{"id":1982,"date":"2022-09-26T14:20:46","date_gmt":"2022-09-26T17:20:46","guid":{"rendered":"https:\/\/www.congresodeortodoncia.cl\/2022\/?page_id=1982"},"modified":"2022-09-26T14:22:17","modified_gmt":"2022-09-26T17:22:17","slug":"abstract-dr-wilmes","status":"publish","type":"page","link":"https:\/\/www.congresodeortodoncia.cl\/2022\/abstract-dr-wilmes\/","title":{"rendered":"Abstract Dr. Wilmes"},"content":{"rendered":"

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Simplificaci\u00f3n de la Mesializaci\u00f3n Para el Cierre de Espacios en la Arcada Superior Mediante los TAD
\n(Dispositivos de anclaje temporal) Palatinos.<\/h3>\n

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La falta cong\u00e9nita de incisivos laterales o segundos premolares, los caninos extremadamente desplazados o los traumatismos graves de los incisivos centrales dan lugar a una dentici\u00f3n superior reducida. Las dos t\u00e9cnicas de tratamiento m\u00e1s comunes son el cierre de espacios o la apertura de espacios para permitir la sustituci\u00f3n prostod\u00f3ntica con una pr\u00f3tesis fija o con implantes de un solo diente. Ambas t\u00e9cnicas podr\u00edan comprometer en t\u00e9rminos de est\u00e9tica, salud periodontal y funci\u00f3n.<\/p>\n

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En muchos casos, el cierre del espacio mediante el movimiento de los dientes mesiales parece ser la opci\u00f3n \u00f3ptima, ya que el tratamiento puede terminarse tan pronto como la dentici\u00f3n est\u00e9 completa. Las sustituciones est\u00e9ticas de los caninos pueden lograrse con la remodelaci\u00f3n y el posicionamiento de los dientes, el blanqueamiento y las carillas de porcelana. Las exigencias de anclaje son mucho m\u00e1s severas cuando faltan dientes en los segmentos anteriores, especialmente en los casos asim\u00e9tricos con desviaciones de la l\u00ednea media. Por esta raz\u00f3n, los mini-implantes se utilizan cada vez m\u00e1s en estos pacientes, especialmente con el desarrollo del anclaje palatino que evita la interferencia con los movimientos dentales. Otras ventajas del paladar anterior como emplazamiento de los implantes son la buena calidad \u00f3sea, la mucosa delgada adherida, evitar lesiones radiculares y una tasa elevada de \u00e9xito. El tratamiento con alineadores transparentes es hoy en d\u00eda omnipresente en la ortodoncia contempor\u00e1nea. Sin embargo, la predictibilidad de lograr el cierre del espacio, especialmente con los alineadores transparentes, es bastante baja. El uso complementario de aparatos personalizados, retenidos con mini\u0002implantes colocados en el paladar anterior, proporciona al cl\u00ednico la oportunidad de realizar objetivos de tratamiento espec\u00edficos con mayor precisi\u00f3n. Pueden utilizarse de forma conjunta o como paso intermedio antes de la fabricaci\u00f3n de alineadores transparentes. La integraci\u00f3n de los avances recientes en tecnolog\u00eda digital, como la planificaci\u00f3n virtual de la instalaci\u00f3n de un TAD, las gu\u00edas de inserci\u00f3n y el dise\u00f1o CAD-CAM y la impresi\u00f3n en 3D de los aparatos de ortodoncia, ampl\u00eda considerablemente las opciones<\/p>\n<\/div>\n<\/div>\n

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Non-Compliance Mesialization for Space Closure in the Upper Arch Using Palatal TADs<\/em><\/span><\/h3>\n

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\nCongenitally missing lateral incisors or second premolars, extremely displaced canines, or severe trauma to the central incisors all result in a reduced upper dentition. The two most common treatment approaches are space closure or space opening to allow prosthodontic replacement with either a fixed prosthesis or single-tooth implants. Both of these approaches involve compromises in terms of esthetics, periodontal health, and function.<\/span><\/p>\n

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\nIn many cases, space closure by means of mesial tooth movement seems to be the most desirable option, since treatment can be finished as soon as the dentition is complete. Esthetic canine substitutions can be achieved with tooth reshaping and positioning, bleaching, and porcelain veneers. Anchorage demands are much more severe when teeth are missing in the anterior segments, especially in asymmetrical cases with midline deviations. For this reason, mini-implants are increasingly used in such patients, especially with the development of palatal anchorage that avoids interference with tooth movements. Further advantages of the anterior palate as an implant site include good bone quality, thin attached mucosa, avoidance of root injury, and a high success rate. Clear aligner therapy is nowadays ubiquitous in contemporary orthodontics. However, the predictability of achieving space closure especially with clear aligners is quite low. The adjunctive use of customised appliances, retained with mini-implants positioned in the anterior palate, provides the clinician the opportunity to realize specific treatment objectives with greater precision and accuracy. They can be used concomitantly, or as an intermediary step prior to the fabrication of clear aligners. Integration of recent advances in digital technology such as virtual planning of a TAD installation, insertion guides and CAD-CAM design and 3D printing of orthodontic appliances broadens the options significantly
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