Many patients have slightly crowded or overlapping anterior teeth. There is no doubt that the best way to treat the anterior crowding in the upper and in the lower arches requires the bonding of brackets to the teeth. However this is not satisfactory for the adult patients. If a patient is unable to accept comprehensive orthodontic procedures, the practitioner must determine whether the patient can be treated with minor tooth movement, restorations (bonding, laminate or crowning), reconturing/striping, extraction or a combination of these procedures. A thorough evaluation of the patient needs and expectations will establish the correct approach for the potential treatment options.
Using a 0,018 inch NiTi wire as a flexible lingual retainer to solve the relapse of the lower anterior teeth was for the first time an application of ERIC and his Co-workers.
The aim of this case presentation is to explain these different clinical application, especially the application procedures of a 0,014 NiTi at lingual/ palatine arches used to solve the crowding case. The 0.014 preformed NiTi wire must be cut longer then the intercanine length regarding the degree of crowding. The lingual/palatine surfaces of the teeth are cleaned, etched and bonded as a normal retainer. The wire is tightly tied to fit each tooth using a inter dental floss and after that the retainer was bonded. The result achieved is a good tooth alignment in a short period of time ( 6-8 months) and with very good aesthetic in such simple ways.
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdf
Correction of crowding teeth in adults. FDI Annual World Dental Congress 2013
1. Correction of crowding teeth in
adults, simple approaches.
Cases report
PhD. Doris Mingomataj1, Ph.D. Edlira Baruti2
1Faculty of Dentistry, Albanian
University, Tirana, Albania
2Faculty of Dentistry, American University
of Tirana, Albania
4. A. G.
31 Year
Male
Diagnoza
• Open Bite
• Super Cl I
• Missing # 13
Before
AfterTreatment
• Porcelain laminate
veneers #12 to #23
• Implant at # 13 position
• 4/5 crowns: # 14, 24, 25
• Direct composite rest.
#16 & #26.
Years later
Orthodontics was
presented as a first
option, but the patient
declined this treatment
option because of the
long time treatment
required.
5. Diagnosis:
• Dissaligned anterior teeth
• Crowded anterior inferior
teeth
Treatment:
• 11, 21, Porcelain laminate
veneers
• Recontouring of lower
anterior teeth
M. K.
34 Year Female
Before
Few years later
After
Treatment time:
• 2 weeks
6. Diagnosis:
• Disaglined theeth
• Missing teeth
Treatment:
• Endodontics & restaurations
• Crowns, bridge
• Implant at # 36
W. H.
54 Year Male
Before After
Treatment time:
• 3 months
8. V. S.
28 Year Female
4 years later
The restorations are
still in good conditions
& all we have to do is
just polish them.
9. Diagnoses:
• Anterior crowded teeth
• Posterior crossbite
• Occlusal interference
• # 36 Continues failure
of restauration
• TMD
Treatment:
Stage I:
• Direct restoration
• Fixed prosthodontics
Stage II:
• Orthodontics
I. T.
25 Year Female
Treatment time:
• Almost 5 months
10. Aim:
Correction of:
• Posterior crossbite
• Oclusale interference
Stage I:
• Direct restoration
• Fixed prosthodontics
I. T.
25 Years Female
Before After
Treatment time:
• 9 days (3 stops)
11. Orthodontic Stage:
• Upper NiTi 0.014 retainer
• TMJ appl at the end
Treatment tjme:
• Almost 4 months
Aim:
Correction of:
• Anterior crowding teeth
•Orthodontic stage
consisted in a upper NiTi
0,014 retainer
I. T.
25 Years Female
13. Diagnoses:
• Anterior disaglined teeth
• Oclusale interference
• TMD
• Early missing of 36, 46
Treatment:
Stage I:
• Orthodontics
Stage II:
• Direct restoration
• Fixed prosthodontics
Treatment time:
• Nearly 3 months
Before
D. S.
26 Year Female
14. Treatment:
Stage I
• Direct composit
restauration (Lower)
• Upper Ni Ti 0,014 retainer
• Fiber reinforced splinting
Stage II
• Fixed prosthodontics
D. S.
26 Year Female
Before After
StageIStageII
16. L. LL.
30 Year Female
Diagnoses:
• Cl. II malocclusion
• Slight anterior crowding
• Already treated orthodonticly
Treatment:
• Upper Ni Ti 0,014
retainer
• Reshape after
aglinement
• TMD appliance
Treatment time:
• Nearly 3 months (3 stops)
17. L. I 35 years old
Diagnoses:
• Cl. II malocclusion
• infraocclusion of the tooth nr
12
• Already treated orthodonticly
Treatment:
• Upper Ni Ti 0,014
retainer
Treatment time:
• 1 months (2 stops)
18. Periodontal problems
at tooth nr 12 because of
the occlusal trauma
Intrusion of the tooth nr
12
Beefore After
20. Skaner show that roots are
at the cortical bone so the
retreatment with regular
orthodontics will cause
damages and probably
fenestration of vestibular
cortex
L.LL 30 years old , female
21. Treatment:
• Upper Ni Ti 0,014
retainer
• Reshape after
aglinement
Treatment time:
• Nearly 3 months
• 3 stops
Before After
As she insisted for the treatmentwe used upper NiTi 0.014 retainer, reshaped
the teeth after alignement . This short and easy treatment was very
satisfactory for her.
L.LL 30 years old , female
22. Diagnosis:
• Crowded anterior teeth
• Cl. I molar relationship
Treatment:
• Alignement using:
• Striping
• Duble NiTi 0.014 retainer
• Fiber reinforced splinting
E. J.
35 Year Female
Before
Treatment time:
• 9 months
27. There are many option of treatment
available for correcting crowded teeth,
including esthetic contouring, bonding,
porcelain laminates, and crowns.
The condition of the existing dentition is a
factor in determining which restorative option
is ideal, without undervaluating the patients
wills.
Notes de l'éditeur
Orthodontics is generally the first consideration when the patient presents with crowded teeth, but when this treatment is not possible, there are menyather treatment options, from crown &bridgis, to direct composite restaurations, bonded laminate veneers, recontouring, striping or minor tooth movement. The practicioner must determine the right path to choose.
Choosing the correct approach is the most important aspect of the treatment. The question is how to treat these cases?
Changes can be additive, subtractive, or both, in this patient we decided correcting the malshaped anterior upper tooth using porcelain veneers, and crowded lower tooth using recontouring.
The condition of the existing dentition is a factor in determining which restorative option is ideal. therefore the best treatment choice in this case was fixed prosthodontics.
existing restorations are easily incorporated into other restorative treatments. As the patient was seeking immediate esthetic improvement, the only option was direct composite restaurations.
Repetedfrakturesoftooth 36 andpatientkeptcomplainingfrompreviouswork, not at all happy aboutit, he wants a final solutiontotheproblemt. The examshowedbesidetheanteriorcrowdedteeth, a posteriorcrossbite, wich in fact was causingocclusalinterference, resulting in failieroftherestauration. thatswhywedecidedtofirstcorrectthecrossbite, andthentoimproveesthetics.
This is the final result of the treatment.
Diastemas are present at both upper and lower anterior tooth. She presented occlusalinterfernces & TMD, cosed even by the early missing of # 36 and 46.
UpperNiTi 0,014 retainer was usedfortheminortoothmovementrequiredtoclosediastemeand a goodaglinementofanteriorteeth, after thattheFiber reinforcedSplinting– In theloweranteriorteethdirectcompositerest. Wasused.-thesecondstageconsisted in 2 bridgesofporcelainfussedtometal.
Improuvement of both arches is shown in this slide.