Facial and occlusal esthetic improvements of an adult skeletal Class III malocclusion using surgical, orthodontic, and implant treatment
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The aim of this clinical report is to describe the complex treatment of an adult Class III malocclusion patient who was disappointed with the outcome of a pre-vious oral rehabilitation. Interdisciplinary treatment planning was performed with a primary indication for implant removal because of marginal bone loss and gingival recession, followed by orthodontic and surgical procedures to co-rrect the esthetics and skeletal malocclusion. The comprehensive treatment approach included: (1) implant removal in the area of the central incisors; (2) combined orthodontic decompensation with mesial displacement and for-ced extrusion of the lateral incisors; (3) extraction of the lateral incisors and placement of new implants corresponding to the central incisors, which re ceived provisional crowns; (4) orthognathic surgery for maxillary advancement to improve occlusal and facial relationships; and finally, (5) orthodontic refinement followed by definitive prosthetic rehabilitation of the maxillary cen tral incisors and reshaping of the adjacent teeth. At the three-year follow-up, clinical and radiographic examinations showed successful replacement of the central incisors and improved skeletal and esthetic appearances. Moreover, a Class II molar relationship was obtained with an ideal overbite, overjet, and intercuspation. In conclusion, we report the successful esthetic anterior reha bilitation of a complex case in which interdisciplinary treatment planning improved facial harmony, provided gingival architecture with sufficient width and thickness, and improved smile esthetics, resulting in enhanced patient comfort and satisfaction. This clinical case report might be useful to improve facial esthetics and occlusion in patients with dentoalveolar and skeletal defects.[Korean J Orthod 2016;46(1):42-54]
Abstract
The aim of this clinical report is to describe the complex treatment of an adult Class III malocclusion patient who was disappointed with the outcome of a pre-vious oral rehabilitation. Interdisciplinary treatment planning was performed with a primary indication for implant removal because of marginal bone loss and gingival recession, followed by orthodontic and surgical procedures to co-rrect the esthetics and skeletal malocclusion. The comprehensive treatment approach included: (1) implant removal in the area of the central incisors; (2) combined orthodontic decompensation with mesial displacement and for-ced extrusion of the lateral incisors; (3) extraction of the lateral incisors and placement of new implants corresponding to the central incisors, which re ceived provisional crowns; (4) orthognathic surgery for maxillary advancement to improve occlusal and facial relationships; and finally, (5) orthodontic refinement followed by definitive prosthetic rehabilitation of the maxillary cen tral incisors and reshaping of the adjacent teeth. At the three-year follow-up, clinical and radiographic examinations showed successful replacement of the central incisors and improved skeletal and esthetic appearances. Moreover, a Class II molar relationship was obtained with an ideal overbite, overjet, and intercuspation. In conclusion, we report the successful esthetic anterior reha bilitation of a complex case in which interdisciplinary treatment planning improved facial harmony, provided gingival architecture with sufficient width and thickness, and improved smile esthetics, resulting in enhanced patient comfort and satisfaction. This clinical case report might be useful to improve facial esthetics and occlusion in patients with dentoalveolar and skeletal defects.[Korean J Orthod 2016;46(1):42-54]
참고문헌 (32)
- de Molon RS, "A combined approach for the treatment of resorbed fresh sockets allowing immediate implant restoration. A 2-year follow-up", J Oral Implantol, 41, pp.712~718 (2015)
- Choquet V, "Clinical and radiographic evaluation of the papilla level adjacent to singletooth dental implants. A retrospective study in the maxillary anterior region", J Periodontol, 72, pp.1364~1371 (2001)
- Kan JY, "Interimplant papilla preservation in the esthetic zone: a report of six consecutive cases", Int J Periodontics Restorative Dent, 23, pp.249~259 (2003)
- Belser UC, "Outcome analysis of implant restorations located in the anterior maxilla: a review of the recent literature", Int J Oral Maxillofac Implants, 19(Suppl), pp.30~42 (2004)
- Spear FM, "Interdisciplinary management of anterior dental esthetics", J Am Dent Assoc, 137, pp.160~169 (2006)
