IntrusÕon of Over-Erupted Maxillary Molar Teeth By UsÕng MÕnÕ-Screw Anchorage

Abstract

Over-erupsiyon of upper molars and premolars following loss of the opposing tooth is a common clinical finding. In such cases, when the interocclusal space is reduced, intrusion treatment with miniscrew implants of the upper posterior teeth to correct a canted occlusal plane could be an ideal treatment strategy for the mandibles’ prosthetic treatment with implant supported fixed dentures. METHODS : The study was comprised of 9 patients aged 27 to 59 years; mean 36,4 years with overerupted maxillary posterior teeth. Four self-drilling miniscrew implants 2 for buccal alveolar bone region and 2 for posterior palatal area were inserted. An elastomeric chain applied 80 g of force to each overerupted maxillary posterior teeth. The elastomeric chain was replaced every three weeks. Panoramic radiograms were obtained preintrusion and immediately after completion of the intrusion. The panoramic radiograms were superposed and the distances between the occlusal planes of first molar teeth were measured. Then osseointegrated implants placed in the opposing posterior mandible region and prosthetic treatments were finalized. RESULTS: Upper posterior teeth were intruded with an average of 4,42± 0,62 mm according to changings of the first maxillary molars’ occlusal planes, after in a mean of 4,89 ± 1,00 months active treatment. There were not any rooth resorption determined during the treatment acccording to radiograms .A good occlusion was achieved with implant supported fixed partial dentures for mandible after treatment

Keywords

• Microimplant, Mini Screws, Intrusion, Bone anchorage

Over-erüpte üst molar dişlerin mini-vida ankrajı ile intrüzyonu

Abstract

Amaç: Antagonist dişlerin kaybedilmesi sonucunda dişlerin kontağını kaybetmesi sebebi ile over-erupsiyona sıklıkla karşılaşılan bir durumdur. Bu durumda over-erupsiyona uğramış dişlerin ortodontik tedavi ile intrüze edilmesi yoluyla interoklüzal mesafenin arttırılması, kayıp dişlerin protetik olarak yerine konulmasına imkân sağlayacak en ideal yöntem olarak öne çıkmaktadır. Bu çalışmanın amacı; implant destekli sabit protetik restorasyonlar için yeterli interoklüzal mesafe kazanmak amacıyla üst molar bölge intrüzyonu sırasında ankraj amaçlı mini vida kullanımının etkinliğinin araştırılmasıdır. Gereç ve Yöntem: Çalışmaya over erüpsiyona uğramış üst molar dişlere sahip 27-59 yaşları arasında ortalama yaş: 36,4 6 erkek, 3 bayan toplam 9 birey dahil edilmiştir.İki adet vestibul iki adet palatinal bölgeye olmak üzere 4 adet self drill mini vida yerleştirilmiştir. Vidalar arasına diş başına 80 g kuvvet uygulayacak şekilde elastik zincirler uygulandı. Elastik zincirler 3 haftada bir değiştirildi. Hastalardan intrüzyona başlamadan önce ve intrüzyonun tamamlanmasını müteakiben panoramik radyografiler alındı. Çakıştırılan radyografiler üzerinde, çalışma bölgesinde bulunan birinci şlerinin oklüzal düzlemleri arasındaki mesafe ölçülerek intrüzyon miktarları hesaplandı. Ortodontik tedaviyi müteakiben bütün hastalara osteointegre implantlar uygulandı ve protetik restorasyonlar yapıldı

Keywords

• Mikroimplant, Mini vida, İntruzyon, Kemik ankrajı

References

1. Park YC, Lee SY, Kim DH, Jee SH. Intrusion of posterior teeth using mini-screw implants. Am J Orthod Dentofacial Orthop. 2003; 123: 690-4.
2. Romeo A, Esteves M, García V, Bermşdez J. Movement evaluation of ove- rerupted upper molars with absolute anchora- ge: An in-vitro study. Med Oral Patol Oral Cir Bucal. 2010 Nov 1; 15(6): 930-5.
3. Melo AC, Jawonski ME, Largura LZ, Thomé G, de Souza JR, da Silva MA. Upper molar intrusion in rehabilitation patients with the aid of microscrews. Aust Orthod J. 2008; 24: 50-3.
4. Arat ZM, Sezer FE, Arslan AD. A new approach in the treatment of skeletal open bite: vertically activated bite block. World J Orthod. 2006; 7: 345-56.
5. Hwang HS, Lee KH. Intrusion of ove- rerupted molars by cortico- tomy and magnets. Am J Orthod Dentofacial Orthop. 2001; 120: 209- 16.
6. Park HS, Jang BK, Kyung HM. Maxil- lary molar intrusion with micro-implant ancho- rage (MIA). Aust Orthod J. 2005; 21: 129-35.
7. Uribe F, Havens B, Nanda R. Reduc- tion of gingival display with maxillary intru- sion using endosseous dental implants. J Clin Orthod. 2008; 42: 157-63.
8. Shellhart CW,Moawad M,Lake P. Case Report: Implants as anchorage for molar up- righting and intrusion. Angle Orthod. 1996; 66(3): 169-172.

9. Roberts WE, Helm FR, Marshall KJ, Gongloff RK. Rigid endosseous implants for orthodontic and orthopedic anchorage. Angle Orthod. 1989; 59(4): 247-56.
10. Costa A,Raffainl M,Melsen B. Mi- niscrews as orthodontic anchorage: a prelimi- nary report. Int J AdultOrhod Orthognath Surg. 1998; 13(3): 201-9.
11. Kanomi R. Mini implant for orthodon- tic anchorage. J Clin Orthod. 1997; 31(11): 763-7.
12. Park HS, Bae SM, Kyung HM,Sung JH. Micro implant anchorage for treatment of skeletal class I bialveoler protrusion. J Clin Orthod. 2001; 35(7): 417-22.
13. Ohnishi H, Yagi T, Yasuda Y, Takada K. A mini-implant for orthodontic anchorage in a deep overbite case. Angle Orthod. 2005; 75(3): 444-52.
14. Ozsoy OP, Ozcirpici AA, Veziroğlu F. Miniscrews for upper incisor intrusion. Eur J of Orthod. 2009; 31: 412-6.
15. Melsen B, Fiorelli G. Upper molar int- rusion. J Clin Orthod. 1996; 30: 91-6.
16. Chang YJ, Lee HS, Chun YS. Mic- roscrew anchorage for molar intrusion. J Clin Orthod. 2004; 38: 325-30.
17. Kravitz ND, Kusnoto B, Tsay PT, Hohlt WF. Intrusion of over- erupted upper first molar using two orthodontic miniscrews. A case report. Angle Orthod. 2007; 77: 915-22.
18. Arslan A, Ozdemir ND, Mert HG, Malkondu O, Sencift K. Intrusion of an ove- rerupted mandibular molar using mini-screws and mini-implants: a case report. Australian Dental Journal 2010; 55: 457-61.