For complex implant cases, simple implantation could not achieve the desired therapeutic effect, and a multidisciplinary approach has become a general trend. Orthodontic treatment before implantation creates favorable conditions for subsequent implantation by increasing restoring three-dimensional space, improving occlusion of patients. It also stimulates the increase of autologous soft and hard tissue while biological potential of periodontal ligament is fully developed. The choice of operation time is vital to keep the level of soft and hard tissue at the implantation site, which improves the curative effect of implantation in terms of function and aesthetics. In this article, the orthodontic-implant combined therapy is briefly reviewed focusing on the three-dimensional space optimization, implant site enhancement by orthodontic extrusion and delayed orthodontic space opening.
Dental Implants ; trends ; Humans ; Orthodontic Extrusion ; Orthodontics ; methods ; trends

Ameloblastoma is a benign odontogenic epithelial tumor with high recurrence rate and requires extensive resection of the surrounding tissue and reconstruction of defect site. Because of the anatomical limitation of the reconstruction site, prosthetic treatment with implants is the first recommendation. This is a case of prosthetic restoration of the reconstruction site with implant fixed prosthesis in patient who underwent mandibular resection and iliac bone reconstruction due to ameloblastoma. However 14 months after completion of implant prosthesis, adjacent natural tooth erupted unexpectedly, resulting in 1mm infra-occlusion occurred including posterior implant prosthesis and anterior natural teeth. In adults, implant infra-occlusion may occur due to residual growth after placement of the maxillary anterior implant. But this case, hypo-occlusion of molar implant and open bite of anterior natural teeth is occurred due to extrusion of adjacent tooth, is rare. Thus we report the treatment process including orthodontic treatment with intrusion of the posterior tooth, and investigate the causes of sudden, unexpected tooth extrusion.
Adult ; Ameloblastoma ; Humans ; Mandibular Reconstruction ; Molar ; Open Bite ; Orthodontic Extrusion ; Prostheses and Implants ; Recurrence ; Tooth

OBJECTIVES: Crown-root fracture and cervical caries in maxillary premolars constitute a challenge in cases of subgingival placement of restoration margins. Surgical extrusion has been practiced successfully in permanent anterior teeth. The aim of the present retrospective study was to assess the clinical outcome of surgical extrusion after orthodontic extrusion in maxillary premolars. MATERIALS AND METHODS: Twenty-one single, tapered root maxillary premolars with subgingival crown-root fracture or caries were included. Presurgical orthodontic extrusion was performed on all teeth to prevent root resorption. Extent of extrusion and rotation was determined based on crown/root ratio. The postoperative splinting period was 7 to 14 days. Clinical and radiographic examination was performed at an interval of 1, 2, and 3 months. RESULTS: After the mean follow-up of 41.9±15.2 months, failure was observed as increased mobility in 3 of 21 cases. No significant difference was observed in the outcome of surgical extrusion based on tooth type, age, sex, 180° rotation, or time for extraction. Furthermore, marginal bone loss was not observed. CONCLUSION: Surgical extrusion of maxillary premolars can be a possible therapeutic option in cases of subgingival crown-root fracture.
Bicuspid ; Follow-Up Studies ; Orthodontic Extrusion ; Retrospective Studies ; Root Caries ; Root Resorption ; Splints ; Tooth

PURPOSE: Various complications occur when a maxillofacial fracture is malunionized or improperly resolved. Malocclusion is the most common complication, followed by facial deformity, temporomandibular joint disorder (TMD), and neurological symptoms. The purpose of this study was to evaluate the dental treatment of postoperative complications after maxillofacial fracture. MATERIALS AND METHODS: In this study, nine patients with a postoperative complication after maxillofacial fracture who had been performed the initial operation from other units and were referred to the authors’ department had been included. Of the nine patients, six had mandibular fractures, one had maxillary fractures, one had maxillary and mandibular complex fractures, and one had multiple facial fractures. All the patients had tooth fractures, dislocations, displacements, and alveolar bone fractures at the time of trauma, but complications occurred because none of the patients underwent preoperative and postoperative dental treatment. Malocclusion and TMD are the most common complications, followed by dental problems (pulp necrosis, tooth extrusion, osteomyelitis, etc.) due to improper treatment of teeth and alveolar bone injuries. The patients were referred to the department of dentistry to undergo treatment for the complications. One of the nine patients underwent orthognathic surgery for a severe open bite. Another patient underwent bone reconstruction using an iliac bone graft and vestibuloplasty with extensive bone loss. The other patients, who complained of moderate occlusal abnormalities and TMDs such as mouth-opening limitation, underwent occlusal treatment by prosthodontic repair and temporomandibular joint treatment instead of surgery. RESULTS: One patient who underwent orthognathic surgery had complete loss of open bite and TMD after surgery. One patient who underwent reconstruction using an iliac bone graft had a good healing process. Other patients were treated with splint, injection, and physical therapy for mouth-opening limitation and temporomandibular joint pain. After treatment, the TMDs were resolved, but the remaining occlusal abnormalities were resolved with prosthetic restoration. CONCLUSIONS: Considering the severity of malocclusion and TMJ symptom and the feasibillity of reoperation, nonsurgical methods such as orthodontic and prosthodontic treatments and splint therapy can be used to manage the dental and TMD complication after the trauma surgery. However, reoperation needs to be strongly considered for severe malocclusion and TMD problem. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40902-018-0167-z) contains supplementary material, which is available to authorized users.
Congenital Abnormalities ; Dentistry ; Dislocations ; Fractures, Bone ; Humans ; Malocclusion ; Mandibular Fractures ; Maxillary Fractures ; Necrosis ; Open Bite ; Orthodontic Extrusion ; Orthognathic Surgery ; Osteomyelitis ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Splints ; Temporomandibular Joint ; Temporomandibular Joint Disorders ; Tooth ; Tooth Fractures ; Transplants ; Vestibuloplasty

