Korean J Orthod.  2019 Mar;49(2):116-123. 10.4041/kjod.2019.49.2.116.

Treatment of Class I crowding using simple tubes bonded with customized resin coverings: A case report

• Jeong SR
• Kim HI
• Lim SH

• KMID: 2453975
• DOI: http://doi.org/10.4041/kjod.2019.49.2.116

Abstract

As an alternative to the conventional fixed appliance that uses orthodontic brackets, a simple round tube without a bonding base can be bonded to the tooth surface by covering the tube with flowable resin. In this technique, bent wires cannot be inserted into the simple tubes; therefore, repositioning of the simple tubes is often required for adjustments. To reduce repositioning of simple tubes, a dome-shaped resin covering of the simple tube can be designed with a customized in-and-out compensation, using three-dimensional computer-aided design software based on digital simulation of orthodontic tooth movement. In the present case, the use of simple tubes bonded with customized resin coverings in a Class I nonextraction case is described in a 17-year-old male, in whom moderate crowding of the anterior teeth was treated over an 8-month period. This case shows that simple tubes can be used as an alternative to brackets in some Class I nonextraction cases, with the potential benefit of reducing decalcification.

Keyword

Appliance; Bracket; Digital simulation; Computer-aided design

MeSH Terms

Adolescent
Compensation and Redress
Computer-Aided Design
Crowding*
Humans
Male
Orthodontic Brackets
Tooth
Tooth Movement

Figure

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  Figure 1 Pretreatment records of a 17-year-old male with anterior crowding exhibiting dental Class I and mild skeletal Class II relationships.

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  Figure 2 A and B, Design of the simple tubes and customized resin coverings on the setup model. C, Customized resin coverings were transferred onto the pretreatment models. D, Gingival simple tubes were placed on the printed model into the recesses receiving them, and transfer trays were fabricated by thermoforming. E, Occlusal simple tubes were placed into the recesses, thereby fixing the mesiodistal ends of the tubes in the transfer tray. F, Flowable resin was injected into the central recesses for customized resin coverings, which fixed the central part of the occlusal simple tubes.

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  Figure 3 Treatment progress. A, Simple tubes were bonded using the transfer tray and an additional wire segment was inserted into the gingival simple tubes bonded on the maxillary left central incisor, lateral incisor, and canine. B, After 2 months of treatment, an occlusal simple tube was bonded on the maxillary left lateral incisor. C and D, After 5 months of treatment, lingual simple tubes were bonded on the maxillary left central and lateral incisors, as well as the canine. E, Simple tubes were bonded passively on the lingual surfaces of the maxillary left central incisor and canine, and another simple tube was positioned occlusally and lingually from the tooth surface of the lateral incisor (green color). As the wire deflection is resolved, buccal root torque will be achieved (blue color). This illustration of three teeth was made using micro computed tomography scan images of extracted teeth from different patients. 2M, 2 Months; 5M, 5 months.

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  Figure 4 Posttreatment records. Superimposition of pretreatment (black line) and posttreatment (red line) cephalometric radiographs reveals labioversion of both maxillary and mandibular incisors, as well as slight backward rotation of the mandible.

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  Figure 5 A, Superimposition of pretreatment (blue), posttreatment (gray), and digital setup (yellow) models. B, Intraoral photographs obtained after 2 years (2Y) of retention. Gingival recession was noted on the maxillary left lateral incisor.

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