A Clinical Guide to Orthodontics by J. Sandy

By J. Sandy

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Fig. 10 Dental wax placed over a bracket can ease the pain of ulceration in the lip and mucosa EXTRA-ORAL RISKS Allergy Allergy to nickel is more common in extra-oral settings, most usually the headgear face bow or head strap. Over 1% of patients have some form of contact dermatitis to zips and buttons/studs on clothing. Of these patients, 3% claim to have experienced a similar rash with orthodontic appliances (Fig. 12). The use of sticking plaster over the area in contact with the skin is sufficient to relieve symptoms.

BRITISH DENTAL JOURNAL VOLUME 196 NO. 2 JANUARY 24 2004 Treatment of ectopic canines may induce resorption of the adjacent teeth because of the length of treatment time and the distance the canine is moved. Tooth intrusion is also associated with increased risk as well as movement of root apices against cortical bone. Above the age of 11 years the risk of resorption with treatment seems to increase. Adults have shorter roots at the outset and the potential for resorption is increased. Opinion is divided on whether treatment length is associated with increased resorption.

Daily fluoride rinses are also recommended. Caries must be treated and periodontal problems appropriately addressed. Fig. 3 Where upper premolars alone are extracted (assuming no crowding in the lower arch), reduction of the overjet and space closure means the molar relationship must be a full unit Class II 684 Lower arch Plan the lower arch first. The size and form of the lower arch should generally be accepted. Excessive expansion in the buccal regions or proclination of the lower incisors is contraindicated in most cases because the soft tissues will generally return the teeth to their original position.

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