2017 AAO Annual Session - Clinical Management of Multiple Agenesis: Demanding Procedure to Goal / Minimizing Esthetic and Functional Risk through POPA / Goal Oriented Treatment Planning with Corticotomy Facilitated Orthodontics

Clinical Management of Multiple Agenesis: Demanding Procedure to Goal

The purpose of this lecture is to discuss medical procedure of reconstraction of multiple agenesis. The solution could be rather difficult – including setting up an ideal treatment plan and coordinating the whole treatment process – since several dental disciplines take part in the process of the treatment. Therefore, orthodontic therapy often consists of only adjusting the position of pillars and gaps in the place of agenesis, then the prosthetic reconstruction takes place. The age of the patient and other factors are important when planning the final prosthetic reconstruction. The author analyze the process of treatment plan formation on several cases, then possible complications, which can occur during the treatment, together with consequential modifications. Resolving multiple agenesis is thus based on interdisciplinary co-operation of an orthodontist, prosthodontist and implantologist; in some cases an maxillofacial surgeon can be involved. The authors stress the importance of the therapy coordinator who manages individual phases of the treatment, who bears the responsibility for forming the team, as well as for the treatment results.

Learning Objectives:

• Analyze the process of treatment plan formation.
• Identify the importance of the therapy coordinator.
• Assess the risks and complication associated with inexact treatment plan, bad coordination and changes of patient wishes.

Minimizing Esthetic and Functional Risk through POPA

This innovative periodontal augmentation procedure, combining regenerative periodontal therapy with simultaneous orthodontic treatment, enables the orthodontist to minimize potential iatrogenic risk factors often associated with orthodontic therapy. Favorably positioned teeth, plus an enhanced muco-gingival complex, facilitates ideal and predictable post treatment esthetics and function.

Learning Objectives:

• Identify iatrogenic risk factors associated with orthodontic therapy.
• Describe etiological issues contributing to these risk factors.
• Prescribe appropriate hard and soft tissue grafting therapies to minimize the various risk factors, for long term post treatment success.

Goal Oriented Treatment Planning with Corticotomy Facilitated Orthodontics

Conventional orthodontic tooth movement is restrained by the presence or absence of the surrounding alveolar bone. Combining orthodontics with selective alveolar decortication and bone augmentation increases the thickness of the alveolar trough, allowing for a wider range of tooth movements. Indications for applying this combined technique are derived from goal-oriented treatment planning, specific orthodontic biomechanics and sequencing. Case selection, proposed direction and amount of tooth movement, and treatment timing must be considered in order to achieve the most favorable outcomes with this combined surgical-orthodontic technique.

Learning Objectives:

• Recognize how alveolar decortication and bone grafting combined with orthodontics allows for a wider range of tooth movements.
• Illustrate creative ways to design orthodontic biomechanics.
• Coordinate treatment timing and sequencing when utilizing this interdisciplinary treatment plan.