Case Report
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Orthodontic traction in dentigerous cyst treatment: a case report

Year 2015, Volume: 32 Issue: 3, 149 - 52, 15.07.2015
https://doi.org/10.17214/aot.89723

Abstract

INTRODUCTION: Impacted third molars increase the risk of cystic follicular tissue changes. The presence of impacted third molars and bone defects caused by cysts increase the risk of mandibular angle fractures during surgical procedures. The aim of this case presentation was to describe an alternative method for the extraction of an impacted third molar where a miniscrew was used for the orthodontic traction of the impacted tooth and, thus, a mandibular angle fracture risk as well as the amount of bone defect was reduced.

CASE REPORT: A 68-year-old male patient had been referred to the Department of Oral Surgery, Ege University with pain and swelling complaint at the third molar area. His panoramic radiograph revealed the presence of a dentigerous cyst and a severely impacted third molar at the mandibular angle. Following the intraoral and radiographic evaluation, a miniscrew was inserted into the buccal cortex between the canine and first premolar. An attachment was bonded to the available exposed surface of the impacted molar and light, continuous extrusive force was applied with a coilspring. A powerarm was used in order to bypass the soft tissue curvature and to prevent soft tissue impingement. After a traction period of 8 months, the molar was surgically removed.

CONCLUSION: Orthodontic extrusion of impacted molars with miniscrews prior to surgical removal may be an alternative treatment option for reducing the risk of mandibular angle fracture in the presence of bone defects.

References

  • Neville BW. Odontogenic cysts and tumors. Neville BW, Damm DD, Allen CM, Bouquot JE, eds. Oral and Maxillofacial Pathology. 1stedn. Philadelphia: WB Saunders; 1995. p.493-6.
  • Johnson NR, Gannon OM, Savage NW, Batstone MD. Frequency of odontogenic cysts and tumors: a systematic review. J Investig Clin Dent 2014;5:9-14.
  • Werkmeister R, Fillies T, Joos U, Smolka K. Relationship between lower wisdom tooth position and cyst development, deep abcess for- mation and mandibular fracture. J Craniomaxillofac Surg 2005;33:164- 8.
  • Eliasson S, Heimdahl A, Nordenram A. Pathological changes related to long-term impaction of third molars. A radiographic study. Int J Oral Maxillofac Surg 1989;18:210-2.
  • Woldenberg Y, Gatot I, Bodner L. Iatrogenic mandibular fracture as- sociated with third molar removal. Can it be prevented? Med Oral Patol Oral Cir Bucal 2007;12:E70-2.
  • Checchi L, Alessandri Bonetti G, Pelliccioni GA. Removing high-risk impacted mandibular third molars: a surgical-orthodontic approach. J Am Dent Assoc 1996;127:1214-7.
  • Alessandri Bonetti G, Bendandi M, Laino L, Checchi V, Checchi L. Orthodontic extraction: riskless extraction of impacted lower third mo- lars close to the mandibular canal. J Oral Maxillofac Surg 2007;65:2580- 6.
  • Bonetti GA, Parenti SI, Checchi L. Orthodontic extraction of mandi- bular third molar to avoid nerve injury and promote periodontal healing. J Clin Periodontol 2008;35:719-23.
  • Carranza FA. Clinical diagnosis. Newman MG, Takei HH, Carranza FA, eds. Carranza’s Clinical Periodontology. 9thedn. Philadelphia: WB Saunders; 2002. p.439.
  • Wang Y, He D, Yang C, Wang B, Qian W. An easy way to apply ort- hodontic extraction for impacted lower third molar compressing to the in- ferior alveolar nerve. J Craniomaxillofac Surg 2012;40:234-7.
  • Hirsch A, Shteiman S, Boyan BD, Schwartz Z. Use of orthodontic tre- atment as an aid to third molar extraction: a method for prevention of mandibular nerve injury and improved periodontal status. J Periodontol 2003;74:887-92.
  • Marchetti C, Bonetti GA, Pieri F, Checchi L. Orthodontic extraction: conservative treatment of impacted mandibular third molar associated with a dentigerous cyst. A case report. Quintessence Int 2004;35:371- 4.

