By J. Sandy
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Extra resources for A Clinical Guide to Orthodontics
13 Bodily movement of the teeth requires a greater degree of force than tipping movements Fig. 14a,b Pre-treatment photographs of a 12-yearold girl with an increased overjet and a class II skeletal pattern associated with a retrognathic mandible ➠ ➠ Fig. 14c A functional appliance was used to correct the saggital relationship Fig. 14e,f The facial appearance following treatment ➠ BRITISH DENTAL JOURNAL VOLUME 196 NO. 1 JANUARY 10 2004 ➠ ➠ Fig. qxd 04/12/2003 14:42 Page 18 PRACTICE Fig. 15 Extra-oral traction applied via an Interlandii headgear Fig.
5 Upper canine tip showing abrasion from the lower canine metal bracket increase in the early stages of treatment. Any enamel erosion must be recorded prior to treatment commencing and appropriate dietary advice given to minimise further tooth substance loss. Carbonated drinks and pure juices are the commonest causes of erosion and should be avoided in patients with fixed appliances. Pulpal reactions Some degree of pulpitis is expected with orthodontic tooth movement which is usually reversible or transient.
11 Enamel trauma When placing appliances careless use of a band seater can result in enamel fracture. 14 Debonding can also result in enamel fracture, both with metal and ceramic brackets (Fig. 15,16 Care must always be taken to remove brackets and residual bonding agents appropriately to minimise the risk of enamel fracture. The use of debonding burs has the potential to remove enamel, especially in air turbine fast handpieces. Care and attention is needed when adhesives are removed. Enamel wear Wear of enamel against both metal and ceramic brackets (abrasion) may occur.