Patient 19yr/male. C/O food lodgement in lower anterior teeth and also wants esthetic correction... please suggest needful treatment plan for the same..



A good case to go for Esthetic correction , patient has severe crowding in anterior region along with TFO , so first plan is to go for regular oral prophylaxis , take an Opg , evaluate perirodontal status of lower anteriors , give treatment options to the patient . Orthodontic treatment is the best option ,provided periodontal health and patient are for it . Else lil complicated for prosthetic correction .

Yes, I agree with u Dr Nikhil...will surely explain about Ortho treatment which can be done in this case to the patient

mandibular arch is in V shape ok that's why crowding of teeth especially in lower mandibular incisor region. Take x Ray and if the first incisors row from labial side if they r placed in middle of mandibular arch then we should not destrub the first row of teeth . In the second row in the lingual side if they erupted in the edges of inside ie lingual side of mandibular edge .Then u can remove the inside incisors . If the incisors placed in the centre of mandible the strength of incisors also more firm to withstand masticatory forces . If the lingual side incisors if they placed at the inside edge of lingual side of mandibular arch then u can go extraction of lingually placed incisors . I never suggest removal of premolars because these r the corner pillars of mandibular arch. As I said previously there is lack of sufficient place to accommidate the incisors in single line .The pt may have defferent food habits of soft diet without any pressure on to the jaws so that the V shape arches r more common now a days in the child hood . We have to educate patients to turn them in to hard diet So better we can put a training programme to turn the children to exit soft diet in to more of hard diet . According to use and dissuse theory the body changes also will happen . Take for example xeroffy neck is best example .

v nice case for orthodontic treatment...consult orthodontist ..may needs arch expansion..nd extrctn of premolar to align d lower anteriors...can u plz tel me pt hv narrow arch?

Yes, Dr Sandhya

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If extraction is done with lingual incisors.will labial side incisors derotation automatically???? Will they move inside with lip pressure???

first do oral prophylaxis. It should be followed by orthodontic correction. This will treat both esthetic and food lodgement problem

Ok mam

Orthodontic treatment by extraction of premolars.arch expansion not indicated as it wll relapse.

Food impaction is more common in diastema and spacing in anterior teeth . The shape of teeth r very irregular so we can't fill the spacing between incisors in between and dental flossing is first option and to keep fresh breath oral mouth washes suggestable like Colgate hexidine and Listerine mouth wash will helpful to minimize halitosis ( foul smell bad breath). So we con t keep any filling material in between teeth only . Perpetual preservation of what remains . So don't suggest for any caps and enamel paintings and fillings .

Thank-you for suggestion. In my first opinion I m also not planning for Restorations at first place..

Orthodontic treatment is the best option.. Expansion of the lower arch won't help.. It's the least stable.. To decide the treatment plan X-rays and all intraoral n extraoral photos will be needed..

Better to consult orthodontist...definitely extraction case...before consulation go for thorough oral prophylaxis and do fillings...

Thank-you doc for suggestion..

Orthodontic treatment is best option for this case as there is so much crowding...

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