Space Regaining
-
Upload
dr-parveen-bathla -
Category
Documents
-
view
223 -
download
0
Transcript of Space Regaining
-
8/10/2019 Space Regaining
1/39
SP CE REG INING
-
8/10/2019 Space Regaining
2/39
INTRODUCTION
METHODS OF SP CE REG INING
FIXED PPLI NCES
OPEN COILED SP CE REG INER
J CKSCREW SP CE REG INER
GERBER SP CE REG INER
REMOV BLE PPLI NCES
H WLEYS PPLI NCE
-
8/10/2019 Space Regaining
3/39
INTRODUCTION
Whenever extraction is done or toothis fallen the adjacent teeth movesinto the arch & tries to fill the space
of that extracted tooth which mayresult inmalocclusion.
For the prevention of thatmalocclusion interceptive measuresare used.
-
8/10/2019 Space Regaining
4/39
The basic interceptive methods used by
pedodontist are:Serial extractionSpace regainingCorrection of ant. & post. crossbite
Oral habits eliminationMuscle exerciseRemoval of soft or hard tissue impedimentsto the pathway of eruption
Resolution of crowdingInterception of developing skeletalmalocclusion
-
8/10/2019 Space Regaining
5/39
SPACE REGAINING:
The process of gainingthe space lost by drifting of adjacentteeth following premature loss of
deciduous teeth/tooth.SPACE REGAINER:A fixed or removable
appliance capable of moving adisplaced permanent tooth into itsproper position in dental arch.
-
8/10/2019 Space Regaining
6/39
SPACE REGAINING
If the space maintainer is not usedon the premature loss of deciduoussecond molar, the permanent firstmolar may tip or move mesiallyresulting in the loss of arch length.
The loss of arch length may impedeon the space required for thesecond molar to erupt.
-
8/10/2019 Space Regaining
7/39
Causes of mesial tipping ordrifting of molars are:Premature extraction of primary
molarsExtensive carious lesion
Ectopic eruption
-
8/10/2019 Space Regaining
8/39
-
8/10/2019 Space Regaining
9/39
-
8/10/2019 Space Regaining
10/39
-
8/10/2019 Space Regaining
11/39
TIMINIG OF DISTILIZATION
If the child is treated before the age of 9yrs. the root of the 1stpermanent molar tobe moved has not completed its growth &
the orthodontic tipping or bodily movementto neutralize its position is easier.
The age ranging between 7-10 yrs. is thebest time for bodily movement or tippingto recover the lost arch space.
-
8/10/2019 Space Regaining
12/39
METHODS OF SPACEREGAINING
Methods are divided into:
1. Fixed appliance
2. Removable appliance
-
8/10/2019 Space Regaining
13/39
Fixed appliances includes:1. Open coiled space regainer:
Herbst space regainer2. Jackscrew space regainer
3. Gerber space regainer
-
8/10/2019 Space Regaining
14/39
Removable appliances include:1.Upper & lower Hawleys appliance with
helical spring
2. Hawleys appliance with split acrylicdumb-bell spring
3. Hawleys appliance with sling shotelastic
4. Hawleys appliance with palatal spring5. Hawleys appliance with expansion
screws
-
8/10/2019 Space Regaining
15/39
OPEN COILED SPACE REGAINER(HERBST SPACE REGAINER)
Inthis the band is adapted &pinched on the teeth that is to bedistalised to regain the space.
The buccal & lingual tubes aresoldered to the adopted band.The tube should be parallel to one
another in all the planes & therelumen should be aimed at thejunction of crown & the gingiva.
-
8/10/2019 Space Regaining
16/39
-
8/10/2019 Space Regaining
17/39
-
8/10/2019 Space Regaining
18/39
-
8/10/2019 Space Regaining
19/39
An impression of the band & tubes istaken with the band seated on the tooth
& the band is then removed.The holes in the tube are plugged withcarding wax to prevent them getting
blocked by stone plaster.The bend is then seated in theimpression & the stone is poured.
A stainless steel wire is then bent to aU shape which will fit in both buccal &lingual tubes.
-
8/10/2019 Space Regaining
20/39
The ant. part of the U shape wireshould have a reverse bend where it
contacts the distal outline of the 1stmolar.
At the junction of the straight part &
curved part of the wire, both buccally &lingually flow enough solder to make astop.
Then cut enough spaced open coil spring
so as to extend from the stop to a pointabout 2mm distal to the ant. limit of thetube on the molar band.
