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http://dx.doi.org/10.4041/kjod.2016.46.1.42

Facial and occlusal esthetic improvements of an adult skeletal Class III malocclusion using surgical, orthodontic, and implant treatment  

de Almeida Cardoso, Mauricio (Department of Orthodontics, University of Sagrado Coracao)
de Molon, Rafael Scaf (Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Univ Estadual Paulista - UNESP)
de Avila, Erica Dorigatti (Department of Dental Materials and Prosthodontics, School of Dentistry at Araraquara, Univ Estadual Paulista - UNESP)
Guedes, Fabio Pinto (Department of Orthodontics, University of Sagrado Coracao)
Filho, Valter Antonio Ban Battilani (Department of Orthodontics, University of Sagrado Coracao)
Filho, Leopoldino Capelozza (Department of Orthodontics, University of Sagrado Coracao)
Correa, Marcio Aurelio (Department of Oral Implantology, University of Sagrado Coracao - USC)
Filho, Hugo Nary (Department of Oral Implantology, University of Sagrado Coracao - USC)
Publication Information
The korean journal of orthodontics / v.46, no.1, 2016 , pp. 42-54 More about this Journal
Abstract
The aim of this clinical report is to describe the complex treatment of an adult Class III malocclusion patient who was disappointed with the outcome of a previous oral rehabilitation. Interdisciplinary treatment planning was performed with a primary indication for implant removal because of marginal bone loss and gingival recession, followed by orthodontic and surgical procedures to correct the esthetics and skeletal malocclusion. The comprehensive treatment approach included: (1) implant removal in the area of the central incisors; (2) combined orthodontic decompensation with mesial displacement and forced extrusion of the lateral incisors; (3) extraction of the lateral incisors and placement of new implants corresponding to the central incisors, which received provisional crowns; (4) orthognathic surgery for maxillary advancement to improve occlusal and facial relationships; and finally, (5) orthodontic refinement followed by definitive prosthetic rehabilitation of the maxillary central incisors and reshaping of the adjacent teeth. At the three-year follow-up, clinical and radiographic examinations showed successful replacement of the central incisors and improved skeletal and esthetic appearances. Moreover, a Class II molar relationship was obtained with an ideal overbite, overjet, and intercuspation. In conclusion, we report the successful esthetic anterior rehabilitation of a complex case in which interdisciplinary treatment planning improved facial harmony, provided gingival architecture with sufficient width and thickness, and improved smile esthetics, resulting in enhanced patient comfort and satisfaction. This clinical case report might be useful to improve facial esthetics and occlusion in patients with dentoalveolar and skeletal defects.
Keywords
Esthetics; Dental implants; Orthodontics; Orthognathic surgery;
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1 de Molon RS, Avila ED, Cirelli JA, Mollo-Jr FD, Andrade MF, Barros-Filho LA, et al. A combined approach for the treatment of resorbed fresh sockets allowing immediate implant restoration. A 2-year follow-up. J Oral Implantol 2015;41:712-8.   DOI
2 Choquet V, Hermans M, Adriaenssens P, Daelemans P, Tarnow DP, Malevez C. Clinical and radiographic evaluation of the papilla level adjacent to single-tooth dental implants. A retrospective study in the maxillary anterior region. J Periodontol 2001;72:1364-71.   DOI
3 Kan JY, Rungcharassaeng K. Interimplant papilla preservation in the esthetic zone: a report of six consecutive cases. Int J Periodontics Restorative Dent 2003;23:249-59.
4 Belser UC, Schmid B, Higginbottom F, Buser D. Outcome analysis of implant restorations located in the anterior maxilla: a review of the recent literature. Int J Oral Maxillofac Implants 2004;19 Suppl:30-42.
5 Spear FM, Kokich VG, Mathews DP. Interdisciplinary management of anterior dental esthetics. J Am Dent Assoc 2006;137:160-9.   DOI
6 de Molon RS, Morais-Camilo JA, Verzola MH, Faeda RS, Pepato MT, Marcantonio E Jr. Impact of diabetes mellitus and metabolic control on bone healing around osseointegrated implants: removal torque and histomorphometric analysis in rats. Clin Oral Implants Res 2013;24:831-7.   DOI
7 de Molon RS, de Avila ED, Cirelli JA, Cardoso Mde A, Capelozza-Filho L, Borelli Barros LA. Optimizing maxillary aesthetics of a severe compromised tooth through orthodontic movement and dental implants. Case Rep Dent 2014;2014:103808.
8 de Avila ED, de Molon RS, de Assis Mollo F Jr, de Barros LA, Capelozza Filho L, de Almeida Cardoso M, et al. Multidisciplinary approach for the aesthetic treatment of maxillary lateral incisors agenesis: thinking about implants? Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114:e22-8.
9 de Molon RS, de Avila ED, de Barros-Filho LA, Ricci WA, Tetradis S, Cirelli JA, et al. Reconstruction of the alveolar buccal bone plate in compromised fresh socket after immediate implant placement followed by immediate provisionalization. J Esthet Restor Dent 2015;27:122-35.   DOI
10 Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants 2004;19 Suppl:43-61.
