Hybrid Removable Essix Appliance for Molar Uprighting: A Case Report

Abstract

Background; Placing and restoring a dental implant when the mesio-distal space is reduced at the occlusal plane and/or the bone level can result in less than satisfactory treatment outcomes. Patient: A 24-year-old male patient with need of fixed replacement of his missing tooth 46 which was lost long time before. Posterior tooth 47 was tipped mesially toward the adjacent edentulous space. Hybrid removable Essix applinace was fabricated for molar uprighting on tilted molar and for saving the available space at 36 position after implant placement two weeks ago. After 3 months and 15 days of treatment by hybrid appliance the tooth 47 was uprighted for placement implant at 46 position. Discussion: The objective in tooth 47 uprighting is ideal positioning of this tooth which will eventually gain more space at 46 position for a fixed crown implant prosthesis. The ideal position of tooth 47 will provide an optimal periodontal environment. Mesial movement and tipping of tooth 47 may initiate a vicious cycle of traumatic occlusion, functional interferences and space problems in conjunction with implant insertion. After the tipped molar is uprighted by Hybrid appliance, the functional and periodontal situation can be improved along with maintaining the available space at 36 position during the treatment period. Conclusion: This limited orthodontic treatment improved the periodontal environment and developed appropriate space for implant prosthesis. The newly designed appliance was aesthetic, cheap, and comfortable, and was successful for uprighting mesially tilted molar.