-
8/10/2019 Space Regaining
21/39
The band is then removed from themodel & the coil spring is slipped on the
wire.The wire is then put in the tubes & theband with the wire & compressed springsis cemented on the molars.
The compressed spring will exertpressure to the molars distally &premolars mesially.The seating pressure is applied on thebuccal side in case of mandibular molars& both buccal & palatal in case ofmaxillary molar.
-
8/10/2019 Space Regaining
22/39
Jackscrew space regainer
The jackscrew space regainer is used torecover the loss of space caused by
tooth drift into an edentulous area.It uses 2 adjacent teeth & a threadedshaft with a screw & a locknut.
This is activated regularly to exert aconsistent force against the bandedteeth.
-
8/10/2019 Space Regaining
23/39
-
8/10/2019 Space Regaining
24/39
A bilateral version of thisappliance consist of a coiled loadedlingual arch that passes throughtubes soldered lingually to molarbands.
This appliance produces rapidresults.
-
8/10/2019 Space Regaining
25/39
GERBER SPACE REGAINER
In this a U shaped assembly isused into which the U shaped wirecan be fitted.
This in turn is soldered onto themesial aspect of the band & thecoiled spring is fitted on to the U
shaped wire, which in turn fittedinto the U assembly & finallycemented.
-
8/10/2019 Space Regaining
26/39
-
8/10/2019 Space Regaining
27/39
-
8/10/2019 Space Regaining
28/39
REMOVABLE SPACE REGAINERS
1.Hawleys appliance with helicalspring:It can be used for both mandibular &
maxillary molars.It consist of:Short labial bow, as it gives moreanchorage.
Adams clasp on contralateral molarsHelical spring with the active armtowards the tissue
-
8/10/2019 Space Regaining
29/39
Helical spring is in 2 configurations:
SingleDoubleDouble helical spring requires
slightly more time to bend but ismore effective.These helical springs should be
adjusted with little or no pressureexerted distally against the molarduring the 1stweek of treatment.
-
8/10/2019 Space Regaining
30/39
At the 2ndweek & thereafter atintervals of 2 weeks, the spring should
be adjusted to produce a slight distalpressure against the permanent 1stmolar.Usually it takes about 2-4 months to
move a molar distally by a distance of2mm.To decrease the treatment time ifexcessive pressure is applied than it will
lead to sore tooth & possible tissuenecrosis in the peridontium of the molarunder treatment.
-
8/10/2019 Space Regaining
31/39
The active arm of the helical springlies in the mesial undercut of themolar.
Placing the spring in the undercutalso aids in the retention of theappliance.
-
8/10/2019 Space Regaining
32/39
2. Hawleys appliance with split
acrylic dumb-bell spring:
It is used in the mandibular arch.
Space regained is upto 2mm bythis appliance.
It is an effective & comfortableappliance.
-
8/10/2019 Space Regaining
33/39
The spring should be adjusted twice
a month, creating an increment ofopening in a split acrylic area of0.5mm at a time.
-
8/10/2019 Space Regaining
34/39
3.Hawleys appliance withslingshot elastic:
In this appliance instead of using aspecially contoured wire springs thattransmits a force against the molar tobe distalised, a wire elastic holder isused with hooks.
Also called asSLINGSHOT APPLIANCE,since the distalizing force is produced bythe elastic stretched between 2 hooks.
-
8/10/2019 Space Regaining
35/39
One hook is located on the middle
one third of the lingual aspect &the other hook in the same positionon the buccal aspect of the molar
to be distalized.
-
8/10/2019 Space Regaining
36/39
4.Hawleys appliance with palatalspring
It is made up of 0.5mm stainlesssteel wire.
The active arm of palatal spring isplaced mesial to the permanentmolar to be distalized.
The activation is 2mm by openingthe spring.
-
8/10/2019 Space Regaining
37/39
-
8/10/2019 Space Regaining
38/39
5. Hawleys appliance withexpansion screws:
Schwarz in 1938 introduced theexpansion screws.
Expansion screws depending on there
incorporation divided into 2 types:1. Encaused type:They are study & resist
stress the spiral part may however
sometimes turn back.2. Skeleton type: Have a part of spiral
embedded in the acrylic & are thereforemore superior.
-
8/10/2019 Space Regaining
39/39
Broader for the maxillary plates &narrower for the mandibular plates.
The smaller size is more effectivefor distalization of tooth.