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 Table of Contents  
CASE REPORT
Year : 2021  |  Volume : 12  |  Issue : 4  |  Page : 164-166

Reverse-M-Zadake spring – A novel design for the management of root divergence


Department of Orthodontics, MIDSR Dental College, Latur, Maharashtra, India

Date of Submission24-Sep-2021
Date of Decision21-Nov-2021
Date of Acceptance26-Nov-2021
Date of Web Publication27-Dec-2021

Correspondence Address:
Dr. Sujit Navnath Zadake
Vaishnav Sadan Babanagar Kallam, Osmanabad, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijor.ijor_23_21

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  Abstract 


The main reason to seek Orthodontic treatment is esthetics. Black triangles after lower incisor extraction are one of the commonly occurring malocclusion which causes esthetic compromises. Relapse is unavoidable while treating such cases. This relapse can be controlled only when there is translatory root movement in the mesial direction. Very little literature is available for the correction of black triangles. In this article, a spring is fabricated by using 0.018 A J Wilcock stainless steel special plus wire containing three helices. This Trihelical spring is a simple, effective, esthetic, and biologically compatible device with excellent root control for the treatment of root divergence.

Keywords: Black triangles, root divergence, translatory root movement, trihelical spring


How to cite this article:
Zadake SN, Joshi Y, Kangane S, Ambekar A. Reverse-M-Zadake spring – A novel design for the management of root divergence. Int J Orthod Rehabil 2021;12:164-6

How to cite this URL:
Zadake SN, Joshi Y, Kangane S, Ambekar A. Reverse-M-Zadake spring – A novel design for the management of root divergence. Int J Orthod Rehabil [serial online] 2021 [cited 2022 Nov 29];12:164-6. Available from: https://www.orthodrehab.org/text.asp?2021/12/4/164/333793




  Introduction Top


The interdental papilla plays a key role in anterior esthetics. With the loss of supporting alveolar bone, connective tissue and epithelial attachment are compromised. Multidisciplinary strategies are available for the prevention and management of black triangles. These spaces have a negative impact on esthetics, function, phonetics, and facilitate food retention affecting periodontal health.[1] Black triangles are the embrasures cervical to the interproximal contact which are not filled by gingival tissue. The prevalence of posttreatment open gingival embrasures in an average adult orthodontic population is about 38%.[2],[3] Uribe et al. showed that more than two-thirds of the patients who had a mandibular incisor extracted had a black triangle embrasure at the end of treatment.[4]


  Armamentarium Top


  • 0.018-inch A J Wilcock special plus stainless steel wire
  • 0.010-inch Ligature wire
  • Bird beak plier
  • Pin and ligature cutter [Figure 1].
Figure 1: Armamentarium

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  Method of Fabrication Top


  • Reverse-M-Zadake (RMZ) spring consist of three coils, each of 3 mm in diameter, one at the center and two at the periphery giving it an appearance of the alphabet 'W' [Figure 2]
  • Two arms emerge from respective helices with anti-tip bends of 35°
  • RMZ spring is then placed in such a way that it should lie away from gingival soft tissue [Figure 3]
  • Ends of these two arms are engaged into brackets of the respective tooth and ligated with ligature wire and cinched back. RVG was taken in the same position [Figure 4]
  • It will deliver a force of 50 gm
  • Pre- and post-treatment comparative photographs [Figure 5].
Figure 2: Design of Reverse-M-Zadakes spring

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Figure 3: Reverse-M-Zadake spring ligated with ligature wire

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Figure 4: RVG after placement of Reverse-M-Zadake spring

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Figure 5: Pre- and post-treatment comparative photographs

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  Activation Top


There are two ways to activate the RMZ spring,

  • Opening of two peripheral helices by 0.5 mm
  • Closing of one middle helix by 0.5 mm.


Root uprighting was achieved within 3 months with 0.5 mm activation per month [Figure 6] and again RVG (Radiovisiograph) was taken to check for root resorption [Figure 7].
Figure 6: Root uprighting with Reverse-M-Zadake spring

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Figure 7: RVG after root uprighting

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  Mechanism of Action Top


Round wire will cause a root uprighting and free tipping of incisors in the distal direction. The roots of the incisors will be convergent at the end of tipping. 0.019 × 0.025”segmented stainless steel archwire was tightly ligated for a month to achieve better torque control [Figure 8]a and [Figure 8]b.
Figure 8: (a) Activated Reverse-M-Zadake spring. (b) Forces generated after engagement in brackets

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  Conclusion Top


RMZ spring is a novel design fabricated by using 0.018-inch A J Wilcock special plus wire for the management of root divergence following lower incisor extraction.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Van der Geld P, Oosterveld P, Van Heck G, Kuijpers-Jagtman AM. Smile attractiveness. Self-perception and influence on personality. Angle Orthod 2007;77:759-65.  Back to cited text no. 1
    
2.
Kurth JR, Kokich VG. Open gingival embrasures after orthodontic treatment in adults: Prevalence and etiology. Am J Orthod Dentofacial Orthop 2001;120:116-23.  Back to cited text no. 2
    
3.
Ko-Kimura N, Kimura-Hayashi M, Yamaguchi M, Ikeda T, Meguro D, Kanekawa M, et al. Some factors associated with open gingival embrasures following orthodontic treatment. Aust Orthod J 2003;19:19-24.  Back to cited text no. 3
    
4.
Uribe F, Holliday B, Nanda R. Incidence of open gingival embrasures after mandibular incisor extractions: A clinical photographic evaluation. Am J Orthod Dentofacial Orthop 2011;139:49-54.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8]



 

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  In this article
Abstract
Introduction
Armamentarium
Method of Fabric...
Activation
Mechanism of Action
Conclusion
References
Article Figures

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