Metal Free Spacemaintainer for Special Needspatients
Matteo Beretta* and Nunzio Cirulli
Digital Dentistry Society, Italy
Submission: November 06, 2017; Published: November 15, 2017
*Corresponding author: Matteo Beretta, DDS, MS, Master in Digital Dentistry, Casale Monferrato (AL), Italy, Email: Info@matteoberetta.pro
How to cite this article: Matteo B, Nunzio C. Metal Free Spacemaintainer for Special Needs Patients. Adv Dent & Oral Health. 2017; 6(2): 555683. DOI: 10.19080/ADOH.2017.06.555683
Introduction
In interceptive orthodonticsitis common to apply a fixed spacemaintainer to guide the eruption of the permanent teeth. At the upper arch this spacemaintainer is often a Nance bar built on molar bands. In our daily practice may happen that some young patients are allergic to metals, some kind of dentalresins or should periodically undergo to MRI in the head district to monitor specific desease as epilepsy or vascular problems. In this cases we may be obligated to remove the spacemaintainer before this diagnostic exam because of the magnetism generated by metallic devices, sometimes in emergency situations, difficult to manage.
Design of the apliance
Using digitaltechnologywedeveloped a line of custom made metal free cad-cam devices, thatallowus to produce safe appliances for special needs. In the case example we planned the extraction of 5.3, necessary to guide the eruption of 1.3 (Figure 1-3). Starting from an intra oral scan we obtain a 1:1 stl file of both dental arches. On the maxillary one, imported in a free cad software*, we designed the custom spacemaintainer (Figure 4 &5), in order to achieve the best comfortable fit for the patient. The stl file from the CAD phaseisused to produce the custom made appliance (Figure 6 & 7) by milling** a machinable fiber reinforced composite material (FDA certified), named TrilorTM*** (CAMphase). This new Nace bar is directly bonded only on the palatal surface of the first molars, without etching andu sing a specific dual curing cement (URC***) with fluoride release and without Bisfenol A (Figure 8 & 9) [1-5].
Discussion
This Nance modified spacemaintainer is totally metal free, esthetic, easy to clean, light, comfortable and really safe, particularly for some categories of patients. This kind of appliance is obtained by a full digital work flow, starting from an intra oral scan till to a milling process, without using a stone or proto typed model and could represent a first step for a new tailor made orthodontics.
*Autodesk Meshmixer,www.meshmixer.com
** i-3D Professional, Bari, Italywww.i3d professional.it
***Bioloren, Saronno (VA), Italy www.bioloren.com
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