Clinical use – vestibular surfaces

Separating teeth in the proximal area

Sufficient separation (approximately 50 – 80 µm) of the teeth in the proximal area is required for the successful Icon treatment. Below, we would like to provide you with some helpful information.

The individual teeth are suspended between the tooth root and the alveolar bone on so-called Sharpey‘s fibers. They are part of the mineralized tissue and help anchor the tendons and ligaments. When the teeth are separated, these fibers stretch and give out a stimulus perceived as pressure if the teeth are crowded, unless anesthesia was administered first. Therefore, adequate expansion and as a result adequate separation of the teeth requires some time – similar to a muscle stretch – and should be performed gradually. The special dental wedges included in the proximal Icon packages have been optimized for this treatment with respect to the application of force. The leveled shape ensures good reachability of the area (lesion) to be treated with the proximal tip. This is not always the case with alternative separation systems (e.g. wooden wedges which swell when exposed to saliva). In contrast to the filling therapy, the wedge is not used to fix the matrix band but for separation. During the first step of the separation, the wedge should be applied into the gap between the teeth until an initial resistance is noticeable. The patient will perceive this procedure as light pressure. The position of the wedge is maintained for several seconds to stretch Sharpey‘s fibers. Then, the wedge is pushed in further until the widest part of the wedge achieves an adequate separation. In doing so, please make sure that the applied wedge does not get jammed.

For extreme crowding, the procedure described above may need to be repeated.

1

≈ 20 µm

2

≈ 40 µm

3

≈ 50 - 80 µm

Illustrations 1 – 3 show the gradual separation of teeth (approx. 20; 40; 50 – 80 µm). The magnified areas display the gradual stretching of Sharpey‘s fibers. The gradual insertion of the wedge will stretch the fibers and separate the teeth.

4 5 6

Insert the wedge until first resistance is noticeable. Gradually insert the wedge further… … until sufficient separation with the wedge is achieved.