Treatment plan

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Posted on By ashok gowda In Orthodontics

Hi dear colleagues, I request to share your treatment plan for this case.

14 yrs old male patient. His lower right 2nd premolar is impacted, and Its root formation is almost complete . Deciduous molar is retained. PAN shows good amount of bone in the furcation area of deciduous molar. Planning ortho for remaining teeth. How do you manage this case. Regards. Ashok


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6 Comments

Not enough information provided.


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Maurice, how do you bring this impacted lower right premolar in to occlusion? if i extract that retained deciduous molar will the impacted premolar errupts ? Or should we have to make use of ortho to pull it out.


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Please supply more orthodontic detail-photos etc thanks


Reply

Thanks Barry. I don't have any clinical pics yet. Referred case by another dentist. I will document clinical pics shortly. Regards.


Reply

CBCT would give bucco-lingual position and direction of the tooth.
If favorable, my approach would be to extract the primary tooth and remove some of the interradicular bone to create channel of eruption.When2/3 of the root is formed, extraction of the primary tooth usually accelerates the eruption of the corresponding permanent.
Place space maintainer on the bottom, bond buccal wire on 3 upper corresponding teeth to prevent supra-eruption.Wait 6 to 9 months and reevaluate. If spontanuous eruption is slow, expose and tract.


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Thanks Laurent. Make sense. Iam planning in the same direction . Regards.


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