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 Table of Contents  
CLINICAL INNOVATION
Year : 2015  |  Volume : 49  |  Issue : 3  |  Page : 161-162

Closure of a maxillary midline diastema using a modified omega loop


1 MDS, PG Student, Department of Orthodontics, KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India
2 MDS, Reader, Department of Orthodontics, KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India
3 MDS, PhD Professor and Head, Department of Orthodontics, KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India

Date of Submission23-Jun-2015
Date of Acceptance15-Jul-2015
Date of Web Publication16-Sep-2015

Correspondence Address:
Malvika Gandhi
T-3, Rajouri Garden, New Delhi - 110 027
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-5742.165564

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  Abstract 

A maxillary midline diastema is important from a clinical management standpoint by virtue of its presence, as well as the esthetic concerns it causes to the patient. While seen in many children as a part of normal development in the mixed dentition (only to disappear as the growth progresses), it may persist in situations associated with some or the other etiological factors. These could be tooth size-shape discrepancy, midline cysts, missing lateral incisors, habits (thumb sucking, tongue thrusting, etc.), familial tendencies, abnormal labial frenum, etc., Treatment planning should seek to manage not only the diastemata in question but also the cause behind it. Possible therapeutic approaches include orthodontic treatment, restorative dentistry, surgery, and its various combinations. This article describes a modified form of loop mechanics used to close diastemata.

Keywords: Loop modification, midline diastema, omega loop


How to cite this article:
Gandhi M, Hattarki R, Keluskar K M. Closure of a maxillary midline diastema using a modified omega loop. J Indian Orthod Soc 2015;49:161-2

How to cite this URL:
Gandhi M, Hattarki R, Keluskar K M. Closure of a maxillary midline diastema using a modified omega loop. J Indian Orthod Soc [serial online] 2015 [cited 2019 May 19];49:161-2. Available from: http://www.jios.in/text.asp?2015/49/3/161/165564

Various types of closing loops are used during orthodontic treatment for space closure. These loops are either made up of stainless steel or titanium molybdenum alloy wire. Prior to activation of any closing loop, the arms of the loop are kept in close approximation. To activate the loop intraorally, the wire is pulled and cinched distal to the molar tube, which tends to move the arms of the loop apart. [1] As the loop attempts to rebound to its original configuration, the process moves the segments of the teeth posterior to it. When using an omega loop in this manner, bodily movement of all teeth until the last molar is brought about, to close a midline diastema.

To reduce the amount of wire degeneration or loss of flexibility of the wire, following is a simple method:

  • Fabricate an omega loop with a 0.017" × 0.025" stainless steel wire
  • Place 2 crimpable hooks, 1 diametrically opposite the other, on the arms of the loop [Figure 1]
    Figure 1: Loop design

    Click here to view
  • Place an e-chain over these hooks on either side. The archwire with the loop is then placed intraorally [Figure 2]
    Figure 2: (a) Pretreatment; (b) placement of modified loop intraorally (prior to activation); (c) closure of diastema (8 weeks of activation completed); (d) posttreatment

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  • Distal end of the wire is pulled and cinched back behind the molar tube. This causes the arms of the loop to move apart, the elastic chain in between gets stretched, and tries to close the loop [Figure 3]
    Figure 3: (a) Pretreatment orthopantomograph; (b) Posttreatment orthopantomograph

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  • For reactivation, the wire is cinched back every appointment such that the arms of the loop are flushed with the mesial wings of the central incisor brackets. Additionally, the e-chain is also changed every appointment. Reactivation to be done once every week until diastema closure is achieved.


Advantages of modified omega loop design

  1. The loop remains active for a longer time [2]
  2. Reactivation of the loop is easier
  3. Loss of flexibility of the wire is compensated by placement of the elastic chain.


Biomechanics of the modified omega loop

The omega loop tends to distribute stresses more evenly instead of concentrating them at the root apex. Accordingly, it has been used here to apply moment to the last tooth in arch causing bodily root thrust.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Cureton SL, Storie D. Simplified activation of closing loops. J Clin Orthod 1998;32:490-2.  Back to cited text no. 1
    
2.
Kassir C. Activating a modified closing loop. J Clin Orthod 2010;44:236.  Back to cited text no. 2
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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