Posts Tagged ‘orthodontics’

Clearstep, an alternative to Invisalign

15 Feb 2012 at 15:56

Campbell & Peace

Articles, Newsletters, Services

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Braces, Orthodontics Nottingham

 

 

 

 

 

 

As demand for improvement in dental and facial aesthetics is increasing the number of adult patients presenting for orthodontic treatment is also increasing.

A recent survey carried out for the British Orthodontic Society found that 45% of UK adults were unhappy with the appearance of their teeth and that 2O% would consider having some form of orthodontic treatment to improve the alignment and appearance of their teeth. Of those patients that would consider treatment their reasons were an improvement in appearance, self-esteem and health and oral function. However adults are often put of by the appearance of traditional metal braces.

Aligners are clear plastic gumshield type appliances that fit on over the surfaces of the teeth. They are made as a series of removable appliances that gradually move the teeth into line. These appliances appeal to the patients looking for minimal visual impact. There are various manufactures of aligners.

Clearstep is one of these systems.

Braces, Orthodontics Nottingham

 

 

 

 

 

 

 

Advantages of Clearstep

  • Virtually invisible
  • Comfortable to wear
  • Minimal restrictions on diet as they are removed for eating
  • Can also be removed for special occasions
  • Impressions can be taken at any stage to alter the progression of treatment
  • Little interference with speech as the plastic does not cover the palate
  • Very good for mild to moderate irregularity of the teeth or patients who have had fixed appliances in the past and have had some minor relapse

Click here to see a patient video on the Clearstep website

Limitations of Clearstep

  • Like any removable appliance these appliances require good patient compliance.
  • It can be difficult to close spaces, derotate teeth or intrude and extrude teeth.
  • Not really suitable where large amounts of tooth movement are required.

How does the process work?

  • Upper and lower silicone impressions and bite registration are taken
  • The orthodontist plans the individual tooth movements and completes the Clearstep prescription form
  • The models are cast in the lab
  • The technicians gradually move the teeth and a series of gumshield appliances are constructed.
  • These appliances are worn in sequence for 2 weeks
  • Patients attend the orthodontist periodically to check the appliances and monitor the progress of tooth movement
  • Retention when desired tooth movements are achieved

Clearstep can be a highly effective way of discretely moving teeth with only minimal impact on the patients’ daily life. As with any orthodontic treatment an accurate diagnosis and treatment plan is essential and treatment with aligners is not always suitable for every patient.

Do you have any patients looking for a clear solution to a mild orthodontic problem? Contact the practice for more information  or to refer your patient.

Braces, Orthodontics Nottingham

Case study: Orthodontic closure of anterior spaces

03 Nov 2011 at 09:55

Campbell & Peace

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Orthodontist Nottingham

Figure 1

 

 

 

 

 

 

Patients with anterior spacing often consider this as a significant aesthetic impairment, and will go to great lengths to have this resolved. However, spacing of the anterior teeth tends to have a low score both for the dental health component and the aesthetic component of the Index of Orthodontic Treatment Need (IOTN).

This lady presented in her early 20’s complaining that she disliked the gaps between her upper front teeth. Her dentist had provided composite build-ups on the mesial and distal surfaces of both upper central incisors and on the mesial surface of her upper right lateral incisor (fig 1).

However, she felt that her upper central incisors were now too large compared to her lateral incisors, too wide relative to their height and also a rather odd shape.

Extra-oral assessment

She presented with a Class 2 skeletal base with a prominent pogonion, a low maxillary mandibular planes angle and a reduced lower anterior face height.

Intra-oral assessment

She was in the permanent dentition with an unrestored dentition with the exception of the build-ups on her anterior teeth. Her oral hygiene was good.

The mandibular arch was mildly crowded and the maxillary arch spaced.

In occlusion, she had a Class 2 division 1 incisor relationship with an increased overjet and overbite. The molar and canine relationship on the right was ¾ unit Class 2 and on the left ¼ unit Class 2.

Radiographic assessment

The panoramic radiograph confirmed the presence of all permanent teeth, with root lengths and bone levels within normal levels. Analysis of the lateral cephalogram indicated a Class 2 skeletal pattern with proclination of the upper incisors and retroclination of the lower incisors.

Aims of treatment

Sagittal correction of the occlusion

Leveling and aligning

Class 1 molar and canine relationship

Space closure

Treatment plan

Removal of composite build-ups

Upper and lower pre-adjusted edgewise fixed appliances (0.022 x 0.028 inch slot MBT prescription)

Mandibular subapical osteotomy

Orthodontist Nottingham

Figure 2

 

 

 

 

 

 

The risk and benefits of treatment where discussed at length especially due to its complex nature and she decided to commence with treatment. The composite build-ups were removed (fig 2) and upper and lower fixed appliances placed for decompensation prior to mandibular surgery.

Orthodontist Nottingham

Figure 3

 

 

 

 

 

 

Initial alignment was commenced with 0.016 nickel titanium archwires progressing to 0.018 x 0.025 nickel titanium until 0.019 x 0.025 stainless steel working archwires could be placed  (fig 3).  Space closure was performed using power chain in the upper labial segment and nickel titanium closing springs in the buccal segments. Pre surgical orthodontics took 11 months and she was debonded 6 months after surgery (fig 4).

Following debond she was fitted with upper and lower vacuum formed retainers.

Orthodontist Nottingham

Figure 4

 

 

 

 

 

 

Closure of anterior spacing always presents a dilemma. Is it possible to close the spaces with orthodontics alone or a restorative solution alone or is a combination of orthodontic redistribution of the spaces followed by aesthetic build-ups of the teeth required? In this case, although her upper laterals are slightly small the patient was delighted with her new smile (fig 5). All orthodontic work carried out by Fiona McKeown.

Orthodontist Nottingham

Figure 5