Dentijeröz kist tedavisinde ortodontik traksiyon: olgu bildirimi

Year 2015, Volume: 32 Issue: 3, 149 - 52, 15.07.2015
https://doi.org/10.17214/aot.89723

Abstract

TANITIM: Üçüncü molar dişlerin gömülü kalması, kistik foliküler doku transformasyonunu ve özellikle dentijeröz kist oluşumu riskini artıran etkenlerden biridir. Dentijeröz kistler genişleme potansiyeline sahiptir ve komşu kemiği rezorbe ederek kemiğin bütünsel ve yapısal direncini zayıflatır. Bu kistlerin tedavisinde enükleasyon ve ilgili dişin çekimi ya da marsupyalizasyon ve kist kavitesinin dekompresyonu hedeflenir. Kemikte meydana gelen defektin büyük hacimli olması ve gömülü dişin mandibuler kanala yakın olması, dişin çekimi esnasında mandibuler sinir hasarı veya mandibula kırığı riskini artırır. Bu olgu bildiriminde iatrojenik mandibula kırığı riski taşıyan gömülü üçüncü moların ortodontik traksiyon sonrası çekimi ile dentijeröz kistin tedavi süreci sunulmaktadır.

OLGU BİLDİRİMİ: Sol mandibuler korpus bölgesinde ağrı ve şişlik şikâyeti ile Ege Üniversitesi Diş Hekimliği Fakültesine başvuran 68 yaşındaki erkek hastanın yapılan klinik muayenesinde sol mandibuler dişsiz kret bölgesinde ödem tespit edilmiştir. Radyografik incelemede bilateral gömülü mandibuler üçüncü molar dişler ve solda dentijeröz kiste bağlı kortikal sınırlara ulaşan kemik defekti izlenmiştir. Yapılan tomografik incelemede bukkal korteksin fenestre olduğu belirlenmiştir. Kemik defektinin sınırları sebebiyle kırık riskini engellemek amacıyla kist marsupyalize edilmiş, aynı seansta ekspoze edilen gömülü molara ortodontik ataşman yerleştirilmiştir. Premolar bölgesine yerleştirilen mini vida ile kemikten ankraj alınarak gömülü moların angulus bölgesinden traksiyonu gerçekleştirilmiş, kist kavitesinin dekompresyonu ve diş hareketi ile anguler bölgede kemiğin kalınlaşması sağlanmıştır. Sekiz ay süren traksiyon periyodunu takiben molar dişin çekimi gerçekleştirilmiştir.

SONUÇ: Kemik defektinin büyüklüğü ve gömülü dişin yaşamsal anatomik dokularla ilişkisine bağlı iatrojenik komplikasyon riski taşıyan dentijeroz kistlerin tedavisinde cerrahi girişim öncesi gömülü dişin ortodontik traksiyonu, güvenli cerrahi için bir tedavi alternatifi olabilir.

