Orthotown August 2017 - 24

message board

Inverted Impacted Teeth,
Patience Is a Virtue
In this age of accelerated treatment done at the "right" time,
some patients still need early evaluation, recall and extended care.

amgortho
Member Since: 08/19/13
Post: 1 of 5

Introduction:
A 9-year-old boy was found to have two impacted incisors, #7 and #8. He had no history of
trauma. #8 was completely inverted with the facial aspect of the crown to the lingual/palatal.
The occlusion was Class I with moderate crowding and a straight facial profile with an ANB
angle of 3 degrees.
Phase I treatment was initiated with fi xed appliances. After the #7 and #8 space opening,
#7 erupted. Inverted tooth #8 was prepared for an expose and bond. The crown of #8 was first
bonded on the lingual aspect. A step-down bend was made in the .019x.025 wire so that #8 elastic
thread could be positioned to pull slightly to the mesial.
Attention was given for the #8 crown not to come through the mucosa during extrusion
rotation, to avoid any future gingival defect of attached gingiva. After 20 months of gentle eruption
forces with an elastic thread, #8 was exposed for a second time for bonding on the facial aspect.
At this time, the tooth was rotated 90 degrees, parallel to the occlusal plane, with the crown
prominently protruded under the mucosa. #8 was gently extruded and rotated from the facial
aspect for another eight months.
After 28 months, the full clinical crown #8 had been gently erupted into the oral cavity
through the attached gingiva. Phase I orthodontic treatment was completed. All teeth were bonded
and Phase II orthodontic treatment continued. The patient had developed a mild open bite. All
teeth were leveled and aligned and orthodontic treatment completed. Roots of #7, #9 and #10
remained healthy. #8 had only mild root resorption and maintained vitality.
The total orthodontic treatment time of Phase I continuing into Phase II treatment was 5 years,
5 months. The family was very happy that tooth #8 could be saved for this young patient. This
young man started to develop a mild Class III growth pattern during the last year of treatment
with ANB of -3 degrees at debond, mild Class III right side. This will be addressed at age 21
once the patient is completely done growing.

Continued on p. 26

24

JULY/AUGUST 2017 // orthotown.com


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Table of Contents for the Digital Edition of Orthotown August 2017

Orthotown.com Highlights
Embrace Progress: The Standard of Care (Records, Anyone?)
Industry News
New Products
Message Board: Girl with Systemic Lupus Erythematosus
Message Board: Inverted Impacted Teeth, Patience is a Virtue
Office Visit: What's Up Doc?
The Speed of Light
What's Your M.O?
Untangling Web Marketing
Ad Index
Orthotown August 2017 - Cover1
Orthotown August 2017 - Cover2
Orthotown August 2017 - 1
Orthotown August 2017 - 2
Orthotown August 2017 - 3
Orthotown August 2017 - 4
Orthotown August 2017 - 5
Orthotown August 2017 - Orthotown.com Highlights
Orthotown August 2017 - 7
Orthotown August 2017 - Embrace Progress: The Standard of Care (Records, Anyone?)
Orthotown August 2017 - 9
Orthotown August 2017 - 10
Orthotown August 2017 - 11
Orthotown August 2017 - Industry News
Orthotown August 2017 - 13
Orthotown August 2017 - New Products
Orthotown August 2017 - 15
Orthotown August 2017 - 16
Orthotown August 2017 - 17
Orthotown August 2017 - 18
Orthotown August 2017 - 19
Orthotown August 2017 - Message Board: Girl with Systemic Lupus Erythematosus
Orthotown August 2017 - 21
Orthotown August 2017 - 22
Orthotown August 2017 - 23
Orthotown August 2017 - Message Board: Inverted Impacted Teeth, Patience is a Virtue
Orthotown August 2017 - 25
Orthotown August 2017 - 26
Orthotown August 2017 - 27
Orthotown August 2017 - Office Visit: What's Up Doc?
Orthotown August 2017 - 29
Orthotown August 2017 - 30
Orthotown August 2017 - 31
Orthotown August 2017 - 32
Orthotown August 2017 - 33
Orthotown August 2017 - 34
Orthotown August 2017 - 35
Orthotown August 2017 - The Speed of Light
Orthotown August 2017 - 37
Orthotown August 2017 - 38
Orthotown August 2017 - 39
Orthotown August 2017 - 40
Orthotown August 2017 - 41
Orthotown August 2017 - 42
Orthotown August 2017 - 43
Orthotown August 2017 - What's Your M.O?
Orthotown August 2017 - 45
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Orthotown August 2017 - Untangling Web Marketing
Orthotown August 2017 - 61
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Orthotown August 2017 - Ad Index
Orthotown August 2017 - Cover3
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