An approach to rotational relapse

Abstract

The tendency of rotated teeth to relapse after treatment following retention is partially because of the supra-alveolar fibers which are stretched during rotational correction. Early treatment, overrotation, a long retention period, and proper contouring of contact points have been used to reduce relapse. With several surgical methods, it has been shown that releasing the tension in the periodontal fibers by severing the supracrestal and transseptal fibers significantly reduced relapse tendencies following rotation. This study was designed to test a simple surgical method (Vanarsdall) and to examine the effect of transsecting supra-alveolar fibers in orthodontically rotated teeth. Twelve cases in which a tooth and its antimere were rotated in excess of 10 degrees prior to orthodontic treatment were chosen for this study. One of the two rotated teeth was chosen for the gingival fibrotomy, while its antimere was retained by conventional orthodontic means and served as a control. The incision was made at a 45-degree angle to the long axis of the tooth, on the labial and lingual aspects of each tooth, 2 months prior to debanding. A significant decrease in the amount of relapse up to 30 days following removal of appliances in the fibrotomy group as compared to the control group (0.42 degrees and 5.75 degrees, respectively) suggests that the procedure be considered for overcoming rotational relapse.