Patrizia Lucchi

Patrizia Lucchi was born in 1970, graduated as dental technician in 1989 and in 1995 in Dentistry cum Laude at the University of Verona. In 2008 she carried out postgraduate Studies in Orthodontics and three Years later received the Master in Pedodontics and Early Treatment at the University of Pisa. Visiting Professor at the University of Cagliari and Pisa, from 20 Years she works in Trento, North Italy, with Dr.Marco Rosa, forming a team specialized in pediatric and orthodontic Dentistry. Her primary ares of interest are Pedodontics, above all Dental Traumatology,, and Esthetics. She published and regularly lectures nationally about this topics.
Patrizia Lucchi was born in 1970, graduated as dental technician in 1989 and in 1995 in Dentistry cum Laude at the University of Verona. In 2008 she carried out postgraduate Studies in Orthodontics and three Years later received the Master in Pedodontics and Early Treatment at the University of Pisa. Visiting Professor at the University of Cagliari and Pisa, from 20 Years she works in Trento, North Italy, with Dr.Marco Rosa, forming a team specialized in pediatric and orthodontic Dentistry. Her primary ares of interest are Pedodontics, above all Dental Traumatology,, and Esthetics. She published and regularly lectures nationally about this topics.

EVENTS BY THIS MEMBER

ARTICLES PUBLISHED BY THIS AUTHOR

Dental trauma involves about 15-20% of young patients and it is probably one of the main causes that lead to a first visit in dental office. It requires precise protocols in order to maximize prognosis and minimize the risk of severe sequel. In order to follow a perfect workflow of intervention, extremely helpful are the guidelines reported in www.iadt-dentaltrauma.org, the website of the International Association of Dental Traumatology. Essential part in dental trauma treatments are the follow up, that should be taken into account for at least two years from the first observation. In 1996 Kaste LM et AA. published an article that reports the first national overall and age-specific population-based prevalence of dental trauma among gender, racial, and ethnic groups in USA. They noticed that 80% of traumatized incisors had enamel involvement until 10 yrs age, but above all at 41-50 yrs 60% of the sample had pulp involvement. This mean long term high cost. How it is possible to minimize this cost? As already mentioned, following the recipes proposed by the IADT. Sometimes this injuries are so complex that the sequelae may be several and serious. In order to demonstrated such kind of situation, a complex case is reported from the first observation, in 2002 to the final restoration in 2016.
This case shows a new approach to solve upper crowding in the mixed dentition following the philosophy of dr. Marco Rosa. The crucial advantage of this method is the possibility of expanding the upper arch in the anterior area and, at the same time, upright the buccally tipped upper permanent molars in the opposite (palatal) direction. Crowding and rotation of permanent incisors is rather common to be observed right after the transition of the permanent lateral incisors, in the early mixed dentition. Therefore, ideally, treatment should be done before the eruption of the permanent upper lateral incisors, in order to create adequate space to allow them to spontaneously emerge and align in the dental arch. There are patients whose early teeth crowding represents a status, quite easily to be defined. Cases in which, after the transition and complete eruption of the central permanent incisors, some of this conditions are noticeable: - No adequate space for the permanent lateral incisors, which are ready to emerge in the dental arch in a few weeks/months. - The lee-way space could be sufficient to fix the lower crowding, but not in the upper arch and it is very likely that the lateral permanent incisors will emerge late, crowded and/or rotated - Serial extractions to intercept upper laterals crowding is a difficult decision to be taken that early. The permanent lateral incisors are crowded inside the periodontal envelope and will probably emerge in a rotated position, causing esthetically impairment and major risk of relapse, if correction is performed 3-4 years later in the permanent dentition. Upper anterior early crowding is associated to a narrow palate in the absence of posterior cross-bite, because of the dento-alveolar compensation: the upper first permanent molars are tilted buccally, while lower molars are tilted lingually. In this cases, rapid palatal expansion (RPE) could represent an effective procedure to gain space, not only at the level of the alveolar bone, but also in the basal bone where canines and premolars are crowded. RPE (Rapid Palatal Expansion) in the absence of posterior crossbite has been proposed to increase the arch perimeter and to solve crowding, but still represents a controversial issue. Infact RPE has some relevant limits: 1) anchor teeth (i.e. the first permanent molars) will tip buccally even more, with potential periodontal damage and occlusal interference; 2) the amount of the anterior expansion (and crowding correction) is limited and sometimes not sufficient, due to the necessity of preventing a full scissor bite which will develop on permanent molars during activation; 3) posterior expansion is not effective in increasing the arch perimeter (while expansion in the canine-incisors area is much more effective). In other words, ideally, RPE could be very effective to fix anterior crowding and increase the arch perimeter, but the expansion should be performed in the anterior area and permanent molars should move in the opposite direction. If RPE is anchored on the second deciduous molars and on the deciduous canines all those ideal conditions are fulfilled.
