Rotation e-Cleat

Abstract

The article describes an innovative and unconventional approach to correct rotations with the aid of self-made rotation e-cleat utilizing the unused elastic module carrier piece freely available in our clinics.

Introduction

According to Baccetti, ¹ tooth rotation can be defined as mesio-lingual or disto-lingual intraalveolar displacement of the tooth around its longitudinal axis. Tooth rotation since time immemorial has been presented as an arduous task not just to ameliorate but also to sustain its correction. There are innumerable factors to be considered for correction of the rotation of the teeth like space deficiency, abnormal eruption pattern and sequence, abnormal pressure by the tongue and lips, and so on. Rotation correction may hamper finishing in our fixed orthodontic treatment results which makes it of utmost important to remove this discrepancy before discontinuing the fixed treatment.^{2, 3}

In the past, numerous methods have been stated in literature for correction of anterior rotation like placing off-centered brackets, use of rotation wedges, creating a couple with the use of palatal/lingual attachments, use of rotation spring, rotation ties, and sectional NiTi wires. This article describes a new yet unconventional approach to correct the rotation with the help of self-made rotation e-cleat utilizing the unused elastic module carrier piece freely available in our clinics.

Procedure and Technique

• In this method, the discarded piece of elastic module carrier is used. It is sliced into pieces 2 mm in size, into which probe/sharp instrument is used to create a hole at the center.

• Through this hole, a piece of 0.010 ligature wire is passed (Figure A). This ligature wire helps in stabilizing the prepared rotation e-cleat onto the bracket wings.

• The e-cleat once placed over the site where the correction is required in the initial phase of alignment and levelling in 0.016 Ni Ti wire (Figure B) is tied onto the tooth with the help of the ligature wire attached to the e cleat.

• The case depicted in this article shows the utilization of these rotational e-cleat since inception of fixed orthodontic treatment where 0.016 NiTi wire is placed with e-cleat on 21 showing mesial-in rotation.

• The rotation e-cleat is positioned onto the distal surface of 21 with the aid of 0.010 ligature wire, which is then engaged onto the bracket wings of 21 to stabilize it.

• Over the rotation e-cleat the wire is placed and engaged intraorally, (Figure C) providing the required moment in the rotational plane of space.

• The rotation e-cleat takes about 3 months for rotation correction, which is subsequently refined by progressive wire changes (Figure D, E, and F).

Figure 1.

(A) A Piece of 0.010 Ligature Wire is Passed Cut Out Piece of Elastic Module Carrier; (B) Rotation e-cleat is Tied Onto the Tooth with the Help of the Ligature Wire Attached to it; (C) Wire Placed over the Rotation e-cleat to Provide Moment for the Rotation Correction; (D) Lateral View-Sequential Wire Change in the Arch for Rotation Correction; (E) Occlusal View Showing the Refinement in the Rotation Correction with Sequential Wire Change and (F) Frontal View Showing the Rotation Correction.

Conclusion

It is simple, efficient, esthetic, hygienic, economical, patient, and doctor friendly and overall predictable system for the rectification of rotation. It shortens the treatment time by providing light continuous forces without separate chair side armamentarium.