Case 8467
A 24-year-old female attended the dental office with an initial chief
complaint concerning pain in the lower left quadrant. Medical
history-taking was unremarkable. After receiving informed consent,
physical examination was undertaken as well as a panoramic radiograph
(Fig. 5). A working diagnosis of gross caries at tooth #18 with a
differential diagnosis of impacted third molars was reached (Fig. 5).
The treatment plan included endodontic and restorative procedures for
tooth #18. Treatment started in 2016 and the dental treatment relived
the pain. The patient was informed about the possibility of recurrent
pain from the unerupted molars and after considering the risks, benefits
and alternatives, she elected on biomimetic oral appliance therapy. In
this case, the upper device also had a Y-split design without second
molar coverage (Fig. 2). The device was worn for approx. 10-16 hrs. per
day, including while sleeping, but not while eating. Gradual adjustments
were made to the appliance approx. every 4-6 wks. The lower device (Fig.
6) was instituted approx. 3mos. later. Treatment with the devices was
finished after about 2yrs. in 2018. Panoral radiography confirmed that
all the third molars were fully erupted (Fig. 7). The case was finished
with standard orthodontic brackets.