Introduction: Failure of teeth to erupt from gingival tissues at usual developmental time is called delayed tooth eruption (DTE). Delayed tooth eruption lead to prolonged fixed orthodontic treatment and its eventual complications. The purpose of the present study was to evaluate the effect of laser-assisted (808 nm) surgical uncovering, on the tooth emergence and orthodontic treatment of DTE.
Methods: A total of 16 orthodontic patients were included in this study and were equally assigned to an experimental and a control group. Subjects for experiment consisted of eight patients (6 girls and 2 boys) with a mean age of 14±0.9 years. All patients exhibited delayed second premolar eruption. The laser wavelength was 810 nm and it was set in a continuous wave mode at a power output of 1.6 watt with a 0.3-mm diameter fiber tip. When the target tissue was sufficiently anesthetized, the tip was directed at an angle of 10 to 20 degrees to the tissue (light contact mode); and was applied continuously for approximately 12 Seconds until an acceptable tooth exposure area was visible. The facial axis of the clinical crown (FACC) line represents the most prominent portion of the facial central lobe for premolars. All orthodontic brackets are aligned along this reference and are located on FA (Facial Axis) point. The standard for adequate tooth eruption was the accessibility of facial axis of the clinical crown (FACC) for bonding the brackets. Data gathered from the patients were statistically surveyed and compared by means of Tukey’s Test and Analysis of Variance (ANOVA).
Results: All patients showed good gingival status, no significant bleeding during or immediately after the surgery, and acceptable level of healing after laser surgery. The biologic width of the teeth was preserved and no violation of this important periodontal parameter was observed. The average time for accessing the FA point in experimental group was 11±1.1 weeks and the mentioned period was increased to 25±1.8 weeks in control group. The data analysis showed that in patients with DTE, laser intervention significantly accelerated tooth eruption (P < 0.05).
Conclusion: Laser-assisted surgical removal of the fibrous tissue over erupting premolars (DTE) with appropriate irradiation parameters appears to be a promising adjunct to orthodontic treatment for bringing the premolar to the aligned and leveled dental arch.
Rasmussen P, Kotsaki A. Inherited retarded eruption in the permanent dentition. J Clin Pediatr Dent 1997;21(3): 205-11.
Suri L, Gagari E, Vastardis H. Delayed tooth eruption: pathogenesis, diagnosis, and treatment. A literature review. Am J Orthod Dentofacial Orthop 2004;126(4):432-45.
Suda N, Hiyama S, Kuroda T. Relationship between formation/eruption of maxillary teeth and skeletal pattern of maxilla. Am J Orthod Dentofacial Orthop 2002;121(1):46-52.
Burch J, Ngan P, Hackman A. Diagnosis and treatment planning for unerupted premolars. Pediatr Dent 1994;16(2):89-95.
Tomizawa M, Yonemochi H, Kohno M, Noda T. Unilateral delayed eruption of maxillary permanent first molars: four case reports. Pediatr Dent 1998;20(1):53-6.
Di Biase DD. Mucous membrane and delayed eruption. Dent Pract Dent Rec 1971;21(7):241-50.
Di Biase DD. Mucous membrane and delayed eruption. Trans Br Soc Study Orthod 1969-1970;5(6):149-58.
Goho C. Delayed eruption due to overlying fibrous connective tissue. ASDC J Dent Child 1987;54(5):359-60.
Katz J, Guelmann M, Barak S. Hereditary gingival fibromatosis with distinct dental, skeletal and developmental abnormalities. Pediatr Dent 2002;24(3):253-6.
Sarver DM, Yanosky M. Principles of cosmetic dentistry in orthodontics: Part 3. Laser treatments for tooth eruption and soft tissue problems. Am J Orthod Dentofacial Orthop 2005;127:262–4.
Hilgers JJ, Tracey SG. Clinical uses of diode lasers in orthodontics. J Clin Orthod 2004;38:266–73.
Sarver DM, Yanosky M. Principles of cosmetic dentistry in orthodontics: part 2. Soft tissue laser technology and cosmetic gingival contouring. Am J Orthod Dentofacial Orthop 2005;127:85–90.
Sarver DM. Use of the 810 nm diode laser: soft tissue management and orthodontic applications of innovative technology. Pract Proc Aesthet Dent 2006;18(suppl):7–13.
Kravitz ND, Kusnoto B. Soft-tissue lasers in orthodontics: an overview. Am J Orthod Dentofacial Orthop 2008;133:S110–4.
Watanabe K, Koga M. A morphometric study with setup models for bracket design. Angle Orthod 2001;71(6):499- 11.
Graham JW. Profound, needle-free anesthesia in orthodontics. J Clin Orthod 2006;40:723-4.
Meechan JG. Intraoral topical anesthesia. Periodontology 2000 2008;46:56-79.
Kravitz ND, Kusnoto B. Placement of mini-implants with topical anesthetic. J Clin Orthod 2006;40:602-4.
Press J. Effective use of the 810 nm diode laser within the wellness model. Pract Proced Aesthet Dent 2006;18: 18-21.
Parker S. Lasers and soft tissue: ‘loose’ soft tissue surgery. Br Dent J 2007;202(4):185–91.
Parker S. Lasers and soft tissue: ‘fixed’ soft tissue surgery. Br Dent J 2007;202(5):247–53.
Garn SM, Rohmann CG. Interaction of nutrition and genetics in the timing of growth. Pediatr Clin North Am 1966;13:353-79.
Kaloust S, Ishii K, Vargervik K. Dental development in Apert syndrome. Cleft Palate Craniofac J 1997;34:117-21.
Kreiborg S, Cohen MM Jr. The oral manifestations of Apert syndrome. J Craniofac Genet Dev Biol 1992;12: 41-8.
Jensen BL, Kreiborg S. Development of the dentition in cleidocranial dysplasia. J Oral Pathol Med 1990;19:89-93.
Buch B, Noffke C, de Kock S. Gardner’s syndrome—the importance of early diagnosis: a case report and a review. J S Afr D ent Assoc 2001;56:242-5.