GAP Australasian-Dentist-Mar Apr 2019

Category 86 AustrAlAsiAn Dentist START DEBOND t he patient was a young adult male, who had concerns with the misalignment of his upper anterior teeth. the patient had no history of orthodontic treatment nor did he present with any habits. He was a regular dental attender. the patient’s oral hygiene was of a fair standard and required some improvement prior to starting orthodontic treatment. the patient was medically fit and healthy. A full orthodontic assessment was carried out including clinical photographs. He had a class iii malocclusion on an average angle skeletal iii base with a decreased overjet of 0 mm and a decreased and complete overbite. there was mild crowding of 3 mm in the upper arch and 0.5 mm in the lower arch. the patient had class iii molars by ¼ unit on both sides and class i canines bilaterally. the aims of treatment were to level and align the arches, on a non-extraction basis within a short period of time. Minimal amounts of interproximal enamel reduction (iPr) were to be carried out to create space for alignment of the anterior teeth. iPr would be carried out more in the lower arch to help alleviate the class iii incisors. the patient was informed the desired outcome could be achieved within six to nine months with four weekly adjustments using the Quickstraightteeth tM alignment system, focussing on alignment of the anterior teeth. the patient was informed the best treatment outcome could be achieved with dual arch fixed appliances. thepatientwasmadeawareoftheadvantagesanddisadvantages of treatment and, in particular with his case, he would need to accept the possible risk of further jaw growth into his early twenties, which may necessitate further orthodontic treatment if this growth is unfavourable. the patient would also need to wear elastic bands between the braces to aid in realignment and require retention through the use of fixed and removable retainers. As the patient had opted for upper and lower arch treatment, an OPG and lateral cephalogram were taken. A Simple Aesthetic Orthodontic Solution for Overcrowding in a Mild Class III Malocclusion by Dr. Preet Bhogal Dr Preet Bhogal lInICal Once the treatment plan had been confirmed, written and verbal consent was obtained. Fixed ceramic appliances (Clarity Advanced, MBt prescription from 3M) were bonded using an indirect bonding method and dual layered transparent trays from Qst. the brackets were expertly positioned by specialist orthodontic technicians using gauges to determine optimal positioning. this reduces technique sensitivity and errors occurring when compared to direct bonding and saves valuable clinical time. in a class iii case like this the lower canine brackets were swapped with each other to provide distal lower canine tipping. Aesthetically coated stainless steel lacebacks were placed on both sides and light iPr was carried out between the lower incisors only. thereafter, the patient was seen every four weeks to change/ tighten the wires. When the teeth were aligned and the aims of treatment had been met, the debond phase was planned. the brackets were removed with special 3M debonding pliers that are designed to prevent damage to the enamel surface and reduce discomfort and all residual composite was removed using a slow speed handpiece and fluted tungsten carbide bur. the palatal surfaces of the anterior teeth were microetched using 27 micron aluminium oxide and a Danville Microetcher ii. the palatal surfaces were then acid-etched and bonded. etched gold Ortho-Flextech wire was used for the upper bonded retainer. A final full set of clinical photographs were obtained, as well as an impression for an upper vacuum formed removable retainer which was fitted 1 week later. the patient was delighted with the final outcome u If you would like to learn more about the Q Academy of Orthodontics, the Quick Straight Teeth tooth alignment system and their education programmes in March 2019 then please contact Stephen Douglas on 0416 629015 or email Steve@quickstraightteeth.net