Peg-shaped and small lateral incisors not at higher risk for root resorption.
ABSTRACT The purpose of this study was to examine the pattern of external root resorption for peg-shaped and small lateral incisors according to various conditions and to compare it with that of normal-shaped lateral incisors. The periapical radiographs of 114 patients with 60 peg-shaped and 54 small lateral incisors were measured before and after treatment. Crown shape was assessed by examining pretreatment study casts. Findings showed that there was no significant difference in external root resorption between peg-shaped (1.09 mm) and normal lateral incisors (0.88 mm). However, a statistically significant difference in apical root resorption between small lateral incisors (1.03 mm) and normal lateral incisors (1.62 mm) was found. Peg-shaped laterals were also coincidentally found to occur more frequently on the left side of the arch.
Article: Root resorption of the maxillary lateral incisor caused by impacted canine: a literature review.[show abstract] [hide abstract]
ABSTRACT: Root resorption of maxillary lateral incisors caused by erupting canines is well known and a relatively common phenomenon. However, much debate and conflicting evidence exists with regard to the actual resorption trigger and potential etiological factors involved. Consequently, there are no obvious clinical clues concerning prevention and diagnosis as well as subsequent treatment decisions. The introduction of cone beam computer tomography has recently allowed drawing a new and much more documented light on the diagnostic and therapeutic strategies. However, no investigations have determined that this new information may result in another and better diagnostic approach and an improved treatment outcome. Therefore, the present review will attempt to summarize the existing evidence on two- and three-dimensional images and try to link the radiological observations to any further preventive, diagnostic, and/or therapeutic measures. Detection thresholds, accuracy, and reliability of impacted canine localization and neighboring root resorption risks will also be considered. This review demonstrates how adding a third-dimension to the radiographic information may notably alter the prevalence of root resorptions and descriptions of this prevalence. In any case, further investigation is needed to determine resorption detection thresholds in various two-dimensional and three-dimensional imaging techniques, as well as to determine therapeutic thresholds and criteria for strategic tooth extraction based on radiographic manifest and not manageable resorption lesions.Clinical Oral Investigations 04/2009; 13(3):247-55. · 2.36 Impact Factor
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ABSTRACT: Current information suggests that the major variation in orthodontic root resorption can be explained by differences in individual predisposition. Our aim was therefore to test the predictive value of the amount of maxillary incisor resorption about 6 and 12 months after bracket placement for the resorption at appliance removal. We measured tooth length of the maxillary incisors on digitally converted periapical radiographs, adjusted for projection errors, made before treatment (T1), about 6 months (T2) and 12 months (T3) after bracket placement, and at the end of active treatment (T4) of 267 prospectively enrolled orthodontic patients, and interpreted reduced tooth length as apical root resorption. Anatomic and occlusal parameters were scored on the T1 radiographs and study models. Anamnestic and treatment parameters were collected from standardized recordings in the charts. The Spearman R for resorption of each incisor ranged from 0.61 to 0.76 at T2 vs T4, and from 0.77 to 0.88 at T3 vs T4 (P <0.001). Only 0.6% of the patients with no incisors with >1.0 mm of resorption at T2 and 0.5% of those with no incisors with >2.0 mm of resorption at T3 had at least 1 incisor with >5.0 mm of resorption at T4. Amount of resorption at T3 and maxillary tooth extraction were included in the final prediction model for resorption of the most severely affected central and lateral incisors at T4, with explained variances of 0.71 and 0.67, respectively. Treatment duration and time with square wires was not related to resorption (P >0.05). Patients at risk of severe apical root resorption can be identified according to the amount of resorption during the initial treatment stages.American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 04/2009; 135(4):448-55. · 1.33 Impact Factor
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ABSTRACT: This case report describes the treatment of one patient with maxillary anterior spacing, caused by bilateral lateral peg-shaped incisors, using a planned sequence of multidisciplinary approaches for esthetic treatment. An asymmetrical gingival line was visible when the patient smiled. To evaluate the desired gingival level and the proportion of restoration to be made using the recurring esthetic dental (RED) proportion method, a diagnostic wax-up model was fabricated. Esthetic crown lengthening corrected the gingival line. RED proportion analysis suggested minor tooth movement prior to any restoration. Two weeks' use of an orthodontic removable appliance with finger springs achieved the proper dental proportion. Home whitening was prescribed for 2 weeks, with an additional 2-week waiting period to ensure tooth color stability. Resin composite treatment corrected the mesial contour of the maxillary canines and reduced the space between the canines and lateral incisors. Final restoration was obtained by placing ceramic veneers on the lateral peg-shaped incisors. The esthetic treatment achieved excellent results; after veneer cementation, the patient exhibited greater confidence with a new smile. CLINICAL SIGNIFICANCE: Esthetic dental treatment requires various disciplines to achieve the treatment goal. This case report is an example of well-planned sequences of treatment from the beginning to complete treatment. By conservative and practical treatment approaches used in this case, the clinician will be able to manage to obtain the highest result of esthetic treatment. (J Esthet Restor Dent 25:16-30, 2013).Journal of Esthetic and Restorative Dentistry 02/2013; 25(1):16-30. · 0.99 Impact Factor