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Case Reports
. 2018 Jan;23(1):87-96.
doi: 10.1590/2177-6709.23.1.087-096.oar.

Prosthetic, orthodontic and implant-supported rehabilitation of five maxillary anterior teeth with alveolar bone loss

Odilon Guariza-Filho  1 , Cristiano Miranda de Araujo  1 , Angela Graciela Deliga Schroder  1 , Orlando Motohiro Tanaka  1 , Ricardo Kern  2 , Antonio Carlos Ruellas  3
Affiliations
Case Reports

Prosthetic, orthodontic and implant-supported rehabilitation of five maxillary anterior teeth with alveolar bone loss

Odilon Guariza-Filho et al. Dental Press J Orthod. 2018 Jan.

Abstract
in English, Portuguese

Introduction: Treatment of maxillofacial injuries is complex and requires the establishment of a comprehensive and accurate diagnosis and correct treatment planning.

Objective: The objective of this case report was to describe the re-treatment of a 27-year-old woman who was involved in a severe car accident that resulted in the loss of five anterior teeth and alveolar bone, and whose previous orthodontic and surgical treatments had been unsuccessful.

Case report: In this case, the space for the missing mandibular molar was reopened to allow for rehabilitation. The positions of the mandibular incisors were improved. The right mandibular canine was moved to the mesial, allowing for correction of the Class II canine relationship on that side, and implants were placed to replace the maxillary anterior teeth.

Conclusion: Anterior aesthetic and functional rehabilitation using a multidisciplinary approach was essential to improve the patient's facial aesthetics, to obtain great improvement in function and to achieve occlusal stability after 2 years of follow-up.

Introdução:: o tratamento de danos bucomaxilofaciais é complexo e requer diagnóstico abrangente e preciso, além de um correto plano de tratamento.

Objetivo:: o objetivo deste relato de caso foi descrever o retratamento de uma paciente do sexo feminino, 27 anos de idade, envolvida em acidente automobilístico grave, que resultou na perda de cinco dentes, além de perda óssea alveolar na região anterior.

Relato de caso:: a paciente apresentava histórico de insucesso de tratamento ortodôntico e cirúrgico. No caso apresentado, o espaço referente aos molares inferiores ausentes foi reaberto, para possibilitar a reabilitação. Houve melhora no posicionamento dos incisivos inferiores. O canino inferior direito foi deslocado para mesial, possibilitando a correção da relação de Classe II intercaninos do mesmo lado. Implantes foram inseridos a fim de substituir os dentes superiores da região anterior.

Conclusão:: a reabilitação estética e funcional da região anterior, realizada por meio de uma abordagem multidisciplinar, foi fundamental para valorizar a estética facial da paciente, melhorar a função e promover estabilidade oclusal após dois anos de acompanhamento.

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Figures

Figure 1
Figure 1. Pretreatment photographs: intraoral view of the Class II dental relationship; intraoral view of the anterior temporary prostheses; occlusal view of the upper and lower arches. Pretreatment panoramic radiograph confirming the absence of the maxillary incisors, left canine and mandibular right first molar, and the extent of anterior alveolar bone loss. Note the short gingival exposure while smiling and slight asymmetry of the lower lip due to a scar.
Figure 2
Figure 2. Intraoral photographs following placement of the alveolar bone graft. Panoramic radiograph showing the positioning of the alveolar bone graft.
Figure 3
Figure 3. Intraoral photographs showing the replaced mandibular right first molar and the Class I canine relationship. Frontal and lateral views of the five dental implants placed in the anterior area. Final panoramic radiograph showing the dental implants.
Figure 4
Figure 4. Final photographs, radiographies and superimposition: the prosthesis were placed, and aesthetic and functional rehabilitation was achieved.
Figure 5
Figure 5. Two-year follow-up photographs demonstrating the maintenance of occlusal stability. CBCT with the implant position.
See this image and copyright information in PMC

References

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