- de Molon RS, "Impact of diabetes mellitus and metabolic control on bone healing around osseointegrated implants: removal torque and histomorphometric analysis in rats", Clin Oral Implants Res, 24, pp.831~837 (2013)
- de Molon RS, "Optimizing maxillary aesthetics of a severe compromised tooth through orthodontic movement and dental implants", Case Rep Dent, 2014, pp.103808~ (2014)
- de Avila ÉD, "Multidisciplinary approach for the aesthetic treatment of maxillary lateral incisors agenesis:thinking about implants?", Oral Surg Oral Med Oral Pathol Oral Radiol, 114, pp.e22~e28 (2012)
- de Molon RS, "Reconstruction of the alveolar buccal bone plate in compromised fresh socket after immediate implant placement followed by immediate provisionalization", J Esthet Restor Dent, 27, pp.122~135 (2015)
- Buser D, "Optimizing esthetics for implant restorations in the anterior maxilla:anatomic and surgical considerations", Int J Oral Maxillofac Implants, 19(Suppl), pp.43~61 (2004)
- Fürhauser R, "Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score", Clin Oral Implants Res, 16, pp.639~644 (2005)
- Jung RE, "A systematic review of the 5-year survival and complication rates of implantsupported single crowns", Clin Oral Implants Res, 19, pp.119~130 (2008)
- Kan JY, "Tissue architecture modification for anterior implant esthetics: an interdisciplinary approach", Eur J Esthet Dent, 4, pp.104~117 (2009)
- Nisapakultorn K, "Factors affecting soft tissue level around anterior maxillary single-tooth implants", Clin Oral Implants Res, 21, pp.662~670 (2010)
- Papalexiou V, "Influence of the interimplant distance on crestal bone resorption and bone density: a histomorphometric study in dogs", J Periodontol, 77, pp.614~621 (2006)
- de Barros LA, "Six-year follow-up of maxillary anterior rehabilitation with forced orthodontic extrusion:achieving esthetic excellence with a multidisciplinary approach", Am J Orthod Dentofacial Orthop, 144, pp.607~615 (2013)
- de Molon RS, "Combination of orthodontic movement and periodontal therapy for full root coverage in a Miller class III recession: a case report with 12 years of follow-up", Braz Dent J, 23, pp.758~763 (2012)
- de Molon RS, "Forced orthodontic eruption for augmentation of soft and hard tissue prior to implant placement", Contemp Clin Dent, 4, pp.243~247 (2013)
- de Molon RS, "Improvement of an anterior infrabone defect using combined periodontal and orthodontic therapy:A 6-year follow-up case report", Eur J Dent, 8, pp.407~411 (2014)
- Corrente G, "Orthodontic movement into infrabony defects in patients with advanced periodontal disease: a clinical and radiological study", J Periodontol, 74, pp.1104~1109 (2003)
- Korayem M, "Implant site development by orthodontic extrusion. A systematic review", Angle Orthod, 78, pp.752~760 (2008)
- Sonego CL, "Aesthetic and functional implications following rotation of the maxillomandibular complex in orthognathic surgery: a systematic review", Int J Oral Maxillofac Surg, 43, pp.40~45 (2014)
- Tarnow DP, "The effect of the distance from the contact point to the crest of bone on the presence or absence of the interproximal dental papilla", J Periodontol, 63, pp.995~996 (1992)
- Funato A, "Timing, positioning, and sequential staging in esthetic implant therapy: a four-dimensional perspective", Int J Periodontics Restorative Dent, 27, pp.313~323 (2007)
- Garber DA, "Restoration-driven implant placement with restoration-generated site development", Compend Contin Educ Dent, 16, pp.796~802 (1995)
- Palacci P, "Aesthetic treatment of the anterior maxilla : soft and hard tissue considerations", Oral Maxillofac Surg Clin North Am, 16, pp.127~137 (2004)
- Seibert JS, "Alveolar ridge preservation and reconstruction", Periodontol 2000, 11, pp.69~84 (1996)
- Margonar R, "Rehabilitation of the maxillary arch after bone graft using immediate loading with implant-supported fixed restoration", J Craniofac Surg, 25, pp.e44~e48 (2014)
- Milinkovic I, "Are there specific indications for the different alveolar bone augmentation procedures for implant placement? A systematic review", Int J Oral Maxillofac Surg, 43, pp.606~625 (2014)
- Margonar R, "Anterior tooth rehabilitation with frozen homogenous bone graft and immediately loaded titanium implant using computer-guided surgery", J Craniofac Surg, 23, pp.e470~e472 (2012)
- Shiu YT, "The role of mechanical stresses in angiogenesis", Crit Rev Biomed Eng, 33, pp.431~510 (2005)
- de Ávila ED, "Health-related quality of life and depression in patients with dentofacial deformity", Oral Maxillofac Surg, 17, pp.187~191 (2013)