View/Download PDF
Clinical Pearls
6 (
4
); 232-234
doi:
10.4103/2321-1407.186440

Simultaneous torquing, aligning and retraction spring: A three-dimensional approach for blocked out canines

Department of Orthodontics and Dentofacial Orthopedics, Teerthanker Mahaveer Dental College and Research Center, Moradabad, India
Department of Orthodontics and Dentofacial Orthopedics, Sardar Patel Post Graduate Institute of Dental and Medical Science, Lucknow, Uttar Pradesh, India
Address for Correspondence: Dr. Abhay Kumar Jain, Department of Orthodontics and Dentofacial Orthopedics, Teerthanker Mahaveer Dental College and Research Center, Delhi Road, Moradabad, Uttar Pradesh, India. E-mail: docabhayjain@gmail.com
Licence
This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
How to cite this article: Jain AK, Agarwal S, Warsi F. Simultaneous torquing, aligning and retraction spring: A three-dimensional approach for blocked out canines. APOS Trends Orthod 2016;6:232-4.

Abstract

Orthodontic management of a buccally blocked-out canine requires a substantial amount of bodily movement, which is difficult to perform because of its long and bulbous root. Even when orthodontic forces are applied in a desired direction, large hyalinized areas are created which impede the root movement. Palatal root torque is needed for the canine to increase the buccal bone thickness, decrease the risk of bone dehiscence and gingival recession. Closing loops generate a distal force along with an extrusive component which retracts the canine into the extraction space but lacks control on the torque of the canine. To overcome this limitation, this simultaneous torquing, aligning, and retraction spring was designed. It can be easily fabricated, activated at chairside for either simultaneous or sequential controlled three-dimensional tooth movements.

Keywords

Aligning
ectopic canine
retraction
spring
torquing

INTRODUCTION

Orthodontic management of a buccally blocked-out canine requires a substantial amount of bodily movement which is difficult to perform because of its long and bulbous root. Even when orthodontic forces are applied in a desired direction, large hyalinized areas are created which impede the root movement. In order to produce efficient canine root movement, very light orthodontic forces are required. This can be achieved by sectional wire with frictionless mechanic coupled with slight activation during canine retraction stage, and using long span of wire (with increased interbracket width and increased flexibility) by differential bonding of the teeth during alignment stage.[1] Cantilever springs are preferred than the continuous wires to avoid the adverse effects on the adjacent teeth such as flattening of the arch which might require even more time for correction.[2] Closing loops generate a distal force along with an extrusive component which retracts the canine into the extraction space but without any control on the torque. Since the canine root has a close proximity to the cortical bone, palatal root torque is needed for the canine during retraction to increase the buccal bone thickness thereby decreasing the risk of cortical anchorage, root resorption, bone dehiscence, gingival recession, and hindered tooth movement.[1] To overcome this limitation, simultaneous torquing, aligning, and retraction (S-TAR) spring [Figure 1] was designed to maintain the torque of the canine in addition to retraction and extrusion of the canine into the extraction space. The steps to fabricate this spring are as follows:

Figure 1: The simultaneous torquing, aligning and retraction spring design

  1. A closing loop of 9 mm in height is bent in a 17" × 25" TMA wire with the distance between the legs of the loop kept at 2 mm. This loop will aid in retraction of the canine.

  2. A V bend is given just distal to the canine in the anterior segment of the wire. The V bend is to localize the torque to the anterior segment of the spring.

  3. Next, a box is fabricated in the anterior to the V bend at the level of the bracket of the canine. The height of the box should be 3-4 mm to help in torquing the canine. The box will help in maintaining the tip and torque of the canine during retraction.

  4. Posteriorly enough wire should be left free to enter the auxiliary tube on the molar band.

  5. Before inserting the spring, preactivation lingual root torque of 15° is given anterior to the V bend of the spring.

  6. Final activation of the spring is done by activating the closing loop by 2 mm.

Figure 2 presents a case with buccally blocked out canine on the right side of the upper arch. Anchorage was prepared using a transpalatal arch along with a base archwire of 19 × 25 stainless steel wire. The S-TAR spring was inserted in the auxiliary tube of the molar and engaged to the canine on that side. Figure 3 shows the spring was in activated state. The canine was brought into occlusion without any adverse effects on the molar [Figures 4 and 5].

Figure 2: Case of a buccally placed right maxillary canine
Figure 3: The simultaneous torquing, aligning and retraction spring engaged and activated by 2 mm
Figure 4: Postalignment buccal view of maxillary canine in occlusion
Figure 5: Post alignment frontal view of maxillary canine in occlusion

The spring shown here can be easily fabricated and activated at chairside for either simultaneous or sequential movement in all three planes of space. The uniqueness of this spring lies in the efficient and controlled torquing moments achieved along with the retraction of the canine into the extraction space.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

  1. , , . Orthodontic tooth movement of total buccally blocked-out canine: A case report. Cases J. 2009;2:7245
    [Google Scholar]
  2. . Versatile auxiliary orthodontic spring for orthodontic correction of impacted teeth. J Indian Orthod Soc. 2011;45:40-7
    [Google Scholar]
View/Download PDF
Download Citations
BibTeX
RIS
Sections
Show Sections