Download - Surgical Treatment of Impacted Incisors
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Surgical treatment of impactedincisors
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Age 8 years.Referred by GDP unerupted 11,12Irregular attender to GDPMH - NAD
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Supernumerary associatedwith 22
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Treatment Plan
Orthodontic Records General Anaesthetic surgical removal of
supernumerary.
Removal of upper right deciduous incisorsand gold chain exposure of upper right
lateral and central incisors. Patient must be seen 2 weeks post
operatively by orthodontist.
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Patient presentation 2 weeks post op.Upper right central gold chain visable, tooth high and unerupted.
Upper right lateral crown visable- gold chain attached
Insufficient anchorage available anteriorly to use a standard 2 x 4appliance therefore initial extrusion to use removable appliance
Visit 1
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Upper removable appliance used initially.
Patient cooperation essential with daily use of light elasticforces to extrude upper right lateral incisor.
Patient reviewed initially after 2 weeks of placement of URA
Visit 2: 2 weeks after treatment commenced
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Placement of 2 x 3 appliance with 0.016 NiTi .Long buccal spans must be protected ideally with SS buccal tubing
Visit 3 : 3 months from op
Vi i 4 5 h f i
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0.018 ss round wire with push coil to create space for upper central.
Wire ligation either side of push coil, patient requested colours too.Upper deciduous canines removed due to space requirements.
Visit 4 : 5 months from operation
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Sufficient space available , Twin wire procedure to extrude
upper central. Base wire 0.020 SS or 19 x 25 SS.
Sectional wire 0.016 Niti linked through gold chain.
Visit 6: 8 months after operation
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Continue with Twin wire until upper central near expectedocclusal level required
Visit 7: 9 months after operation
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Gold chain removed
Central incisor bracket
Placed and twin wirecontinues
Visit 8 : 11 months after op
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Next visit upper 0.018 x 0.025 niti wire placed.
Long buccal spans protected with buccal tubing
Visit 9:13 months
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Debond
Demineralisation evidentGingival margins altered due to
Reduced torque in upper right
Central incisor
Visit 10 : 15 months post op
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Visit 11
1 year post debond Upper fixed section retainer still in place.
Upper first premolars erupting.
Both maxillary canines buccally placed,there will be insufficient room for their
eruption. Jamie Lee will require further care at a later
date
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Summary This case took 14 months of active
orthodontic treatment.
Presents different ways of extruding teeth
which have been prevented from eruptingnaturally.
Confirms that any interceptive treatment is
likely to result in further treatment requiredat a later stage when the permanentdentition is established