Date: Friday, April 27, 2007 11:13 PM
From: "ESCO automatic digest system" <LISTSERV@LISTSERV.UIC.EDU>
Subject: ESCO Digest - 25 Apr 2007 to 27 Apr 2007 (#2007-42)

There are 6 messages totalling 714 lines in this issue.

Topics of the day:

1. Re: Forced eruption
2. Re: Forced eruption
3. Re: Forced eruption
4. Re: Forced eruption
5. Re: Forced eruption
6. Re: Forced eruption


Date: Thursday, April 26, 2007 4:35 PM
From: Lively Orthodontics, P.A. <mdlively@BELLSOUTH.NET>
Subject: Re: Forced eruption

Dear Dr. Waldman:

I am in a similar situation only after the luxation.  I have done several luxations on ankylosed incisors with good success.  But, the oral surgeon I used literally performed a borderline extraction followed by immediate loading of the tooth.  I now have a patient that has gone back 2x for luxation but on both occasions, the oral surgeon simply rotated the tooth in the socket, making it mobile but we have not been able to extrude the tooth.  So, I have found that mobility does not mean that ankylosis is not present.  I believe that this is also due to "spot" ankylosis.  Unless they rotate the teeth a full 360 degrees, any fibers ankylosed may still remain.  I do not want to have the patient go back a 3rd time, but it is not working.  The only issue is you might encounter, if it is ankylosis, is that following the luxation, you need to load the tooth immediately with forces greater that what you would use for slow extrusion.  If all fibers are severed, you free up the tooth but might find the bone will not follow as you extrude the tooth.

Good luck:
Mark Lively
Stuart, FL

Date: Thursday, April 26, 2007 9:47 AM
From: kurinchi kumaran <drkurinchi@YAHOO.COM>
Subject: Re: Forced eruption

it will be helpfull if u attach the iopa of the
patient particular problem.(partial fracture at some
point and non unioin at one point)

Date: Thursday, April 26, 2007 9:47 AM
From: Robert H. Kazmierski, D.M.D. <str8teeth1@VERIZON.NET>
Subject: Re: Forced eruption

Dear Alexander,

While others (especially those not in our specialty) report that they have,
I have never had luxation work. Maybe it's just me. In the past, when I have
needed to extrude suspected ankylosed teeth, I have used a Nance appliance
and not placed any pressure on the adjacent teeth. I have the lab place a
thick wire with a soldered loop on the end from the Nance to a point over
the tooth to be extruded. If Wilson inserts are used to connect the Nance to
the first molars you can temporarily remove it and clean it at each visit.
Elastic thread to a bracket, or gold chain, or minim pin with the end bent
like a hook then allows you to attempt extrusion without endangering
adjacent teeth. Hope this helped. Good luck.

Rob Kazmierski
Moorestown, NJ

Date: Thursday, April 26, 2007 4:58 AM
From: David E. Paquette <dave@PAQUETTEORTHO.COM>
Subject: Re: Forced eruption


I agree with the periodontist.  You also consider using miniscrew for stationary anchorage


Date: Thursday, April 26, 2007 8:47 PM
From: Dr. Reder <breder@NEAPOLITAN.COM>
Subject: Re: Forced eruption

Dave Paquette

Dear Alex- Yes- you are "spot" on. I would go with luxation and immediate extrusive forces using a utility arch from the 6's.

Date: Thursday, April 26, 2007 8:47 PM
From: Paul Thomas <PaulT@DOLPHINIMAGING.COM>
Subject: Re: Forced eruption

Dear Alexander,

All It doesn't take much in the way of ankylosis to create the situation you describe. I've seen teeth which appear to have some clinical mobility but still won' t move.  The trauma you mention was likely the source.  One other option is to have corticotomies done via Piezosurgery and then "distract" the bone/root segment orthodontically after a 7-10 day latent period.  Allow consolidation and then remove the root.  I doubt the luxation will make that much difference.  At least that has been my experience.     

-=Paul=- Paul M Thomas Senior Research Fellow Eastman Dental Institute for Oral Healthcare Sciences 256 Gray's Inn Road London WCX1 8LD