Dental Problems

Interceptive Orthodontics – Fixed Space Regainers

tooth-5Interceptive orthodontics is the procedure which revolves around the small problems that are present during the development of dentition. If this condition is left untreated it might increase the severity of the condition and consequently it may difficult for the treatment at a later date. In this article, there is a brief discussion on the interceptive orthodontics -fixed space regainers. Read on to know more.

Interceptive orthodontics -fixed space regainers

The common problems of interceptive orthodontics which could be intercepted, would include space regaining, crowding, corssbites, midline diastemas and orthopedic guidance.

Space regaining:

Space maintenance is essential in the early loss of the posterior primary teeth because this early loss of teeth contributes to the occlusal disharmonies development. There are of two types of space regaining method which include the following:

  • Fixed space regainers
  • Removable space regainers

In this article, we shall discuss about the fixed space regainers

Fixed space regainers:

The various types of fixed space regainers are discussed below:

  • Open coil space regainers
  • Gerber space maintainer
  • Hotz lingual arch
  • Sectional arch technique
  • Lip bumper or plumper and
  • Anterior space regainer

Open coil space regainer:

A reciprocal active fixed regainer can be used to good advantage in the mandibular arch when the first premolar has erupted into the oral cavity.

Construction:

  • A molar band is fitted to the first permanent molar.Molar tubes are soldered or spot welded in a horizontal position both buccally and lingually to the band.
  • Impressions will be taken with alginate.
  • A stainless steel wire which is slightly smaller than the tube size is selected and bent into a ‘U’shape.
  • The base of the ‘U’should contain a reverse bend to contact the distal surface of the first premolar.
  • As the wore comes out of the tube it should aim toward the first premolar at a point just below the greatest distal convexity of the first premolar.
  • A stop should be placed on both arms where the straight part meets the bend of the wire.
  • A spaced coil spring is selected which will slide on the wire and is cut about 2 to 3 mm. longer than the distance from the anterior stop to the molar tube.
  • The band is cemented with the coil springs compressed.

Gerber space maintainer:

  • This type of appliance may be fabricated directly in the mouth during one relatively short appointment and requires no lab work.
  • A “U” assembly, which may be welded or soldered in place with silver solder and fluoride flux is fitted in the tube, the appliance placed and wire section extended to contact the tooth mesial to the edentulous area.
  • The length of the push coil springs is established by placing the band-tube-wire assembly in the mouth, extending the wire to the desired length, in contact with the mesial tooth and measuring the distance between the tube stops on the wire and the end of the “U” tube.
  • To this distance, add the amount of space needed in the regainer, plus 1 to 2 mm, to ensure spring activation and cut springs to this length.
  • The springs are compressed enough to allow the assembly to fit the edentulous area.

Hotz lingual arch:

  • Another method for moving the molar distally utilizes the looped Hotz lingual arch.
  • This is appropriate in a situation where the lower first permanent molar has drifted mesially, but the premolar or cuspid has not drifted distally.
  • But there must be x-ray evidence that there is sufficient space between the first molar and the developing second molar.
  • Anchorage for the movement is achieved as the arch contacts all the teeth.
  • Besides, spurs across the canines can also be used to the same effect.
  • After adjustment, the posts in the passive position should be approximately 1 mm distal to their passive positions over the lumen of their tubes. The arch is then forced forward and the posts slipped down into place.
  • As mentioned earlier, it is advantageous to use the removable type of lingual arch space maintainer, since it facilitates frequent removal of the arch for the purpose of activation.

Sectional arch technique:

  • A sectional arch technique can also be used to regain the lost arch length.
  • Up to 4 millimeters of space can be regained in an effective and efficient manner by the method described. It can be Used in the cases where the second molar is erupted.

Lip bumper or plumper:

  • The appliance is most easily used for the space regaining procedures in which bilateral movement is desired.
  • It consists of a heavy labial arch wire over which an acrylic flange is prepared in the anterior region such that it does not contact the lower anteriors.
  • Instead, it is used to relieve the lip pressure.
  • This pressure can be used to distalize the molars by:
    1. Incorporating loops in the arch wire just before it enters the buccal tube.
    2. Utilizing a coil spring. It can also be used unilaterally.

Anterior space regainer:

  • A technique described is the use of an anterior space regainer utilizing direct bonding. To the lateral incisors was attached labial tubes.
  • A 0.014” round wire was then inserted in an open coil spring and activated.

The above article discusses about the interceptive orthodontics -fixed space regainers and various types of fixed space regainers -open coil space regainers, Gerber space maintainer, Hotz lingual arch, Lip bumper or plumper and anterior space regainer. Thus, individuals going for any of the procedures need to take complete guidance from their dentist before opting for the procedure.

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