A clinical trial was conducted to investigate the development of caries lesions associated with fixed orthodontic appliance therapy. To introduce a cariogenic challenge on Sound buccal enamel surface in vivo, specially designed orthodontic bands were attached to premolars scheduled for extraction for orthodontic reasons. The bands were modified by having two metal wires (0·8 mm in diameter) welded to the inner surface of the band to produce a space for plaque accumulation similar to that occurring under loose orthodontic bands. The bands were cemented with a zinc phosphate cement (Tenet®) an left in situ for 4 weeks. Of 22 premolar teeth banded in eight different patients, eight showed definite white spot lesions, eight showed definite faint enamel opacities, and six showed no discernable lesions. Examination of definite white spot lesions by scanning electron microscopy revealed characteristic patterns of initial tissue destruction. Focal holes and an accentuation of the perikymata were observed affecting the enamel surface zone, an area previously considered to remain relatively intact during the development of a caries lesion. The superficial nature of the caries lesions observed and the rapidly of their formation is significant in the clinical management of decalcified areas forming beneath orthodontics bands.
This article examines the concept of orthodontic anchorage and focuses on ways skeletally derived anchorage is gained. A brief history of the different skeletal anchorage systems to date is given. The article gives an emphasis on the use of one particular skeletal anchorage technique--the micro-implant--to assist with orthodontic anchorage and active tooth movement. Advantages and disadvantages of this new technique are discussed. An illustration of the use of micro-implants is given with reference to a case where they have been used in a novel manner to provide distal movement of maxillary molars.
The treatment of transplant patients is becoming an ever-increasing part of modern-day orthodontic practice. This report details the successful orthodontic management of a paediatric renal transplant patient with significant drug-induced gingival overgrowth. The problems that such patients present with are discussed before considering the specific orthodontic techniques employed. Recommendations are made for practitioners managing such cases.
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