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Aim: This case report aimed to present an orthodontic mechanic alternative for space opening in a patient missing maxillary lateral incisors, using miniplates as anchorage, associated with self-ligating brackets., Background: Dental agenesis affects the population causing esthetic and functional damages. The prevalence of missing maxillary lateral incisors should be considered for its significant rate and negative impact on smile esthetics., Case Report: This treatment was chosen based on the presence of balanced facial pattern, large canine anatomy, the need to improve dental occlusion to prevent further wear, and patient's esthetic complaint. To obtain the results, upper third molars were extracted, and two miniplates were installed to distalize the upper arch with no need for patient compliance or auxiliary devices. Self-ligating brackets were used to reduce friction on posterior teeth, thus facilitating movement with light force application. At the end of 19 months, the patient presented with class I good overbite and overjet, and adequate space for implant and prosthetics; also, good facial esthetic was maintained., Conclusion: When indicated, space opening may provide excellent esthetics and functional results, and even more predictable results when skeletal anchorage miniplates are used to distalize all posterior teeth., Clinical Significance: Considering the high level of esthetic and functional compromise caused by dental agenesis, the technique hereby described represents a viable mechanic alternative within orthodontic possibilities.

Congenitally missing teeth are one of the most common tooth anomalies associated to therapeutic sets of problems. Orthodontists should consider these clinical cases because management often requires an integrated orthodontic and restorative approach. In the present study authors reported a therapy note referred to a 14-year-old male patient affected by missing maxillary lateral incisors, bilateral dental Class II and deep bite, treated in 2009 at the Department of Orthodontics of the University of Messina. An orthodontic treatment has been planned with the aim of distalize maxillary molar and the following opening of the spaces necessary for the prosthetic restoration of missing lateral incisor. For the distalization of maxillary molars has been decided to use a Distal Jet supported by miniscrew (Distal-Screw, American Orthodontics, Sheboygan, WI, USA). After seven months of treatment with distal screw, maxillary molar distalization was completed, obtaining a bilateral molar Class I. A multi-bracket orthodontic appliance was bonded in the upper and lower arch using Empower Brackets (American Orthodontics). Class II molar relationship has been over-corrected to Class I in about seven months. The orientation of the force vector resulted in a tipping and rotation of the first molars, without significant vertical changes. Distal Jet reinforced with screws seems to be effective in molar distalization without any type of side effects. The advantages of this device were the absence of patient compliance, relatively predictable outcomes, favorable esthetics, possibility of different activations in each side.

In patients with agenesis or enamel anomalies in anterior teeth combined orthodontic and restorative treatment is often necessary to achieve an optimal aesthetic result. How both can best be achieved, but also how to maintain the result, requires communication between the dentist and the orthodontist. The orthodontic treatment plan needs to be established in cooperation with the dentist who will carry out the restorative treatment while the patient is at a young age. Since with these young patients, who are still growing craniofacially and whose teeth are still developing, possible future restorative and/or orthodontic treatment, as well as the means of orthodontic retention, need to be included in the treatment plan. In cleft palate patients, it is also important that methods of orthodontic retention of maxillary arch width are given timely attention in the restorative treatment plan because it is especially vulnerable to relapse.

Introduction: Maxillary canine-first premolar transposition (Mx.C.P1) is an uncommon dental positional anomaly that may create many orthodontic problems from both esthetic and functional points of view., Objective: In this report we show the orthodontic management of a case of Mx.C.P1 associated with bilateral maxillary lateral incisor agenesis and unilateral mandibular second premolar agenesis, Methods: The patient was treated with a multibracket appliance and the extraction of the lower premolar., Results: treatment was completed without the need for any prosthetic replacement.

This is a case report about the successful orthodontic treatment of a bilateral cleft lip and palate patient by using a combination of bone grafting and subsequent prosthodontic rehabilitation. An adult patient with a bilateral cleft lip and palate presented with a concave profile, anterior and lateral crossbite, a markedly deep overbite, and residual bilateral alveolar clefts. His jaw movement patterns were unstable and irregular due to his collapsed bite. Orthodontic treatment with bilateral bone grafting improved his concave profile by downward and backward rotation of the mandible within the freeway space, and optimum occlusion and functionally stable and smooth jaw movements were obtained. After a 6-year retention period, no skeletal relapse could be detected, and his occlusal stability was satisfactory.

