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Download Edgren -- Interceptive Treatment of Impacted Teeth Utilizing CBCT
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Early Interceptive Treatment of Impacted Teeth Utilizing CBCT and the Frontal Analysis. Presenter: Brad Edgren DDS/MS The Fundamental Objectives of Early Intervention: • Normalization of Skeletal Dysplasias and Asymmetries • Developing jaw size to encourage the proper eruption of the permanent teeth • Improvement of Occlusal Function • Intervention and termination of recalcitrant habits (i.e. thumb and finger sucking) ! • Utilization of future Growth • Recognition of excessive growth, i.e. the mandible Advantages of Early Orthodontic Intervention: • Reduces tooth extractions • Reduces the incidence of the impaction of teeth (e.g. Canines) • Reduces the possibility of Orthognathic surgery • Reduces the incidence of Temporomandibular Disorders • Children at age 7 are more cooperative and eager • The dentofacial skeleton is more receptive to maxillary expansion ! • Growth in some females is completed surprisingly early (age 10) Keys to Early Intervention with Dental Impactions: • Clinical Exam • Radiographic Imaging • Lateral and Frontal Cephalometric Analyses • Growth Analysis • Maxillary Expansion should be always considered - hence the need for the Frontal analysis • Diligent monitoring of all erupting teeth • Phase I treatment is not complete until the impacted teeth have erupted or are erupting normally • Radiographic Imaging at the end of Phase I treatment ! ! ! ! ! ! • Referral to an Oral Surgeon as necessary - the earlier is better Benefits of the Frontal Analysis: • Detect Skeletal Asymmetries • Evaluation of the Maxillary and Mandibular Skeletal widths • Evaluation of Dental Arch widths • Evaluation of Nasal widths • Turbinate enlargement evaluation • Angulation and Position of Impacted teeth • Dental midlines compared to Skeletal midlines • Occlusal cants ! ! • Pathology References: Edgren B. The frontal cephalometric analysis - the forgotten perspective. Orthod Pract 2013;4(5): 28-33. Sambataro S et al. Early Predictive variables for upper canine impaction as derived from posteroanterior cephalograms. Angel Orthod 2004;75:28-34. Schindel RH, Duffy SL. Maxillary transverse discrepancies and potentially impacted maxillary canines in mixed-dentition patients. Angle Orthod 2007;77:430-35. Miner RM et al. Cone-beam computed tomography transverse analysis. Part 1: Normative data. Am J Orthod Dentofacial Orthop 2012;142:300-7. Baccetti T et al. Interceptive treatment of palatal impaction of maxillary canines with rapid maxillary expansion: A randomized clinical trial. Am J Orthod Dentofacial Orthop 2009;136:657-61. Baccetti T et al. Treatment timing for rapid maxillary expansion. Angle Orthod 2001;71:343-350. Ericson S, Kurol J. Early treatment of palatally erupting maxillary canines by extraction of the primary canines. Eur J Orthod 1988;10(1):283-295. ! !
