space regaining

8/10/2019 Space Regaining

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SP CE REG INING


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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


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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.


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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


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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.


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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.


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Causes of mesial tipping ordrifting of molars are:Premature extraction of primary

molarsExtensive carious lesion

Ectopic eruption


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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.


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METHODS OF SPACEREGAINING

Methods are divided into:

1. Fixed appliance

2. Removable appliance


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Fixed appliances includes:1. Open coiled space regainer:

Herbst space regainer2. Jackscrew space regainer

3. Gerber space regainer


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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


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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.


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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.


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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.


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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.


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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.


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A bilateral version of thisappliance consist of a coiled loadedlingual arch that passes throughtubes soldered lingually to molarbands.

This appliance produces rapidresults.


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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.


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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


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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.


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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.


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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.


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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.


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The spring should be adjusted twice

a month, creating an increment ofopening in a split acrylic area of0.5mm at a time.


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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.


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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.


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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.


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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.


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Broader for the maxillary plates &narrower for the mandibular plates.

The smaller size is more effectivefor distalization of tooth.

space regaining

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