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This clinical case report presents the nonsurgical orthodontic treatment of a patient with skeletal Class II malocclusion, posterior crossbite, anterior open bite, accentuated dental discrepancies in both arches, and an odontoma. The proposed treatment involved maxillary expansion, extraction of atypical maxillary lateral incisors and mandibular first molars, and intrusion of maxillary teeth with the aid of mini-implants. The results obtained with these procedures included good tooth alignment, normal overbite and overjet, removal of the odontoma, and a harmonious smile. In complex cases, an accurate diagnosis is the key to a favorable outcome.

Orthodontic treatment for adult patients who have mutilated dentitions can be clinically challenging. A 58-year-old man with several occlusally abraded teeth, a congenitally missing maxillary lateral incisor, and prior implant placement sought orthodontic treatment and restoration. Prosthetic restoration would not be possible. The "dilemma" for this patient was whether to trephine and remove an existing implant and make space for a new lateral incisor implant, or to restore the maxillary canine as a lateral incisor.

Introduction The aim of this study was to compare the prevalence of agenesis of the maxillary lateral incisors in the cleft area of patients with unilateral cleft lip and palate with and without Simonart's band. Methods A sample of panoramic radiographs of 121 patients with a mean age of 7 years was divided into 2 groups: group 1 included 60 patients with Simonart's band, and group 2 included 61 patients without Simonart's band. Patients with syndromes were not included. Chi-square tests were used for intergroup comparisons (P Results In the pooled subgroup, the prevalences of maxillary lateral incisor agenesis, supernumerary maxillary lateral incisors, 1 maxillary lateral incisor mesial to the cleft, and 1 maxillary lateral incisor distal to the cleft were 40.5%, 12.5%, 8.2%, and 38.8%, respectively. In group 1, these frequencies were 35%, 10%, 6.7%, and 48.3%; in group 2, they were 45.9%, 13.1%, 11.5%, and 29.5%. There was a statistically significant difference between the groups for the prevalence of a maxillary lateral incisor distal to the cleft. Conclusions The presence of Simonart's band is associated with a higher frequency of maxillary lateral incisor development in the maxillary process.

Introduction The purpose of this research was to investigate relationships among the location and orientation of palatally displaced canines and the dimension and orientation of the maxillary lateral incisor. Methods An experimental group of 40 patients with 46 palatally displaced canines (20 from boys, 26 from girls; mean age of the subjects, 13.9 years; age range, 10.5-15.9 years) was selected from the records of patients referred to a radiology practice specializing in cone-beam volumetric tomography imaging. This group was age- and sex-matched with 30 normal subjects with 60 canines (26 from boys, 34 from girls; mean age of the subjects, 13.8 years; age range, 10.4-15.7 years). Digital cone-beam volumetric tomography images were imported into an imaging software and were reoriented and reconstructed into several radiographic images in coronal and sagittal sections; a maxillary arch occlusal view was also produced. The angular and linear variables of the canines and the maxillary lateral incisors were measured by using software measurement tools. Independent t tests or Mann-Whitney U tests were used accordingly based on normality of the data to compare the variables between the palatally displaced canine and the control groups. Multiple linear regressions were used to examine the relationships between the canine variables (dependent variables) and the maxillary lateral incisor variables together with confounding variables (independent variables). Results The maxillary lateral incisors in the palatally displaced canine group tended to be more upright in the sagittal and coronal planes. Generally, the most significant independent variables according to backward examination of linear regression for canine variables (coronal and sagittal angulations, and distance to the occlusal plane of palatally displaced canines) were the coronal and sagittal angulations of the maxillary lateral incisors, the length and buccolingual root width of the maxillary lateral incisors, and age. Conclusions The orientation and location of palatally displaced canines were associated with changes in the angulations of maxillary lateral incisors and small lateral incisors.