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., (Copyright © 2014 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

We successfully treated a nonsyndromic oligodontia patient with implant-anchored orthodontics and prosthetic restorations. A woman, age 18 years 11 months, had a straight profile and a skeletal Class I jaw-base relationship but had spaced arches because of 7 congenitally missing teeth. After leveling and alignment of the dentition, a titanium miniscrew was temporarily placed at the distal alveolus of the mandibular right first premolar, and the posterior teeth were mesialized to reduce the restorative spaces. After determination of the incisor positions, 3 dental implants were respectively inserted at the sites of the maxillary canines and the mandibular left lateral incisor with guided bone regeneration procedures. Then, screw-retained temporary prostheses were delivered after subepithelial connective tissue grafting and used for molar mesialization as absolute anchorage. After 36 months of active orthodontic treatment, an acceptable occlusion was achieved, both functionally and esthetically, with the 3 dental implants. The maxillary and mandibular molars were mesialized, but the changes of incisor position were minimal. As a result, a proper facial profile was maintained, and an attractive smile was achieved. The resultant occlusion was stable throughout a 3-year retention period. In conclusion, interdisciplinary treatment combined with orthodontics, implant surgery, and prosthodontics was useful for a nonsyndromic oligodontia patient. Especially, the new strategy-implant-anchored orthodontics-can facilitate the treatment more simply with greater predictability., (Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Unlabelled: Congenitally absent teeth may pose aesthetic and functional problems for patients. Treatment is often complex and involves a multidisciplinary team. Using retrospective data, the patient's pathway, when a combined orthodontic-restorative dentistry approach was used, will be summarized. It was found that the number of teeth missing ranged from 1 to 8 with a mean of 3.4 per patient. Combined treatment was found to take on average around 38 months, using over 20 appointments., Clinical Relevance: Hypodontia is a relatively common condition. It is important that practitioners and patients are aware of the length of time treatment can take.

It can be difficult to formulate a definitive diagnosis and treatment plan for patients with hypodontia while dental development is still in progress. Proper radiographs should be used periodically to check for the possibility of delayed tooth development to reduce the potential of misdiagnosis and improper treatment. This article presents a case with orthodontic treatment of hypodontia and delayed development of a maxillary second premolar.

This case report describes the orthodontic treatment of an adult patient with iatrogenic absence of the maxillary canines, moderate maxillary and severe mandibular dental crowding, a Bolton discrepancy with a large mandibular anterior excess, a maxillary right lateral incisor crossbite, and Angle Class II molar relationships. The treatment consisted of fixed appliance therapy, mandibular incisor extraction, tooth bleaching, and dental recontouring. This method of treatment maintained the patient's good facial appearance, improved the dental esthetics, and provided a good functional occlusion, eliminating the arch length and Bolton discrepancies and providing a good outcome with minimal undesirable effects., (Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Introduction: Orthodontic-surgical treatment was performed in patient with skeletal Class III malocclusion due to exceeding mandibular growth. Patient also presented upper and lower dental protrusion, overjet of -3.0 mm, overbite of -1.0 mm, congenital absence of tooth #22, teeth #13 and supernumerary impaction, tooth #12 with conoid shape and partly erupted in supraversion, prolonged retention of tooth #53, tendency to vertical growth of the face and facial asymmetry. The discrepancy on the upper arch was -2.0 mm and -5.0 mm on the lower arch., Methods: The presurgical orthodontic treatment was performed with extraction of the teeth #35 and #45. On the upper arch, teeth #53, #12 and supernumerary were extracted to accomplish the traction of the impacted canine. The spaces of the lower extractions were closed with mesialization of posterior segment. After aligning and leveling the teeth, extractions spaces closure and correct positioning of teeth on the bone bases, the correct intercuspation of the dental arch, with molars and canines in Angle's Class I, coincident midline, normal overjet and overbite and ideal torques, were evaluated through study models. The patient was submitted to orthognathic surgery and then the postsurgical orthodontic treatment was finished., Results: The Class III malocclusion was treated establishing occlusal and facial normal standards.

