Main Instructor 吳姿瑩
Department / Institution Taipei Veterans General Hospital
Classification Case report
Trauma may cause bone fracture, crown/root fracture and tooth displacement. Previously traumatized teeth may have the risk of losing pulp vitality and replacement resorption. Orthodontist could play the role of spaces redistribution and establishing stabilized occlusion. Radiographic monitoring of traumatized teeth through treatment is mandatory.
We presented a case of 30 y/o male who had had a bicycle riding accident with facial trauma. Nasoorbitoethmoidal complex fracture and lower anterior alveolar bone fracture were noted. Uncomplicated crown fracture of tooth 21, loss of pulp vitality of tooth 31.32.41, avulsion of tooth 43 and PFM crown loosening during traffic accident of tooth 46 were also recorded.
The patient was diagnosed as Class III anterior cross-bite (OJ : -3/-4 mm). Meanwhile, the tooth 46 was unrestorable due to large decay and apical lesions.
In order to remove poor prognostic teeth, achieve better occlusion and reduce the number of prosthesis, we decided to protract tooth 47 and upright horizontally impacted tooth 48. The treatment plan for the patient was 18.104.22.168 extraction. Tooth 32.33.34 substituted 31.32.33 and tooth 31.41.42 substituted 41.42.43. Q3 screw was planned for distalization. In Q4, we planned to close space by anterior retraction and tooth 47 protraction and 48 uprighting.
「Discussion and Summary」
After 60 months of treatment, the space of extracted tooth 46 and missing tooth 43 were closed by protraction of 47 (7.5 mm) and uprighting and protraction of the horizontally impacted 48. Anterior crossbite was corrected, and the traumatized teeth were under good monitoring. The periodontal condition of posterior teeth was also stable after a large amount of mesialization.
A Traumatic Case with Third Molar Uprighting and Posterior Teeth Protraction- An Interdisciplinary Case Report