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Bimaxillary protrusion with an atrophic alveolar defect: Orthodontics, autogenous chin-block graft, soft tissue augmentation, and an implant.

Authors :
Chiu, Grace S.C.
Chang, Chris H.N.
Roberts, W. Eugene
Source :
American Journal of Orthodontics & Dentofacial Orthopedics; Jan2015, Vol. 147 Issue 1, p97-113, 17p
Publication Year :
2015

Abstract

Bimaxillary protrusion in a 28-year-old woman was complicated by multiple missing, restoratively compromised, or hopeless teeth. The maxillary right central incisor had a history of avulsion and replantation that subsequently evolved into generalized external root resorption with Class III mobility and severe loss of the supporting periodontium. This complex malocclusion had a discrepancy index of 21, and 8 additional points were scored for the atrophic dental implant site (maxillary right central incisor). The comprehensive treatment plan included extraction of 4 teeth (both maxillary first premolars, the maxillary right central incisor, and the mandibular right first molar), orthodontic closure of all spaces except for the future implant site (maxillary right central incisor), augmentation of the alveolar defect with an autogenous chin-block graft, enhancement of the gingival biotype with a connective tissue graft, and an implant-supported prosthesis. Orthodontists must understand the limitations of bone grafts. Augmented alveolar defects are slow to completely turn over to living bone, so they are usually good sites for implants but respond poorly to orthodontic space closure. However, postsurgical orthodontic treatment is often indicated to optimally finish the esthetic zone before placing the final prosthesis. The latter was effectively performed for this patient, resulting in a total treatment time of about 36 months for comprehensive interdisciplinary care. An excellent functional and esthetic result was achieved. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
08895406
Volume :
147
Issue :
1
Database :
Supplemental Index
Journal :
American Journal of Orthodontics & Dentofacial Orthopedics
Publication Type :
Academic Journal
Accession number :
100152197
Full Text :
https://doi.org/10.1016/j.ajodo.2014.08.021