The use of implant-supported restorations in patients with hypodontia remains challenging and requires a multistage treatment that begins in late mixed dentition and continues into late adolescence. The aim of this article is to review the role of orthodontics in endosseous implant rehabilitation of patients with hypodontia. The MEDLINE, Web of Science, Scopus, Cochrane databases, and necessary scientific textbooks were searched for relevant studies and reviews, and as far as possible, they were only included if they had been cited at least once in the literature. Dental implants are susceptible to overloading as the periodontal ligament is absent and the proprioceptive nerve endings are either lacking or very limited. Patients with hypodontia may present with skeletal features such as short and retrognathic maxilla, prognathic mandible, and shorter lower anterior facial height, and they sometimes need orthognathic correction as part of their overall treatment. Dental problems vary and include bimaxillary retroclination of incisors, spacing, centerline discrepancies, microdontia, hypoplastic enamels, ankylosis of the retained primary teeth, overeruptions, and volume deficiencies of alveolar ridges. The challenges mentioned, as well as bone volume deficiencies, compromise the successful placement of implants. Orthodontic strategies and techniques, such as uprighting mechanics, extrusion/intrusion, delayed space opening, and orthodontic implant site-switching, can be used to create, preserve, or augment the implant site. After orthodontic site development, the final planned position of the teeth should be maintained with a rigid bonded retainer; overlooking this stage may compromise the implant site and require orthodontic retreatment.

With a worldwide incidence of 1/750 live births, facial clefts rank as the second most frequent congenital malformation. The term "sequelae" is used here to designate the conditions, which follow and are the result of labial-alveolar-palatal clefts. Most sequelae stem in fact from primary treatment and not from the initial malformation. However, there is no consensus regarding a management protocol. Among the 201 European centers treating this type of malformation, 194 different protocols are used for unilateral facial clefts alone! Unfortunately, primary surgery can trigger a wide range of harmful repercussions. It is for this reason that secondary surgery is called for, generally after the adolescent growth spurt. The aim is to correct the damage done by primary surgery, which can affect the nose, lips, teeth and jaws and impact functions such as speech, breathing and swallowing, as well as morphological and psychological development. Nonetheless, the children concerned are sometimes lost to treatment only to re-emerge in adulthood, aware of the resultant defects and looking for facial esthetic improvement. The sequelae of labial-alveolar-palatal clefts take very different clinical forms according to whether the cleft has been treated or not and the type and timing of the procedures performed. The surgeon's experience will be paramount in the management of such cases, which draws heavily upon dento-maxillo-facial orthopedics. In this context, we intend, in this paper, to propose modalities for the management of labial-alveolar-palatal clefts supported by information currently available in the literature. Management of labial-alveolar-palatal clefts requires an interdisciplinary rather than the only multidisciplinary approach. The practitioner coordinating the management must, like an orchestra conductor, ensure both the rhythm and the tempo of the treatment. The rhythm will determine the choice of chronological protocol and the tempo will govern the timing and importance given to each of the specialists involved. Practices vary from country to country but the orthodontist may be called on to assume this responsibility., (Copyright © 2012. Published by Elsevier Masson SAS.)

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., (Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Unlabelled: AIM The purpose of this study is to present a new clinical approach for the treatment of upper lateral incisor agenesis., Materials and Methods: A new treatment option was conceived and applied: posterior space opening as a safeguard of occlusal integrity and dental and periodontal aesthetics of the front teeth. This is acheved by means of the anterior space closure, with the mesialisation of the canines and the bicuspids, combined with a posterior space opening to create adequate room for the placement of an implant in the second premolar area. The obtained space should be maintained with a space retainer or a provisional Maryland bridge until the patient is old enough to undergo implant rehabilitation and the canines must be reshaped into a lateral incisor., Conclusion: The results of this treatment are a correct teeth alignment, without diastema, Class I occlusion, and occlusal integrity with all natural teeth in the anterior area. In this way there are many advantages for the patient; so it is an effective approach.

