Issue Stories

Clinical Pearls

Balancing Aesthetics with Acrylic Rigidity Needs

Timothy Wheeler, DMD, PhD
University of Florida College of Dentistry, Gainesville, Fla

My patients love the aesthetics of clear retainers; however, there are plenty of times where I need the rigidity of acrylic on the lingual of either upper or lower teeth in order to provide retention. When this was necessary, I typically would use a Hawley retainer, but my patients didn’t like the labial wire, so compliance would decrease.

Clear Fusion retainers have provided my patients with the facial aesthetics that they demand along with the acrylic rigidity that I need in order to maintain their correction. Because of the great aesthetics, compliance is excellent which then improves the retention outcomes. I have found that the occlusal wear of the retainers has been excellent for the long term, with no remakes in the year that my patients have been using them.

Alleviating Crowding

Richard J. DePaul, Jr, DDS
Mayfield Heights, Ohio

The most common chief complaint patients have is crowding. Crowding is a discrepancy between the mesiodistal size of the teeth and the length of the dental arch. Reduction of interproximal tooth mass is one way to create space to align crowded teeth.

This reduction is accomplished with a procedure called reprox (also known as stripping, slenderizing, or IPR). Using reprox we can create space locally, where it is needed, and the teeth are gently aligned into the newly created space.

There are many ways to perform reprox, including the use of diamond disks, diamond strips, or finishing burs. We have found the most rapid and effective way to perform reprox is to use a diamond disk (Komet 934.HP.220). Next, any needed recontouring of the teeth is accomplished with a finishing bur, followed by diamond strip finishing. This method quickly, safely, and painlessly creates space to move the teeth.

The diamond disk works best on areas where the contacts are reasonably well aligned. In areas that have rotated teeth we do not use a diamond disk as this would alter the facial or lingual surface of the teeth. We use a bur and/or a diamond strip directly on the mesial or distal tooth surfaces in this situation to provide interproximal reduction only. In effect, we are “shrinking teeth” mesiodistally to align them to their appropriate position.

The Powerprox Six Month Braces® Reprox and Bracket Removal Kit (Appliance Therapy Group) has everything you need to perform reprox on your patients.

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