Management of Unerupted Lateral Incisor by LASER Assisted Surgical Exposure

Maxillary incisors are aesthetically important, parents often notices it first and are troubled . The children are bullied or teased due to delayed eruption resulting in psychological complications.
By: Pioon laser technology co., ltd
 
WUHAN, China - Nov. 5, 2020 - PRLog -- Diagnosis of unerupted incisors-
A) Clinical evaluation-
1) Firstly patient's chronological age and dental age should be examined to determine if there is delayed eruption or not.
2) The amount of space available for the eruption of tooth, space loss, midline shift, position of the adjacent teeth, and contour of the bone should be examined
3) Palpation of the labial bulge on the mucosa if visible and if not visible then evaluation by radiograph
4) The distance from the mucogingival junction - An adequate amount of keratinized gingival tissue that is under proper plaque control, is a fundamental requirement for periodontal health. Labially or buccally erupting teeth show reduced dimensions of gingiva as abnormal eruption of permanent teeth restricts or eliminates the keratinized tissue between the erupting cusp and the deciduous tooth. A lack of attached gingiva (keratinized gingiva) poses a potential risk for gingival recession in labially or buccally erupted teeth due to the possibility of accumulation of plaque and/or traumatic tooth-brushing.
B) Radiographic evaluation- The accurate location of the unerupted lateral incisor by the conventional two - dimensional radiographs is done. For the exact estimation of buccolingual position a second periodical film is obtained by using a) Clark's rule b) Buccal-object rule. CBCT (Cone Beam Computed Tomography) can be used to avoid multiple exposure and to know the accurate position of the tooth.
1) Firstly determine the presence of lateral incisors and if bone is present on the erupting tooth buds
2) The amount of root formed
In this case the patient's chronological age was 9 years suggesting of delayed eruption of lateral incisor. Palpation of the painless incompressible labial fibromucosal protuberance or bulge is done to locate the crown. It is supported by the intraoral periapical radiograph. No bone is seen on the crown of the unerupted lateral incisor. The location and size of window to be made during surgical exposure is determined to be 1mm below the mucogingival junction.
Treatment- Pioon S1 blue dental LASER (https://www.pioon.com/) of 450 nm wavelength was used for the surgical exposure of lateral incisor.
Conclusion - When unerupted tooth is not deeply placed, surgical exposure with Pioon LASER at 450 nm allows conservation of attached gingiva, no injection, less bleeding during surgery, less use of analgesic and anti-inflammatory drugs, minimal postoperative complication and also immediate placement of orthodontic brackets so less appointments as well. Hence LASER represents indispensable modality to treat paediatric patients with ease.

End
Source:Pioon laser technology co., ltd
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Industry:Medical
Location:Wuhan - Hubei - China
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