Ești medic rezident? Adaugă codul #somethingmore în coș pentru a accesa lista ta specială de prețuri!

Studiu Occlus-o-Guide on Dentogenesis Imperfecta

236 vizualizări
0 Likes
0 0

Share

Share linkul

Foloseste link-ul pentru share in social media

Share cu un prieten

Please login to send this document by email!

Include pe site-ul tau

Selecteaza pagina de start

4. using implant therapy and adhesive dentistry. Row et al. (15) proposed a multidisciplinary approach for a seventeen-year old patient through adhesive den- tistry, periodontal surgery, implant-supported prosthe- ses, orthodontic treatment and orthognathic surgery. Huth (16) proposed restoration of the primary teeth with stainless steel crowns and composite crowns in a 4-year-old child. Ubaldini et al. (17)described an esthetic solution through composite resin restorations as a transitional treatment step for the anterior teeth of an eight-year old boy with DI. This clinic case could be considered an example of approach for all those patients with systemic and/or dental diseases that do not allow adequate dental retention, which is necessary for most orthodontic appliances; elastodontic devices do not require adequate dental retention and define a minimum intervention on the surfaces of the teeth (18). Annali di Stomatologia 2017;VIII (1):34-38 37 Minimally invasive orthodontics: elastodontic therapy in a growing patient affected by Dentinogenesis Imperfecta Figure 5. Intraoral photos with Occlus- o-Guide series G at 9 years of age. Figure 6. Intraoral photos with Occlus- o-Guide series N at 11 years of age. @ CIC Edizioni Internazionali

5. References 1. Seow WK. Developmental defects of enamel and dentine: challenges for basic science research and clinical man- agement. Australian Dental Journal. 2014 jun;59suppl1:143- 154. 2. Akhlaghi N, Eshghi AR, Mohamadpour M. Dental Manage- ment of a Child with Dentinogenesis Imperfecta: A Case Re- port. J Dent (Tehran). 2016 Mar;13(2):133-138. 3. Li F, Liu Y, Liu H, Yang J, Zhang F, Feng H. Phenotype and genotype analyses in seven families with dentinogenesis im- perfecta or dentin dysplasia. Oral Dis. 2017 Apr;23(3):360- 366. 4. Davis GR, Fearne JM, Sabel N, Norén JG. Microscopic study of dental hard tissues in primary teeth with Dentinogenesis Imperfecta Type II: Correlation of 3D imaging using X-ray mi- crotomography and polarising microscopy. Arch Oral Biol. 2015 Jul;60(7):1013-1020. 5. Ierardo G, Calcagnile F, Luzzi V, Ladniak B, Bossu M, Cel- li M, Zambrano A, Franchi L, Polimeni A. Osteogenesis im- perfecta and rapid maxillary expansion: Report of 3 pa- tients.Am J Orthod Dentofacial Orthop. 2015 Jul;148(1):130- 137. 6. Devaraju D, Devi BY, Vasudevan V, Manjunath V. Dentino- genesis imperfecta type I: A case report with literature re- view on nomenclature system. J Oral Maxillofac Pathol. 2014 Sep;18(Suppl 1):S131-134. 7. Orsini G, Majorana A, Mazzoni A, Putignano A, Falconi M, Polimeni A, Breschi L. Immunocytochemical detection of dentin matrix proteins in primary teeth from patients with dentinogenesis imperfecta associated with osteogenesis im- perfecta. Eur J Histochem. 2014 Dec1;58(4):2405. 8. Laganà G, Cozza P. Interceptive therapy with elastodontic appliance: case report. Annali Stom. 2010 Jul-Dec(3-4):22- 28. 9. Saccucci M, Tecco S, Ierardo, G, Luzzi V, Festa F, Polimeni A. Effects of interceptive orthodontics on orbicular muscle activity: a surface electromyographic study in children. J Elec- tromyogr Kinesiol. 2011 Aug;21(4):665-671. 10. Janson G, Nakamura A, Ciqueto K, Castro R, De Freitas MR, Costanza Henriques JF. Treatment stability with the erup- tion guidance appliance. Am J Ortho dentofacial orthop. 2007;131(6):717-718. 11. Ierardo G, Luzzi V, Panetta F, Sfasciotti GL, Polimeni A. Noo- nan syndrome: A case report. Eur J Paediatr Dent. 2010 Jun;11(2):97-100. 12. Auconi P, Caldarelli G, Scala A, Ierardo G, Polimeni A. A net- work approach to orthodontic diagnosis. Orthod Craniofac Res. 2011 Nov;14(4):189-197. 13. Polimeni A. Odontoiatria Pediatrica. Elsevier 2012. 14. Bencharit S, Border MB, Mack CR, Byrd WC, Wright JT. Full- mouth rehabilitation for a patient with dentinogenesis im- perfecta: a clinical report. J Oral Implantol. 2014 Oct;40 (5):593-600. 15. Roh WJ, Kang SG, Kim SJ. Multidisciplinary approach for a patient with dentinogenesis imperfecta and anterior trau- ma. Am J Orthod Dentofacial Orthop. 2010 Sep;138(3):352- 360. 16. Huth KCh, Paschos E, Sagner T, Hickel R. Diagnostic fea- tures and pedodontic-orthodontic management in dentino- genesis imperfecta type II: a case report. Int J Paediatr Dent. 2002 Sep;12(5):316-321. 17. Ubaldini AL, Giorgi MC, Carvalho AB, Pascon FM, Lima DA, Baron GM, Paulillo LA, Aguiar FH. Adhesive Restorations as An Esthetic Solution in Dentinogenesis Imperfecta. J Dent Child (Chic). 2015 Sep-Dec;82(3):171-175. 18. Ierardo G, Luzzi V, Vestri A, Sfasciotti GL, Polimeni A. Eval- uation of customer satisfaction at the Department of Paediatric Dentistry of “Sapienza” University of Rome. Eur J Paediatr Dent. 2008 Mar;9(1):30-36. Annali di Stomatologia 2017;VIII (1):34-38 38 G. Ierardo et al. Figure 7. Orthopanoramics at 11 years of age. Figure 8. Cephalometric skull at 11 years of age. @ CIC Edizioni Internazionali