Treatment of children with several congenitally missing teeth is challenging, because growth and development of the oral structures must be considered. The treatment options include retaining the deciduous teeth and postponing treatment until later or extracting the deciduous teeth and doing one of the following: allowing the space to close spontaneously, closing the space orthodontically, or in patients whose growth is finished, using a prosthetic or implant replacement. One other viable option, if donor teeth are available, is autotransplantation. The treatment plan for patients with missing teeth should be based on a comprehensive evaluation of the patient's age, occlusion, and space requirements as well as on the size and shape of the adjacent teeth. This case report presents the management of a patient in the early mixed dentition with multiple missing teeth. The treatment consisted of a combination of autotransplantation of the maxillary right first premolar to the mandibular right first premolar region and orthodontic treatment with a 5-year follow-up after autotransplantation., (Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal., (Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

The congenital absence of one or more maxillary lateral incisors poses a challenge to effective treatment planning for general dentists and dental specialists. An evaluation of anterior smile esthetics must include both static and dynamic evaluations of frontal and profile views to optimize both dental and facial appearance. This article presents a case with canine substitution treatment to replace a missing maxillary lateral incisor combined with the extraction of two mandibular lateral incisors and a small maxillary lateral incisor Both the patient's occlusion and facial appearance were significantly improved after orthodontic treatment.

The young dental patient with maxillary lateral incisor agenesis, maxillary canine impaction, and cystic fibrosis presents considerable challenges to the dentist. An interdisciplinary approach is described here for the orthodontist and restorative dentist to plan and work together with the patient's and parents' cooperation and consent. Despite some compromises, a successful outcome was achieved, as demonstrated in this case report. The use of conservative yet esthetic and durable fixed replacement prostheses is highlighted. Congenitally absent maxillary lateral incisors, impacted maxillary canines, and cystic fibrosis are clinical conditions that can significantly complicate and compromise dental treatment for any young patient. All three can be present simultaneously, as described in this case report.

Tooth agenesis is one of the most common developmental dental anomalies. Successful and satisfying dental treatment is always the goal for patients and dental practitioners, meaning that a patient's needs are solved in a functional and esthetic way. Patients and dentists have to find the best way to reach their common goal of satisfaction. The authors introduce and provide examples of different approaches to solve the problem of congenitally missing lateral incisors. This article discusses the restorative approach, the approach using implants, and the orthodontic approach. In most cases, an interdisciplinary treatment plan has to be worked out and executed., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Treatment of patients with a cleft lip and palate can be challenging. A boy, 15 years 11 months old, with a bilateral cleft lip and palate and a convex profile, transposed teeth and congenitally missing teeth was treated by orthodontic treatment. 3 year posttreatment records showed excellent results with good occlusion, facial balance and harmony, and long-term stability.

Background: The long-term management of hypohidrotic ectodermal dysplasia (HED) from prepuberty to adulthood often necessitates orthodontic and orthopedic treatment in conjunction with prosthodontic care., Case Description: The authors present a report regarding the combined orthodontic and prosthodontic treatment of a child with HED-associated oligodontia from the ages of 10 to 18 years. The authors fabricated successive maxillary removable partial dentures, equipped with midline jackscrews, at different phases of the treatment and planned treatment to close the patient's midline diastema. After completion of the orthodontic therapy, three-dimensional analysis of the final dental casts showed a measurable increase in the transverse dimensions of the maxillary dental arch, and posttreatment cephalometric analysis revealed the face to have normal vertical dimensions and a mild retroposition of the maxilla., Conclusions: and, Clinical Implications: Orthodontic and orthopedic treatment in coordination with prosthetic restoration at the appropriate time may benefit the stomatognathic function, normal growth, esthetics and emotional well-being of young people with HED.

Unlabelled: Clinicians agree that, regardless of gender or race, tooth agenesis has become more prominent in recent societies. The congenital absence of one or more maxillary lateral incisors poses a challenge to effective treatment planning for the restorative dentist. However, the one-sided orthodontic approach of just moving canines mesially to eliminate restorative procedures leads to compromise. Adult patients presenting with malocclusions, missing lateral incisors, or anterior crowding but who fail to get proper orthodontic treatment, requesting instead esthetic solutions that do not establish a stable occlusion, proper alignment, and proper axial inclination of the teeth will have compromised esthetic and periodontal results. An evaluation of anterior smile esthetics must include both static and dynamic evaluations of frontal and profile views to optimize both dental and facial appearance. This article presents how orthodontics is combined with other specialties in treating a congenitally missing lateral incisor. One case is used to illustrate how orthodontic treatment is progressed in collaboration with other specialists., Clinical Significance: Patients with missing teeth, crowding, midline deviation, unesthetic gingival contours, or other restorative needs may require the interaction between various specialists. For the successful treatment of orthodontic-restorative patients, an interdisciplinary team effort is vital., (© 2010, COPYRIGHT THE AUTHORS. JOURNAL COMPILATION © 2010, WILEY PERIODICALS, INC.)

