Adjunctive Role of Orthodontic Therapy

[Anonymous]

Orthodontic tooth movement may be a substantial benefit to the adult periorestorative patient. Many adults who seek routine restorative dentistry have problems with tooth malposition that compromise their ability to clean and maintain their dentitions. If these individuals also are susceptible to periodontal disease, tooth malposition may be an exacerbating factor that could cause premature loss of specific teeth. Orthodontic appliances have become smaller, less noticeable, and easier to maintain during orthodontic therapy. Many adults are taking advantage of the opportunity to have their teeth aligned to improve the esthetics of their smiles. If these individuals also have underlying gingival or osseous periodontal defects, these defects often can be Improved during orthodontic therapy If the orthodontist is aware of the situation and designs the appropriate tooth movement. In addition, implants have become a major part of the treatment plan for many adults with missing teeth. If adjacent teeth have drifted into edentulous spaces, orthodontic therapy is often helpful to provide the ideal amount of space for implants and subsequent restorations.

        

[siteadmin]

but at times difficult to convince the adult patient for orthodontics

        

[NANDINI TRIPATHI]

Well I think it is a very good idea to include orthodontic treatment in treating periodontaly compromised teeth.as an example you can look at Essix appliances which are clear polyurethene appliances and are almost invisible.The option of clear alligners is also available now in india which can correct the minor to moderate tooth movements in adults and children alike but more important for adults and periodontally compromised cases.
It requires a little more councilling on the part of the dentist but the patient remains grateful all his life.
One should not forget though that such cases generally require a permanent retention.The appliances like essix can easily be handled by general practitioners.If you have any queries you can ask me.Also please go through the web site of Essix at http://www.essix.com.

        

[drmithila]

Essix® plastics have been accepted worldwide for their strength, clarity, size and cost. They are proven, consistent and guaranteed; providing absolute stability and esthetics which, make teeth appear brilliant. They are used for retainers, Minor Tooth Movement (MTM), temporary bridges, stabilization and protection of the osteointegrating implant, whitening trays, temporary bridges and mouthguards. All applications put the clinician in control, not outside labs.

Essix Retainers are versatile; their flexibility and positioning capabilities make them an alternative to spring retainers in correcting minor tooth movements.1 They do not interfere with hygiene care, as opposed to fixed retainers which can interfere with proper care.

Essix thermoformed appliances for Minor Tooth Movement can be easily activated with the Hilliard Thermopliers. With the pliers one can create space, increase retention, close diastemas and increase force adjustments. In addition, bodily movement, rotation, tipping and torquing are easily achieved. Bite planes can be fabricated with the Hilliard Thermopliers without bonding or otherwise adding to the appliance. Essix whitening trays adapt well and cling to tooth surfaces – superior to EVA material — without distortion.

Because the whitening trays are plastic they are practically invisible. The Essix temporary bridge is superior in all respects when compared with other temporary devices. They are inexpensive and esthetic appliances that not only replace missing anterior teeth, but also serve as an efficient retainer. Essix mouthguards provide excellent protection against dental injuries, fractures and concussions during sports; particularly when bodily contact is involved.

The purpose of this article is to alert generalists and orthodontists to some of the multiple applications and techniques of the Essix appliances and the multiple benefits and uses of the Hilliard Thermopliers.

        

[drmithila]

ADVANTAGES OF ESSIX RETAINERS

The advantages include: The ability to supervise without office visits, absolute stability of the anterior teeth, durability, ease of cleaning, low cost, ease of fabrication and the brilliant appearance of the teeth caused by light reflecting through the appliance.4 The retainers are worn only at night, changing the rules of permanent retention

        

[drsushant]

FABRICATION OF ESSIX RETAINERS

1. Because accuracy of the impression is paramount, it is recommended that a polyvinyl siloxane (PVS) system be used . This is especially true for accurately recording cuspid to cuspid retaining points. Since full arches have many retaining points alginate (Cavex) may also be used.

2. Use Debubblizer in both the impression and stone mix

3. Use die stone (Essix stone) for dimensional accuracy.

4. By placing a “cola” can tab into the distal extent of the impression a neat stone model can be poured .

5. The resulting cast should be trimmed so that its height is no more than 3/4″ (2cm) which aids vacuum adaptation of the Essix plastic

        

[drsushant]

Vacuum-formed (Essix) retainer

Another common type is the vacuum formed retainer (VFR). This is a polypropylene or polyvinylchloride (PVC) material, typically .020″ or .030″ thick. Essix is a brand name many dental offices are familiar with. This clear or transparent retainer fits over the entire arch of teeth or only from canine to canine (clip on retainer) and is produced from a mold. It is similar in appearance to Invisalign trays, though the latter are not considered “retainers”. VFRs, if worn 24 hours per day, do not allow the upper and lower teeth to touch because plastic covers the chewing surfaces of the teeth. Some orthodontists feel that it is important for the top and bottom chewing surfaces to meet to allow for “favorable settling” to occur. VFRs are less expensive, less conspicuous, and easier to wear than Hawley retainers. However, for patients with disorders such as Bruxism, VFRs are prone to rapid breakage and deterioration, especially if the material is PVC, a short chain molecule. This breaks down swiftly as compared to polypropylene, a long chain molecule.

Most removable retainers are supplied with a retainer case for protection. During the first few days of retainer use, many people experience extra saliva in their mouth. This is natural and is due to the presence of a new object inside the mouth and consequent stimulation of the salivary glands. It may be difficult to speak for a while after getting a retainer, but this speech difficulty should go away over time as one gets used to wearing it.

        

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