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 aprevious 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.