Aim: The aims of this report are to present three cases of autotransplantation along with a review of the indications, selection criteria for patient donor and recipient sites, and the major steps in the surgical procedure., Background: Autogenous tooth transplantation, or autotransplantation, is the surgical movement of a tooth from one location in the mouth to another in the same individual. It can be a good treatment option in many cases if the dentist knows the implications, indications, and contraindications., Case Descriptions: Three cases with different treatment indications and plans are presented. All showed autotransplantation of teeth as part of orthodontic treatment. It emphasized the benefits of this treatment modality such as new bone formation and lower costs. One case, a rare example of multiple congenitally missing teeth treated by autotransplantation, also was presented., Summary: As shown in these case reports, there are instances where the autotransplantation of teeth is appropriate and may possibly simplify future planned orthodontic or prosthodontic treatment., Clinical Significance: Tooth autotransplantation is an easy and good treatment option, applicable in a lot of cases, substituting different types of prostheses, including dental implants.

Unlabelled: The aim of this second article in this series of two is to outline a variety of methods which may be used to compensate for variations in tooth shape and number using a combination of orthodontic and restorative approaches. It will also provide an overview of other areas of patient care which necessitate a multi-disciplinary orthodontic/restorative approach. The article will highlight the importance of combined planning from the outset and the close relationship between the different specialties, which must be maintained throughout treatment. The methods of compensating for variations in tooth number and shape will often require contributions from both orthodontist and restorative dentist. It is important that both disciplines are involved in the assessment and treatment planning process so that they know what will be expected of them during the patient's care. Treatment planning in isolation may lead to care being delivered which is below the optimum standard which can be achieved. The orthodontist and restorative dentist are likely to liaise with the patient's general dental practitioner so that he/she can provide the restorative treatment in some cases., Clinical Relevance: Great improvements in aesthetics and function may be obtained using an interdisciplinary approach for patients who have variations in tooth number and shape.

This case report describes the orthodontic treatment of a 10-year-old female patient with a combination of Angle Class III malocclusion, a missing maxillary right lateral incisor, a supernumerary tooth with a short root on the lingual side of the maxillary incisor, a skeletal Class III jaw base relationship caused by a diminutive maxilla, and retroposition of the maxilla. We chose to close the space of the missing tooth, as well as the space created by extraction of the maxillary lateral incisor, by forward movement of the canine and premolars using a maxillary protractor with edgewise appliances. As a result, both the maxillary premolars and the molars were moved mesially, and a Class II molar relationship with tight interdigitation was achieved. Our results suggest that the combination of maxillary protractor and nontorque brackets was effective not only for correcting skeletal Class III malocclusion, but also for forward movement of the maxillary posterior teeth.

Unlabelled: The first article in this series of two aims to outline the assessment of patients for whom a combined orthodontic-restorative approach would be beneficial. In particular, it will concentrate on the assessment of patients who have hypodontia and tooth size discrepancies. The importance of the aesthetic assessment for these cases will be highlighted. Variations in tooth number and tooth size discrepancy often require a combined treatment planning approach from the orthodontist and restorative dentist. The referring general dental practitioner has a key role in recognizing that this approach may be required and highlighting this in the initial patient referral. It is likely in the more straightforward cases that the GDP will be providing the restorative treatment and so an increased understanding of these cases would be beneficial. In the second paper, treatment options will be presented., Clinical Relevance: For patients who require a combined orthodontic/restorative approach, it is important that orthodontic and restorative disciplines liaise closely in the assessment and treatment planning process so that optimal care may be planned.

The purpose of this article is to review treatment concepts for patients with congenitally missing teeth in the mandible, for patients in whom teeth in only the mandibular arch were extracted, or for patients with Class III camouflage treatment. The therapy result in these situations is a Class III molar relationship. With this type of intercuspation, esthetic and functional aspects must be observed., (© 2009 BY QUINTESSENCE PUBLISHING CO, INC.)

