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A Simplified Method for Crimping Double-Back Bends A Simplified Method for Crimping Double-Back Bends Ayman El Nigoumi Department of Orthodontics and Dentofacial Orthopaedics, Cairo University, Cairo, Egypt Abstract Sakha Ahil Many orthodontic appliances such as the Quad Helix, Transpalatal Department of Orthodontics and arch, Pendulum and Nance appliance utilize double-back bends Dentofacial Orthopaedics, Cairo that are inserted in lingual sheaths typically bonded to, or welded University, Cairo, Egypt on, banded posterior teeth. These bends are advantageous because of ease of removal and reinsertion of the appliance for modification or activation without the need for debanding and Seif El Din Hegab recementation, and because there is no need to drop to a softer Department of Orthodontics and wire after appliance modification. Dentofacial Orthopaedics, Cairo Some problems encountered when making a double-back University, Cairo, Egypt bend include poor adaptation of the wire sections preventing passive insertion into the lingual sheaths, a weakened joint due to multiple attempts to approximate the two sections, and hand Correspondence: injury due to slippage of the wire during this tedious procedure. e-mail: [email protected] The modified pliers developed by Hashir requires permanent welding or soldering of a 19-gauge stainless steel wire to a utility Article history: plier1. Received: 19/04/2016 Thus we propose a new, simplified approach to making a double- Accepted: 20/06/2016 back bend with ease and precision. Published online: 22/08/2016 Keywords Conflict of interest: double back bend, lingual sheath, goshgarian sheath, TPA The authors declare that they have no conflicts of interest related to this research. How to cite this article: El Nigoumi A, Ahil S, Hegab S. A simplified method for crimping double-backPROOF bends. EJCO 2016;doi: PROOF 10.12889/2016_T00257 doi:10.12889/2016_T00257 © 2016 SIDO El Nigoumi A. • A Simplified Method for Crimping Double-Back Bends PROCEDURE A 0.036” wire is roughly bent into a double-back bend. 1 All three sections of the wire are all held securely with a mosquito forceps and PROOF 2PROOFlocked firmly. doi:10.12889/2016_T00257 © 2016 SIDO An Adams plier is used to grasp as much as possible of the wire sections and 3 pressed down. A well-adapted double-back bend is seen. 4 PROOF PROOF REFERENCE LIST 1. Hashir YM. A modified plier for crimping a double-back bend. J Clin Orthod 2012;46:26. doi:10.12889/2016_T00257 © 2016 SIDO CLINICAL ARTICLE Modified Palatine Arch: An Option for Traction of Impacted Maxillary Central Incisors in the Presence of Odontomas Matheus Melo Pithon Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro UFRJ, Rio Abstract de Janeiro, Brazil Department of Health, I Universidade Estadual do Sudoeste A new appliance for applying traction to impacted teeth is da Bahia UESB, Bahia, Brazil described. The appliance is supported on rings fitted to the maxillary first molars (16 and 26) and extends to the anterior Correspondence: region, where lingual tubes are fixed, supporting the molars e-mail: [email protected] which will traction the impacted teeth. In the present case, the maxillary central incisors were disimpacted and mixed occlusion, Article history: normal for the age of the patient, was re-established. Received: 29/07/2016 Accepted: 09/11/2016 Published online: 02/12/2016 Conflict of interest: The authors declare that they have no conflicts of interest related to this research. How to cite this article: Pithon MM. Modified palatine arch: an option for traction of impacted maxillary central incisors in the presence of odontomas. EJCO 2016; 4 doi: 10.12889/2016_C00266 Keywords Odontoma, tooth, unerupted, orthodontics, corrective doi:10.12889/2016_C00266 © 2016 SIDO Pithon MM. • Modified Palatine Arch INTRODUCTION represented, and which are caused general health. He was at the stage Impaction of a permanent tooth is by a series of factors6–8. of mixed dentition, with an absence uncommon in mixed dentition. An Treatment for tooth impaction due to of maxillary central incisors. In the impacted central incisor is usually the presence of odontomas consists mandibular arch, crowding of the diagnosed when the tooth fails to of the removal of the odontoma, teeth and various primary teeth in the erupt1. Although the maxillary canine followed by orthodontic traction of mouth were noted . (Figs. 1 and 2) is the most frequently impacted the impacted teeth. There are various Initially, complete orthodontic anterior tooth, impaction of the ways to disimpact impacted teeth documentation was requested. The maxillary central incisor poses a using mobile or fixed appliances. panoramic radiograph confirmed the problem at an earlier age2. This tooth The authors describe a new method presence of odontomas close to the usually erupts several years before the consisting of the fabrication and use maxillary central incisors . (Fig. 3a,b) canine, when the child is