SYNOPSIS
SUBJECT FOR DISSERTATION
TITLE OF THE TOPIC
TO EVALUATE THE USE OF MODIFIED POWER ARM
[DISCOPENDER 468] FOR EFFICIENT ANTERIOR TEETH
RETRACTION. A CLINICAL STUDY
GUIDE: DR.M.B.HALKATI M.D.S.
Professor and Head
Department of Orthodontics and Dentofacial Orthopaedics
Submitted by:
DR. HEMAVATHI PATIL
PG in Dept. of Orthodontics and Dentofacial Orthopaedics
AL-AMEEN DENTAL COLLEGE, BIJAPUR
ANNEXURE II
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA.
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1. NAME OF THE CANDIDATEAND ADDRESS
(IN BLOCK LETTERS) / Dr. HEMAVATHI PATIL
DEPARTMENT OF ORTHODONTICS AND
DENTOFACIAL ORTHOPAEDICS.
AL-AMEEN DENTAL COLLEGE AND
HOSPITAL, BIJAPUR-586 102.
KARNATAKA.
2. NAME OF INSTITUTION / AL-AMEEN DENTAL COLLEGE AND
HOSPITAL, BIJAPUR-586 102.
KARNATAKA.
3. COURSE OF STUDY AND
SUBJECT /
M.D.S. (MASTER OF DENTAL SURGERY)IN
ORTHODONTICS AND DENTOFACIAL
ORTHOPAEDICS.
4, DATE OF ADMISSION TO
COURSE / 25th May 2011
5. TITLE OF THE TOPIC / TO EVALUATE THE USE OF MODIFIED POWER ARM [DISCOPENDER 468] FOR EFFICIENT ANTERIOR TEETH RETRACTION. A CLINICAL STUDY
6 / BRIEF RESUME OF THE INTENDED WORK
6.1 NEED FOE THE STUDY
The demand for speedy and efficient orthodontic treatment has been increasing in recent years. Control of anterior tooth movement is essential for the orthodontists to execute an individualized treatment plan. The use of power arms attached to the arch wire enables one to readily achieve controlled movement of anterior teeth. That is, the force system for the desired type of tooth movement such as lingual crown tipping, lingual root tipping, or bodily movement can be easily carried out by attaching various heights of power arm to the arch wire.
Many studies have been done which shows that placement of power arm to the arch wire between lateral incisor and canine enables orthodontists to maintain better control of anterior teeth movement2.
In the study, by Sia has inspired the development of crimpable hook with labially located vertical height disks [Discopender 468, biomaterials Korea]5. Also many manufacturers like Dentos, AO, and Rocky mountain have brought many modified power arms in the market.
Hence the study has been under taken to evaluate the efficacy of modified power arm [Discopender 468] for controlled anterior tooth retraction.
6.2 REVIEW OF LITERATURE
(1) SheauSoon Sia, Yoshiyuki Koga, Noriaki Yoshida [2007] 1 :Concluded the location of the centre of resistance regarding anterior tooth retraction with sliding mechanics, controlled crown-lingual tipping, bodily translation movement and controlled crown labial movement could be achieved by attaching a power arm length that was lower equivalent, or higher than the level of centre of resistance, respectively and also determined the power arm length could be the most easily modifiable for the direction of anterior tooth movement during retraction in sliding mechanics.
(2) Jun-ya Tominaga et al [2009]2Tried the power arm placement mesial to canine at the level of 0mmAnd 5.5mm, and exceeded more than 5.5mm and recommended placement of power arm of an arch wire between the central incisor and canine enables orthodontics to maintain better control of the anterior teeth movement.
(3) Seong-Hun Kim, Young-Suk Hwang, Andre Ferreira and Kyu-Rhim Chung [2009]3,Analysed en-mass anterior teeth retraction with temporary skeletal anchorage devices and supported accomplishment of en-mass retraction of anterior teeth using TSAD’s as the only source of anchorage.
(4) SheauSoon Sia, Tatsunori Shibazaki, Yoshiyuki Koga, Noriaki Yoshida [2009]4 Studied in angles Class II Division I malocclusion patient for initial tooth movement with sliding mechanics at various height of retraction forces using magnetic sensor devise and suggested that the correct height of retraction force on the power arm is the key for efficient anterior tooth retraction.
(5) Tomio Ikegami, Ricky Wing-Kit Wong, Urban Hagg, Wilson Lee and Kyoko-Hibino [2010] 5Recommended [Hybrid Orthodontic Treatment System [HOTS] by reducing treatment period and supported the use of variable heights, crimpable vertical hooks for anterior tooth movement during retraction.
