Objective: The aim of this study was to introduce a new method for bilateral distal movement of the entire maxillary posterior segment.Case report: A 17-year-old girl with Class I skeletal malocclusion (end-to-end molar relationships, deviated midline and space deficiency for left maxillary canine) was referred for orthodontic treatment. She did not accept maxillary first premolars extraction. A modified Hyrax appliance (Dentaurum Ispringen, Germany) was used for bilateral distalization of maxillary posterior teeth simultaneously. Expansion vector was set anteroposteriorly. Posterior legs of Hyrax were welded to first maxillary molar bands. All posterior teeth on each side consolidated with a segment of 0.017 × 0.025-in stainless steel wire from the buccal side. Anterior legs of Hyrax were bent into eyelet form and attached to the anterior palate with two mini-screws (2 × 10 mm) (Jeil Medical Corporation Seoul, South Korea). Hyrax opening rate was 0.8 mm per month. Lateral cephalometric radiographs were used to evaluate the extent of distal movement. 3.5-mm distalization of posterior maxillary teeth was achieved in five months.Results: A nearly bodily distal movement without anchorage loss was obtained.Conclusion: The mini-screw-supported modified Hyrax appliance was found to be helpful for achieving en-masse distal movement of maxillary posterior teeth.
Forced eruption can be performed in teeth with caries, fracture, resorption or perforation in the cervical third of the root or isolated teeth with one- or two-walled vertical periodontal defects. The purpose of this case report is to introduce an innovative orthodontic appliance which enables forced eruption. This appliance is easy to fabricate, cost-effective and very effective in forced eruption of non-restorable teeth.
Maxillary permanent incisors have a major role in facial esthetics. Impaction of them has great adverse effect on smile and causes serious concerns in patient and parents. Physical barriers (e.g., overretained primary teeth, supernumerary teeth, and pathologic lesions), space problems, developmental abnormalities, altered eruption sequence, trauma, palatal clefts, and genetics can act as etiologic factors. Currently, the conventional technique to treatment of impacted teeth consists of a combined orthodontic and surgical approach, to guide the impacted teeth in a constant position and surrounded by normal hard and soft tissues. Treatment is challenging because of some limitations such as patient's age, cooperation, anchorage, and mechanotherapy possibilities. Hence, sophisticated treatment planning is crucial. A 9-year-old girl with horizontally impacted maxillary left central incisor treated with surgical exposure and closed orthodontic forced eruption with 2 × 4 partial setup fixed appliances. Force was applied with 0.014 inch nickel–titanium wire as elastic overlay and handmade ligated bracket. To save chair time in each appointment, the overlay was activated by twisting of ligature wire extensions around it. After 16-month treatment, impacted incisor emerged in oral cavity, with accepted alignment and inclination. Handmade ligated bracket with ligature wire extensions is useful for the treatment of impacted teeth. Due to easy activation of overlay in this method, chair time become short in each appointment.
Fixed orthodontic attachments/appliances work as a medium to transfer the force applied to the teeth. In bonded types, several factors affect the attachment bond strength and their clinical success. The primary approach for increasing the bond strength focused on altering the time and concentration of acid etching; however, the results showed that these changes might increase susceptibility to enamel decalcification. The bonding mechanism of orthodontic attachments may be chemical, mechanical, or a combination of both. Most attachment bonding surfaces (ABSs) have no chemical bond to resin composites. Hence, mechanical retention plays a major role. Developing more bonding surfaces by increasing the macroscopic size of the attachments has esthetic and hygienic limitations, so the ABS design plays a more important role in maintaining and improving the bond strength. In this research, different ABS designs are reviewed and categorized according to manufacturing methods and their features.
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