CATEGORY 56 AUSTRALASIAN DENTIST LINICAL any occlusal interferences. In case there are, we should place an anterior bite plane in order to aid in the distalization. b. Anchorage considerations u Since perfect bodily movement is almost never achieved, at the end of the distalization, a distally tippedmolar results. Loss of space may occur during its uprighting. Hence, maximum control and bodily movement of the molar is desired during distalization. u Tendency of the molar to return mesially, particularly if 2nd molars are present. u Molars are not used as anchorage for at least 4–5 months after they have been moved distally. c. Collateral effects of distalizers u They procline the anterior segment. u Bodily distal movement is difficult. u They produce condyle deflection. u Premature points in the palatine cusps. u Due to the hinge effect, some appliances produce a mandibular posterior rotation that will result in an anterior open bite. u According to William Wilson in 1978, molar distalization should not be done before 11 years of age as the maxillary tuberosity enters its rapid growth phase which may lead to second and third molar impaction. The use of the extra-oral arch can provoke many movements: 1. A distal force and a flattening of the occlusal plane, in which the extraoral traction must be applied over the centre of resistance of the molar. 2. A distal force and a settlement of the occlusal plane, in which the extra-oral traction must be applied under the centre of resistance of the molar. 3. A distal force without changes of the occlusal plane, in which the extra-oral traction passes through the centre of resistance of the molar. The distalizing appliance must include the following characteristics: u Must not require patient cooperation. u High degree of biomechanical control. u Compact design. u Minimal interference when the patient eats or speaks. u Absence of pain during the distalizing process. u Easy activation. u Compatibility with other orthodontic techniques. u Automatic cessation of the distalizing movement. u Must be easy to clean. Conclusion Newer and better methods of molar distalization are being developed, especially since the advent of miniscrews into clinical Orthodontics. However, it is in the hands of the clinician to thoroughly analyse the clinical picture and select the appropriate molar distalizing appliance. u Dr Geoff Hall, Specialist orthodontist Founder and Director of OrthoED, Smilefast, CAPS and Clear Aligner Excellence Tel: 03 9108 0475 geoff@orthoed.com.au Objective To evaluate the effect of the Waterpik® dental water with the Pik Pocket™ tip using half strength (0.06%) chlorhexidine (CHX) compared to rinsing with full strength (0.12%) CHX. Methodology This randomized, three months study involved twenty-four patients with a minimum of two implants. Once daily, half the subjects used the Waterpik® dental water jet with the Pik Pocket™ tip with 0.06% CHX and the other half rinsed with 0.12% CHX. Plaque, gingivitis, bleeding, stain, and calculus were evaluated. Results Patients who used the Waterpik® dental water jet and the Pik Pocket™ tip had significantly greater reductions in plaque, gingivitis, and stain than those who only rinsed with CHX. For bleeding, the Waterpik® dental water jet was 87% more effective at reducing gingival bleeding. Conclusion Patients who used the Waterpik® water flosser and the Pik Pocket™ tip had significantly greater reductions in plaque, gingivitis, and stains than those who only rinsed with CHX. u Delivering CHX with the Waterpik® Pik Pocket™ Tip is more effective than rinsing with CHX for implant maintenance Effects of Subgingival Chlorhexidine Irrigation on Peri-Implant Maintenance Felo A, Shibly O, Ciancio S, Lauciello F, Ho A. Am J Dent 1997; 10:107-110
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