Orthotown August 2015 - (Page 12)

clinical orthodontics // message board Managing Missing Upper Canines Docs weigh in on cases involving missing upper canines and the various treatment planning options. Orthotown.com > Message Boards > Clinical Topics > Clinical Orthodontics > Managing Missing Upper Canines A Message from Dr. Dan Grob, Editorial Director of Orthotown Magazine The dilemma of missing upper canines poses many restorative and orthodontic challenges. Cosmetics, of course, is the most obvious, but the anatomy of the bicuspid usually utilized for replacement is also an issue. Dealing with the lingual cusp, the two roots as well as the tooth-size discrepancy are just some of the issues to be dealt with. This treatment of a patient with this problem more than adequately addresses this difficult situation. Str8edge Member Since: 07/17/11 Post: 1 of 14 Related Message Boards Class II, Div 1 Missing UL5 Missing UL5 Missing Laterals ... When and Why? Missing Laterals Introduction These cases are pretty rare, but I have seen two patients recently who are congenitally missing U3s. In this 16-year-old male there is no way I would consider trying to close the spaces, and my first thought is to keep things simple and just prepare the case for implants to replace the missing U3s, but I also considered the plan of mesializing the U4s into the 3s position and prepare for implants of the U4s. I can see a couple advantages to this. 1. Better bone at implant site (maybe?). 2. Less aesthetic implant site. 3. Easier retention (especially aesthetically). 4. Natural tooth at the cuspid position (not sure if this is an advantage). It almost seems like the extra work is not worth it, but are there other good reasons to consider this plan? What do you think in these cases where closing the space is not an option? ■ MAY 14 2015 zxzxzx Member Since: 02/28/03 Post: 2 of 14 In most orthodontic cases, the patient needs orthodontics and we make all of the significant decisions. In a case like this, the dentist, who will finalize the restorative, makes the major decisions. So I would talk with the GP now. If he or she is not that into restorative, ask the GP to recommend someone they work with, and throw your ideas at them, like implants in the #3 and #4 space. When I was new at this, I had a patient with seven missing teeth. I talked with the GP about my treatment plan, which was to leave one upper #3 in the #2 position. He's OK with that. "Sounds great, Charlie." So when it is time to restore the case, he sends her to a prosthodontist who goes ape that I have a canine in the lateral position and wants me to redo the case. I'm pretty accommodating, but that time I said I was done, both because the GP OK'd the original plan and because the kid was not into ortho as much as I was. ■ MAY 14 2015 Str8edge Member Since: 07/17/11 Post: 3 of 14 Good advice. I will speak with the GP. I find that a lot of times when I ask these types of questions they rarely give me a straight answer because they don't really know, either. Especially in a case like this, which is unusual-missing both upper canines-but at least if you ask, you can say you asked! ■ MAY 14 2015 12 JULY/AUGUST 2015 // orthotown.com http://www.Orthotown.com http://www.orthotown.com/MessageBoard/thread.aspx?a=11&s=6&f=1295&t=160905&g=1 http://www.orthotown.com/MessageBoard/thread.aspx?a=11&s=6&f=693&t=152588&g=1 http://www.orthotown.com

Table of Contents for the Digital Edition of Orthotown August 2015

Orthotown.com Highlights
Embrace Progress: AAO Reflections
Poll
Managing Missing Upper Canines
Adult Class II Patient Possibility for Pre-Prosthetic Treatment
The Truth About Phase I Orthodontics
Ten Steps to Hire Slow— And Achieve Success Fast
Townie Choice Awards
A Review of “Uncomplicate Business”
Separating Your Practice from the Rest
10 Best Practices for Patient- Referral and Retention Programs
The Mini-Screw for Skeletal Anchorage in Pre-Prosthetic Orthodontics
The Use of Laser Technology in the Modern Orthodontic Practice
Ad Index

Orthotown August 2015