Vitale Marina Consuelo, Nardi Maria Gloria, Pellegrini Matteo, Spadari Francesco, Pulicari Federica, Alcozer Roberto, Minardi Martina, Sfondrini Maria Francesca, Bertino Karin, Scribante Andrea
Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy.
Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy.
Case Rep Dent. 2022 Oct 6;2022:3973382. doi: 10.1155/2022/3973382. eCollection 2022.
Maxillary canine is the most frequent dental element that could likely remain impacted in the bone structure, with a percentage between 1 and 5%. This study presents a case report using a diode laser for surgical-orthodontics disinclusion of a palatal mucosal impacted permanent left upper canine (2.3) and the simultaneous application of an orthodontic bracket.
After cementation of the trans-palatal bar to the upper first molars with a hook for orthodontic traction, local anaesthesia with articaine was performed, followed by surgical operculectomy using a diode laser (810 nm wavelength, continuous wave mode with a power output of 3 W, and a 0.4 mm diameter optical fiber), and the orthodontic bracket with a passive metal looped ligature was applied. Subsequently, active elastic traction was applied on 2.3 and the upper arch was bonded for the application of a series of orthodontic wires, lace-back, and metal ligatures. A progressive reactivation of the elastic traction and extraction of 6.3 was necessary to translate the canine into the correct arch position.
Diode laser surgical-orthodontic disinclusion of impacted upper canine was performed successively, resulting in a dry surgical field ideal for orthodontic bracket adhesion. No pain and no swelling have been reported from the patient. The orthodontic treatment allowed the canine to be moved to the correct position in the arch.
This case showed that the diode laser is a valid alternative for the surgical-orthodontic disinclusion of an included tooth element.
上颌尖牙是最常可能滞留于骨结构中的牙体,发生率在1%至5%之间。本研究呈现了一例病例报告,使用二极管激光进行外科正畸解除腭侧黏膜阻生的左上恒尖牙(2.3),并同时应用正畸托槽。
用带正畸牵引钩的跨腭杆粘结于上颌第一磨牙后,使用阿替卡因进行局部麻醉,随后用二极管激光(波长810nm,连续波模式,功率输出3W,光纤直径0.4mm)进行手术切除龈瓣,并应用带有被动金属圈状结扎丝的正畸托槽。随后,对2.3施加主动弹性牵引,并粘结上颌牙弓以应用一系列正畸弓丝、回扎丝和金属结扎丝。为将尖牙移动至正确的牙弓位置,需要逐步重新激活弹性牵引并拔除6.3。
连续进行二极管激光外科正畸解除上颌阻生尖牙,形成了有利于正畸托槽粘结的无血手术视野。患者未报告疼痛和肿胀。正畸治疗使尖牙移动至牙弓中的正确位置。
该病例表明,二极管激光是外科正畸解除阻生牙体的有效替代方法。