Clinical Case Report Of Orthodontics And Prosthodontics In The Combined Treatment Of Tooth Or Dentition Defect With Malocclusion

Background: Nowadays,patients with tooth defect and dentition defect are ubiquitous in people of all ages.Such patients often have problems of chewing,pronunciation and beauty,which seriously affect their life and work.However,more and more patients in case of tooth defect or dentition defect have the problems of the insufficient repair clearance,scattered teeth in the gap and occlusion disorders,teeth dislocation and so on.If we only use the prosthodontic treatment,not only the clinical operation is more difficult,but the efficacy of the repair cannot be guaranteed.The combination therapy of orthodontics and prosthodontics in the correction of malocclusion,alignment dentition,improve the occlusal relationship at the same time,better recovery of tooth morphology and function,is an ideal oral interdisciplinary combined treatment,which is worth clinical application and promotion.Objective: This clinical study of tooth or dentition defect patients with teeth micromaxillary deformity,first using orthodontic treatment to correct the malocclusion,creating favorable conditions for the repair or implant,then we did the corresponding follow-up treatment,so as to analyze and explore the clinical efficacy of orthodontics with prosthodontics in the combined treatment of complex dental or dentition defects and provide the clinical basis for the selection of the methods of treatment for such patients.Materials and methods: Eight patients who had tooth or dentition defect with malocclusion were selected and collected at at the Department of Stomatology,Second Affiliated Hospital of Dalian Medical University,from January 2014 to January 2017.Among them,five cases of dentition defect,two cases of dental defect,and one case of dental defect and dentition defect;two males and six females,the youngest 17 years old and the oldest 34 years old,with an average of 25.5 years old.All patients before surgery did clinical examination,x-ray and model measurements,analysis and induction of patients with malocclusion,the difficulties of clinical repair and other oral problems.After comprehensive analysis,combined with the patient's own wishes,we developed a comprehensive and targeted combination of orthodontic and remediation programs.In accordance with the first orthodontic treatment of treatment programs,alignment dentition,restoration of normal occlusion,that is,up and down the crest of spire staggered,the anterior teeth have a more normal coverage,to solve the difficulty of repair,and then the patient fixed prosthesis and implant denture repair treatment.After the treatment,the patients were followed up for 2 to 6 months to evaluate the clinical effect of the prosthesis and the effect of the combination therapy of orthodontics and prosthodontics.Results: All 8 patients had good dentures without damage,looseness and inflammation.There was no serious recurrence in one patient.One patient did not wear the orthodontic retainers on time,resulting in a gap of less than 1 mm between the maxillary incisor and the canine on the left side.The remaining patients did not have bite changes and tooth shift recurrence.Eight patients were highly satisfied with the treatment.Conclusion: For patients who had tooth or dentition defects with malocclusion,aimed at the complex intraoral situations,orthodontic treatment should first be used to correct the malocclusion,establish the normal occlusion relationship and open up the space.After creating favorable conditions for the repair or implant,we did the corresponding follow-up treatment.In the orthodontic treatment to ensure patients with normal dental alignment and good occlusal function,while repair efforts focused on the shape of the crown and the recovery of masticatory function,such oral interdisciplinary treatment programs can achieve the desired and effective treatment,it is worth promoting the use of the clinic.