER- O SANDID
3d-Implant site preparationM. ABOULNASER- O SANDID
Orthodontic extrusion
• Orthodontic extrusion uses “orthodontic forces”.
• The PDL including alveolar bone follows the extruding tooth
• Rapid extrusion uses heavier forces, more frequent activations and results in extruding the tooth beyond the PDL – lengthen clinical crown
Orthodontic extrusion
www.orthofree.com
Orthodontic extrusion uses “orthodontic forces”. The PDL including alveolar bone follows the extruding tooth
Rapid extrusion uses heavier forces, more frequent activations and results in extruding the tooth beyond the PDL – lengthen clinical crown
Retention periodDr Jebin
M. ABOULNASER- O SANDID
Orthodontic extrusion
• (a) Buccal view of the fractured premolar, (b) Occlusal view, (c) Initial radiographic appearance, (d) Initial orthodontic root extrusion of the premolar, (e) Buccal view of the orthodontic apparatus, (f) Stabilization of the
orthodontic extrusion over 5 months
http://www.jidonline.com/viewimage.asp?img=JInterdiscipDentistry_2012_2_3_221_113270_u1.jpg
M. ABOULNASER- O SANDID
Combined endodontic-orthodontic and prosthodontictreatment of fractured teeth
• Fractured teeth- Orthodontic extrusion
M. ABOULNASER- O SANDID
Orthodontic Treatment in Periodontally Compromised Patients
• Patient with advanced periodontitis and migration of the maxillary left central incisor,
• Clinical view after the end of the orthodontic treatment the teeth are retained by means of a resin-bonded splints
• Biomechanics used to intrude and move the central incisor into the defect
M. ABOULNASER- O SANDID
Orthodontic Treatment in Periodontally Compromised Patients
• Radiographic view of the osseoous defect ,• Radiographic wiew at the end of the treatment with reduction of the defect
Stefanis Re, Giuseppe CorrenteIJP and DR
Orthodontic treatment - Periodontal pocket reduction
M. ABOULNASER- O SANDID
Orthodontic Treatment in Periodontally Compromised Patients
Orthodontic treatment - Periodontal pocket reduction
Stefanis Re, Giuseppe CorrenteIJP and DR
M. ABOULNASER- O SANDID
Crown lengthening
• Crown lengthening is as a viable procedure that enables to restore teeth having a short clinical crown,
• extensive subgingival caries, subgingival tooth fractures at dentogingival junction, when performed in ideal clinical conditions…
Before crown lengtheninig After crown lengtheninig
M. ABOULNASER- O SANDID
Crown lengthening
Orthodontic Forced Eruption Combined with Circumferential Fiberotomy
http://drromanmelnyk.com/crown-lengthening/
M. ABOULNASER- O SANDID
Orthodontic intrusion
• intrusion
M. ABOULNASER- O SANDID
References • http://www.dentistrytoday.com/orthodontics?start=20
• http://www.slideshare.net/almuzian/orthodontics-and-restorative-dentistry-by-almuzian-36418366• http://www.semortho.com/article/S1073-8746(97)80034-5/abstract• https://www.orthodontisteenligne.com/cas-traites-2/multidisciplinaire/• http://pocketdentistry.com/11-interdisciplinary-orthodontics/