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Titanium screw anchorage for traction of many impacted teeth in a patient with cleidocranial dysplasia

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Introduction: Cleidocranial dysplasia (CCD) is a rare inherited skeletal dysplasia, often with prolonged retention of deciduous teeth and several impacted permanent successors and supernumerary elements. Methods: This article demonstrates the usefulness of titanium screws for orthodontic anchorage to induce eruption of the impacted teeth in a patient with CCD. A boy, aged 10 years 11 months, had a number of impacted permanent teeth. After the supernumerary teeth were extracted and the incisors were surgically exposed, 2 titanium screws were placed in the palate without incisions or flap surgery. After implantation, a lingual arch appliance was placed, and orthodontic load began 4 weeks after surgery with an elastic chain. Results: After 4 months of traction, 3 impacted incisors had erupted into the mouth. Conclusions: This new method for retraction of impacted teeth can reduce the patient’s treatment time and psychological stress. Treatment with titanium screws for traction of impacted teeth might be a new treatment strategy for managing CCD patients.

Section snippets

Case presentation

A boy, aged 10 years 11 months, had a chief complaint of a protrusive chin and impacted permanent teeth. A concave profile due to maxillary hypoplasia was noted. On the panoramic radiograph, prolonged retention of the deciduous teeth and more than 20 impacted supernumerary and permanent teeth were observed in both jaws (Fig 1, A). Therefore, we planned extraction of the supernumerary teeth and traction of the impacted permanent teeth. After placement of a lingual arch appliance in the maxilla,

Discussion

Dental treatment of adult CCD patients mainly consists of a surgical-prosthetic approach. After extraction of supernumerary teeth or retained deciduous teeth, dental implants or dentures are placed to reconstruct the occlusion.3, 4 However, a surgical-orthodontic approach is generally planned for adolescent CCD patients.5, 6, 7, 8, 9 In general, removal of deciduous and supernumerary teeth will improve the possibility of spontaneous eruption.5 However, Jensen and Kreiborg6 reported that most

Conclusions

This new method of retraction of many impacted teeth can reduce the patient’s treatment time and psychological stress. Treatment with titanium screws for traction of impacted teeth might be a new treatment strategy for CCD patients.

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    Bone overlying permanent teeth should also be removed since histology studies show that alveolar bone in CCD has abnormal dense trabeculation with multiple reversal lines.17 Orthodontic treatment with mini-implant screws for traction of impacted teeth can reduce the treatment time for CCD patients.33 Leaving numerous deeply unerupted teeth in place is not an acceptable practice.

  • Forced eruption of a palatally impacted and transposed canine with a temporary skeletal anchorage device

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    However, a disturbance in the eruption of the maxillary canine is relatively common because the tooth can be deflected from its long and normal eruptive path by various sources of interference. A number of mechanics have been devised to recover impacted maxillary canines into occlusion.6-20,23,24 This patient had simultaneous impaction of the maxillary left canine with unilateral transposition of the maxillary left lateral incisor and canine.

  • Risks and complications of miniscrew anchorage in clinical orthodontics

    2014, Japanese Dental Science Review
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    Several kinds of TAD have been marketed, however; miniscrews made from Ti-6V-4Al alloy has gained acceptance among orthodontists and patients because of their biocompatibility, little discomfort, relatively noninvasive, and fewer limitation in placement [9,10]. Despite their small diameter and short length, miniscrews can provide stable anchorage for various types of tooth movements, including intrusion, retraction, and protraction [11–33]. On the contrary, the clinical use of miniscrew anchorage accompanies some risks and complications, which occur during screw insertion, under orthodontic loading, and during removal [34].

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