Orthotown November 2017 - 43
Figs. 2-6: Courtesy of Planmeca Romexis.
Fig. 1: The 2014 panoramic radiograph from the pediatric dentist revealed
that something could be going on, but left much to be interpreted. At this
point, no referral was made.
Fig. 2: The 2017 panoramic radiograph from the pediatric dentist. Referral
was made, at which point a CBCT scan was taken to determine the appropriate
course of treatment.
Figs. 3 and 4: Images from the CBCT scan reveal the damage to the maxillary
left lateral incisor (left) and the maxillary right lateral incisor (right).
Fig. 5: Images from the CBCT reveal
the damage to the maxillary right
lateral incisor and the relationship
between the maxillary right canine
and the maxillary right lateral incisor.
Fig. 6: Images reveal some damage to
maxillary left central incisor.
Case study
Figs. 7 and 8: Photos of extracted maxillary
right lateral incisor, left, and maxillary left
lateral incisor reveal damage that could have
been prevented.
Here's a situation where a CBCT scan could have made a significant difference
if it had been taken sooner; the patient likely would have been able to keep her
laterals and avoid canine substitution. Without a CBCT scan, you wouldn't
recognize there may be a problem with the laterals, because
things appear fine.
This case shows how the lack of appropriate imaging/
monitoring can be disastrous for a patient. This could have been
prevented had serial extractions or expansion been completed;
the extractions would have provided the necessary room for the
maxillary canines to redirect, thereby potentially saving the laterals.
At the very least, periodic radiographs should have been taken to
reveal whether damage to the maxillary laterals was occurring/
continuing. Additionally, the patient should have received a
referral to an orthodontist for monitoring. Unfortunately for
this patient, none of this was done.
orthotown.com \\ NOVEMBER 2017
43
http://www.orthotown.com
Table of Contents for the Digital Edition of Orthotown November 2017
Orthotown November 2017 - Cover1
Orthotown November 2017 - Cover2
Orthotown November 2017 - 1
Orthotown November 2017 - 2
Orthotown November 2017 - 3
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