References

  • Neville BW. Odontogenic cysts and tumors. Neville BW, Damm DD, Allen CM, Bouquot JE, eds. Oral and Maxillofacial Pathology. 1stedn. Philadelphia: WB Saunders; 1995. p.493-6.
  • Johnson NR, Gannon OM, Savage NW, Batstone MD. Frequency of odontogenic cysts and tumors: a systematic review. J Investig Clin Dent 2014;5:9-14.
  • Werkmeister R, Fillies T, Joos U, Smolka K. Relationship between lower wisdom tooth position and cyst development, deep abcess for- mation and mandibular fracture. J Craniomaxillofac Surg 2005;33:164- 8.
  • Eliasson S, Heimdahl A, Nordenram A. Pathological changes related to long-term impaction of third molars. A radiographic study. Int J Oral Maxillofac Surg 1989;18:210-2.
  • Woldenberg Y, Gatot I, Bodner L. Iatrogenic mandibular fracture as- sociated with third molar removal. Can it be prevented? Med Oral Patol Oral Cir Bucal 2007;12:E70-2.
  • Checchi L, Alessandri Bonetti G, Pelliccioni GA. Removing high-risk impacted mandibular third molars: a surgical-orthodontic approach. J Am Dent Assoc 1996;127:1214-7.
  • Alessandri Bonetti G, Bendandi M, Laino L, Checchi V, Checchi L. Orthodontic extraction: riskless extraction of impacted lower third mo- lars close to the mandibular canal. J Oral Maxillofac Surg 2007;65:2580- 6.
  • Bonetti GA, Parenti SI, Checchi L. Orthodontic extraction of mandi- bular third molar to avoid nerve injury and promote periodontal healing. J Clin Periodontol 2008;35:719-23.
  • Carranza FA. Clinical diagnosis. Newman MG, Takei HH, Carranza FA, eds. Carranza’s Clinical Periodontology. 9thedn. Philadelphia: WB Saunders; 2002. p.439.
  • Wang Y, He D, Yang C, Wang B, Qian W. An easy way to apply ort- hodontic extraction for impacted lower third molar compressing to the in- ferior alveolar nerve. J Craniomaxillofac Surg 2012;40:234-7.
  • Hirsch A, Shteiman S, Boyan BD, Schwartz Z. Use of orthodontic tre- atment as an aid to third molar extraction: a method for prevention of mandibular nerve injury and improved periodontal status. J Periodontol 2003;74:887-92.
  • Marchetti C, Bonetti GA, Pieri F, Checchi L. Orthodontic extraction: conservative treatment of impacted mandibular third molar associated with a dentigerous cyst. A case report. Quintessence Int 2004;35:371- 4.
There are 12 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Case Report
Authors

Enver Yetkiner

Uğur Tekin

Çınar Atagün This is me

Publication Date July 15, 2015
Published in Issue Year 2015 Volume: 32 Issue: 3

Cite

APA Yetkiner, E., Tekin, U., & Atagün, Ç. (2015). Dentijeröz kist tedavisinde ortodontik traksiyon: olgu bildirimi. Acta Odontologica Turcica, 32(3), 149-52. https://doi.org/10.17214/aot.89723
AMA Yetkiner E, Tekin U, Atagün Ç. Dentijeröz kist tedavisinde ortodontik traksiyon: olgu bildirimi. Acta Odontol Turc. July 2015;32(3):149-52. doi:10.17214/aot.89723
Chicago Yetkiner, Enver, Uğur Tekin, and Çınar Atagün. “Dentijeröz Kist Tedavisinde Ortodontik Traksiyon: Olgu Bildirimi”. Acta Odontologica Turcica 32, no. 3 (July 2015): 149-52. https://doi.org/10.17214/aot.89723.
EndNote Yetkiner E, Tekin U, Atagün Ç (July 1, 2015) Dentijeröz kist tedavisinde ortodontik traksiyon: olgu bildirimi. Acta Odontologica Turcica 32 3 149–52.
IEEE E. Yetkiner, U. Tekin, and Ç. Atagün, “Dentijeröz kist tedavisinde ortodontik traksiyon: olgu bildirimi”, Acta Odontol Turc, vol. 32, no. 3, pp. 149–52, 2015, doi: 10.17214/aot.89723.
ISNAD Yetkiner, Enver et al. “Dentijeröz Kist Tedavisinde Ortodontik Traksiyon: Olgu Bildirimi”. Acta Odontologica Turcica 32/3 (July 2015), 149-52. https://doi.org/10.17214/aot.89723.
JAMA Yetkiner E, Tekin U, Atagün Ç. Dentijeröz kist tedavisinde ortodontik traksiyon: olgu bildirimi. Acta Odontol Turc. 2015;32:149–52.
MLA Yetkiner, Enver et al. “Dentijeröz Kist Tedavisinde Ortodontik Traksiyon: Olgu Bildirimi”. Acta Odontologica Turcica, vol. 32, no. 3, 2015, pp. 149-52, doi:10.17214/aot.89723.
Vancouver Yetkiner E, Tekin U, Atagün Ç. Dentijeröz kist tedavisinde ortodontik traksiyon: olgu bildirimi. Acta Odontol Turc. 2015;32(3):149-52.