SEARCH WITHIN CONTENT
Citation Information : Australasian Orthodontic Journal. Volume 34, Issue 1, Pages 78-84, DOI: https://doi.org/10.21307/aoj-2020-061
License : (CC BY 4.0)
Published Online: 20-July-2021
Introduction: Of the types of dental trauma, intrusive luxation is considered to have the worst prognosis. When forceful intrusion affects multiple adjacent teeth, orthodontic repositioning may be required; however, orthodontic treatment can be complicated by the development of a cant in the occlusal plane, especially when the affected teeth are not symmetrically located from the midline and corrective forces and anchorage are unbalanced. Designing an appropriate mechanism to overcome this problem is essential.
Case presentation: The present case report describes a 28-year-old male who suffered the traumatic intrusion of multiple teeth, with accompanying alveolar bone fractures, following a road traffic accident. The intruded teeth were repositioned using orthodontic traction, following which, endodontic treatment was performed. After initial alignment, differential curve of Spee mechanics were applied to correct the occlusal plane and an acceptable result was achieved. The overall outcome was maintained at a 24-months review.
Conclusion: This report demonstrates the importance of the early repositioning of intruded teeth to avoid dento-alveolar ankylosis, as well as the use of differential curve of Spee mechanics which provides effective force application in the management of a canted occlusal plane.
1. Tsilingaridis G, Malmgren B, Andreasen JO, Malmgren O. Intrusive luxation of 60 permanent incisors: a retrospective study of treatment and outcome. Dent Traumatol 2012; 28:416-22.
2. Neto JJ, Gondim JO, de Carvalho FM, Giro EM. Longitudinal clinical and radiographic evaluation of severely intruded permanent incisors in a pediatric population. Dent Traumatol 2009;25:510-4.
3. Skaare AB, Jacobsen I. Dental injuries in Norwegians aged 7-18 years. Dent Traumatol 2003;19:67-71.
4. Oulis C, Vadiakas G, Siskos G. Management of intrusive luxation injuries. Endod Dent Traumatol 1996;12:113-9.
5. Borum MK, Andreasen JO. Therapeutic and economic implications of traumatic dental injuries in Denmark: an estimate based on 7549 patients treated at a major trauma centre. Int J Paediatr Dent 2001;11:249-58.
6. Freihofer HP Jr. [Results of treatment of fractures of the alveolar process]. SSO Schweiz Monatsschr Zahnheilkd 1969;79:623-9. German.
7. Krenkel C, Grunert I. [Teeth in and around fracture lines treated with bonded silca wire splints]. Dtsch Z Mund Kiefer Gesichtschir 1987;11:208-10. German.
8. Andreasen JO. Fractures of the alveolar process of the jaw. A clinical and radiographic follow-up study. Scand J Dent Res 1970;78:263-72.
9. Diangelis AJ, Andreasen JO, Ebeleseder KA, Kenny DJ, Trope M, Sigurdsson A et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth. Dent Traumatol 2012;28:2-12.
10. Sxenısxık NE, Hasipek S. Occlusal cant: etiology, evaluation, and management. Turkish J Orthod 2015;27:174-80.
11. Burstone CJ. Precision lingual arches, active applications. J Clin Orthod 1989;23:101-9.
12. Kang YG, Nam JH, Park YG. Use of rhythmic wire system with miniscrews to correct occlusal-plane canting. Am J Orthod Dentofacial Orthop 2010;137:540-7.
13. Jeon YJ, Kim YH, Son WS, Hans MG. Correction of a canted occlusal plane with miniscrews in a patient with facial asymmetry. Am J Orthod Dentofacial Orthop 2006;130:244-52.
14. Ko DI, Lim SH, Kim KW. Treatment of occlusal plane canting using miniscrew anchorage. World J Orthod 2006;7:269-78.
15. Yáñez-Vico RM, Iglesias-Linares A, Cadenas de Llano-Pérula M, Solano-Reina A, Solano-Reina E. Management of occlusal canting with miniscrews. Angle Orthod 2014;84:737-47.
16. Mostafa YA, Tawfik KM, El-Mangoury NH. Surgical-orthodontic treatment for overerupted maxillary molars. J Clin Orthod 1985;19:350-1.
17. Yao CC, Wu CB, Wu HY, Kok SH, Chang HF, Chen YJ. Intrusion of the overerupted upper left first and second molars by miniimplants with partial-fixed orthodontic appliances: a case report. Angle Orthod 2004;74:550-7.
18. Lauridsen E, Gerds T, Andreasen JO. Alveolar process fractures in the permanent dentition. Part 2. The risk of healing complications in teeth involved in an alveolar process fracture. Dent Traumatol 2016;32:128-39.
19. Andreasen JO. A time-related study of periodontal healing and root resorption activity after replantation of mature permanent incisors in monkeys. Swed Dent J 1980;4:101-10.
20. Andreasen JO. Analysis of pathogenesis and topography of replacement root resorption (ankylosis) after replantation of mature permanent incisors in monkeys. Swed Dent J 1980;4:231-40.
21. Breivik M, Kvam E. Histometric study of root resorption on human premolars following experimental replantation. Scand J Dent Res 1987;95:273-80.
22. Loriato LB, Machado AW, Souki BQ, Pereira TJ. Late diagnosis of dentoalveolar ankylosis: impact on effectiveness and efficiency of orthodontic treatment. Am J Orthod Dentofacial Orthop 2009;135:799-808.
23. Lin F, Sun H, Yao L, Chen Q, Ni Z. Orthodontic treatment of severe anterior open bite and alveolar bone defect complicated by an ankylosed maxillary central incisor: a case report. Head Face Med 2014;10:47.
24. Gomes JC, Gomes CC, Bolognese AM. Clinical and histological alterations in the surrounding periodontium of dog’s teeth submitted for an intrusive luxation. Dent Traumatol 2008;24:332-6.
25. Frost HM. The regional acceleratory phenomenon: a review. Henry Ford Hosp Med J 1983;31:3-9.
26. Wigen TI, Agnalt R, Jacobsen I. Intrusive luxation of permanent incisors in Norwegians aged 6-17 years: a retrospective study of treatment and outcome. Dent Traumatol 2008;24:612-8.
27. Proffit WR, Fields HW, Sarver DM. Contemporary Orthodontics, 5th Edition. Amsterdam: Elsevier, 2012;287.
28. Pepersack WJ. Tooth vitality after alveolar segmental osteotomy. J Maxillofac Surg 1973;1:85-91.
29. Vedtofte P, Nattestad A. Pulp sensibility and pulp necrosis after Le Fort I osteotomy. J Craniomaxillofac Surg 1989;17:167-71.