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  • TOOTH FAIRY will be making a stop tonight! He lost his baby tooth,central incisor P, and O is loose too. $$ "Kids usually start losing their baby teeth around age six or seven and the teeth in the front of the mouth, called incisors, are usually the first to go. When a permanent tooth starts coming in, the roots of the baby tooth dissolve until it is loose enough to fall out painlessly and with very little blood. However, sometimes teeth don’t fall out as easily as we hope and parents may wonder if they should pull the tooth. The answer, though, is that it may be tempting to pull a loose tooth, but it’s best to wait until it’s ready to come out without being forced." ~ https://madisonfamilydental.com/dos-donts-pulling-baby-teeth/

    #babyteeth #toothfairy #centralincisor #firstloosetooth #firstbabytoothlost #6yearsold
  • TOOTH FAIRY will be making a stop tonight! He lost his baby tooth,central incisor P, and O is loose too. $$ "Kids usually start losing their baby teeth around age six or seven and the teeth in the front of the mouth, called incisors, are usually the first to go. When a permanent tooth starts coming in, the roots of the baby tooth dissolve until it is loose enough to fall out painlessly and with very little blood. However, sometimes teeth don’t fall out as easily as we hope and parents may wonder if they should pull the tooth. The answer, though, is that it may be tempting to pull a loose tooth, but it’s best to wait until it’s ready to come out without being forced." ~ https://madisonfamilydental.com/dos-donts-pulling-baby-teeth/

#babyteeth #toothfairy #centralincisor #firstloosetooth #firstbabytoothlost #6yearsold
  •  13  2 18 November, 2018
  • *Flashcard Friday : Impacted Maxillary Central Incisor*
    @iamdr.nik
    _________________________________
    Incidence:
    Uncommon at 0.13% or referrals into UK hospitals at 2.6% (DiBiase, 1969)

    Aetiology:
    • Tooth number
    Supernumeries, odontomes, retained primary reeth, early loss of teeth resulting in crowding • Tooth position
    ectopic • Tooth pathology
    Trauma (dilaceration), ankylosis, cysts
    _________________________________

    2)Diagnosis - History; Clinical; Radographic
    • History
    Any previous loss of teeth? Any trauma?
    • Clinical
    Can the central incisor be palpated?
    Has the lateral incisor and/or mandibular incisor erupted ahead of the maxillary central incisor?
    Any rotations or spacing in central incisor region?
    • Radiographic
    IOPAs, Upper standard occlusal, OPT, Ceph, CBCT

    Horizontal > vertical parallax at locating tooth - 83% v. 69% (Armstrong, 2003)
    CBCT scans can be used especially for dilaceration cases
    _________________________________

    3) Management principles
    • Space creation -can allow spontaneous eruption of incisor (with URA and expansion or 2×4 fixed appliance)
    • Obstruction - supernumery removal and create space or expose tooth
    • Expose & Bond - closed > open in relation to gingival aesthetics and periodontal condition but Parkin (2017) found no difference between techniques
    • Surgical XLA of maxillary central incisor and restore space or bring lateral into space to preserve alveolar bone for eventual implant placement
    _________________________________
    Recommended Reading
    Yaqoob et al., (2010): Management of unerupted maxillary incisors

    Seehra et al., (2018): National Clinical Guidelines for the nanagement of unerupted maxillary incisors in children

    Thank you to @dr.jamesandrews @ruliyanto_orthodontist & @nycorthodontist for their photo contributions
  • *Flashcard Friday : Impacted Maxillary Central Incisor*
@iamdr.nik
_________________________________
Incidence:
Uncommon at 0.13% or referrals into UK hospitals at 2.6% (DiBiase, 1969)

Aetiology:
• Tooth number 
Supernumeries, odontomes, retained primary reeth, early loss of teeth resulting in crowding • Tooth position 
ectopic • Tooth pathology 
Trauma (dilaceration), ankylosis, cysts
_________________________________

2)Diagnosis - History; Clinical; Radographic
• History
Any previous loss of teeth? Any trauma?
• Clinical
Can the central incisor be palpated?
Has the lateral incisor and/or mandibular incisor erupted ahead of the maxillary central incisor?
Any rotations or spacing in central incisor region?
• Radiographic
IOPAs, Upper standard occlusal, OPT, Ceph, CBCT

Horizontal > vertical parallax at locating tooth - 83% v. 69% (Armstrong, 2003) 
CBCT scans can be used especially for dilaceration cases
_________________________________

3) Management principles
• Space creation -can allow spontaneous eruption of incisor (with URA and expansion or 2×4 fixed appliance)
• Obstruction - supernumery removal and create space or expose tooth
• Expose & Bond - closed > open in relation to gingival aesthetics and periodontal condition but Parkin (2017) found no difference between techniques
• Surgical XLA of maxillary central incisor and restore space or bring lateral into space to preserve alveolar bone for eventual implant placement
_________________________________
Recommended Reading
Yaqoob et al., (2010): Management of unerupted maxillary incisors

Seehra et al., (2018): National Clinical Guidelines for the nanagement of unerupted maxillary incisors in children

Thank you to @dr.jamesandrews @ruliyanto_orthodontist & @nycorthodontist for their photo contributions
  •  55  6 16 November, 2018