Distalization with a modified C-palatal plate for severe upper crowding and a missing lower incisor.

This case report presents the orthodontic treatment of a 25-year-old patient with skeletal Class II and severe maxillary arch crowding, moderate mandibular arch crowding, anterior crossbite, and a missing lower incisor. He was treated with molar distalization using a modified C-palatal plate and temporary anchorage devices to create sufficient space for retraction. The total treatment duration was 21 months. After treatment, his occlusion and smile esthetics showed significant improvement. The modified C-palatal plate represents a treatment modality that enhances the prospects of non-extraction treatment and reduces the need for extraction.

A Survey of Pediatric Dentists on the Treatment Timing and Modalities for White Spot Lesions in the United States.

PURPOSE: The purpose of this study was to estimate the prevalence of white spot lesions (WSLs) in various practice settings and patient populations, and to gather information about the treatment timing and modalities used by pediatric dentists in the United States. STUDY DESIGN: A fourteen question, multiple choice, electronic survey was developed and distributed to 6,092 active American Academy of Pediatric Dentistry (AAPD) members. RESULTS: A total of 625 active members responded, garnering a 9.7% response rate. Before treatment, there were significantly more WSLs reported in Corporate practice than Multi-Doctor Practice (P=0.002), and significantly more WSLs in Academics/Hospital-Based Practices than in Multi-Doctor Practices (P=0.002). For WSLs after treatment, there were significantly more WSLs in Academic/Hospital-Based practices than in single-practitioner settings (P=0.003). Approximately 38% of pediatric dentists preferred to treat WSLs before, during or after orthodontic treatment, while 23% treat only before and 20% treat only after treatment. The three most common treatment modalities for WSLs, were prescription fluoride toothpaste (5000 ppm), fluoride varnish, and fluoride rinse. Approximately 47% of respondents reported they were "very comfortable" treating WSLs and 31.0% felt "comfortable." CONCLUSIONS: The prevalence of WSLs differed across types of practice. There is no agreement among pediatric dentist as to timing and treatment modalities for WSLs.

PEARLS. Closure of Mandibular Spaces During Retention.

There are few reliable options for closing relapsed lower anterior or posterior spaces other than a short phase of re-treatment. Tightening a conventional wraparound retainer is often inadequate, and the labial bow tends to slip off the anterior teeth. This brilliant Pearl incorporates cinched .018" nickel titanium wires in the labial bow to facilitate space closure. Remember to place the activation loops distal to the spaces that need closing.