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08 January 2019

The use of Kilroy springs for the disinclusion of upper canines: a clinical case

Author: Maurizio Cannata


The exposure of a superior canine in bone inclusion is always a moment of great commitment, both from the diagnostic and therapeutic point of view. Today, thanks to Conical Beam Tomography (CBCT), tridimensionally localizing an included dental element is relatively simple. This makes it much easier to set up an appropriate treatment plan. Once the diagnostic phase has been completed, the following operational phases are subject to various obstacles, first of all the potential loss of anchorage during the traction of the canine.

In this article, through the discussion of a clinical case, we analyze the various phases of the therapeutic process that starts from the exposure of the included tooth up to its correct positioning in the arch.

  • The surgical flap must have an adequate extension, such as to facilitate the removal of the bone casing, hemostasis and gluing of the attachment or of the button on the exposed dental surface, avoiding damage to the nearby anatomical structures.
  • The ideal traction device should have a force as constant and adequately directed as possible, so as to allow the tooth to escape in a short time.
  • The appropriate anchorage on the other dental elements in these phases is a critical aspect, to avoid the collapse of the proximal dental elements towards the tooth to be exposed.

The clinical case in question was treated using the MBT technique and Kilroy spring.
The MBT technique allowed us to preliminarily perform the alignment and leveling phases of the dental elements and to obtain an adequate space for the element to be exposed. The rectangular end arch used in this technique has a thickness and a rigidity suitable to avoid undesirable anchoring losses. The Kilroy spring is an auxiliary steel device to be mounted on the orthodontic arch. It has characteristics of great elasticity and is able to exert a constant force, which allows to move the enclosed canine downwards and outwards, allowing the exposure of the tooth and at the same time its movement towards its natural seat. The combination of the MBT technique with this auxiliary allows to complete most of the orthodontic treatment before the exposure of the included canines and also makes the use of other anchoring devices superfluous.

The Kilroy spring, invented by S. Jay Bowman and Aldo Carano, is produced by the American Orthodontics and distributed in Italy by Micerium.

For additional informations:
The use of Kilroy Springs in the disimpaction of upper canines

  • Fig. 1 Initial orthopantomography

    Fig. 1 Initial orthopantomography

  • Fig. 2 The Kilroy spring inserted on the steel arc ready for activation

    Fig. 2 The Kilroy spring inserted on the steel arc ready for activation

  • <p>Fig. 3 Two Kilroy springs activated by rotation on the dental element to be exposed and fastened with binding thread. The resulting vector will be directed downward and outward</p>

    Fig. 3 Two Kilroy springs activated by rotation on the dental element to be exposed and fastened with binding thread. The resulting vector will be directed downward and outward

  • <p>Fig. 4 The notable palatine transversal contraction, in need of correction, is evident</p>

    Fig. 4 The notable palatine transversal contraction, in need of correction, is evident

  • <p>Fig. 5 The palate at the end of the transversal expansion</p>

    Fig. 5 The palate at the end of the transversal expansion

  • <p>Fig. 6 The display of the canine. Note the festooning of the flap, respecting the periodontal structures of proximal teeth and haemostasis. The tunnel obtained from the extraction of the deciduous element will be used to pull the element included in its natural seat</p>

    Fig. 6 The display of the canine. Note the festooning of the flap, respecting the periodontal structures of proximal teeth and haemostasis. The tunnel obtained from the extraction of the deciduous element will be used to pull the element included in its natural seat

  • <p>Fig. 7 The Kilroy springs inserted and activated on the two canines included. On the 13th note the presence of a double traction, given the very central initial position</p>

    Fig. 7 The Kilroy springs inserted and activated on the two canines included. On the 13th note the presence of a double traction, given the very central initial position

  • <p>Fig. 8 As soon as the exposed tooth portion allows it, the buttons are replaced by attachments and the traction continues through elastic chains</p>

    Fig. 8 As soon as the exposed tooth portion allows it, the buttons are replaced by attachments and the traction continues through elastic chains

  • <p>Fig 9. The derotation of the canines is completed with the use of superelastic round bow .014</p>

    Fig 9. The derotation of the canines is completed with the use of superelastic round bow .014

  • <p>Fig. 10 The case at the end of the treatment</p>

    Fig. 10 The case at the end of the treatment

  • <p>Fig. 11 Final Orthopantomography</p>

    Fig. 11 Final Orthopantomography

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