Stripping En Ortodoncia
Páginas: 10 (2301 palabras)
Publicado: 14 de septiembre de 2011
©2007 JCO, Inc. May not be distributed without permission. www.jco-online.com
OVERVIEW
Guidelines for Contemporary Air-Rotor Stripping
DIPAK CHUDASAMA, BDS, MSC, MOrth RCS JOHN J. SHERIDAN, DDS, MSD
(Editor’s Note: In this quarterly column, JCO provides a brief overview of a clinical topic of interest to orthodontists. Contributions and suggestions for future subjects are welcome.)
Air-rotor stripping (ARS) was first described more than 20 years ago in this journal as an alternative to extraction or expansion in borderline cases.1 Since then, further studies have indicated that hard and soft dental tissues can respond to the physiological trigger of interproximal reduction by nonpathological adaptation, and that an ARS site may be more resistant to carious and periodontaldisease than unaltered enamel surfaces are.2-11 ARS can be used in adolescents as well as adults, since the interproximal enamel thickness is basically the same in both groups. Unlike previous methods of interproximal reduction, ARS generates space primarily, although not exclusively, in the buccal segments. The amount of ARS can be directly correlated to the amount of
crowding to be resolved.If 6mm of arch length is needed, 6mm of space can be created. Using the guideline of 1mm of interproximal reduction at each contact point, as much as 8mm of space can be generated in the buccal segments of one dental arch (Fig. 1). Another unique feature of ARS is that it is performed with a high-speed turbine handpiece, rather than hand-pulled abrasive strips or handpiece-mounted disks. Anabrasive strip is awk-
A
Dr. Chudasama
Dr. Sheridan
B
Fig. 1 A. Removing 1mm of interproximal enamel from each buccal contact point can create enough space to alleviate moderate crowding. B. After consolidation of ARS sites, 4mm of space has been gained.
Dr. Chudasama is an Associate Professor and Dr. Sheridan is Professor of Orthodontics, Jacksonville University School of Orthodontics,2800 University Blvd. N., Jacksonville, FL 32211. Dr. Sheridan is also an Associate Editor of the Journal of Clinical Orthodontics. E-mail him at jsherid@ju.edu.
VOLUME XLI NUMBER 6
© 2007 JCO, Inc.
315
OVERVIEW
ward and laborious to use in the buccal segments, while the proximity of the tongue and cheeks makes a rotating disk potentially dangerous. Interproximal reduction with anair-turbine handpiece, on the other hand, is precise, painless, and efficient. Extraction and expansion are particularly difficult to incorporate in planning treatment for the increasing number of adult patients who choose clear plastic appliances such as Essix,* Invisalign,** and Ideal Smile.*** ARS is frequently utilized as an alternative for the alleviation of mild-to-moderate crowding inconjunction with these appliances.
The following contemporary guidelines are suggested to help the clinician realize the full potential of ARS. 1. Remove only a measured 1mm (.5mm per proximal surface) of enamel from any buccal interproximal area. The obvious reason for performing interproximal reduction in the buccal segments is that they contain substantially more proximal enamel than is found inthe anterior region.12,13 Although most authors have stated that one-half of the proximal enamel bulk can be safely reduced without adverse consequences, we have been uncomfortable with this anecdotal estimate because it has no scientific basis, and because the critical detail of
*Raintree Essix Corporation, 4001 Division St., Metairie, LA 70002; www.essix.com. Essix is a registered trademark.**Registered trademark of Align Technology, Inc., 851 Martin Ave., Santa Clara, CA 95050; www.aligntech.com. ***GAC International, Inc., 355 Knickerbocker Ave., Bohemia, NY 11716; www.gacintl.com.
Fig. 2 Commercially available gauges precisely measure amount of interproximal reduction.
Fig. 3 Establishing open field with separator or coil spring provides better visual access for ARS and for...
OVERVIEW
Guidelines for Contemporary Air-Rotor Stripping
DIPAK CHUDASAMA, BDS, MSC, MOrth RCS JOHN J. SHERIDAN, DDS, MSD
(Editor’s Note: In this quarterly column, JCO provides a brief overview of a clinical topic of interest to orthodontists. Contributions and suggestions for future subjects are welcome.)
Air-rotor stripping (ARS) was first described more than 20 years ago in this journal as an alternative to extraction or expansion in borderline cases.1 Since then, further studies have indicated that hard and soft dental tissues can respond to the physiological trigger of interproximal reduction by nonpathological adaptation, and that an ARS site may be more resistant to carious and periodontaldisease than unaltered enamel surfaces are.2-11 ARS can be used in adolescents as well as adults, since the interproximal enamel thickness is basically the same in both groups. Unlike previous methods of interproximal reduction, ARS generates space primarily, although not exclusively, in the buccal segments. The amount of ARS can be directly correlated to the amount of
crowding to be resolved.If 6mm of arch length is needed, 6mm of space can be created. Using the guideline of 1mm of interproximal reduction at each contact point, as much as 8mm of space can be generated in the buccal segments of one dental arch (Fig. 1). Another unique feature of ARS is that it is performed with a high-speed turbine handpiece, rather than hand-pulled abrasive strips or handpiece-mounted disks. Anabrasive strip is awk-
A
Dr. Chudasama
Dr. Sheridan
B
Fig. 1 A. Removing 1mm of interproximal enamel from each buccal contact point can create enough space to alleviate moderate crowding. B. After consolidation of ARS sites, 4mm of space has been gained.
Dr. Chudasama is an Associate Professor and Dr. Sheridan is Professor of Orthodontics, Jacksonville University School of Orthodontics,2800 University Blvd. N., Jacksonville, FL 32211. Dr. Sheridan is also an Associate Editor of the Journal of Clinical Orthodontics. E-mail him at jsherid@ju.edu.
VOLUME XLI NUMBER 6
© 2007 JCO, Inc.
315
OVERVIEW
ward and laborious to use in the buccal segments, while the proximity of the tongue and cheeks makes a rotating disk potentially dangerous. Interproximal reduction with anair-turbine handpiece, on the other hand, is precise, painless, and efficient. Extraction and expansion are particularly difficult to incorporate in planning treatment for the increasing number of adult patients who choose clear plastic appliances such as Essix,* Invisalign,** and Ideal Smile.*** ARS is frequently utilized as an alternative for the alleviation of mild-to-moderate crowding inconjunction with these appliances.
The following contemporary guidelines are suggested to help the clinician realize the full potential of ARS. 1. Remove only a measured 1mm (.5mm per proximal surface) of enamel from any buccal interproximal area. The obvious reason for performing interproximal reduction in the buccal segments is that they contain substantially more proximal enamel than is found inthe anterior region.12,13 Although most authors have stated that one-half of the proximal enamel bulk can be safely reduced without adverse consequences, we have been uncomfortable with this anecdotal estimate because it has no scientific basis, and because the critical detail of
*Raintree Essix Corporation, 4001 Division St., Metairie, LA 70002; www.essix.com. Essix is a registered trademark.**Registered trademark of Align Technology, Inc., 851 Martin Ave., Santa Clara, CA 95050; www.aligntech.com. ***GAC International, Inc., 355 Knickerbocker Ave., Bohemia, NY 11716; www.gacintl.com.
Fig. 2 Commercially available gauges precisely measure amount of interproximal reduction.
Fig. 3 Establishing open field with separator or coil spring provides better visual access for ARS and for...
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