Introduction: The goal of this study was to compare the dimensions of maxillary lateral incisors in subjects with and without palatally displaced canines. Methods: An experimental group of 40 patients with 46 palatally displaced canines (20 in boys, 26 in girls; mean age, 13.9 years; range, 10.5-15.9 years) was selected from the records of patients referred to a radiology practice specializing in cone-beam volumetric tomography imaging. The palatally displaced canine group was age- and sex-matched with 30 normal subjects with 60 canines (26 in boys, 34 in girls; mean age, 13.8 years; range, 10.4-15.7 years). Cone-beam volumetric tomography DICOM files were imported into Dolphin Imaging software (version 11.0; Dolphin Imaging & Management Solutions, Chatsworth, Calif), and the volumetric images were reoriented with the long axis of the lateral incisor vertical and then reconstructed into images of a sagittal slice through the maxillary lateral incisors and 3 axial slices across the maxillary lateral incisor root. The linear variables of the maxillary lateral incisors were measured by using digital measurement tools. The widths of the maxillary lateral incisor roots were registered at the cementoenamel junction level, 4 mm apical to the cementoenamel junction level and 8 mm apical to the cementoenamel junction level. An independent t test was used to test for differences between the groups, because the data were normally distributed. Results: In the group with palatally displaced canines, the mean length of the maxillary lateral incisors was 2.1 mm shorter (P

In this case report, we present an unusual approach that was used to treat a 14-year-old patient with a bilateral canine-premolar transposition and a missing maxillary lateral incisor. The orthodontic treatment involved maintaining the transposition and creating a space for lateral incisor replacement. Toward the end of the treatment, accentuated buccal root torque was performed, and lateral group function was established to improve the treatment outcome. Finally, an ideal esthetic and functional occlusion was achieved. The 8-year posttreatment follow-up records show the stability of this treatment.

In this in-vitro study, we compared the shear bond strengths of orthodontic brackets bonded to various commonly used esthetic pontic materials.Prefabricated denture teeth (acrylic resin, Trubyte, Dentsply, York, Pa) and samples made from Integrity (bis-acryl composite resin, Dentsply Caulk, Milford, Del) and Alike (polymethylmethacrylate resin, GC America, Alsip, Ill) were used to represent the more common esthetic provisional materials. Each material group contained 30 samples; a total of 90 samples were bonded in the same fashion with APC PLUS maxillary lateral incisor brackets (3M Unitek, Monrovia, Calif). Each material group was then divided into 2 testing subgroups. One subgroup was tested for shear bond strength 24 hours after bonding, and the other subgroup was tested after bonding and storage in distilled water at 37 degrees C for a week. Each bracket was loaded perpendicularly in a universal testing machine at a crosshead speed of 1.0 mm per minute until bonding failure. The mean shear bond strength and standard deviation were determined for each group. Analysis of variance (ANOVA, 2-factor and 1-factor) with Tukey HSD post-hoc tests, Student t tests, and Mann-Whitney U tests were used to test the main effects of pontic materials and time of loading (alpha = 0.05). The data were stratified, and 1-way ANOVA tests were performed with the Bonferroni adjustment (alpha = 0.01) to examine the effect of the pontic material on shear bond strength after either 1 day or 7 days of storage.Significant differences were found based on pontic material and time (P0.05), but there was a significant interaction (P = 0.044), making the results uninterpretable. At 1 day, the Integrity material had a significantly higher mean shear bond strength than both Alike and the denture tooth materials (P0.001). However, at 7 days, both Integrity and Alike had significantly higher mean shear bond strengths compared with the prefabricated denture tooth (P0.001).Although the use of Integrity or Alike requires an additional armamentarium, necessitating individual pontic fabrication by the dental practitioner, indications for clinical use are evident with direct applications to multi-disciplinary treatment modalities.

