jco_2013-01-41
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VOLUME XLVII NUMBER 1 41 W hen orthodontic treatment is finished before complete eruption of the maxillary second molars, the orthodontist is pre- sented with a dilemma if the mo- lars eventually erupt in buccally displaced positions. We have developed a meth- od to correct such a displaced sec- ond molar using a vacuum-formed retainer with an attached lingual button. The procedure is shown here in a young adult patient who had previously undergone ortho- dontic therapy as an adolescent. Procedure 1. Prepare a plaster cast, apply a separating medium, and cement a metal button about 5-6mm from the lingual gingival margin of the displaced second molar (A). 2. Vacuum-form and trim the retainer* as usual, then cut away the material covering the displaced tooth, allowing space for the tooth to move lingually. Remove the acrylic from the head of the lin- gual button (B). 3. Bond a lingual button or buc- cal tube to the buccal surface of the displaced molar. 4. Instruct the patient to wear an elastic (1oz) between the two at- tachments whenever the retainer is in place (C). 5. Check the progress of the molar every four to six weeks. Once the displaced tooth has been aligned (in this case, after six weeks), fabricate a new retainer (D). Discussion This simple modification of a vacuum-formed retainer can be easily fabricated in the orthodontic office. If the practice owns button- forming Thermopliers,* the clini- cian can place a similar button within the retainer material itself. Because patients may have difficulty attaching elastics in this region of the mouth, it is impor- tant for them to practice applying and removing elastics several times at the delivery appointment. The vertical separation of the teeth with the retainer in place usually provides adequate clear- ance for molar movement, while the intrusive forces applied by the elastic prevent extrusion. XIAO-GUANG ZHAO, BDS, MSD, PHD Lecturer Department of Orthodontics Sun Yat-Sen University Guangzhou, Guangdong China [email protected] JIU-XIANG LIN, BDS, PHD Professor Peking University School and China © 2013 JCO, Inc. TECHNIQUE CLINIC Second-Molar Correction with a Modified Vacuum-Formed Retainer B A C D *Erkodur 1.5mm sheets, Erkodent Erich www.erkodent.com. ©2013 JCO, Inc. May not be distributed without permission. www.jco-online.com
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Transcript of jco_2013-01-41
VOLUME XLVII NUMBER 1 41
When orthodontic treatment is finished before complete
eruption of the maxillary second molars, the orthodontist is pre-sented with a dilemma if the mo -lars eventually erupt in buccally displaced positions.
We have developed a meth-od to correct such a displaced sec-ond molar using a vacuum-formed retainer with an attached lingual button. The procedure is shown here in a young adult pa tient who had previously undergone ortho-dontic therapy as an adolescent.
Procedure
1. Prepare a plaster cast, apply a separating medium, and cement a metal button about 5-6mm from
the lingual gingival margin of the displaced second molar (A).2. Vacuum-form and trim the retainer* as usual, then cut away the material covering the displaced tooth, allowing space for the tooth to move lingually. Re move the acrylic from the head of the lin-gual button (B).3. Bond a lingual button or buc-cal tube to the buccal surface of the displaced molar.4. Instruct the patient to wear an elastic (1oz) between the two at -tachments whenever the retainer is in place (C).5. Check the progress of the molar every four to six weeks. Once the displaced tooth has been aligned (in this case, after six weeks), fabricate a new retainer (D).
Discussion
This simple modification of a vacuum-formed retainer can be easily fabricated in the orthodontic office. If the practice owns button-forming Thermopliers,* the clini-cian can place a similar button within the retainer material itself.
Because patients may have difficulty attaching elastics in this region of the mouth, it is impor-tant for them to practice applying and removing elastics several times at the delivery appointment.
The vertical separation of the teeth with the retainer in place usually provides adequate clear-ance for molar movement, while the intrusive forces applied by the elastic prevent extrusion.
XIAO-GUANG ZHAO, BDS, MSD, PHD
LecturerDepartment of Orthodontics
Sun Yat-Sen UniversityGuangzhou, Guangdong
JIU-XIANG LIN, BDS, PHDProfessor
Peking University School and
China
© 2013 JCO, Inc.
TECHNIQUE CLINICSecond-Molar Correction with a Modified Vacuum-Formed Retainer
B
A C
D
*Erkodur 1.5mm sheets, Erkodent Erich
www.erkodent.com.
©2013 JCO, Inc. May not be distributed without permission. www.jco-online.com
