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      Orthodontic tooth movement enhancing bony apposition in alveolar bony defect: a case report

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      1 , 1 ,
      Cases Journal
      BioMed Central

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          Abstract

          Introduction

          Prevalence of complications from orthognathic surgery is relatively low but if it happens it is vital to manage the post complication bony defect appropriately.

          Case Presentation

          This case report describes a 20-year-old gentleman who suffered from a complication from a bimaxillary orthognathic surgery. A bone grafting was carried out to repair the bony defect from the surgery but it was unsuccessful. A non-invasive technique employing the use of very light orthodontic force with a laceback stainless steel ligature is described and a successful space closure with an improvement in the periodontal condition and bone apposition has been shown.

          Conclusion

          This technique can be considered if orthodontic tooth movement is needed across a deficient alveolar ridge.

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          Most cited references10

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          Management of alveolar clefts.

          The management of alveolar clefts has changed through the years as medical knowledge has improved. An alveolar cleft is the result of abnormal primary palate formation during weeks 4 to 12 of gestation. The rationale for its closure includes 1) stabilizing the maxillary arch, 2) permitting support for tooth eruption, 3) eliminating oronasal fistulae, and 4) providing improved esthetic results. Methods for closure of the alveolar cleft have been solidified during the last century with the use of bone grafting. Secondary bone grafting is now the preferred method of treatment, because early grafting has proven detrimental to midfacial growth. Various materials for bone grafting have been proposed, including iliac crest, cranium, tibia, rib, and mandibular symphysis. Regardless of the timing and materials used, the main principles in approaching alveolar clefts have been well described. They include 1) appropriate flap design, 2) wide exposure, 3) nasal floor reconstruction, 4) closure of oronasal fistula, 5) packing bony defect with cancellous bone, and 6) coverage of bone graft with gingival mucoperiosteal flaps. Certain alveolar clefts are difficult to manage by grafting alone, and orthodontic preparation may be required. Complications of alveolar bone grafts include donor site morbidity as well as graft exposure and loss.
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            Periodontal tissue response to orthodontic movement of teeth with infrabony pockets.

            The aim of this study was to evaluate the effect of orthodontic tooth movement on the level of the connective tissue attachment in sites with infrabony pockets. The experiment was carried out in four beagle dogs. The second and fourth premolars were extracted. After healing, angular bony defects were prepared at the mesial aspect of the third premolars. The exposed root surface was scaled and planed, and a notch was prepared at the bottom of the defect. Plaque-collecting cotton floss ligatures were placed around the neck of the teeth and maintained in situ for 3 weeks, followed by an additional 2 months of plaque accumulation before the orthodontic tooth movement was initiated. In each dog, one premolar was moved away from the angular bony defect and one premolar into and through the angular bony defect. The maxillary third premolars served as control teeth and were not subjected to orthodontic tooth movement. After orthodontic treatment (5 to 6 months), the teeth were stabilized for a period of 2 months before biopsy sampling. Clinical, radiographic, and histologic evaluations revealed that it was possible to establish and maintain an infrabony pocket with a subcrestal, plaque-induced inflammatory lesion during the entire course of the study. While the control teeth had maintained their attachment levels, all but one of the orthodontically moved teeth showed additional loss of attachment.(ABSTRACT TRUNCATED AT 250 WORDS)
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              The transition from standard edgewise to preadjusted appliance systems.

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                Author and article information

                Journal
                Cases J
                Cases Journal
                BioMed Central
                1757-1626
                2009
                3 February 2009
                : 2
                : 116
                Affiliations
                [1 ]Discipline of Orthodontics, Faculty of Dentistry, the University of Hong Kong, 2/F Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong SAR, PR China
                Article
                1757-1626-2-116
                10.1186/1757-1626-2-116
                2642784
                19192268
                74b7347d-de14-4aec-b83e-9159d410e191
                Copyright ©2009 Hibino and Wong; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 13 October 2008
                : 3 February 2009
                Categories
                Case Report

                Medicine
                Medicine

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