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Things I have learned from hanging out with the kids. Sarah Good. BOC 2021.September 22nd 2021. Episode 130

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Hosted by
Farooq Ahmed

Join me for Sarah’s lecture looking at her management of trauma, hypodontia and molar incisor hypomineralisation

 

 

Expansion

o   UK evidence base – usually for crossbites only

o   US – encourage expansion in ‘phase 1’

o   Difference = cultural clinical practice

 

Deciduous trauma

o   Dilacerated and horizontal upper incisor

o   Guidelines on impacted central incisors RCS

o   Exposure and bonding

o   Aligned

§  URA followed by sectional fixed

§  If patient is willing, can consider attempt

o   Canines are more likely to be impacted

o   May require second course of orthodontics

 

Avulsion on adult teeth

o   Teenager with avulsed upper incisor, out of the mouth for 2 hours

o   Dental trauma guidelines – up to date guidance

o   Re-implant, but expect ankylosis

o   RCT and plan for decoronation

 

Luxation injury

o   Surgical repositioning

o   Orthodontic alignment

 

Supernumerary

o   Removal of supernumerary and wait prior to orthodontic treatment

 

Molar incisor hypo mineralisation

o   Guidelines for extraction of first permanent molars in children RCS

o   Not an orthodontic decision, team approach to prognosis

o   Sarah delivers an orthodontic plan, and discusses prognosis of MIH separately

o   Extraction of 6s

o   May have impacted 8s, and require future orthodontics

 

Hypodontia patients

Dentally anxious patient with impacted canine

o   Address patients concerns of gaps, then extraction of C to allow 3 to come through

 

Impacted canine

o   50% resorption centrals, 60% lateral resorption

o   Leave 2s in situ

o   Exposure of canines

o   2s left in place until 3s vertically erupted

o   2s extraction and same day 3s built up – minimise aesthetic consequences

 

 

Patients not wanting lower arch treatment – patient taking control of enforced decision

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