Jadbinder Seehra

Dr Jadbinder Seehra is a Senior Specialist Clinical Teacher at Kings College London and Consultant Orthodontist based at both Guys and St Thomas NHS Foundation Trust and Kings College Hospital NHS Foundation Trust. He is currently the Deputy lead for the Orthodontic Masters (MSc) programme at Kings College London and Director of Orthodontic Therapy, Kings Health Partners where he provides academic and clinical training to orthodontic postgraduate students and orthodontic therapists. He has held various positions of leadership and responsibility within both the British Orthodontic Society and Royal College of Surgeons of England. He has been awarded numerous national prizes for his excellence in orthodontic research and is currently undertaking a PhD. He has published extensively in the scientific literature and has also written an orthodontic textbook.

Course details

Incisors and Canines: Exposure, Substitution and Periodontal Outcomes

The maxillary incisor and canine are two of the most commonly impacted teeth in the permanent dentition. Abnormalities in their normal eruption usually present during childhood and early adolescence. Their impaction can lead to localised disturbances in the developing occlusion. Moreover, their prominent position within the smile arc can make the aesthetic consequences associated with the absence of these teeth quite considerable. Multidisciplinary treatment consisting of surgical exposure and concomitant orthodontic traction is often undertaken to accommodate and align these teeth into the arch. Additionally, in maxillary lateral incisor agenesis cases, the maxillary canine can serve as a viable option to replace the absent incisor. Despite the obvious advantages of these treatment modalities, they are not without potential risk to the periodontal tissues.

From a clinical aspect, providing an estimate of the periodontal impact following multidisciplinary treatment undertaken on the anterior maxillary teeth would be useful for both clinicians and patients. The aims of this presentation are two-fold. Firstly, using a systematic review approach, the existing evidence base relating to periodontal outcomes associated with impacted maxillary central incisor and canine teeth, which have been successfully aligned following surgical exposure and orthodontic traction with fixed appliance therapy will be presented. Secondly, the evidence pertaining to periodontal outcomes following canine substitution in absent maxillary lateral incisor cases will be reviewed.

Learning objectives

• To understand the effect on the periodontal tissues of maxillary canine teeth following substitution in absent maxillary lateral incisor cases.
• To understand the existing evidence base level regarding periodontal outcomes of anterior maxillary teeth that have undergone multidisciplinary treatment.
• To understand the effect on the periodontal tissues of impacted maxillary central incisor and canine teeth as a result of combined surgical -orthodontic treatment.