Bimaxillary Protrusion with an Atrophic Alveolar Defect: Orthodontics, Autogenous Chin-Block Graft, Soft Tissue Augmentation, and an Implant

dc.contributor.authorChiu, Grace
dc.contributor.authorChang, Chris
dc.contributor.authorRoberts, W. Eugene
dc.contributor.departmentDepartment of Orthodontics and Oral Facial Geneticsen_US
dc.date.accessioned2015-11-24T16:10:08Z
dc.date.available2015-11-24T16:10:08Z
dc.date.issued2015-01
dc.description.abstractBimaxillary protrusion in a 28 yr female was complicated by multiple missing, restoratively compromised or hopeless teeth. The maxillary right central incisor (#8) had a history of avulsion and replantation, that subsequently evolved into generalized external root resorption with Class III mobility and a severe loss of supporting periodontium. This complex malocclusion had a Discrepancy Index (DI) of 21, and 8 additional points were scored for the atrophic dental implant site (#8). The comprehensive treatment plan was extraction of four teeth (# 5, 8, 12 & 30), orthodontic closure of all space except for the future implant site (#8), augmentation of the alveolar defect with a autogenous chin- block graft, enhancement of the gingival biotype with a connective tissue graft, and an implant-supported prosthesis. Orthodontists must understand the limitations of bone grafts. Augmented alveolar defects are slow to completely turn over to living bone, so they are usually good sites for implants, but respond poorly to orthodontic space closure. However, postsurgical orthodontics treatment is often indicated to optimally finish the esthetic zone prior to placing the final prosthesis. The latter was effectively performed for the present patient resulting in a total treatment time of ~36 months for comprehensive, interdisciplinary care. An excellent functional and esthetic result was achieved, as documented by a Cast-Radiograph Evaluation (CRE) score of 21 and a Pink & White dental esthetics score of 2.en_US
dc.eprint.versionAuthor's manuscripten_US
dc.identifier.citationChiu, G. S., Chang, C. H., & Roberts, W. E. (2015). Bimaxillary protrusion with an atrophic alveolar defect: Orthodontics, autogenous chin-block graft, soft tissue augmentation, and an implant. American Journal of Orthodontics and Dentofacial Orthopedics, 147(1), 97-113.en_US
dc.identifier.urihttps://hdl.handle.net/1805/7539
dc.language.isoen_USen_US
dc.publisherElsevieren_US
dc.relation.isversionof10.1016/j.ajodo.2014.08.021en_US
dc.relation.journalAmerican Journal of Orthodontics and Dentofacial Orthopedicsen_US
dc.rightsPublisher Policyen_US
dc.sourceAuthoren_US
dc.subjectbimaxillary protrusionen_US
dc.subjectatrophic alveolar defecten_US
dc.subjectorthodonticsen_US
dc.titleBimaxillary Protrusion with an Atrophic Alveolar Defect: Orthodontics, Autogenous Chin-Block Graft, Soft Tissue Augmentation, and an Implanten_US
dc.typeArticleen_US
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