[Method of fixation of removable orthodontic appliances].
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Although apparently simple and efficient to use, removable appliances are no longer the appliance of choice for comprehensive orthodontic treatment in the permanent dentition. Their mechanical properties result in simple tipping of teeth, therefore multiple simultaneous tooth movements with apical control are not possible. It is for these and other reasons that removable appliances are usually only indicated for specific interventions in the mixed dentition, and as an adjunct to more complex fixed appliance treatment. Removable appliances, once popular because of their case of use, are no longer seen as the appliance of choice. This article discusses the rationale behind this statement and indicates cases suitable for removable appliance treatment.
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Lymphocyte transformation tests were performed on peripheral blood taken from individuals with a history of contact dermatitis who also presented with a positive patch test to nickel sulphate, and from individuals with no history of contact dermatitis. The results implied that nickel leached out from metallic orthodontic appliances in sufficient amounts and of a chemical nature adequate to stimulate proliferation of lymphocytes from some of the nickel-sensitive subjects.
BACKGROUND: Implants replacing missing teeth provide advantages over clinical orthodontic treatment as compensation for reaction forces is no longer necessary and the lack of teeth is immediately resolved. METHODS: A total of 38 two-stage implants were inserted (16 in maxilla, 22 in mandible) in 10 partially edentulous patients with orthodontic problems. Osseointegration and marginal bone levels were assessed via intra-oral radiographs taken at the abutment stage and at the completion of the orthodontic treatment and also via probing depth, measurement of recession toward the implant/abutment (I/A) interface, and sulcus bleeding index, recorded after completion of orthodontic treatment. RESULTS: In the maxilla, the cumulative survival rate was 87.1% after 2 years; for the mandible, it remained 100%. Mean amount of bone loss was 1.6 mm for maxilla and 0.8 mm for mandible. No correlation could be found between directions of orthodontic forces and marginal bone loss. Mean percentage of bleeding sites was 38.5% and 25%, respectively, for implants in the maxilla and mandible. Attachment level was 1.2 mm (SD: 1.2) below I/A interface after completion of the orthodonic treatment. CONCLUSION: No significant marginal bone loss was present. Using implants during orthodontics can result in an easier and more predictable treatment.
Three clinical case studies are presented to demonstrate the use of a simple functional appliance in orthodontic situations not covered by traditionally-accepted dental and skeletal indications. In each case, the appliance was used to reduce the severity of the malocclusion, before a routine fixed-appliance detailing phase.
Five identical samples, each consisting of a fixed appliance, a headgear and a quad-helix for one-half of a dental arch, were immersed in 0.9% sodium chloride for 2 hours, 24 hours and 7 days. A control appliance was subjected to dynamic test conditions in a specially built "oral simulator" under similar test conditions. A significant release of nickel was detected from the quad-helix during the first two hours in static conditions, whereas during the following two periods significantly less nickel was released from the quad-helix than from the other appliances. The fixed appliance with simulated function showed a significantly higher cumulative release of nickel than the similar appliance in static conditions, 44.2 micrograms (SD 22.8) and 17.1 micrograms (SD 3.4). The total amounts of chromium released from the fixed appliance were significantly lower than those of nickel. No difference in the release of chromium was seen between the static and dynamic conditions. The results indicate certain differences in the amount and pattern of nickel release from different stainless steel orthodontic appliances in vitro. The release rate of nickel from dynamically loaded fixed appliances was found to be accelerated compared with that released under static conditions. Caution should be exercised when applying the results to the in vivo situation.
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