Dental Tribune United Kingdom Edition

23ClinicalMarch 26-April 1, 2012United Kingdom Edition How the best perform GRACEY CURETTES AND EVEREDGE THE MOST EFFICIENT COMBINATION FOR ALL YOUR HAND SCALING NEEDS PERIODONTAL EVEREDGE® TECHNOLOGY is unlike anything you’ve experienced before in a scaler. We’ve applied state- of-the-art technology in metallurgy, heat treatment and crynogenics to create a superior stainless steel alloy for scalers and curettes that stay sharper longer than any instrument you’ve used. That means less frequent sharpening, less hand fatigue, and greater comfort throughout the day. The improved sharpness of EVEREDGE® TECHNOLOGY instruments does not come from a superficial coating – the long-lasting wear is present throughout the entire instrument tip. ©2012 Hu-Friedy Mfg. Co., LLC. All rights reserved. For more information on our products please: - call us on 0770 318 6612 or 0770 318 6474, - visit our website www.hu-friedy.eu - e-mail us on info@hufriedy.eu - contact your regular Dental Dealer. STANDARD GRACEY CURETTE SG5/675 AFTER FIVE GRACEY CURETTE SRP11/1273 MINI FIVE GRACEY CURETTE SAS7/877 HU-FRIEDY - THE ORIGINAL MANUFACTURER OF GRACEY CURETTES! STANDARD GRACEY CURETTE — The Gracey curettes combine a unique offset blade with 9 different shank designs to be used on specific tooth surfaces, thus improving adaptation and deposit removal. Also referred to as Finishing Gracey Curettes. AFTER FIVE GRACEY CURETTE — Designed for instrumentation in deeper periodontal pockets. Elongated terminal shank (3mm) provides better clearance around crowns, and superior access to root contours and pockets 5 mm or more in depth. Thinner blade permits easier subgingival insertion. MINI FIVE GRACEY CURETTE — Designed with the same elongated terminal shank (3 mm) and thinned blades as the After Five Gracey Curettes. 50% shorter blade for access to smaller roots, narrow pockets, furcations, and developmental grooves. Gracey ad_GB_A4_2012.indd 1 16.02.12 14:38 velopment of adverse events is very rare. If they do occur they tend to be minor in nature and transient with no long-term ad- verse sequelae.” With further regard to the occlusion, it is also critical that when we come to retain the an- terior teeth in their final posi- tion, we do not interfere with the posterior occlusion settling. We need to ensure that pa- tients fully understand the role of long term fixed and remov- able retention and we need to provide retainers that hold the anterior teeth in place while al- lowing the posterior occlusion to readjust. Provision of con- ventional removable retainers such as an Essix retainer is not good enough and could poten- tially lead to further problems, and fixed retention alone can be insufficient. This concept is quite differ- ent from conventional ortho- dontics where it is the intention to retain the whole arch in the occlusion that the orthodontist has determined. As such we have had to develop new con- cepts of retention to deal with the unique challenges posed by short term orthodontics, rather than borrow directly from con- ventional orthodontic retention protocols. When is treatment complete? In conventional orthodontics the end point is achieved when we have positioned the teeth in, or as close as possible to, a class one occlusion. This is a very accurately clinically de- fined position. In short term or- thodontics there is not a simple way to measure clinically when treatment is complete. The end of treatment is subjective and based on: 1When the clinician feels that no more aesthetic im- provement can be gained 2The patients is happy with the appearance 3Time – treatment should not progress beyond six - nine months or we are in the realms of conventional orthodontics and need to be appropriately trained Due to this subjective na- ture, it is very important to define, before treatment com- mences, what the expectations are of the patient and what we can deliver as clinicians within an acceptable time-frame. It is important to have this discus- sion with patients using study models and photographs, not- ing in particular what the main concerns are of the pa- tient and highlighting any areas where there may be compro- mises in achieving the desired outcome. For example in the below spaced case, there is a miss- ing lower incisor. As such we will most likely be left with residual spacing distal to the canines or even between the incisors. This should still deal with the patient’s main concern of significant anterior spacing but we have to let her know of this potential negative scenario and offer the option of conven- tional orthodontics or make her aware that further treatment may be required if she feels that residual spacing is still not acceptable. Similarly with this rather crowded lower arch, we have to accept that we will not be able to move the premolars into an ideal position, giving a fuller smile, without chang- ing the occlusion significantly. Again discussion with the pa- tient regarding a compromised outcome needs to take place ‘This concept is quite different from conventional ortho- dontics where it is the intention to re- tain the whole arch in the occlusion that the orthodon- tist has determined’ page 24DTà