between 8 of an appliance to traction impacted Because of the lack of clarity of the and 10 years of age, and its impaction teeth in the presence of odontoma. radiograph, computed tomography is more obvious to parents3–5. Use of this appliance resulted in dental was requested which (Fig. 3c,d) Impaction of the maxillary central traction with easy biomechanics and showed impaction of the incisors incisors may be due to the presence without aesthetic compromise. and the presence of odontomas. It of supernumerary teeth, odontomas was therefore decided to perform or trauma4. Odontoma is the most CLINICAL CASE orthodontic traction of the incisors common type of odontogenic The patient arrived at the orthodontic and remove the odontomas. tumour1–3, representing up to 70% dental office, accompanied by his of all such lesions2,4,5. However, guardian, having been referred by his APPLIANCE DESIGN some authors consider odontogenic paediatric dentist with the complaint Initially, orthodontic rings were fitted tumours to be developmental that his maxillary permanent central to the patient’s maxillary first molars. malformations (hamartomas), incisors had not erupted. Lingual tubes for the transpalatine in which all dental tissues are The patient had satisfactory oral and bar from the palatine and a triple a b c d e f g h Figure 1: Initial photographs. doi:10.12889/2016_C00266 © 2016 SIDO CLINICAL ARTICLE a b c d e Figure 2: Initial orthodontic models. a b Figure 3: Initial radiographic exams. c d tube from the vestibular region were canine. After the palatine arch was segment of the palatine arch was welded to these rings. Impressions contoured, anterior rods were welded acrylized. The appliance was polished were then taken and the rings were with silver solder to obtain a surface and finished after the acrylic resin visible in the cast. A stainless steel to which the lingual tubes could be was polymerized . (Fig. 4) 0.032″ archwire was placed along welded. After this, the palatine tubes The rings were cemented to the the contour of the palatine arch. were welded onto the wire segment, maxillary first molars (16 and 26) This wire was adapted to the lingual and the palatine arch was removed before surgery for odontoma removal. tube and followed the contour in the from the model and placed in the It was not possible to bond the anterior region close to the distal spot-welding machine. The palatine buttons for traction on the vestibular region of the left maxillary primary tubes were repaired and the anterior surface of the teeth during surgery doi:10.12889/2016_C00266 © 2016 SIDO Pithon MM. • Modified Palatine Arch because they significantly projected arch and springs for traction of the between the springs and the chain, and so the buttons were bonded to incisors were fitted. The springs were which wasjoined to the tubes bonded the lingual surface. fabricated with a 0.032″ stainless to the teeth, was made with ligature Seven days after accessories were steel wire with a bend to fit in the wire . The fabricated appliance (Fig. 4) bonded and the odontomas were lingual tubes, and helicoid in shape would cause an extrusion movement removed, the patient returned to to facilitate activation by the chain of and movement inside the dental office and the palatine bonded accessories. The connection Complete traction of the impacted a b c d e f g h i j k Figure 4: Finished appliance with springs in place. doi:10.12889/2016_C00266 © 2016 SIDO CLINICAL ARTICLE incisors was achieved over 4 months incisor poses a problem at an earlier of the impacted teeth8, followed by . The palatine arch was age and affects the child’s aesthetic multidisciplinary treatment. However, (Figs. 5 and 6) then removed, and the rings were used appearance, giving parents cause for extraction of impacted teeth must be to support a transpalatine bar in order concern6,7. a last resort because the development to prevent mesial migration of the When impacted teeth are associated and maintenance of the premaxilla permanent first molars, maintaining with odontomas, these pathologies depends on the development and the leeway space. The patient’s must be removed in order to eruption of the incisors7. dental development is currently being provide space for the teeth to erupt Various appliances for applying monitored . spontaneously or after orthodontic traction to impacted teeth are (Figs. 7 and 8) traction. described In the literature7–9. Traction DISCUSSION In cases of impacted teeth, it is may be applied to impacted teeth The authors have described the important to inform the patient and using mobile or fixed appliances. Fixed clinical case of a young patient who their parents of the possibility of appliances are more commonly used presented with impacted maxillary treatment failure before extensive for practical reasons and because central incisors due to the presence measures are implemented to they can also be used to correct other of compound odontomas.
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