Introduction Malocclusion is an increasingly common, multifactorial problem. The most prevalent malocclusion results from excess tooth size compared with the size of the supporting bone; this creates a tooth-size arch-size discrepancy. Although the causes of malocclusion are obscure in most instances, a contributing factor appears to be tooth size. The goal of this study was to test whether the dimensions of the crowns of the permanent teeth differ in young men with naturally good occlusions compared with those who required orthodontic treatment. Methods Tooth crown dimensions (mesiodistal and buccolingual) were measured in 2 samples of American white men. One group (n = 42) had naturally good occlusion; the other group (n = 90) required orthodontic treatment to correct tooth-size arch-size discrepancy. Results The means of 23 of the 24 tooth crown dimensions—involving the 14 tooth types (central incisor through first molar) in both arches—were significantly larger in subjects with malocclusions than in those with good occlusions. Multivariable analysis showed that mesiodistal size of the maxillary lateral incisor was the most significant difference between the 2 samples, but this might reflect the composition of the sample (maxillary lateral incisor size is notoriously variable in white men). Conclusions Tooth size is not necessarily the foremost cause of malocclusion in a patient, but it should be evaluated.

A 48-year-old man, otherwise in good health, was seen with a chronic painful fissure of the upper lip mucosa. For at least 2 years it had failed to respond to a variety of topical agents. Though not previously reported, the primary etiologic factor was thought to be irritation from contact with his misaligned anterior teeth. Eight months into orthodontic treatment, the lesion healed and did not return. Orthodontics included preadusted edgewise mechanics. However, the right maxillary lateral incisor was not bracketed but instead guided into position by direct contact with the archwire. (Am J Orthod Dentofacial Orthop 2001;119:71-5)

This is a case report of a 23-year-old black woman with a skeletal Class II Division 1 malocclusion and an anterior open bite. The maxillary central incisor root was severely dilacerated, a maxillary lateral incisor and canine were transposed, a maxillary canine was impacted near the orbital rim, and a mandibular secong premolar was congenitally missing. Selective extractions and attention to detail provided outstanding occlusal function and improved facial esthetics. (Am J Orthod Dentofacial Orthop 1999;115:148-52)

Introduction The objectives of this study were to evaluate the prevalence of dental anomalies in patients with agenesis of maxillary lateral incisors and to compare the findings with the prevalence of these anomalies in the general population. Methods A sample of 126 patients, aged 7 to 35 years, with agenesis of at least 1 maxillary lateral incisor was selected. Panoramic and periapical radiographs and dental casts were used to analyze other associated dental anomalies, including agenesis of other permanent teeth, ectopia of unerupted permanent teeth, microdontia of maxillary lateral incisors, and supernumerary teeth. The occurrence of these anomalies was compared with prevalence data previously reported for the general population. Statistical testing was performed with the chi-square test (P Results Patients with maxillary lateral incisor agenesis had a significantly increased prevalence rate of permanent tooth agenesis (18.2%), excluding the third molars. The occurrence of third-molar agenesis in a subgroup aged 14 years or older (n = 76) was 35.5%. The frequencies of maxillary second premolar agenesis (10.3%), mandibular second premolar agenesis (7.9%), microdontia of maxillary lateral incisors (38.8%), and distoangulation of mandibular second premolars (3.9%) were significantly increased in our sample compared with the general population. In a subgroup of patients aged 10 years or older (n = 115), the prevalence of palatally displaced canines was elevated (5.2%). The prevalences of mesioangulation of mandibular second molars and supernumerary teeth were not higher in the sample. Conclusions Permanent tooth agenesis, maxillary lateral incisor microdontia, palatally displaced canines, and distoangulation of mandibular second premolars are frequently associated with maxillary lateral incisor agenesis, providing additional evidence of a genetic interrelationship in the causes of these dental anomalies.

