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Assessing the Effectiveness of Using Passive Lingual Arch in
Resolving Incisor Crowding in the Mixed Dentition
Dr. Abdul Wahab Nourallah*
(Received 26 / 8 / 2013. Accepted 12 / 11 / 2013)
ABSTRACT
Arch length preservation, and maintenance of the leeway space in the mixed
dentition can often provide an adequate space to resolve lower incisor crowding. Yet, the
frequency of this occurrence is not known. To obtain this information, lingual arches were
placed in the mandibular arches of 107 consecutive mixed dentition patients with incisor
crowding to preserve arch length and make the leeway space available to resolve the
crowding. Arch length decreased by only 0.44mm, whereas the intercanine, interpremolar,
and intermolar dimensions increased by0.72-2.27mm. There was an adequate space to
resolve the crowding in 65 out of 107 patients(60%). If perfect arch length preservation
occurred, there would bean adequate space to resolve the crowding in 73 out of 107
patients(68%).
Keywords: lingual arch, mixed dentition, leeway space, incisors crowding
*
Assistant Professor, Department of Pediatric Dentistry, Faculty of Dentistry, Tishreen University,
Lattakia, Syria
54
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1. MOYERS, R.E. van der LINDEN, F.P.G.M. RIOLO, M.L. McNAMARA, J.A. Jr.
Standards of human occlusal development. 3ed. Ed., Monogram 5 Craniofacial
growth Series, Ann Arbor Michigan. Center of Human development. The University
of Michigan. 1976, 460.
2. SAYIN, M. TUERKKAHRAMAN, H. Factors contributing to mandibular crowding in
the early mixed dentition. Angle Orthod., 74, 2004, 754-758.
3. SINGER, J. The effect of the passive lingual arch on the lower denture. Angle Orthod.,
44, 1974, 73-87.
4. DeBAETS, J. CHIARINI, M. The pseudo Class I: a newly defined type of malocclusion.
J. Clin. Orthod., 29, 1995, 73-87.
5. DUGONI, S. LEE, J.S. VALERA, J. DUGONI, A. Early mixed dentition treatment:
postretention evaluation of stability and relapse. Angle Orthod., 65,1995, 311-9.
6. TUERKKAHRAMAN, H. SAYIN, M. Relationship between mandibular anterior
crowding and lateral dentofacial morphology in the early mixed dentition. Angel
Orthod., 74, 2004, 759-764.
7. TUNISON, W. FLORES, C. ELBADRAWY, H. USAMA, N. ADEL-Bialy, T. Dental
arch space changes following premature loss of primary first molars: A Systematic
review. Pediatric Dentistry 30, 2008, 297-302.
61
N#
. : . ? .# $ + 8. AZZURRA, V. Effects of lingual arch used as space maintainer on mandibular arch
dimension: A systematic review. Am. J. Orthod. DentofacialOrthop., 138, 2010, 382383.
9. REBELLATO, J. LINDAUER, S.T. RUBENSTEIN, L.K. ISAACSON, R.J.
DAVIDOVICH, M. VROOM, K. Lowerarch perimeter preservation using the
lingual arch. Am. J. Orthod. DentofacialOrthoped., 112, 1997, 449-53.
10. ARNOLD, S. Analysis of leeway space in the mixed dentition (Master Thesis) Boston
University 1991, 76-80.
11. SAMPSON, W.S. RICHARD, L.C. Prediction of mandibular incisor and canine
crowding changes in the mixed dentition. Am. J. Orthod. DentofacialOrthop., 88,
1985, 47-63.
12. MOORREES, C.F.A. CHADA, J.M. Available space for incisors during dental
development: a growth study based on physiologic age. Angle Orthod., 35, 1956, 1222.
13. BISHARA, S.E. JAKOBSEN, J.R. NOWAK, A. Arch width changes from 6 weeks to
45 years of age. Am. J. Orthod.,111, 1997, 401-9.
14. SILLMAN, J.H. Dimensional changes of dental arches: a longitudinal study from
birth to 25 years. Am. J. Orthod., 50, 1964, 824-41.
15. SINCLAIR, P.M. LITTLE, R.M. Maturation of untreated normal occlusions. Am. J.
Orthod., 83, 1983, 114-23.
16. BARROW, G.V. WHITE, R.J. Developmental changes in the maxillary and
mandibular dental arches. Am. J. Orthod., 22, 1952, 41-6.
17. FOSTER, T.D. HAMILTON, M.C. LAVALLE, C.L.B. A study of dental arch
crowding in four age groups. Dental Practice. 21, 1970, 9-12.
18. LITTLE, R.M. REIDEL, R.A. STEIN, A. Mandibular arch length increase during the
mixed dentition: postretention evaluation of stability and relapse. Am. J. Orthod.
DentofacialOrthop., 97, 1990, 393-404.
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