Orthotown June 2017 - 36
Case studies
I have found MOP to be an adjunct
to orthodontic appliances and aligners
for potentially aiding tooth movement in
appropriate cases (Figs. 1 and 2).1 HFV
can be used with an aligner seater with
five-minute daily use by the patient (Fig.
3). Both techniques are now incorporated
in my practices.
Attention now turns to using these
techniques on difficult orthodontic cases
with braces or clear aligners. The list of these
malocclusions is long and includes impacted
teeth that are not emerging efficiently,
transverse expansion, open bites that are
not closing, and teeth that are failing to
Fig. 1: Manual
osteoperforation
(MOP) device
Fig. 2: Power
MOP device
erupt. Traditional treatment options in these
cases-Wilckodontics, luxation, osteotomy
and extraction, for example-are often
considerably invasive, risky and expensive.
"Saving" the case with techniques that are
less invasive is therefore a most desirable
intention.
Fig. 3: Highfrequency
vibration (HFV)
device
When addressing difficult cases, I
perform more MOP and often perforate
as apically as possible because the tooth
stubbornness is often located well along the
root. The advantage of the MOP system, in
my opinion, is that treatment can be targeted
to and localized in the area of most need.
CASE 1
IMPACTED CANINE
A 15-year-old patient presented
with an impacted upper right canine
that was surgically exposed after six
months in braces (Figs. 4-6).
Eight months beyond the exposure
time, the canine had emerged but was not
moving anymore and was instead acting
as an anchor to the surrounding teeth
(Fig. 7). MOP was performed around
the offending root and neighboring
ones (Fig. 8). Four weeks later, some
progress was observed (Fig. 9). Four
months later, MOP was applied again
and extended mesial to the lateral
incisor (Fig. 10). Two months after the
second MOP session, the case was back
on track without luxation or further
surgery (Fig. 11).
At 21 months, the patient still
required some finishing.
Fig. 9: Progress
36
JUNE 2017 // orthotown.com
Fig. 4: A female patient, age 15 years, 3 months
Fig. 5: Pre-orthodontic intraoral right
Fig. 6: Pre-orthodontic panoramic film
Fig. 7: Nonmoving upper right canine
Fig. 8: MOP upper right
Fig. 10: Second application of MOP
Fig. 11: Back on track
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Table of Contents for the Digital Edition of Orthotown June 2017
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