Introduction The objectives of this study were to evaluate the prevalence of dental anomalies in patients with agenesis of maxillary lateral incisors and to compare the findings with the prevalence of these anomalies in the general population. Methods A sample of 126 patients, aged 7 to 35 years, with agenesis of at least 1 maxillary lateral incisor was selected. Panoramic and periapical radiographs and dental casts were used to analyze other associated dental anomalies, including agenesis of other permanent teeth, ectopia of unerupted permanent teeth, microdontia of maxillary lateral incisors, and supernumerary teeth. The occurrence of these anomalies was compared with prevalence data previously reported for the general population. Statistical testing was performed with the chi-square test (P Results Patients with maxillary lateral incisor agenesis had a significantly increased prevalence rate of permanent tooth agenesis (18.2%), excluding the third molars. The occurrence of third-molar agenesis in a subgroup aged 14 years or older (n = 76) was 35.5%. The frequencies of maxillary second premolar agenesis (10.3%), mandibular second premolar agenesis (7.9%), microdontia of maxillary lateral incisors (38.8%), and distoangulation of mandibular second premolars (3.9%) were significantly increased in our sample compared with the general population. In a subgroup of patients aged 10 years or older (n = 115), the prevalence of palatally displaced canines was elevated (5.2%). The prevalences of mesioangulation of mandibular second molars and supernumerary teeth were not higher in the sample. Conclusions Permanent tooth agenesis, maxillary lateral incisor microdontia, palatally displaced canines, and distoangulation of mandibular second premolars are frequently associated with maxillary lateral incisor agenesis, providing additional evidence of a genetic interrelationship in the causes of these dental anomalies.

Introduction Orthodontic space opening during adolescence is a common treatment for congenitally missing maxillary lateral incisors. Because of continued facial growth and compensatory tooth eruption, several years can elapse between completion of orthodontic treatment for a teenage patient and implant placement. There are reports that, after successful orthodontic opening of the implant space, the central incisor and canine roots reapproximate during retention and prevent implant placement. Methods To study this phenomenon, the records of 94 patients with missing maxillary lateral incisors were collected. Periapical and panoramic radiographs were used to measure intercoronal and interradicular distances between the central incisor and the canine adjacent to the missing lateral incisor before and after orthodontic treatment and at implant placement. Results Although root approximation between the adjacent central incisor and canine during retention did not occur consistently, 11% of the patients experienced relapse significant enough to prevent implant placement. Conclusions To ensure sufficient space for implant placement, we recommend at least 6.3 mm of intercoronal space and 5.7 mm of interradicular space between the adjacent central incisor and canine. A bonded wire or resin-bonded bridge will help to reduce root approximation that might occur during retention.

The purpose of this report is to review the orthodontic treatment of a patient with bilateral transposition of maxillary canines and first premolars in addition to congenital absence of a maxillary lateral incisor. This unique combination of factors led to substitution of the maxillary left first premolar for the left lateral incisor. The occlusal fit, gingival form, and esthetic appearance of premolar/lateral incisor substitution are discussed.

The present investigation was done to evaluate the incidence and distribution of root proximity after orthodontic treatment and to test the hypothesis that interproximal areas with thin interdental bone provide less resistance against marginal periodontal breakdown than areas with normal width of bone between the roots. Only adult patients were examined at least 16 years after active orthodontic treatment. The distance between the roots was measured directly on periapical radiographs. Gingival health, level of connective tissue attachment, and clinical scores for bone levels in sites with thin interdental bone and neighboring or contralateral sites with normal width of bone between the roots were compared. Among the 400 patients studied, 25 had unilateral or bilateral areas with root proximity. Root proximity was diagnosed between maxillary central and lateral incisors in 18 patients, between mandibular central and lateral incisors in two patients, and between maxillary lateral incisor and canine, maxillary first and second molars, mandibular canine and first premolar, mandibular first and second premolars, or mandibular first and second molars in only one patient. No statistically significant differences in inflammation, level of attachment, and bone level were observed between root proximity sites and control sites. The results indicate that anterior teeth are not predisposed to more rapid periodontal breakdown when roots are in close proximity. Too few molar sites were included to draw conclusions regarding such areas.