This case report describes the treatment of a patient with a Class II Division 1 subdivision right malocclusion with 8 congenitally missing teeth, incompetent lips, and incisor protrusion. The treatment plan included extractions and space closure with retraction of the anterior teeth; symmetric mechanics were used in the mandibular arch and asymmetric mechanics in the maxillary arch. Because of the mechanics used, some midline deviations were expected. Knowledge of diagnosis and treatment planning of asymmetric malocclusions and dental esthetics are essential for success when correcting asymmetic problems, but, even so, small clinical compromises should be expected.

Missing maxillary lateral incisors create a major esthetic problem due to their strategic position in the smile. The two treatment approaches commonly taken are creating adequate space to prosthetically replace the missing lateral incisors or closing the spaces and replacing the missing lateral incisors by the canines. This article will discuss indications, advantages, disadvantages and problems encountered in cases of space opening and space closure for missing laterals. The amount of space to be created, the preparation and the timing for implant placement, the bone volume, the implant size and prosthetic considerations will also be discussed. The methods for reshaping canines and building them up to simulate lateral incisors in orthodontic space closure, and positioning the canines and first premolars - so that they resemble to the teeth they are replacing - will be described.

The objective of this article is to describe the various clinical situations of prolonged retention of mandibular deciduous second molars. Indications for orthodontic space closure in the absence of permanent successors and treatment alternatives in space opening, including retaining the deciduous molars, are described. Periodic monitoring, composite buildups, and indications and timing of extraction of infraoccluded and ankylosed deciduous molars with and without permanent successors are reviewed.

Occasionally, general dentists are challenged with providing restorative treatment for a postorthodontic patient who has had moderate to severe root resorption. When this happens, a number of questions about the cause of such resorption and the appropriate treatment arise in the dentist's mind. This article will describe the orthodontic and restorative management of three patients with severe maxillary incisor root resorption, provide a thorough discussion of the currently available literature on the topic of root resorption, and answer clinical questions regarding this relatively infrequent but devastating sequel to orthodontic treatment.

Introduction: Missing permanent teeth is observed with syndromes or is frequently hereditarily propagated in families. The treatment of these patients is a multi-task of specialists of oral surgery, orthodontics and prosthodontics., Discussion: Despite functional and aesthetic considerations, the main problem of all treatment is that it had to be performed in a growing child. This article discusses the conventional and implant-driven concepts to treat patients from childhood to adolescence with selective or multiple missing permanent teeth.

Esthetic dentistry has evolved dramatically over the years to the point of becoming an expectation from most patients. It is not a fad but is becoming a standard of care for the majority of dental treatment. By learning to practice good quality interdisciplinary dentistry, it is possible to turn a general practice into a comprehensive care practice that caters to high-quality esthetics and function. This article discusses incorporating interdisciplinary dentistry into the general practice and offers some clinical examples.

Objective: To investigate the orthodontic management of patients with developmentally absent maxillary lateral incisors., Materials and Methods: A questionnaire was mailed to all orthodontists on the specialist list held by the British Orthodontic Society., Results: The questionnaires (57.3% response) were analysed in two groups: Group 1 consisted of orthodontists who worked only in an orthodontic practice environment; Group 2 consisted of orthodontists who worked full-time or part-time in an environment where there were restorative dentists available for advice. Group 1 orthodontists were significantly more likely to recommend (p = 0.006) space closure in the management of developmentally absent maxillary lateral incisors. Group 2 orthodontists were significantly more likely to recommend (p = 0.004) minimal preparation bridges. Group 2 orthodontists also saw significantly more patients with hypodontia (p

Stickler syndrome (MIM 108300, 604841, 184840) is an autosomal dominant disease characterized by midfacial flattening and variable disorders of vision, hearing and articulation. There are three types of the syndrome caused by mutations in different genes (type 1, COL2A1; type 2, COL11A1; and type 3, COL11A2). About 20% of type 1 patients have cleft palate or bifid uvula, but there have been no case reports of orthodontic treatment of this syndrome so far. The Japanese female patient presented here with Stickler syndrome was characterized by a flat midface and had high myopia, sensorineural hearing loss, enlarged joints, and cleft of the soft palate. She had fairly small SNA and SNB angles and a steep mandibular plane with an enlarged gonial angle. The incisors of both arches were retroclined, and a large overjet and overbite were noted. Orthodontic treatment was initiated at 11 years of age using a lingual arch appliance followed by an edgewise multibracket appliance. Stable functional occlusion was obtained after the treatment. Most of the other seven Stickler syndrome patients exhibited pretreatment characteristics of small SNA and SNB angles, steep mandibular planes, enlarged gonial angles, and retroclined incisors of both arches, demonstrating the characteristic skeletal and occlusal features of this syndrome.

