Use of orthodontic expansion screw in fabricating section custom trays

Ali Mirfazaelian, DDS, MSca School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran

Routine custom trays are difficult to use to make impressions for patients with microstomia, sclerodermia, or perioral burns.1 Several types of split custom trays have been introduced to accommodate these situations.2-6 The use of an orthodontic expansion screw (2 guide pins and a screw) without the screw axis, serves as a guide or key and keyway to fabricate a split custom tray (Fig. 1). Preparation of a butt joint along the 2 pieces of a maxillary tray can enhance its stabilization during border correction and impression mak-

ing (Fig. 2). The expansion screw is placed vertically in the handle of the custom tray to accommodate the limited space (Fig. 3). The length of the guide pins in the expansion screw can be reduced for easier insertion and removal if necessary. Maxillary and mandibular trays require different locations for the key and keyway. For the maxillary tray, the holes must be located in the overlay piece and the guide pins are placed in the other half for better access (Fig. 3). For the mandibular tray, guide pins are placed in the overlay piece and holes are located in the other half (Fig. 4).
I express my appreciation to M. Bidgoli, DDS, postgraduate student in prosthodontics, who contributed to the completion of this case.

aAssistant

Professor, Department of Prosthodontics. J Prosthet Dent 2000;83:474-5.

Fig. 1. Three-axis expansion screw after removal of screw.

Fig. 3. Two pieces of maxillary sectional tray after separation.

Fig. 2. Maxillary tray (underlying piece) with butt joint along line of separation. First part of handle with expansion screw is embedded in acrylic resin.
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Fig. 4. Mandibular sectional trays in patients mouth. Length of guide pins reduced for easier insertion and removal.

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REFERENCES
1. Laney WR. Diagnosis and treatment in prosthodontics. Philadelphia: Lea & Febiger; 1983. p. 53-4. 2. Moghadam BK. Preliminary impression in patients with microstomia. J Prosthet Dent 1992;67:23-5. 3. Al-Hadi LA. A simplified technique for prosthetic treatment of microstomia in a patient with scleroderma: a case report. Quintessence Int 1994;25:531-3. 4. Arcuri MR, Eikel L, Deets K. Maxillary sectional impression technique for microstomic patients. Quintessence Dental Technol 1986;10:627-9. 5. McCord JF, Tyson KW, Blair IS. A sectional complete denture for a patient with microstomia. J Prosthet Dent 1989;61:645-7. 6. Luebke RJ. Sectional impression tray for patients with constricted oral opening. J Prosthet Dent 1984;52:135-7.

Reprint requests to: DR ALI MIRFAZAELIAN DEPARTMENT OF PROSTHODONTICS SCHOOL OF DENTISTRY TEHRAN UNIVERSITY OF MEDICAL SCIENCES TEHRAN IRAN FAX: (9821)6401132 E-MAIL: mir-ali@nrcgeb.ac.ir Copyright 2000 by The Editorial Council of The Journal of Prosthetic Dentistry. 0022-3913/2000/$12.00 + 0. 10/4/105378 doi:10.1067/mpr.2000.105378

Noteworthy Abstracts of the Current Literature

In vitro, relative microleakage of five restorative systems Grobler SR, Rossouw RJ, Van Wyk Kotze TJ. Int Dent J 1999;49:47-52.

Purpose. It has been reported that a good seal prevents microleakage, which prevents pulpal irritation and recurrent dental caries. This in vitro study evaluated the relative microleakages of 5 restorative systems to cementum/dentine. Material and methods. Sixty-five human permanent canines were prepared class 5 cavities (10 to 15 for each group of tested materials) in the cut root apices of these teeth (below the cementoenamel junction). Teeth were restored with 5 restorative systems (Dyract, Optibond MFA, AeliteBond, All-Bond 2, and ScotchBond MP). Root apices were sealed and the teeth coated with nail varnish, except for 1 mm surrounding the restoration. Specimens were thermocycled (500) in a 2% methylene blue solution. Root sections, including the restorations, were dissolved in acid and the concentration of the dye determined spectrophotometrically. Statistical analysis using a Kruskal-Wallis multiple comparison was calculated for the 5 materials at a 5% level of significance. Results. The sequence for the microleakage values were as follows: Dyract < OptiBond MFA < AeliteBond < All-Bond 2 Conclusion. Dyract exhibited the lowest microleakage at the dentine-cementum interface. This may increase the longevity of the restoration in clinical service, with no or less secondary caries formation. 29 References. RP Renner

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