The Journal of the American Dental Association
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J Am Dent Assoc, Vol 139, No 6, 715-723.
© 2008 American Dental Association

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CLINICAL PRACTICE

Differential Diagnosis and Management of Flared Maxillary Anterior Teeth



Gary Greenstein, DDS, MS, John Cavallaro, DDS, David Scharf, DDS and Dennis Tarnow, DDS

Background. Flaring of maxillary anterior teeth can be caused by primary or secondary occlusal trauma. A differential diagnosis needs to be made with regard to the etiology of the problem to establish a proper treatment plan.

Types of Studies Reviewed. The authors reviewed relevant articles in the literature addressing migration of maxillary anterior teeth to ascertain the proper diagnosis and methods of therapy pertaining to migrated maxillary anterior teeth.

Results. The authors identify critical questions that clinicians must answer to ascertain which forces cause flaring of maxillary anterior teeth. They describe treatment methods relevant to flaring of teeth associated with primary and secondary occlusal trauma. The authors provide diagnostic and treatment flowcharts to guide clinicians in making therapeutic decisions.

Clinical Implications. Failure to treat maxillary flared anterior teeth can result in an unappealing esthetic appearance. Furthermore, if these problems are not treated in a timely manner, they can become worse and result in loss of teeth. Initiation of proper therapy may include occlusal equilibration, periodontal therapy, orthodontic retraction—alone or in combination with each other—and, in certain types of cases, splinting of teeth.

Key Words: Tooth; oral pathology; occlusion; occlusal splints

Abbreviations: CEJ: Cementoenamel junction. • PDL: Periodontal ligament.







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