CASE REPORT
NiTi bonded space regainer/maintainer
Abstract
Early orthodontic interventions are often initiated in the
developing dentition to promote favorable developmental
changes. Interceptive orthodontic can eliminate or reduce
the severity of a developing malocclusion, the complexity
of orthodontic treatment, overall treatment time and cost.
Premature loss of deciduous tooth or teeth can often destroy
the integrity of normal occlusion. There are many space
regaining and maintaining devices mentioned in literature.
In this article, I present a simple space regaining method by a
piece of nickel titanium (NiTi) wire bonded between the teeth
in active loop form, and the unique shape memory property
of NiTi wire will upright or move the teeth and the lost space
can be regained easily.
Key words
Light cure composite, NiTi wire, space-regainer
DOI: 10.4103/0970-4388.66751 PMID: ****
Introduction
The dental profession is concerned with the prevention
and the effective interception of developing occlusion.
An important part of preventive orthodontics is the
correct handling of spaces created by the untimely loss
of deciduous teeth. As more and more people become
aware of the importance of the repair of deciduous
teeth, this problem is bound to arise less often, but at
present it is major one. Unfortunately, some dentists
have been guilty of advising patient to disregard the
repair of deciduous teeth because they will be lost.
Perhaps it is because children are sometimes more
difficult to manage, or on a time and fee basis the results
are less productive to the dentist.[1] The space loss
due to premature loss of deciduous teeth, especially
deciduous molars, can lead to mesial migration of the
first permanent molar, disturb the integrity of arch
and may cause the impaction or ectopic eruption of
J INDIAN SOC PEDOD PREVENT DENT | Apr - June 2010 | Issue 2 | Vol 28 |
Negi KS
Assistant Professor, Department of Orthodontics, H. P.
Government Dental College and Hospital, Shimla, Himachal
Pradesh, India
Correspondence:
Dr. K. S. Negi, Assistant Professor, Department of Orthodontics
and Dentofacial Orthopedics, H. P. Government Dental College
and Hospital, Shimla, Himachal Pradesh, India.
E-mail: docksnortho@yahoo.com
the second premolar [Figures 1a and b]. Conventional
space regainers used, e.g., spring regainer, lip bumper,
active lingual bar, extraoral appliances, etc., have
disadvantages like:
• Require multiple visits to dental office,
• Need band formation,
• Complicated laboratory procedures,
• Band may effect gingival health adversely,
• Possibilities of secondary caries under the band, and
• Need patient compliance.
Materials and Methods
NiTi space regainer/maintainer is simple appliance, can
be used chairside in a single visit. A composite dimple
is bonded on the buccal side of permanent first molar
and with the help of an explorer burrow a tunnel into
the mesial of dimple, creating a composite tunnel that
is open only on the mesial end. A piece of 0.016 inch
NiTi wire is then bonded on the buccal side of primary
molar/first premolar and extended beyond the dimple
[Figure 2a].
After the composite has set on both the teeth with the
help of birdbeak plier, the free end of wire is directed
into the tunnel made in the dimple of first molar
[Figure 2b]. This will give a form of activated loop
of NiTi wire [Figure 2]. A small amount of bonding
material is placed in the opening of the tunnel to make
the attachment more permanent [Figure 2c].
113
 Negi: NiTi space regainer / maintainer

a a

b b
Figure 1: Pretreatment (a) Orthopantomogram (b) photograph
showing premature loss of deciduous second molar leading to
space loss

a Figure 2: (a) Light cure composite dimple i placed on buccal surface of

permanent first molar and a small blind tunnel opening on the mesial
side is made, and a piece of 0.016 inch NiTi wire is bonded on the
buccal side of first premolar. (b) Free end of the wire is inserted into
the tunnel forming active loop. (c) Opening of the tunnel is sealed with
composite filling material.

Over time the loop returned to its original shape

due to unique shape memory property of NiTi wire,
distalizing and uprighting the first molar [Figure 3a
and b]. Once the active correction completes, the wire
segment is left in place as a passive space maintainer till
the eruption of second premolar [Figure 4a and b].[2]
b

Figure 3: (a, b) Photograph and orthopantomogram showing NiTi wire Advantages of this method are
regaining its shape, applying light continuous force on first premolar
and first molar by drifting them apart from each other or uprighting
mesially tipped permanent first molar providing adequate space for
• The whole procedure can be completed in a single
the eruption of second premolar. visit at the chair side,

114 J INDIAN SOC PEDOD PREVENT DENT | Apr - June 2010 | Issue 2 | Vol 28 |
 Negi: NiTi space regainer / maintainer

a b

Figure 4: (a) After regaining space, wire is left as a retainer till the second premolar erupts. (b) Orthopantomogram showing second premolars
erupted in regained space.

• No need of procedures like impression taking, fitting References

of bands and soldering,
• Better oral hygiene can be maintained as the 1. Graber TM. Orthodontics Principle and Practice. 3 rd ed.
appliance is self-cleansing and Philadelphia: W.B. Saunders Company; 1988. p. 637-8.
• Improved patient compliance. 2. Negi KS. Modified bonded space Regainer/Retainer. Orthod
Cyber J 2007. Available from: http://www.oc-j.com/sept07/
bonded.htm. [cited in 2007].
Conclusion
Bonded space regainer using NiTi wire is one sitting
Source of Support: Nil, Conflict of Interest: Nil
effective method of regaining and maintaining space.

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