1. Dr. Mohammed Zaheer Kola*, Dr Hussam Sulaiman Almadi
Delayed eruption of impacted canine forcing the dislodgment of Fixed partial denture……CASE REPORT
Dr. Mohammed Zaheer Kola*, Dr Hussam Sulaiman Almadi
Faculty, College of Dentistry, Prince Sattam bin Abdulaziz University , Alkharj
Introduction
Treatment Plan
Pictures
Discussion
Unerupted teeth, unusual eruption, transposition and malpositioning of teeth have always compromised the oral health situation. Unerupted teeth or late erupted teeth have always shown the negative effect on normally erupted teeth either by forcing the tooth from out of arch, or compromising the position. Some cases delayed eruption of teeth because of some pathological or non-pathological situation may also disturbed the teeth or prostheses which is already present in the oral cavity. This poster shall represent a clinical case where prosthesis was being dislodged by delayed eruption of canine, causing discomfort and compromised aesthetic. After the combined group discussion with different speciality and their limitation, the prostheses was removed and impacted canine was extracted to precede the placement of new prostheses.
- Oral prophylaxis.
Diagnostic cast & Index
RCT irt 25
Orthodontic referral for impacted canines
Maxillo facial surgeon for extraction of canine by palatal approach
Extraction of retained deciduous canines
Fabrication of new prostheses with additional abutment and intentional open bite.
Prosthodontic rehabilitation for this particular clinical scenario was little confusing and challenging. As their were many option for treating this case and it was a challenge for operator to defend the approach he applied. Extrusion of canine would have been done but as discussed patient was not convinced with the duration of the treatment.
The treatment rendered before was not well planned as impacted canines were ignored during diagnosis and treatment planning and also the deciduous teeth were considered as abutment for the fixed partial denture.
Every dentist has its own way of approaching the treatment plan, but at the end the outcome of treatment should be best acceptable by patient for his comfort and aesthetics.
Treatment
Upper and lower diagnostic impression were made and diagnostic cast achieved. Index were made on diagnostic cast. Orthodontic reference is taken regarding the eruption and extrusion plan for the impacted canine. The suggestion was to remove the prostheses and extrude the teeth , mean while a temporary prostheses was planned. But duration of treatment time was one of the setback factor. The position of right canine was very deep in the bone and placed and was almost near naso antral level. When patient was explained about the treatment plan and time duration, he was not so enthusiastic. He insisted on any other approach which will restore his aesthetics as early as possible. Another approach was reviewed. Removing the prostheses, followed by extraction of both the deciduous canine and extraction of impacted canines. But keeping the buccal bone intact was major concern. The treatment plan was discussed with maxillo facial surgeon and explained the need of keeping buccal bone intact to maintain the esthetical appearance.
Conclusions
Treatment of ill fitting fixed partial which was forced to displaced by erupting maxillary canine was discussed in detail. Various treatment option and their restriction were reviewed. The best possible approach was applied with all the consent.
Case Report
Response to Treatment
A male patient aged 30 years reported to the prince sattam bin abdulaziz university dental college complains of ill-fitting and dislodging fixed prostheses in upper anterior region. Patient was worried about aesthetic and pointing out extra teeth erupting out from above the fixed prostheses. Intra oral examination revealed presence of well fabricated prostheses in upper and lower arch. The FPD in upper arch from first premolar to extending other first premolar and lower from canine to canine. The erupting canine on the left side was forcing the prostheses to dislodge. There was no significant sign and symptoms. The prostheses were placed four years back and patient was satisfied with the aesthetic and outcome till date. Radiographic examination revealed the bilateral unerupted canine. . Bilateral retained deciduous canine was taken as abutment for the prostheses. Missing lateral incisor on right side was noticed.
Patient was satisfied with the out come of the treatment, but open bite was concern for him.He was expalined about the need of giving minimal open bite to avoid trauma from occlusion and convinced. Patient was advice for proper oral hygiene and regular follow up.
References
Ericson, Sune, and Jüri Kurol. "Radiographlc assessment of maxillary canine eruption in children with clinical signs of eruption disturbance." The European Journal of Orthodontics 8.3 (1986):
Ramakrishnan, Hari Haran. "Understanding Problems and Failures in TSFDP." (2015).