6.3
6.4 / AIM:
To evaluate the use of modified power arm [Discopender 468] for efficient anterior
Teeth retraction.
OBJECTIVES OF STUDY :
1) To determine rate of retraction.
2) To determine the anchor loss after space closure.
3) To determine upper anterior torque after space closure.
7. / MATERIAL AND METHOD
7.1 SOURCE OF DATA
Ten Orthodontics patients will be selected from the department of
Orthodontic Al-Ameen Dental College Hospital, BIJAPUR [Karnataka, INDIA].
INCLUSION CRITERIA
1. Patients Diagnosed as angle Class II division I Malocclusion.
2. Availability of good & normal Periodontal condition.
3. Underwent orthodontic treatment with maxillary first premolar
extraction and anterior crowding relieved.
EXCLUSION CRITERIA
1. Patients with poor periodontal condition.
2. Patients with medically compromised conditions.
3. Patients with TMJ disorders.
7.2 METHOD OF COLLECTING DATA
· 10 orthodontic patient will be taken for the study from the department of orthodontics, Al-Ameen Dental college and hospital, Bijapur with Class II division I malocclusion, requiring upper first premolar extraction as a part of orthodontic treatment.
· O.18 slot MBT prescription bracket will be used in all the patients. After initial levelling and aligning with round and rectangular HANT arch wires. Maxillary arch will be divided into three parts, one anterior segment and two posterior segments. 0.017x0.025 SS wire will be placed in the anterior and posterior segments. In this study the modified power arm [Discopender 468], which would be new type of crimpable Vertical hook that has three hooks at the height of 4, 6 & 8mm. This crimpable hook is designed to allow maxillary anterior teeth retraction.
· The modified power arm [Discopender 468] is to be placed mesial to canine that is between canine and lateral and one between mesial to molar that is between premolar and molar.
· Then the NiTi coil spring is placed between two modified power arms [Discopender 468] for efficient anterior tooth retraction. The force vectors are selected accordingly.
· The hooks from the height 468 bring about crown tipping, controlled tipping and bodily movement respectively.
IN THE STUDY FOLLOWING FACTORS WILL BE EVALUATED
· Determining rate of retraction:
The rate of retraction is defined as the distance travelled, divided by the time required to complete space closure. This is recorded in millimetre per interval with the help of Vernier calliper.
· Determination of anchor loss after space closure.
Pre treatment and post space closure lateral cephalograph will be taken
and change in the position of the marker are superimposed and anchor
loss is measured by marking ptm vertical and measuring the distance
from ptm vertical to distal surface of first molar.
· Determination of upper anterior torque after space closure:
Pre treatment and post space closure lateral cephalograph will be taken for all the Patients to evaluate torque change in upper incisors.
The following parameters were analyzed;
· Upper 1to SN plane
· Upper 1to ANS-PNS
7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR
INTERVENTION TO BE CONDUCTED ON PATIENT OR OTHER HUMAN OR
ANIMAL ? IF SO PLEASE DESCRIBE BRIEFLY.
YES
6 PATIENTS WILL BE SELECTED FOR THE PURPOSE.
7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION ?
YES
8.REFERENCES
1. SheauSoon Sia, Yoshiyuki Koga, Noriaki Yoshida. Determining the centre of resistance of maxillary anterior teeth subjected to retraction forces in sliding mechanics. An in vivo study. Angle Orthod. 2007; 77(6):999-1003.
2. Jun-ya Tominaga; Motohiro Tanaka; Yoshiyuki Koga; Carmen Gonzales; Masaru Kobayashi; Noriaki Yoshida. Optimal loading conditions for controlled movement of anterior teeth in sliding mechanics. A 3D finite element study. Angle Orthod. 2009 Nov; 79 (6):1102-1107.
3. Seong-Hun Kim, Young-Suk Hwang, Andre Ferreira and Kyu- Rhim Chung. Analysis of temporary skeletal anchorage devices used for en-masse retraction: A preliminary study. Am J Orthod.
Dentofacial Orthop. 2009 Aug; 136(2):268-276.
4. SheauSoon Sia, Tatsunori Shibazaki, Yoshiyuki Koga, Noriaki Yoshida. Experimental determination of optimal force system required for control of anterior tooth movement in sliding mechanics. Am J Orthod Dentofacial orthop. 2009 Jan; 135(1): 36-41
5. Tomio Ikegami, Ricky Wing-Kit Wong, Urban Hagg, Wilson Lee and Kyoko-Hibino. HOTS achieves a predictable treatment outcome with a shorter treatment time. World J Orthod. 2010; Summer; 11 (2):168-179.