Introduction:

Presence mesiodens is not uncommon in clinic practice. It is cause of impacted permanent maxillary central incisors. Diagnosis of the delayed tooth is usually made on the basis of clinical and radiographic findings. The treatment include surgical exposure of the impacted maxillary central incisors and extraction of supernumerary tooth, because it is a direct obstruction for the eruption of maxillary central incisors. Impacted maxillary central incisors is moved into it's proper position with orthodontic traction. The aim is presented surgical-orthodontic treatment of impacted teeth, which is necessary to achieve stability esthetic and functional results.

Case report:

This case report describes a surgical-orthodontic treatment of 9.5-old boy with both impacted permanent maxillary central incisors with supernumerary tooth which disturbs their normal eruption.

Conclusion:

The gnathometric evaluation of spaces in dental arch, the assessment of dental age and radiographic analysis are preconditions of successful therapy. The impacted maxillary central incisors were successfully positioned in the maxillary arch, with an adequate width of attached gingiva. The careful and persuasive treatment planning of an orthodontist, oral surgeon and periodontist are the key to success in resolving such cases.

Parodontopathy is a complex disease of periodontal tissues. The patological changes that occure here are destructive and lead to gradual or progressive periodontium disease and its anatomical and functional desintegration. The aim of the research was to use the PCR method (Polimerase Chain Reaction) to identify the presence and spreading of the oral pathogen Actinobacillus actinomycetemcomitans in subgingival plaque in patients suffering from the agressive parodontopathy and then compare it to qualitative-quantitaive structure of dental plaque in patients suffering from chronic parodontopathy. The study included 70 patients, average age of 45. The identification of microorganisms in subgingival plaque was determined by PCR method. In order to comfirm the diagnosis and determine the extent of destruction of periodontal tissue the standar epidemiological criteria were used: plaque index (Silness-Lӧe), gingival index (Lӧe-Silness), SBI index (Mühleman-Son) and DPP. Extremely high statictical significance of presence of A. actinomycetemcomitans was obtained in patients with agressive parodontopathy. The presence of A. actinomycetemcomitans and P. gingivalis showed the difference in distribution in patients with chronic as well as in patients with agressive pardontopathy. In our sample A.a was detected in a high percentage of younger patients with the diagnosis of agressive parodontopathy. Higher rate of A. actinomycetemcomitans in subgingival plaque has a direct impact on the course of parodontopathy. Its detection may be a useful marker for identifying the icreased risk for developing agressive parodontopathy in patients of younger population.