Modified Crib-Based Ortho-Traction Appliance

International Journal of Dental Science and Innovative Research (IJDSIR) IJDSIR : Dental Publication Service Available Online at:www.ijdsir.com Volume – 8, Issue – 5, September – 2025, Page No. : 152 - 154 Corresponding Author: Dr. Aakanksha Kedar, ijdsir, Volume – 8 Issue - 5, Page No. : 152 - 154 Page152 ISSN: 2581-5989 PubMed - National Library of Medicine - ID: 101738774 Modified Crib-Based Ortho-Traction Appliance 1Dr. Aakanksha Kedar, PG Student, DY Patil Dental School, Lohegaon 2Dr. Sandeep Jethe, HOD, DY Patil Dental School, Lohegaon 3Dr. Varsha Merani, Reader, DY Patil Dental School, Lohegaon 4Dr. Shailesh Dongre, Reader, DY Patil Dental School, Lohegaon 5Dr. Arun Mhaske, Lecturer, DY Patil Dental School, Lohegaon 6Dr. Suyog Shendage, Lecturer, DY Patil Dental School, Lohegaon 7Dr. Abdul Foujdar, Tutor, DY Patil Dental School, Lohegaon 8Dr. Sunil Kalyankar, PG Student, DY Patil Dental School, Lohegaon Corresponding Author: Dr. Aakanksha Kedar, PG Student, DY Patil Dental School, Lohegaon Citation of this Article: Dr. Aakanksha Kedar, Dr. Sandeep Jethe, Dr. Varsha Merani, Dr. Shailesh Dongre, Dr. Arun Mhaske, Dr. Suyog Shendage, Dr. Abdul Foujdar, Dr. Sunil Kalyankar, “Modified Crib-Based Ortho-Traction Appliance”, IJDSIRSeptember – 2025, Volume – 8, Issue – 5, P. No. 152 – 154. Copyright: © 2025, Dr. Aakanksha Kedar, et al. This is an open access journal and article distributed under the terms of the creative common’s attribution non-commercial License. Which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given, and the new creations are licensed under the identical terms. Type of Publication: Original Research Article Conflicts of Interest: Nil Abstract Tooth impaction can be defined as the infra-osseous position of the tooth after expected time of eruption. Multiple impacted teeth might be related to genetic syndromes such as cleido-cranial dysplasia (CCD) or endocrine disorders which certainly complicate the treatment and lengthen the overall treatment time considerably. It needs co-ordinated management to guide eruption of as many teeth as possible. The Customizable design of Ortho-traction appliance with modified crib provides traction of multiple impacted teeth at the same time. This reduces treatment time and patient discomfort. Additional crib like design not only provides place for hooks but also prevents tongue thrusting. Keywords: Orthodontic traction, multiple teeth, Appliance for traction Introduction Tooth impaction can be defined as the infra-osseous position of the tooth after expected time of eruption. It occurs as much as 25% to 50% of the population1. According to a review by Bishara2, the primary etiological causes of tooth impaction include space deficiency, disturbances in tooth eruption sequence, retention of deciduous teeth, trauma, premature root closure, rotation of tooth buds, thickened overlying osseous or mucosal tissues, cysts and odontoma. Multiple Dr. Aakanksha Kedar, et al. International Journal of Dental Science and Innovative Research (IJDSIR) ©2025 IJDSIR, All Rights Reserved Page153 Page153 Page153 Page153 Page153 Page153 Page153 Page153 Page153 Page153 Page153 Page153 Page153 Page153 Page153 Page153 Page153 Page153 Page153 impacted teeth might be related to genetic syndromes such as cleidocranial dysplasia (CCD) or endocrine disorders. Orthodontic intervention to bring these impacted teeth into the line of occlusion is important for long-term function and stability. Multiple impactions certainly complicate the treatment and lengthen the overall treatment time considerably. Due to impaction of multiple teeth in syndrome cases like Cleidocranial dysplasia, conventional method of traction with help of adjacent teeth is not possible. It needs coordinated management to guide eruption of as many teeth as possible 3. In such a case, open communication between the orthodontist and oral surgeon is essential, as it will allow for the appropriate surgical and orthodontic techniques to be used. Armamentarium 1. 19 gauge SS wire. 2. 0.007 inch band material. 3. Silver solder Framework  Design can be customized depending upon teeth present.  Banding posterior teeth.  U shape wire along the palate soldered to molar bands.  A smaller U shaped wire soldered anteriorly on base ach wire vertically making it look like a crib, this will not only be used for hooks attachment during traction but also will act like a tongue crib.  Additional hooks labially on premolar and molar band for traction of impacted canine and premolar.  This design will provides anchorage and also help in traction of multiple teeth at the same time.  Easy to fabricate. Anterior crib like structure in premaxilla acts like tongue crib as tongue thrusting is common in such patients.  Explained in figure 1,2,3 4 and 5 Ortho-traction appliance with crib framework Figure 1and 2: Showing anterior crib along with hooks for preventing tongue thrusting and traction of teeth at the same time Figure 3 and 4: Showing side view with additional hooks for traction (if needed). Conclusion This is simple and effective framework for traction of multiple teeth at the same time in cases required. The design could be modified according to teeth present or Dr. Aakanksha Kedar, et al. International Journal of Dental Science and Innovative Research (IJDSIR) ©2025 IJDSIR, All Rights Reserved Page154 Page154 Page154 Page154 Page154 Page154 Page154 Page154 Page154 Page154 Page154 Page154 Page154 Page154 Page154 Page154 Page154 Page154 Page154 hooks required for traction. The anterior crib like structure will also halt tongue thrusting, this will lead to effective traction and habit correction. Figure 5: 3D perspective view of the appliance Figure 6: Appliance cemented in mouth References 1. Andreasen JO, Pindborg JJ, Hjörting-Hansen E, Axéll T. Oral health care: more than caries and periodontal disease. A survey of epidemiological studies on oral disease. Int Dent J 1986; 36(4): 20714. 2. Bishara SE. Impacted maxillary canines: a review. Am J Orthodont Dentofac Orthoped 1992; 101: 15971. 3. Giliana Clauser Zuccati, Tiziana Doldo. Multiple bilateral impactions in an adolescent girl. Am J Orthodont Dentofac Orthoped 2010; 137: s163-72. 4. Ishihara Y, Kamioka H, Takano-Yamamoto T, Yamashiro T. Patient with nonsyndromic bilateral and multiple impacted teeth and dentigerous cysts. Am J Orthod Dentofacial Orthop 2012; 141(2): 22841 5. Niu Q, Zhang L, Dai J, Li F, Feng X. Orthodontic Management with Traction and Asymmetric Extraction for Multiple Impacted Permanent Maxillary Teeth – A Case Report . Open Dent J, 2016; 10: