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Case Reports
. 2023 Dec 4;15(12):e49938.
doi: 10.7759/cureus.49938. eCollection 2023 Dec.

A Modified Hyrax Assembly for Intrusion of a Traumatically Extruded Incisor: An Innovative Technique

Pinaki Roy  1 , Poonam Sharma  2 , Harpreet Singh  2 , Pranav Kapoor  2 , Raj Kumar Maurya  3
Affiliations
Case Reports

A Modified Hyrax Assembly for Intrusion of a Traumatically Extruded Incisor: An Innovative Technique

Pinaki Roy et al. Cureus. .

Abstract

This case report demonstrates an innovative technique involving concomitant correction of a traumatic extrusive luxated tooth, the mobility of which was being aggravated by anterior occlusal contacts, along with transverse rapid maxillary expansion to capitalize on the advantage of residual growth and simplify the need for comprehensive fixed orthodontic appliance. By incorporating a molar tube into the acrylic splint of the bonded Hyrax expander adjacent to the buccal surfaces and parallel to the buccal cusps of the maxillary first molars, effective intrusion of traumatically extruded upper incisor was achieved concomitantly using a modified intrusion arch during the passive stabilization period after expansion, thereby reducing treatment time. This enabled the immediate correction of extruded tooth and reduced the overall treatment duration and the complexity of post-expansion fixed mechanotherapy, improving compliance and uplifting the self-esteem of the patient. The modified bonded Hyrax assembly can serve as a versatile interim appliance for the simultaneous management of a variety of orthodontic problems such as crowding, spacing, and incisor proclination without compromising the basic integrity of the bonded assembly.

Keywords: hyrax expander; incisor intrusion; molar tube; orthodontic; trauma.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. (a) Pretreatment frontal photograph. (b) Pretreatment intraoral frontal view showing a Class III incisal relationship with the traumatic extruded maxillary right central incisor. (c) Pretreatment intraoral right lateral view.
Figure 2
Figure 2. Pretreatment radiographs: (a) intraoral periapical X-ray, (b) lateral cephalogram, and (c) orthopantomagram.
Figure 3
Figure 3. Pretreatment profile photograph.
Figure 4
Figure 4. (a) Right lateral view showing the modification of the Hyrax assembly by buccally incorporating molar tubes in the acrylic. (b) Occlusal view of the modified bonded Hyrax assembly.
Figure 5
Figure 5. Right lateral view showing the initiation of molar tube-supported intrusion of the incisor.
Figure 6
Figure 6. Frontal view showing the initiation of intrusion of the incisor.
Figure 7
Figure 7. Right lateral view showing accomplished intrusion at the end of the stabilization period.
Figure 8
Figure 8. Frontal view showing favorably aligned upper incisor.
See this image and copyright information in PMC

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