Clinical crown lengthening procedure would be an effective method for overcoming adverse clinical condition such as short abutment length. There are three kinds of methods in clinical crown lengthening, those are, surgical crown lengthening, orthodontic extrusion and surgical extrusion. Clinicians have to try their best to choose a proper method among those for favorable results. This report aims to review the considerations in each method with various cases and to suggest a decision flow for appropriate selection.
Crown Lengthening* ; Crowns* ; Methods* ; Orthodontic Extrusion

The purpose of this study is to identify the factors affecting the treatment outcome after surgical-orthodontic treatment of the maxillary impacted incisors using multiple regression analysis. The study enrolled 83 patients who had surgical-orthodontic treatment in impacted maxillary central incisor between January 2005 and December 2015. Possible explanatory variables related to the prognosis of impacted incisor were age, gender, tooth developmental stage, height, position and angle of the teeth.The results of multiple regression analysis showed that as the height of the stem cell from apical papilla (SCAP) increased, the tooth length ratio increased by 0.345 units (p < 0.01). There was no statistically significant difference in gender, tooth development stage, distance and angle between the center line and the tooth, and the height of incisal tip of the tooth. In conclusion, the height of the SCAP of the impacted central incisor is factor affecting the tooth length after orthodontic traction.
Humans ; Incisor ; Orthodontic Extrusion ; Prognosis ; Stem Cells ; Tooth ; Traction ; Treatment Outcome

Delayed eruption disorders caused by systemic or local conditions are mostly found during childhood and can be treated with orthodontic forced eruption. When the disorder is not found nor treated during childhood, however, orthodontic eruption might become a difficult option while prosthodontic restoration can be considered as an another option. Considerations for the prosthodontic treatment plan include the extent of tooth loss, interdental mesio-distal space and interarch space, and age of the patient. In this case report, oral rehabilitation of the patient with delayed eruption disorder through zirconia partial fixed prostheses for both maxilla and mandible was performed.
Humans ; Mandible ; Maxilla ; Orthodontic Extrusion ; Prostheses and Implants ; Rehabilitation ; Tooth Loss

Exposing sound structure of a subgingivally fractured tooth using orthodontic extrusion is considered to be a conservative way to re-establish biologic width without sacrificing esthetics or jeopardizing periodontal support of neighboring teeth. When a misaligned tooth is traumatically involved, a more comprehensive approach combining tooth extrusion and re-alignment may be necessary for a successful restorative outcome. This case report describes a successful esthetic management of a patient with complicated crown-root fracture on the maxillary right central incisor and pre-existing malocclusion in the maxillary anterior region. Forced eruption along with re-alignment of teeth by orthodontic movement seems to allow re-positioning of the fracture line to a favorable position and correction of crowding, providing a better esthetic result.
Crowding ; Esthetics ; Humans ; Incisor ; Malocclusion ; Orthodontic Extrusion* ; Tooth*

OBJECTIVE: Forced eruption has been proposed for the reconstruction of deficient bone and soft tissue. The aim of this study was to examine the changes in the alveolar ridge width and the vertical levels of the interproximal bone and papilla following forced eruption. METHODS: Patients whose hopeless maxillary anterior teeth were expected to undergo severe bone resorption and soft tissue recession upon extraction were recruited. In addition, patients whose maxillary anterior teeth required forced eruption for restoration due to tooth fracture or dental caries were included. Before and after forced eruption, the interproximal bone height was measured by radiographic analysis, and changes in the alveolar ridge width and the interproximal papilla height were measured with an acrylic stent. RESULTS: This prospective study demonstrated that the levels of the interproximal alveolar bone and papilla were significantly increased by 1.36 mm and 1.09 mm, respectively, in the vertical direction. However, the alveolar ridge width was significantly reduced by an average of 0.67 mm in the buccolingual direction. The changes in the level of the interproximal alveolar bone and papilla were positively correlated. CONCLUSIONS: Although the levels of the interproximal bone and papilla were significantly increased, the alveolar ridge width was significantly decreased following forced eruption. There was a modest positive and significant correlation between the changes in the height of the interproximal alveolar bone and the papilla. Based on our findings, modification of vertical forced eruption should be considered when augmentation of the alveolar ridge width is required.
Alveolar Process* ; Bone Resorption ; Dental Caries ; Humans ; Orthodontic Extrusion* ; Prospective Studies ; Stents ; Tooth ; Tooth Fractures ; Tooth Movement

Orthodontic extrusion is usually performed by means of a fixed orthodontic appliance that utilizes arch wire attached to adjacent teeth and transfers the desired force by elastic from the wire to the root. However, clinicians often encounter cases where the bonding required for tooth traction is not possible because the adjacent teeth have been restored with ceramic or veneer. The purpose of this case report is to describe a modified orthodontic extrusion appliance that is useful when conventional orthodontic treatment is not possible. The modified appliance was fabricated using an artificial tooth, clear plastic sheeting, and a braided fiber-reinforced composite strip that covered adjacent teeth without bonding. It satisfied the esthetic and functional needs of the patient and established the optimal biologic width.
Ceramics ; Humans ; Orthodontic Appliances ; Orthodontic Extrusion ; Plastics ; Tooth ; Tooth, Artificial ; Traction