A new technique for forced eruption of impacted /certified fixed orthodontic courses by Indian dental academy

A New Technique for ForcedA New Technique for Forced
Eruption of Impacted TeethEruption of Impacted Teeth
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INDIAN DENTAL ACADEMY
Leader in continuing dental education
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Methods for forced eruption ofMethods for forced eruption of
impacted teethimpacted teeth
• ElasticsElastics
• Elastomeric chainElastomeric chain
• Cantilever springs are highly elastic andCantilever springs are highly elastic and
exert relatively long-lasting forces, butexert relatively long-lasting forces, but
tend to break easily and can betend to break easily and can be
uncomfortable for patientsuncomfortable for patients
• NITI coil springNITI coil spring
• Easy- Way-Coil (EWC) systemEasy- Way-Coil (EWC) system

Appliance DesignAppliance Design
• Remanium* closed-coil stainless steelRemanium* closed-coil stainless steel
spring, an .010" ligature wire, and aspring, an .010" ligature wire, and a
bondable lingual button (Fig. 1).bondable lingual button (Fig. 1).

• The spring has an outerThe spring has an outer
diameter of .047" and andiameter of .047" and an
inner diameter of .030’’inner diameter of .030’’
• Each 1mm activationEach 1mm activation
generates an average forcegenerates an average force
of .158N or 16.1g.of .158N or 16.1g.
• To assemble the system,To assemble the system,
cut a 1" length of springcut a 1" length of spring
with a ligature cutter. Atwith a ligature cutter. At
one end, carefully bendone end, carefully bend
the last few coils of thethe last few coils of the
spring at a 45° angle tospring at a 45° angle to
make an eyelet about 1mmmake an eyelet about 1mm
in length (Fig. 2A). Attachin length (Fig. 2A). Attach
the eyelet to the lingualthe eyelet to the lingual
button with the .010"button with the .010"
ligature wire (Fig. 2B). Afterligature wire (Fig. 2B). After
twisting and trimmingtwisting and trimming

• The spring should beThe spring should be
reactivated at fourweekreactivated at fourweek
intervals to maintain a constantintervals to maintain a constant
force.force.
• Additional reactivations areAdditional reactivations are
performed until the springperformed until the spring
cannot be shortened furthercannot be shortened further
(Fig. 5).(Fig. 5).
• At this point, the spring can beAt this point, the spring can be
replaced with a length ofreplaced with a length of
power tube for additionalpower tube for additional
eruption (Fig. 6).eruption (Fig. 6).
• If necessary, the direction ofIf necessary, the direction of
force can easily be made moreforce can easily be made more
mesial or distal by placing amesial or distal by placing a
new attachment groove in thenew attachment groove in the
space-holder spring.space-holder spring.

• After another fourAfter another four
weeks, the crown willweeks, the crown will
have emerged enoughhave emerged enough
to remove the lingualto remove the lingual
button and place abutton and place a
bracket on the tooth.bracket on the tooth.
Further alignment canFurther alignment can
be accomplished withbe accomplished with
a "piggyback" archa "piggyback" arch
segment (Fig. 7).segment (Fig. 7).

• Unlike springs made of otherUnlike springs made of other
materials, such as nickelmaterials, such as nickel
titanium, the stainless steeltitanium, the stainless steel
spring can be accuratelyspring can be accurately
formed into a sturdy eyelet,formed into a sturdy eyelet,
with no introduction ofwith no introduction of
torque.torque.
• 1. High impaction of the1. High impaction of the
maxillary left canine, withmaxillary left canine, with
the spring force applied in athe spring force applied in a
distoi-ncisal direction (Fig.distoi-ncisal direction (Fig.
8).8).

• 2. Palatal2. Palatal
impaction of theimpaction of the
maxillary leftmaxillary left
canine, with thecanine, with the
spring forcespring force
applied in aapplied in a
distobuccaldistobuccal
direction (Fig. 9).direction (Fig. 9).

• 3. Impaction of the3. Impaction of the
mandibular left secondmandibular left second
premolar, with thepremolar, with the
spring force applied inspring force applied in
a mesiogingivala mesiogingival
direction (Fig. 10).direction (Fig. 10).
• The length oftreatmentThe length oftreatment
ranged from 13 to 39ranged from 13 to 39
months in the entiremonths in the entire
sample, with ansample, with an
average of 26.6average of 26.6
months. No infectiousmonths. No infectious
reactions in the oralreactions in the oral
mucosa weremucosa were
observed in any of theobserved in any of the
patients, nor was therepatients, nor was there
any loosening of theany loosening of the
bonded EWC attachbonded EWC attach
ment.ment.

ConclusionConclusion
• The EWC system allows the constantThe EWC system allows the constant
application of force throughout theapplication of force throughout the
eruption of impacted teeth. It can beeruption of impacted teeth. It can be
applied either unilaterally or bilaterally,applied either unilaterally or bilaterally,
with secure anchorage and no undewith secure anchorage and no unde
sirable side effects. This new technique issirable side effects. This new technique is
versatile, efficient, inexpensive, and easyversatile, efficient, inexpensive, and easy
to perform.to perform.

Thank youThank you
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A new technique for forced eruption of impacted /certified fixed orthodontic courses by Indian dental academy

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A new technique for forced eruption of impacted /certified fixed orthodontic courses by Indian dental academy