The present study aimed to determine whether routine orthodontic space closure can be successfully achieved in patients with unilateral aplasia of the lower second premolars without extracting contralateral or opposing teeth. The dental records and lateral cephalograms of 17 consecutively treated subjects (11 females, 6 males) aged between 14.8 and 19.3 years at the end of active treatment (mean 16.1 years) were analysed. The spaces were closed by 'push-and-pull' mechanics (PPM). Pre- and post-treatment data were compared using a Student's t-test. At the end of active treatment, all parameters (ANB, SNA, SNB, ML/NL, U1-NA, L1-NB, overbite and overjet, upper and lower midline, upper and lower space balance) presented mean values close to accepted norms with satisfactory standard deviations (SDs). Five indicators of success changed significantly: (1) Space closure in the aplastic region was achieved. (2) On the aplastic side, a mean mesial molar relationship of 1.12 (SD 0.18) cusp width (cw) was achieved. The mean alteration from pre- to post-treatment was 1.53 cw (SD 0.29, P

When a maxillary lateral incisor is missing, often the treatment options can be clearly defined, that is, substitute an adjacent tooth for the missing one; open the space for an implant, a bonded bridge or fixed bridge. When a maxillary central incisor is missing and the space for the tooth is absent, the treatment choices become complicated, especially in a growing child. There must be multi-disciplinary coordination among the restorative dentist, the oral surgeon or periodontist, and the orthodontist to obtain the optimum result. At the initiation of treatment, this information must be relayed and the treatment plan agreed upon by the patient or the parents of the patient.

Managing edentulous spaces in patients with congenitally missing teeth demands careful planning and, often, a multidisciplinary approach. Orthodontic tooth movement can be considered to close spaces as well as improve the distribution of available teeth. In this second paper, the advantages of a collaborative approach are discussed.

Surgical orthodontic treatment and dental implant therapy were performed on a man (aged 18 years 8 months) with mandibular prognathism and seven congenitally missing teeth: upper canines, first and second premolars and lower right second premolar. After 17 months of preoperative orthodontic treatment at age 20 years 1 month, sagittal split ramus osteotomy was performed using the remaining upper deciduous teeth as an anchor for intermaxillary fixation. In postoperative orthodontic treatment, the remaining deciduous teeth were extracted, and fixture installation was performed. The entire therapy required 4 years to complete (age 22 years 8 months). After completion of orthodontic treatment, superstructures were put in place. This patient had many dental problems, so multidisciplinary care was performed in conjunction with other departments to improve oral function and facial esthetics.

Introduction: Even minor dimensional changes in the child's upper airway can already affect the resistance therein. Craniofacial anomalies may constrict the upper airway and are suspected to be a direct cause of obstructive sleep apnea syndrome (OSAS) in children., Case Reports: In the present two cases we report on the successful orthodontic treatment of an 8-year-old girl and a 6 1/2-year-old boy with craniofacial anomalies and severe OSAS diagnosed during a sleep study. The primary treatment aim was to improve the cardio-respiratory situation during sleep by enlarging the upper airway and preventing its collapse. Prior to the onset of treatment we had ruled out the presence in both children of any adenotonsillar hypertrophy requiring surgical treatment. Patient 1 (the girl) presented mouth breathing predominantly while sleeping and a narrow skeletal maxilla that was treated via rapid maxillary expansion followed by a Fränkel-II appliance. A function regulator type-II was applied in the second patient, a boy suffering from OSAS, and spinal muscular dystrophy with a narrow skeletal upper jaw and mandibular retrognathism. We were able to successfully treat both cases of obstructive sleep apnea with these orthodontic procedures., Conclusion: Orthodontic therapeutic measures should be considered as a causal treatment option in children with OSAS and craniofacial anomalies restricting the upper airway. Parents and patient cooperation, as well as good interdisciplinary care within the field of sleep medicine are mandatory for this kind of treatment.