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Therefore, interdisciplinary treatment between orthodontics, periodontics and prosthetics becomes an optimal combination for the integral rehabilitation of these patients in whom not only esthetics is important but the function of the sotmatognathic system as well and which will lead us to success in dental treatments. The patient attended the orthodontics clinic claiming to have a retained tooth. This case report presents a 13 year old patient with microdontia of the upper lateral incisors and retention of the upper right central incisor.
For diagnosis elaboration, several auxiliaries were used: study models, extra and intraoral photgraphs, lateral headfilm, ortopantomography and periapical, occlusal and carpal radiographs.
Interdisciplinary treatment began at the Orthodontics clinic where he was diagnosed as a Skeletal class II due to a maxillary protrusion with a vertical growth tendency and microdontia of both upper lateral incisors and retention of the upper right central incisor. Fixed appliances were placed with 0. Afterwards, the patient was referred to the Periodontics clinic where the surgical exposure of the retained incisor was performed with a complete surgical flap and osteotomy with chisels.
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In the surgical process a lingual button was bonded with Heliosit orthodontic resin Ivoclar. The patient was sutured with silk.
Orthodontic traction of the tooth was performed with the use of elastics and elastomeric chains to an accessory 0. Orthodontic treatment was continued with the conventional Roth archwire sequence: 0. Once a correct anterior and canine guide and posterior occlusal settling was achieved, a new interconsultation was made with the Prosthodontics clinic where a diagnostic wax-up was performed for the ceromer crown fabrication with Ivoclarint the microdontic upper lateral incisors.
The appliances were removed and retainers were placed: in the lower arch, a Hawley retainer with a 0. In the upper arch a temporary retainer was made with a 0. Once the appliances were removed, the lateral incisors were reduced slightly at the tooth's neck with a conical bur. A silicone impression was obtained.
Ceromer crowns were fabricated and cemented with light-curing dual resin from Ivoclarbrand and occlusal adjustments were made. In the orthodontics clinic, final retainers made from 0.
Final records were obtained: panoramic radiograph and lateral headfilm; study models and facial and intraoral photographs. RESULTS The patient's multidisciplinary treatment was divided in three phases: Phase 1 consisted in periodontal surgery for exposing the retained upper central incisor Figure 3 ; Phase 2 in which traction of the retained incisor was performed through elastics and accessory archwires and the teeth were brought to an ideal position in order to establish a good occlusal settling as well as anterior guidance Figure 4 ; and phase 3 in which preparations of the microdontic teeth were completed for placing ceromer crowns Figure 5.
Periodontal surgery: A surgical flap, B enamel conditioning with etching acid, C placement and polymerization of the lingual button for traction, D The flap is repositioned. Figure 4. Attaching accesories for traction of impacted teeht. A Accesory arch 0. B Placing occlusal stops in order to avoid occlusal interference. C Brace placing on the tooth to its correct level. The chaotic vice account sent to differ calculated.
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