Removing a Bonded RPE…Made Easy
by Dr. Michel Champagne
As mentioned in another info-letter, a RPE requieres a retention period of 6 months and then it can be removed. Many clinicians avoid the bonded acrylic RPE fearing problems during the removal phase. If you want to enjoy easy removal of a bonded RPE, you must start the right way i.e. at the bonding appointment. After pumicing the surface, it is time to etch the enamel but I avoid etching the occlusal surface. I also avoid applying any sealing resin to the enamel. My product of choice is Excell from the company Reliance which comes with a plastic conditioner and jars of bonding paste A and B. I use the regular set bonding paste which gives me a 3 minute working time. A plastic primer (included) is painted into the inside of the appliance, paste A and B are mixed together and applied also to the inside of the appliance. Avoid putting to much paste into the appliance (do not fill the appliance) because the product is fluid and any excess will extrude all over. Once well seated, be sure to remove all the excess with a 2×2 gauze and focus on the distal of the molars where any excess will be difficult to remove after full polymerization.
Done, 6 months of retention have passed, it is time to remove the appliance. This step should take only a few minutes. To make the removal easy you need a removing plier that has a hook at one of the tips, Orthotechnology makes an excellent one OT-349RT (Figure 1). You need to insert the hook under the gingival margin of the appliance and squeeze lightly (Figure 2). Repeat this motion at 2-3 spots on the buccal of the appliance left and right, you should feel a partial debond. Do not try to remove it in one pass, repeat the same process 2 to 3 times and you will have the appliance in your hands, probably in a few pieces. A small caution, be sure to note at the RPE bonding appointment any primary tooth that could have exfoliated during the months of appliance wear because they will be extracted with the appliance (Figure 3). This could be painful…solution…a few drops of anesthetic et voila.
Figure 1. The hooked plier Figure 2. Squeezing motion Figure 3. Appliance with some extractions