Minimally invasive orthodontic therapy to manage eruption problems

OBJECTIVES The purpose of this study was to investigate the therapeutic po-tential of an orthodontic pre-formed oral appliance, belonging to the category of the Eruption Guidance Appliance (EGA). This device is silicone made and it has lots of interesting potential-ity in clinical use. This kind of removable orthodontic device is recommended during an early or a mixed dentition. To analyze the efficiency and the efficacy of this EGA in managing and resolving eruption diseases, the following case is reported. MATERIALS AND METHODS An 8-year and 7 month-old patient, female, was referred to the orthodontist by her dentist for evaluation of malocclusion. The patient presented with symmetri-cal face and a molar and canine Class I malocclusion (according to the Angle classification) and an anterior crossbite in the re-gion of the two upper and lower left central incisors (2.1 and 4.1 area) has been reported. The two incisors were affected by some periodontal diseases. From or-thopantomography it was possible to diagnose the inclusion of the upper left lateral incisor (2.2) and the absence of agenesis. The therapeutic plan, that we have adopted, has provided to treat the young patient with a preformed silicone made orthodontic appliance (LM Activa-tor™). The most advantageous aspect of this device was that it was ex-clusively for night use, for a total of 7-8 hours a day. We describe the anterior cross-bite treated in the early mixed dentition using the eruption guidance appliance as the only therapeutic device. RESULTS The use of EGA allowed the resolution of the anterior crossbite in only 15 days. This was due to the correct repositioning of the upper central incisor (2.1). Furthermore after 45 days from the beginning of therapy the incisal margin of the upper left lateral incisor (2.2) had become well evident in the arch. This type of preformed orthodontic device allowed, therefore, both the resolution of the anterior crossbite, and the eruption of the included element. CONCLUSIONS The results indicate that the Eruption Guidance Appliance is the first choice for an early orthodontic procedure of selected case. It allows to intercept dif-ferent malocclusions during the growth and reduces the need for an additional orthodontic treat-ment, which could cause im-portant diseases to periodontal tissues. Treating orthodontic malocclu-sions in the early mixed dentition through the Eruption Guidance Appliance is an effective method to restore normal and physiologi-cal occlusion. Unfortunately with-out active intervention, there are only a few spontaneous correc-tions to correct growth that can be expected. CLINICAL SIGNIFICANCE The treatment of dental maloc-clusions with this type of intra-oral device certainly guarantees rapid effects. Since the results are very rapid as well as evident, the patient acquires a strong motivation during the therapy. Furthermore, the results are ac-companied by a comfortable management of the device and by a very simple use of it. Both elements promote the patient’s compliance, which is essential for the effectiveness of the treatment itself. Since this type of therapy considers the facial type and the specific characteristics of each individual patient, it can be defined a “custom-ized-therapy”, to all intents and purposes. If the occlusal alterations were early intercepted and treated, further orthodontic treatment would be greatly reduced.