Preserving decidous teeth in young people with dental agenesis is mandatory. Maintaining space for any future prosthetic restoration and esthetics during the adolescence is one of the weightiest treatment goals in planning our treatment. Sometimes this treatment option can provide adequate esthetics for long time, even more than expected. And, if done with care, it´s possible to move deciduous teeth orthodontically, in order to facilitate the final restorations. Deciduous teeth preservation is a mandatory clinical behaviour in young patients affected of dental agenesis. In those cases the treatment goals are, at first during adolescence, to keep a pleasant smile, and then space maintenance until the end of growth, waiting for prosthetic restoration.
The prevalence of congenitally missing teeth has been studied and reported by many Authors: a presence ranging between 6 to 10% was found in the population, with a prevalence of congenitally missing upper lateral incisors (CMLI) between 1 and 2%. Furthermore, it has been found that agenesis of both maxillary lateral incisors is more common than the single one. Patients with congenitally missing maxillary lateral incisors (CMLI) often need challenging interdisciplinary treatment and the replacement of CMLI offers three treatment options: canine substitution, tooth-supported restorations, or single implants. The ideal treatment must fulfill individual esthetics, functional requirements and periodontal health: not only at the end of the treatment, but also in the long-term. The rationale, effectiveness and advantage for space closure treatment have been widely discussed in previous articles, and this treatment finds its greatest application since CMLI is usually diagnosed at young age. Space closure offers indeed the possibility of completing treatment before adolescence and achieving a long-term stable outcome at a young age. Hence, it is possible to avoid a long lasting period with temporary restorations waiting for the final restorative procedures at the end of growth. Long-term investigations on periodontal, functional and esthetic stability have shown that space closure can lead to an acceptable functional occlusion with no difference in prevalence of TMJ signs or symptoms and to a better periodontal condition with minor tendency to accumulate plaque and develop gingivitis when compared to prosthetic replacement. Moreover, in the last 15 years, gradual improvement in orthodontic finishing, supported by careful and minimally invasive restorative procedures, has led to high quality esthetic results, almost indistinguishable from natural dentition. The purpose of this article is to show the considerable improvement that can be nowadays achieved with the space-closure alternative by combining techniques from esthetic dentistry with carefully detailed orthodontic treatment. In order to obtain an ideal smile, a detailed orthodontic treatment is mandatory and thus includes: - Extrusion of canine and intrusion of first premolar to reach optimal leveling of the gingival margins. This also allows not to have to grind the palatine cusp of first bicuspid during final build-up - Root palatal torque of extruded canines in order to maintain proper thickness of the periodontal labial plate and prevent the risk of recessions. - Proper torque of intruded first premolars considering root anatomy to allow minimally invasive restorations. Premolar intrusion and canine extrusion themselves can remodel the periodontal profile and properly locate the gingival margins, so that an optimal esthetic result can be achieved. This means the gingival margin of the new canine (i.e. the intruded first premolar) is at the same level of the central incisor, while the gingival margin of the new lateral incisor (the extruded canine) is at a 2-3 mm lower level. The intrusion of the first premolars was also performed in order to obtain a larger “canine” after the building-up of the generally short and small first premolars in the “normal” canine position. About the difference in color between cuspid and bicuspid, cuspids are usually darker and/or more yellowish than the incisors, new home bleaching systems are available to achieve very good and stable results. In order to explain how it is possible to achieve excellence in space closure, a case is shown step by step.

Academic programs

Scientific programs

FOLLOW ME

WRITE ME

Name (required)

Email (required)

Subject

Website

Message (required)


Privacy Policy