Introduction-An impacted tooth simply means that it is “stuck” and cannot erupt into function. The most commonly impacted or un-erupted tooth is the permanent maxillary canine. Primarily the impaction is due to arch length deficiency. Since the canine is usually the last tooth to erupt anterior to the first molar in the maxillary arch, shortage of space may result in ectopic eruption or impaction of this tooth. There has been numerous hypotheses developed regarding the etiology of canine impaction, the issue remains controversial. Impacted canine can cause complications without such as internal or external resorption, loss in arch length, infection associated with partial eruption, and resorption of the roots of lateral incisors.
Treatment modality- Various treatment modalities have been proposed to avoid the complications associated with impacted canines such as use of scalpel, caustic agents, electrocautery and diode laser. However, Diode laser therapy is an effective and noninvasive treatment option for exposure of impacted canine without bone covering the tooth. But in most of the cases, it first requires orthodontic preparation of the maxillary arch in order to create adequate space between the lateral incisor and first premolar prior to surgical exposure. PIOON Laser offers different wavelengths like 450nm/810nm or 980nm. Out of which 450nm can be used in non-contact/contact mode whereas 810nm and 980nm are used in contact mode to perform the procedure.
In this case after obtaining the informed consent surgical exposure of the tooth with diode laser at wavelength of 450nm was used in non-contact mode under topical anesthesia and the soft tissue over the impacted tooth was exposed. The impacted tooth was cleaned and scaled to permit bonding and an orthodontic bracket was bonded to position immediately in the same siting after the exposure of the tooth. The patient was given postoperative oral hygiene instructions that included chlorhexidine rinses, gentle tooth-brushing.
Sana F et al. in 2018 and Deepa D et al used 940nm and 980nm wavelength respectively. They concluded that use of diode laser in the surgical intervention of submerged tooth exposure gives many intraoperative and postoperative advantages along with excellent results. Fornaini C et al. in 2016 also proved that wavelength 450 nm proved to be very effective and safe for soft tissue procedures with no side effects for the patients.
Rationale behind Use of Lasers Diode laser offers advantages like patient compliance, reduced pain and discomfort, faster healing process, absence of bleeding and less chair side time. The greatest advantage is the complete absence of bleeding, which gives the possibility to immediately bond the bracket in dry enamel, so preventing the possibility of detach and reducing the risk of a further re-intervention
Conclusion- The use of lasers in orthodontics, and in particular diode lasers, has made it possible for orthodontic clinicians to more easily address the challenges faced on a daily basis in an orthodontic practice.
References -
Sana F, Rizwan G, Shanin F, Dimple V and Nikhil M. Management of Impacted Canine with Surgical Exposure using Soft Tissue Diode Laser and Alignment by Orthodontic Treatment: A Case Report. JORDMIMS, 2017, 4(1), Page 50-52
Deepa D, Gazal J , Shivangi A. Diode laser excision of the soft tissue around submerged permanent canine - A case report. International Journal of Periodontology and Implantology, April-June 2017;2(2):64-66
Fornaini C, Rocca JP, Merigo E. 450 nm diode laser: a new help in oral surgery. World J Clin Cases 2016; 4:253–257.
Preoperative View (Courtesy- Dr. Sana Farista)
Postoperative View (Courtesy- Dr.Sana Farista)
Introduction- Maxillary incisors are aesthetically important, parents often notices it first and are troubled (1,2).
It is necessary to bring the unerupted incisor into its correct position with proper monitoring and timely surgical orthodontic intervention so as no prosthetic solution is required as nothing is better than tooth itself.
LASER have its advantages over conventional scalpel for the surgical exposure of the unerupted incisors.Diagnosis of unerupted incisors-A) Clinical evaluation-1) Firstly patient’s chronological age and dental age should be examined to determine if there is delayed eruption or not.2) The amount of space available for the eruption of tooth, space loss, midline shift, position of the adjacent teeth, and contour of the bone should be examined3) Palpation of the labial bulge on the mucosa if visible and if not visible then evaluation by radiograph4) The distance from the mucogingival junction - An adequate amount of keratinized gingival tissue that is under proper plaque control, is a fundamental requirement for periodontal health.
Labially or buccally erupting teeth show reduced dimensions of gingiva as abnormal eruption of permanent teeth restricts or eliminates the keratinized tissue between the erupting cusp and the deciduous tooth.
A lack of attached gingiva (keratinized gingiva) poses a potential risk for gingival recession in labially or buccally erupted teeth due to the possibility of accumulation of plaque and/or traumatic tooth-brushing.B) Radiographic evaluation- The accurate location of the unerupted lateral incisor by the conventional two - dimensional radiographs is done.
CBCT (Cone Beam Computed Tomography) can be used to avoid multiple exposure and to know the accurate position of the tooth.1) Firstly determine the presence of lateral incisors and if bone is present on the erupting tooth buds2) The amount of root formedIn this case the patient’s chronological age was 9 years suggesting of delayed eruption of lateral incisor.
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You do not want to deal with anything complicated.Luckily for you, there are so many things in life that are not only simple but also beneficial for you in the long run.Some of the examples include going out for a walk, breathing routines, going to the grocery store or even cleaning.There are so many other simple ways to do life, but there is a specific way that is not only simple to do but it is also very important when it comes to your overall health and that is brushing your teeth.In this article, we are going to simply discuss how easy and convenient it is to maintain proper oral hygiene standards.
If you are someone who needs your mind to be refreshed back to its state of simplicity, then you have come to the right place.The act of maintaining oral hygiene is something that requires little effort.Before we get into the main material, there is something that should be addressed first and that is the current market situation regarding dental hygiene products.Current market situation:The market of dental hygiene-related products has become widely expansive that you can buy teeth whitening products online.
It is safe to say that you can get the products at any moment.Therefore, there shall be no excuses for you to say that you are unable to brush your teeth due to a lack of access to dental hygiene products.Now that we got that important piece of information squared away, let’s discuss the recommendations for maintaining oral hygiene.Recommendations for brushing teeth:To achieve maximum oral hygiene standards, there are some rules you have to follow.The list of rules include:Brush your teeth twice a dayThis is something that every single expert on dental care recommends you to do.
The best times of the day to brush your teeth are when you are awake for the day and before you go to bed for the night.
It can help remove any excess food debris and also any bad breath from the food.
Thankfully enough, it should only take two minutes for you to fully brush your teeth.
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