Interproximal Reduction
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interproximal reduction
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- A busy Monday for the dentists in Pediatric Hospital when a 14 year old girl named Reign with her mom, entered the hospital’s vicinity because of their daughter’s complaint about the disrupting appearance of her front teeth.
- Hello Reign, I am Dr. Tan. I will be doing a series of exams today.
- Dr. Tan assessed the patient’s condition with the following protocols:Initial examination of the history, physical examination, and posture of the patientExtraoral examinationIntraoral examinationPanoramic radiographLateral cephalometric radiograph Printing the maxilla and lower jaw as a study model Steiner’s Analysis Down analysis Wits analysis Howes Index Arch length discrepancy was also determinedModel analysis was performed from the sagittal direction
- Good afternoon Mrs. Lee and Reign, so i have made a diagnosis through a whole series of examinations. These are the findings that we noted on your daughter’s condition
- skeletal class 1 classification Class 1 of type 1 and 2 Angle malocclusions with upper jaw crowding 11 ambiversions12 palatoversions41 mesolipyoversion42 stopalatoversion7 mm overjet4 mm overbitemedian line shift to the right as much as 1 mmconvex profile absence of interference with the temporomandibular joint
- Basically the etiology or cause of the disrupting appearance of her teeth is the persistence of teeth, imbalance in growth, development of teeth and arches of the upper and lower jaws.
- So what can we do about it doc? Do we need to perform extractions?
- Reign will undergo two phases of treatment, the preliminary phase where I will be doing scaling and cleaning.
- Oh so what’s the second phase of the treatment? Does it include the extraction already since her teeth are too crowded.
- Mrs. Lee we will do a non-extraction procedure because it has relatively small risk of complications if we will do it this way. The next procedure is the orthodontic phase.
- I will also do a preventive measure for her permanent first molars wherein I will put resin as a sealant therapy to the pits and fissures of those teeth.
- You got that right. initially we will put brackets in the maxilla/upper jaw, after the buccal tube is installed in teeth 16 and 26. The buccal tube is a metal that is welded on the buccal part and this will hold the arch wires.
- Are we talking about braces?
- then bonding the brackets on the teeth 15, 14, 13, 11, 21, 22, 23, 24, 25. Also we will perform an interproximal reduction or the slicing the sides of the teeth to give space for the other teeth, i will do it on the mesial and distal surface of tooth 11 and 13.
- That's a lot doc, how about the lower jaw of my daughter?
- We'll do orthodontic treatment as well, The buccal tube will be placed in teeth 36 and 46, followed by bonding bracket in teeth 35, 34, 33, 31, 41, 43, 44, and 45, slicing in the mesial and distal teeth 36, 35, 34, 33, 46, 45, 44, 43.
- NiTi wires will be used to start the alignment and leveling. Stainless steel wires, ligature wire, and elastic rubber will be used as well to correct interdigitation
- What is the slicing of the sides of the teeth doc and why will you perform it after you put the braces?
- Interproximal reduction or the slicing of the teeth is normally done to a dentition that is properly leveled and aligned, that's why we need to fix the alignment and level of her teeth first before that procedure. Also it will help us to assess if we can achieve the correct occlusion for the patient or not.
- The interproximal reduction that will be done to her is performed at 0.125 mm for every 16 to 13 teeth as many as 4 maxillary posterior teeth, so that a space of 0.5 mm was obtained.
- Okay, so this will be a long duration of treatment but expect that we’ll be cooperative.
- And for the lower jaw slicing was performed at 0.125 mm in each tooth 36 to 46 as many as 8 posterior teeth in the lower jaw, so that a space of 1 mm was obtained. Slicing from one tooth to another will be performed after a shift of teeth covered the gap caused by previous slicing. Then we will apply topical fluoride every after slicing.
- That is highly appreciated Mrs. Lee. Thank you for your time and our appointment will be on Wednesday, 8:30 am.
- Okay Doc, thank you!
- The preliminary phase and orthodontic phase was already done. The dentist instructed the patient and the parent few reminders to maintain the oral hygiene of the patient.
- Our treatment is already done, so Reign I have few reminders for you. Just maintain your diet and oral hygiene also you have to go back here for routine control every 3 weeks.
- Thank you so much doc!
- No problem with that Mrs. Lee and you too Reign.
- THEEND
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