Page 15 - REMOVABLE ORTHODONTIC APPLIANCES

Introduction 7
• Patients find that the bulk is unsatisfactory Skeletal factors
• With conventional clasping techniques the Cases with class I, mild or moderate class II and
retention is less satisfactory and this very mild class III skeletal patterns are suitable
contributes to a patient's dislike of the for management. Removable appliances are
appliance not suitable for the complete treatment of more
• The considerably reduced area available for marked class II or class III cases.
active components means that it is not possi-
ble to construct springs with a sufficiently
long range of action. Summary
Removable appliances can be used to treat a
large number of mild and moderate malocclu-
Case selection
sions, especially in the growing patient where the
lower arch is acceptable or will improve sponta-
Age of patient
neously following relief of crowding. They are
Removable appliances are most suitable for use also useful for the reduction of overbite, the elim-
between the ages of 6 and 16 years, with the ination of displacements and the provision of
majority of treatment undertaken during the additional anchorage. They can provide a ready
late mixed and early permanent dentition adjunct to other forms of treatment, especially
stages. treatment with fixed appliances where they are
almost routinely used as removable retainers
when active tooth movement is completed.
Dental factors
In some malocclusions, the positions of the
tooth apices are relatively correct and the References
irregularity is due to the crowns being tipped
Brenchley, M.L. (1966) Some spontaneous and advanta-
from the correct positions. Such cases are geous tooth movements. Dental Practitioner, 16:307-311
most suited to treatment by removable appli-
ances because tipping movements are
required. For the relief of moderate crowding, Further reading
extractions should be close to the site where
Adams, C.P., Kerr, W.J.S. (1990) Design construction and
space is needed. Cases that require controlled
space closure, for example where mild crowd- use of removable appliances. Wright, London
British Orthodontic Society (1998) Young practitioners guide
ing is to be treated by second premolar to orthodontics. British Orthodontic Society, London
extractions, are not suitable for the use of Isaacson, K.G., Reed, R.T., Stephens, CD. (1990) Func-
removable appliances. Severe crowding, tional orthodontic appliances. Blackwell, Oxford
multiple rotations or marked apical displace- Littlewood, S.J., Tait, A.G., Mandall, N.A., Lewis, D.H.
ment of teeth are also inappropriate for (2001) The role of removable appliances in contempo-
removable appliance treatment. Spacing, rary orthodontics. British Dental Journal, 191: 304-310
except where it is associated with an increased Proffitt, W.R. (2000) Contemporay orthodontics, 3rd edn.
Mosby, St Louis
overjet, cannot usually be dealt with by Russell, J.L et al. (1999) The consultant orthodontic service.
removable appliances alone.
British Dental Journal, 187: 149-153
Crossbites, especially those associated with a Stephens, CD., Isaacson, K.G. (1990) Practical orthodontic
displacement, may be effectively treated with assessment. Heinemann, Oxford
removable appliances where the use of occlusal Turbill, E.A., Richmond, S., Wright, J.L. (1999) A closer
coverage eliminates the displacement. Exces- look at general dental service orthodontics in England
& Wales. British Dental Journal, 187: 271-274
sive overbites or marked anterior open bites Williams, J.K., Cook, P.A., Isaacson. K.G., Thorn, A.R.
are not suitable for management with remov- (1995) Fixed orthodontic appliances - principles and
able appliances alone. practice. Wright, Oxford.