3. The recesses are for all teeth except first molars in order to have an extrusion of these teeth and an ad- ditional decrease of the overbite. G.P. used Occlus-o-Guide all night long and 2-4 hours in the afternoon at home and she did the exer- cises to activate the muscle (Fig. 5). At 9 years of age, with totally deep bite resolution, she used the Occlus-o-Guide only at night to hold down previous results and follow patient’s dental growth. At 11 years of age, after successful teeth switching, we prescribed an Occlus-o-Guide Series N, which is functional for permanent dentition and guaranteed an eruptive guide for last dental elements. In these series the recesses are also for first and sec- ond molars in order to preserve and define the over- bite and the correction of second class of malocclu- sion. She carried the device just at night in order to pre- serve the correct overbite and improve the molar rela- tionship (Figs. 6-8). Discussion and Conclusions Dentinogenesis imperfecta (DI) is a genetic disorder affecting the structural integrity of the dentin and re- sulting in weakened dentin. The posterior teeth often need to be extracted due to severe wear or fracture. This frequently yields a loss of posterior occlusion and occlusal vertical dimension. This case shows as the patient optimally corrected her second class mal- occlusion, deep bite and dental misalignment without a severe intervention on surfaces of the teeth. The elastodontic devices allowed a proper eruptive guide for all teeth in different steps of dentition. G.P. used all these appliances with comfort and facility and only few hours a day. Very early, she carried the devices only at night be- cause the deep-bite was corrected in the initial steps of therapy. On Literature there are no case report about ortho- dontic rehabilitation of patients affected by DI in mixed dentition. Bencharit et al. (14) demonstrated that restoring functional occlusion and esthetics for adult patient with DI can be completed successfully Annali di Stomatologia 2017;VIII (1):34-38 36 G. Ierardo et al. Figure 2. Initial Orthopanoramics. Figure 3. Initial cephalometric skull. Figure 4. Intraoral photos with Nite- Guide at 7 years of age and correction of deepbite. @ CIC Edizioni Internazionali

