Relapse treatment in a patient with previous first premolar extractions for referral to restorative dentistry

Abstract

Relapse is an unavoidable challenge for the specialist; in orthodontic practice several recommendations have been stated to prevent it: maintain the original arch form, particularly the lower; do not modify inter-canine width, do not modify the bucco-lingual incisor inclination, achieve a good intercuspation, perform circumferential supracrestal fiberotomy and overcorrect rotated teeth. A case report is here by presented. The patient was 25-year-old and had had a
previous orthodontic treatment with four first premolar extractions. He presented moderate upper and lower crowding, gingivitis, no temporomandibular joint symptoms, and dental anatomy abnormalities in teeth 3.4 and 4.4. Objectives:Preparation for referral to restorative dentistry, obtain a normal overbite and overjet, maintain arch form, match dental midlines, achieve good intercuspation, root para llelism and improve periodontal health. Methods: Non-extraction case treated with fixed appliances: In-Ovation® 0.022” x 0.028” Roth Thermo-activated Palatal Expander® to obtain space on the upper arch. Results: All the objectives were achieved despite the dental anatomy abnormalities, except for root parallelism due to anomalies in root form. Conclusions: The case was treated following the established orthodontic recommendations to prevent a second episode of relapse and at the same time obtain a good prognosis for referral to restorative dentistry.