CASE REPORT


https://doi.org/10.5005/jp-journals-10083-0915
Journal of Scientific Dentistry
Volume 10 | Issue 1 | Year 2020

Novel Approach for Anterior Space Closure: Fixed Single Wire Technique


Pazhaniswamy Manivannan1, Visweswaran Vijaykumar2, Arya J Varma3, Lidhiya Alexander4

1–4Department of Orthodontics and Dentofacial Orthopaedics, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth, Puducherry, India

Corresponding Author: Visweswaran Vijaykumar, Department of Orthodontics and Dentofacial Orthopaedics, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth, Puducherry, India, Phone: +91 9003368623, e-mail: vvykr20@gmail.com

How to cite this article Manivannan P, Vijaykumar V, Varma AJ, Alexander L. Novel Approach for Anterior Space Closure: Fixed Single Wire Technique. J Sci Den 2020;10(1):10–13.

Source of support: Nil

Conflict of interest: None

ABSTRACT

Spacing is a very common complication of anterior teeth which has to be corrected to bring perfect smile. Though spacing is a simple malocclusion to treat, knowledge about the type of spacing and treatment plan is required. Dental spacing can be due to various reasons which can be divided into developmental and physiologic causes. There are various treatment objectives available to treat spacing of the dentition such as orthodontic fixed appliances, direct and indirect veneers, crowns and bridges. In this case report, we have used a single wire fixed mechanics to close the space in anterior region. A 0.016 × 0.022 stainless steel wire with a loop mesial to canine on both sides was used in this case. The duration of the treatment was 8 weeks.

Keywords: e-chain, New wire technique, Orthodontic fixed appliance, Space closure, Spacing novel..

INTRODUCTION

Spacing though a very common entity in the field of orthodontics, it remains one of the challenging malocclusions to treat.1 A study conducted by Shobha Sundareswaran on the prevalence of malocclusion among South Indian population showed that spacing was present in 18% (280) of children examined with a significantly higher prevalence among males (20.2% (157), p < 0.05).1,2

Various modes of treatment have been used to treat an anterior spacing but none has shown significant benefits than other. This technique is preferred over other removable techniques because of ease of fabrication and minimal force required for tipping of the anteriors.1 Fixed appliance is one such technique which was found to be expensive when compared to all other available treatment modalities.3

This case report presents the case of a male patient successfully treated with a fixed single wire mechanics highlighting the efficacy and cost-effectiveness of this simple technique over other treatment modalities in the management of anterior spacing.4

CASE DESCRIPTION

A 20-year-old male patient reported to the Department of Orthodontics and Dentofacial Orthopaedics, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth, Puducherry, with a chief complaint of anterior spacing. Patient had a history of orthodontic treatment 1 year back for the same. On examination, the patient had Angle’s class I molar relation and class I canine relation on both the sides. Overjet was measured to be 4 mm. The patient was not willing for removable appliance therapy, and hence, fixed single wire technique was employed to close the anterior space.

APPLIANCE FABRICATION

Pretreatment records were taken and separators were placed in relation to 16 and 26. 372 preformed bands were cemented on to the maxillary permanent first molars. Composite resin tags of dimension 3 mm width and 2 mm height were placed on the maxillary central and lateral incisors. The tags were placed parallel to the buccal tubes to avoid unwanted intrusion or extrusion of the anterior teeth. The tags were placed gingival to the position of the wire to avoid wire slipping gingivally. A 0.016 × 0.022 stainless steel archwire of oval archform was used with a loop fabricated mesial to both the canines.

The objective of treatment was to maintain Angle’s class I molar relation and canine relation. A continuous elastomeric chain with twice their resting length was used on both the sides connecting the hook on the molar tube and the fabricated loop.

The patient was monitored regularly every 21 days, and at 8th week post appliance delivery, the spacing in the anterior region was corrected with a reduction in the overjet of about 2 mm. The patient was advised to wear a Begg wrap around retainer post 8th week for the next 6 months. The patient displayed no signs of relapse or other occlusal problems at 12 months follow-up.

DISCUSSION

Patient seeking orthodontic treatment is more concerned about esthetics. Esthetics is compromised in patients with anterior spacing. Anterior spacing is characterized by spaces in the mesial and distal aspects of the tooth in the anterior region.5 Numerous etiologic factors such as tooth material jaw size discrepancies, congenitally missing teeth, peg laterals, habits, and other such factors contribute to the spacing in the anterior teeth. Orthodontists usually encounter the problem of relapse in case of anterior spacing treatment.6

Figs 1A to D: Pretreatment: (A) Straight view; (B) Right profile view; (C) Left profile view; (D) Occlusal view

Figs 2A to D: Midtreatment: (A) Straight view; (B) Right profile view; (C) Left profile view; (D) Occlusal view

Figs 3A to D: Posttreatment with retainer: (A) Straight view; (B) Right profile view; (C) Left profile view; (D) Occlusal view

Figs 4A to D: Posttreatment without retainer: (A) Straight view; (B) Right profile view; (C) Left profile view; (D) Occlusal view

Various techniques have been employed for anterior space closure. Depending on the etiology, the treatment technique differs for anterior space closure. Small spaces can be corrected using removable appliances. Prosthetic replacement and other techniques such as composite buildup, veneers, and crowns are commonly used in case of tooth material and jaw size discrepancy. The removable appliances close the anterior space by tipping the crowns of the anteriors, and they do not provide effective vertical control or torque control, which can have a strong tendency toward relapse.7,8

The light wire technique enables teeth to be moved by being simply tipped. It does not cause pain and does not damage tooth roots or tooth investing tissues. This mechanics is definitely time-saving as compared to treatment solely with either light wire technique, which may need different auxiliaries for control of root position or preadjusted edgewise technique where friction is encountered, and both of which may increase total treatment time. This article describes a case with anterior spacing in the maxilla closed with a single wire technique. Axial inclination of the tooth can also be corrected by placing the resin tags along the long axis of the tooth.9,10

CONCLUSION

Single wire technique is a better way of treating anterior space when compared with all other technique and it was found to be cost-effective. It requires minimum inventory and less chairside time. Treatment duration is also reduced and the results are stable.

REFERENCES

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