2. In order to correct second class malocclusions there are a lot of different orthodontic appliances described in literature although in the last years the elastodontic devices are the most used. The elastodontic appliances are made with a vinyl resin that is called Elvax® which has optimal charac- teristics of resilience. These appliances are removable, easy to use, com- fortable, safe and simple in construction and function, and they are indicated both in primary and in sec- ondary dentition. They are both functional devices and positioners (8). They are realized in order to correct different ortho- dontic problems: mandibular crowing, deep-bite, open-bite, increased overjet, mandible retrusion. These appliances are characterized by a preformed bite construction that allows a mandibular advance- ment, concurrently with a vertical opening in the ante- rior region to provide a greater vertical development of the posterior teeth (9). Positioners usually achieve minor tooth movement af- ter orthodontic treatment as a result of the elastomer- ic material (8). They use the lip-bumper effect thanks to their labial and oral “shields”. Depending on the type of elastomeric devise, the teeth have their recesses that guide the correct posi- tion in the mouth. Hence elastomeric devices can solve not only the second class malocclusions through a mandibular ad- vancement and increase in lower and anterior face height, but also determines a lot of important dental effect: lingual tipping and regression of the maxillary incisors, correction of molar relationships, decrease overjet and overbite (10). They can solve these orthodontic problems with a minimum operation on teeth, because they don’t need much anchoring. Hence they can be as well used in some cases with oral/systemic diseases (11). The aim of the study was to report the use of an elastodontic therapy in a growing patient affected by DI, second class malocclusion, deep bite and lower arch crowding from the deciduous dentition to perma- nent one. Case report The study reports the case of a 5 years old age child (G.P.) affected by DI. She was totally treated with elastomeric devices since five years to twelve years of age. The extraoral exam underlined these orthodontic characteristics: long face and flat profile with a verti- cal asymmetry (12). The intra-oral exam showed: deep-bite, distal step on the right and on the left, deep dental wear (Fig. 1). The cephalometric analysis underlined increased overjet (3, 7), increased overbite, normal divergence (FMA=23), SNA=73.2, SNB=72, Jarabak poly- gon=400 (Figs. 2, 3). At first, the patient was treated with an elastodontic device known as “Nite-Guide”, which is only for pri- mary dentition from 5 to 7 years old kids. It guides the eruption of primary mandibular incisors and defines a first class of malocclusion and corrects overjet and overbite (13). She carried the Nite-Guide device both at night and on daylight (two hours a day) performing exercises aimed to activate facial muscles and facilitate the deep bite reopening (Fig. 4). Waiting for mandibular permanent incisors eruption, overjet and overbite were corrected. Because of the lower crowding we extracted the deciduous mandibular incisors. At a later stage, when the patient was 7 years old, during her first permanent molars and incisors erup- tion and after optimal house-practices, an Occlus-o- Guide Series G was placed. This kind of Occlus-o-Guide is used in mixed dentition in order to: correct second class of malocclusion and guide the permanent teeth in the right position in the arch as well as to decrease the overjet and overbite. Annali di Stomatologia 2017;VIII (1):34-38 35 Minimally invasive orthodontics: elastodontic therapy in a growing patient affected by Dentinogenesis Imperfecta Figure 1. Clinical case at 5 years of age. @ CIC Edizioni Internazionali