11 Furhauser R, Florescu D, Benesch T, Haas R, Mailath G, Watzek G. Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. Clin Oral Implants Res 2005;16:639-44.   DOI
12 Jung RE, Pjetursson BE, Glauser R, Zembic A, Zwahlen M, Lang NP. A systematic review of the 5-year survival and complication rates of implant-supported single crowns. Clin Oral Implants Res 2008;19:119-30.   DOI
13 Margonar R, Queiroz TP, Luvizuto ER, Santos PL, Wady AF, Paleari AG. Anterior tooth rehabilitation with frozen homogenous bone graft and immediately loaded titanium implant using computer-guided surgery. J Craniofac Surg 2012;23:e470-2.   DOI
14 Seibert JS, Salama H. Alveolar ridge preservation and reconstruction. Periodontol 2000 1996;11:69-84.   DOI
15 Margonar R, Queiroz TP, Marcantonio E, Luvizuto ER, Faloni AP, Betoni W Jr, et al. Rehabilitation of the maxillary arch after bone graft using immediate loading with implant-supported fixed restoration. J Craniofac Surg 2014;25:e44-8.   DOI
16 Milinkovic I, Cordaro L. Are there specific indications for the different alveolar bone augmentation procedures for implant placement? A systematic review. Int J Oral Maxillofac Surg 2014;43:606-25.   DOI
17 Shiu YT, Weiss JA, Hoying JB, Iwamoto MN, Joung IS, Quam CT. The role of mechanical stresses in angiogenesis. Crit Rev Biomed Eng 2005;33:431-510.   DOI
18 de Avila ED, de Molon RS, Loffredo LC, Massucato EM, Hochuli-Vieira E. Health-related quality of life and depression in patients with dentofacial deformity. Oral Maxillofac Surg 2013;17:187-91.   DOI
19 Nisapakultorn K, Suphanantachat S, Silkosessak O, Rattanamongkolgul S. Factors affecting soft tissue level around anterior maxillary single-tooth implants. Clin Oral Implants Res 2010;21:662-70.   DOI
20 Kan JY, Rungcharassaeng K, Fillman M, Caruso J. Tissue architecture modification for anterior implant esthetics: an interdisciplinary approach. Eur J Esthet Dent 2009;4:104-17.
21 Papalexiou V, Novaes AB Jr, Ribeiro RF, Muglia V, Oliveira RR. Influence of the interimplant distance on crestal bone resorption and bone density: a histomorphometric study in dogs. J Periodontol 2006;77:614-21.   DOI
22 de Barros LA, de Almeida Cardoso M, de Avila ED, de Molon RS, Siqueira DF, Mollo-Junior Fde A, et al. Six-year follow-up of maxillary anterior rehabilitation with forced orthodontic extrusion: achieving esthetic excellence with a multidisciplinary approach. Am J Orthod Dentofacial Orthop 2013;144:607-15.   DOI
23 de Molon RS, de Avila ED, de Souza JA, Nogueira AV, Cirelli CC, Cirelli JA. Combination of orthodontic movement and periodontal therapy for full root coverage in a Miller class III recession: a case report with 12 years of follow-up. Braz Dent J 2012;23:758-63.   DOI
24 de Molon RS, de Avila ED, de Souza JA, Nogueira AV, Cirelli CC, Margonar R, et al. Forced orthodontic eruption for augmentation of soft and hard tissue prior to implant placement. Contemp Clin Dent 2013;4:243-7.   DOI
25 de Molon RS, Kim YJ, Dos Santos-Pinto A, Cirelli JA. Improvement of an anterior infrabone defect using combined periodontal and orthodontic therapy: A 6-year follow-up case report. Eur J Dent 2014;8:407-11.   DOI
26 Tarnow DP, Magner AW, Fletcher P. The effect of the distance from the contact point to the crest of bone on the presence or absence of the interproximal dental papilla. J Periodontol 1992;63:995-6.   DOI
27 Corrente G, Abundo R, Re S, Cardaropoli D, Cardaropoli G. Orthodontic movement into infrabony defects in patients with advanced periodontal disease: a clinical and radiological study. J Periodontol 2003;74:1104-9.   DOI
28 Korayem M, Flores-Mir C, Nassar U, Olfert K. Implant site development by orthodontic extrusion. A systematic review. Angle Orthod 2008;78:752-60.   DOI
29 Sonego CL, Bobrowski AN, Chagas OL Jr, Torriani MA. Aesthetic and functional implications following rotation of the maxillomandibular complex in orthognathic surgery: a systematic review. Int J Oral Maxillofac Surg 2014;43:40-5.   DOI
30 Funato A, Salama MA, Ishikawa T, Garber DA, Salama H. Timing, positioning, and sequential staging in esthetic implant therapy: a four-dimensional perspective. Int J Periodontics Restorative Dent 2007;27:313-23.
31 Garber DA, Belser UC. Restoration-driven implant placement with restoration-generated site development. Compend Contin Educ Dent 1995;16:796, 798-802, 804.
32 Palacci P. Aesthetic treatment of the anterior maxilla: soft and hard tissue considerations. Oral Maxillofac Surg Clin North Am 2004;16:127-37.   DOI