Modified Bonded Space Regainer/Retainer

by Dr. K.S. Negi

 

Sr. Lecturer, Department of Orthodontics

H.P. Government Dental College and Hospital, Shimla, India.

docksnortho@yahoomail.com

 

 

 

 

 

Abstract:

Early orthodontic interventions are often initiated in the developing dentition to promote favorable developmental changes. Interceptive orthodontic can eliminate or reduce the severity of a developing malocclusion, the complexity of orthodontic treatment, overall treatment time and cost. Premature loss of deciduous tooth or teeth can often destroy the integrity of normal occlusion. Though we have many space regaining and maintaining devices mentioned in literature. This article presents a simple space regaining method by a piece of Nickel Titanium wire bonded between the teeth in active loop form, and The unique shape memory property of Ni Ti wire will upright or move the teeth and the lost space can be regained easily.

 

Key Words: space-regainer, NiTi wire, Light cure composite.

 

 

 

 

The dental profession is concerned with the prevention and the effective interception of developing occlusion. An important part of preventive orthodontics is the correct handling of inadequate space created by the untimely loss of deciduous teeth. As more and more people become aware of the importance of the repair of deciduous teeth, this problem is bound to arise less often, but at present it is major one. Unfortunately some dentists have been guilty of advising patient to disregard the repair of deciduous teeth, because they will be lost. Perhaps it is because children are sometimes more difficult to manage or a time and fee basis the results are less productive to the dentist.1

The space loss due to premature loss of deciduous teeth especially deciduous molars can lead to mesial migration of the first permanent molar, disturb the integrity of arch and may cause the impaction or ectopic eruption of the second premolar. Conventional space regainers used e.g. spring regainer, lip bumper, active lingual bar, extra-oral appliances etc., have disadvantages such as:

 

Modified space regainer / maintainer is a simple appliance that can be placed chairside in single visit. A composite dimple is bonded on the buccal side of permanent first molar and with the help of an explorer, a turnnel is burrowed into the mesial of the dimple. This creates a composite tunnel that is open only on the mesial. A piece of .016" NiTi wire then bonded on the buccal side of primary molar and extended beyond the dimple. After the composite has set on both teeth, with the help of birdbeak plier, direct the free end of wire into the tunnel made in the dimple of first molar. This will give a form of activated loop NiTi wire (fig. 1,2). A small amount of bonding material is placed in the opening of tunnel to make the attachment more permanent.

Figure1: Pre-Treatment Figure 2: NiTi wire Bonded

 

Over the time the loop returns to its original shape due to the memory properties of NiTi wire, at the same time distalizing and uprighting the first molar (fig. 3). Once the active correction is completed, the wire segment is left in place as a passive space maintainer (fig 4,6), untill the eruption of second premolar. 2

Figure 3: NiTi wire regaining it's shape Figure 4: NiTi wire has regained it's shape by drifting 6 and D
Figure 5: Pre-Treatment Figure 6: After regaining space

 

Advantages

 

Conclusion

Modified bonded space regainer using NiTi wire is a one sitting method effective in regaining and maintaining space.

 

 

 

References:

T. M. Graber. Orthodontics Principle and Practice 3rd edition

Dimond, H. Jr. A Nickel Titanium space regainer-retainer. J. Clin. Orthod. 2001; 35(12): 767-768