1. Gaetano Ierardo DDS, PhD Valeria Luzzi DDS, PhD Giuliana Nardacci DDS Iole Vozza DDS, PhD Antonella Polimeni MD, DDS Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, Rome, Italy Corresponding author: Giuliana Nardacci Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome Via Caserta 6 00161 Rome, Italy E-mail: giuliananardacci@hotmail.it Summary Aim . The aim of the study was to report the use of an elastodontic therapy in a growing patient af- fected by Dentinogenesis Imperfecta, second class malocclusion, deep bite and lower arch crowding from the deciduous dentition to perma- nent one. Case report . At first, the 5-year-old patient was treated with an elastodontic device known as “Nite-Guide”. When the patient was 7 years old, during her first permanent molars and incisors eruption and after optimal house-practices, an Occlus-o-Guide Series G was placed at night and on daylight (two hours a day) performing exercis- es aimed to activate facial muscles and facilitate the deep bite reopening. At 9 years of age, with totally deep bite resolution, she used the Occluso- Guide only at night to hold down previous results and follow patient’s dental growth. At 11 years of age, after successful teeth switching, we pre- scribed an Occlus-o-Guide Series N, which is functional for permanent dentition and guaran- teed an eruptive guide for last dental elements. Conclusions. This clinic case could be consid- ered an example of approach for all those pa- tients with systemic and/or dental diseases that do not allow adequate dental retention, which is necessary for most orthodontic appliances; elastodontic devices do not require adequate dental retention and define a minimum interven- tion on the surfaces of the teeth. Key words: dentinogenesis imperfecta, orthodon- tics, elastodontic device. Introduction Dentinogenesis Imperfecta (DI) is a disorder of tooth development. It’s characterized by severe hypominer- alization of dentin and altered dentine structure (1-3). In 1973, Shield determined a classification of three dentinal disorders: type I, II and III Dentinogenesis Imperfecta and two types of dentin dysplasia (1). Dentinogenesis Imperfecta type I is the phenotype that is often related to a genetic fragile bone condi- tion, Osteogenesis Imperfecta. This is usually caused by a defect in the two genes encondin type I collagen (1). The type I is also related to other systemic diseases, such as Ehlers-Danlos and Goldblatt syndromes (1). This type is characterized by opalescent brown dis- coloration in both dentitions, and due to reduced sup- port of the dentin, the overlying enamel fractured eas- ily (1). There are also several steps of progressive pulp obliteration which usually begins as soon as the eruption of the teeth occurs. Clinically teeth are often opalescent. The second type of Dentinogenesis Imperfecta is an autosomal dominant condition with a prevalence rate of approximately 1:8000. It’s caused by a mutation of DSPP gene. The clinical and radiographic features are similar to the first type, even though they are expressed more consistently (1). Dentinogenesis Imperfecta type III is also caused by the same DSPP mutation as type II, but shows vari- able discoloration and morphology of the teeth, rang- ing from normal appearing teeth to shell teeth with dentin formation reduction (1, 4, 5). This clinic condition can be related to Osteogenesis Imperfecta (6, 7). From a radiographic point of view, teeth affected from DI are called “specter teeth” because of the empti- ness appearance which makes possible to observe only the polished outlines. In these patients with a no real retention and sub- stance of the teeth, a good anchorage is hard to ob- tain; for this reason this study offers a treatment pos- sibility in order to solve some orthodontic problems of these patients. Annali di Stomatologia 2017;VIII (1):34-38 34 Minimally invasive orthodontics: elastodontic therapy in a growing patient affected by Dentinogenesis Imperfecta Original article @ CIC Edizioni Internazionali

Vizualizări

  • 236 Total Views
  • 165 Website Views
  • 71 Embedded Views

Acțiuni

  • 0 Social Shares
  • 0 Likes
  • 0 Dislikes
  • 0 Comentarii

Share count

  • 0 Facebook
  • 0 Twitter
  • 0 LinkedIn
  • 0 Google+

Embeds 4

  • 16 www.uportho.ro
  • 5 uportho.com
  • 1 uportho.ro
  • 2 www.uportho.com