[Orthodontics in general practice. 2. Treatment of eruption failures].
Since the introduction of composites and bonding in orthodontics, the possibilities of aligning impacted teeth into the dental arch after a surgical intervention, have remarkably increased. There are 4 important treatment techniques. The closed-eruption technique includes bracket-bonding to and ligating of the exposed tooth, followed by repositioning of the mucosal flap. The disadvantage of the method is the uncontrollable orthodontic force on the non-visible tooth during orthodontic extrusion. The open-eruption technique aims at keeping the exposed tooth visible, followed by spontaneous eruption. However, the exposure appears often as a radical exposure with unfavourable gingival consequences. The open-eruption technique with apical positioned mucosal flap is designed to expose teeth highly buccally impacted. The mucosal graft may cause a typical thick, stretched and not aesthetically acceptable gum after orthodontic treatment, even in case of using a split-thickness graft. The modified window technique is an open-eruption technique with minimal exposure, resulting in immediate eruption. If orthodontic treatment is required, the tooth is no longer impacted. The success rates of the 4 techniques vary from 75 until 99%. Study of the literature reveals insufficient scientific evidence in favour of 1 treatment technique. However, independent of the surgical technique applied, general practitioners play a crucial role in diagnostics of eruption failures and timely referral to an orthodontist.
Swart
R J
RJ
Afdeling Orthodontie en Orale Biologie, van het UMC St Radboud, Nijmegen. r.swart@dent.umcn.nl
Kiekens
R M A
RM
Bergé
S J
SJ
Kuijpers-Jagtman
A M
AM
D006801:Humans; D009967:Orthodontic Appliances; D009969:Orthodontic Wires; D009972:Orthodontics, Interceptive / Q000379:methods*; D013524:Surgical Flaps; D014079:Tooth Eruption, Ectopic / Q000601:surgery; D014087:Tooth Movement Techniques / Q000295:instrumentation* / Q000379:methods*; D014095:Tooth, Impacted / Q000601:surgery*