December’s Tip

The Eyelet, Part II

By Dr. Adrian J. Palencar, MUDr, MAGD, IBO, FADI, FPFA, FICD

December 2023

Quite frequently the maxillary second molar has erupted in bucco- version, and there is minimal space to bond the buccal tube.  Even if the buccal tube is successfully bonded, the patient may not be able to tolerate it.  Therefore, the last resort is bonding an eyelet.

The author would like to share with you the case, where he was desperate to help the patient.  The patient arrived as a TM dysfunction patient for finishing the case with the SWA. The patient presented herself with the mandibular orthotic (Anterior Repositioning Splint) in therapeutic position.  In this position, the patient reported great amelioration of signs and symptoms of TM dysfunction.  It was necessary to bracket entire maxillary arch for the forced eruption (elevation) of mandibular posterior sextants.  The patient was an adult female, hyperdivergent with extremely hypertonic peri-oral muscles.  The teeth in question for bonding were #17(2) and #27(15).  We started with a standard molar tube, continued with mini – molar tube, and the patient could not tolerate either one. She developed uncomfortable lacerations and precipitated few emergency appointments.  Finally, we bonded an eyelet on the buccal aspect of both second molars and the patient was comfortable.  She could not tolerate a bend-back (cinch), therefore the author cut off the end of the arch wire with the small football shaped diamond bur.

References:

  1. The author’s personal experience and research
  2. Cerum Ortho Organizers Catalogue, E8