A treatment method for / dental courses /certified fixed orthodontic courses by Indian dental academy


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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call

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A treatment method for / dental courses /certified fixed orthodontic courses by Indian dental academy

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. Class II Correction • Headgears/ Class II elastics –Patient Compliance • Implants becoming popular • Xtn of First molars – Williams (1976) • Williams R. Single arch extraction—upper first molars or what to do when nonextraction treatment fails. Am J Orthod 1979;76:376–393. • Williams R, Hosila FJ. The effect of different extraction sites upon incisor retraction. Am J Orthod 1976;69:388–410. www.indiandentalacademy.com
  3. 3. Technique • 3 stages – Class II Correction – Space Closure & Torque – Detailing & Finishing www.indiandentalacademy.com
  4. 4. Phase 1: Class II Correction www.indiandentalacademy.com
  5. 5. Maxilla • The second molars are banded -7-mm buccal tubes and palatal sheaths – palatal bar – increase anchorage – correct eventual rotations and transversal malpositions • Extraction of First Molar – healing period of three weeks • Low-friction brackets - Begg light wire brackets • Maxillary premolars not bonded www.indiandentalacademy.com
  6. 6. Beginning of Class II correction www.indiandentalacademy.com
  7. 7. The Archwire • 0.016-in premium plus pull straightened Australian wire (Wilcock, Whittlesea, Australia) • If the maxillary anterior teeth cannot easily be attached to the archwire, this is completed after space is created by distal movement of the maxillary canines • Anchor bends – 5mm mesial of the second molar tubes prevents mesial tipping of these teeth • degree of bends depends on the desired amount of bite opening www.indiandentalacademy.com
  8. 8. • canines are fixed with stainless steel high hat lock pins • occlusal part - partially bent mesially - hook for the horizontal elastics (5/16 in, 2.6 oz), • attached - buccal hooks on the maxillary second molar bands • patient is instructed to replace the elastics only once per week • elastics should run inside the anchor bends in the main arch – prevent irritation to gingiva www.indiandentalacademy.com
  9. 9. If second molars move too quickly • horizontal elastics - replaced by Class II elastics (5/16 in, 2.6o) www.indiandentalacademy.com
  10. 10. Completion of Class II correction; a Class I canine and premolar inter-digitation is realized www.indiandentalacademy.com
  11. 11. Phase II : Space Closure & Torque www.indiandentalacademy.com
  12. 12. • modified with offset bends, anchor bends, and vertical offsets between second molars and second premolars • Depending on the required bite opening, v-bends between both premolars and premolars and canines are added • alignment of the maxillary premolars takes approximately one month, after which the 0.016-in archwire is replaced by a 0.018-in premium plus archwire www.indiandentalacademy.com
  13. 13. Individual adjustments • to correct the relation of maxillary central and lateral incisors in conjunction with the smile line - form of the maxillary arch is adapted to the form of the original arch • An individual two-spur torque auxilliary of 0.014-in regular wire (Wilcock, Whittlesea, Australia) ending distally of the maxillary canine brackets is applied • Aside from the torque effect, this spring has the tendency to protrude the maxillary anterior teeth. www.indiandentalacademy.com
  14. 14. • adverse effect is eliminated by horizontal traction in the lateral regions • If extensive torque is required and rest spaces are small, the palatal bar between the maxillary second molars is maintained. In the opposite situation, the bar is temporarily removed. www.indiandentalacademy.com
  15. 15. Beginning of space closure and torque; the maxillary premolars are bonded and the maxillary 0.016-in archwire is adjusted. www.indiandentalacademy.com
  16. 16. • If extensive torque is required and rest spaces are small, the palatal bar between the maxillary second molars is maintained • In the opposite situation, the bar is temporarily removed www.indiandentalacademy.com
  17. 17. A 0.018-in maxillary archwire in combination with a 0.014-in torquing auxilliary, uprighting and horizontal tractions; the palatal bar can be temporarily removed www.indiandentalacademy.com
  18. 18. • The patients are seen at intervals of six to eight weeks • The closing of the lateral spaces and torque action must be balanced • Orthodontists have to observe the progress and decide about individual adaptations in the use of horizontal tractions, uprighting springs, and eventual wear of Class II elastics. www.indiandentalacademy.com
  19. 19. Mandible • In case of the eventual wear of Class II elastics, the mandibular archwire shape is expanded to compensate for lingual tipping of the mandibular molars • When indicated, individual uprighting springs are placed in the vertical slots www.indiandentalacademy.com
  20. 20. Phase III : Detailing & Finishing www.indiandentalacademy.com
  21. 21. • In the final phase of treatment, adjustments are made in the archwires for detailed finishing and the palatal bar is reinserted when indicated • Each tooth can be uprighted independently by placement of springs, taking into account the adverse effects of the uprighting springs that all point into the same direction and causing a mesial directed tendency www.indiandentalacademy.com
  22. 22. Space closure, torque, and uprighting are complete www.indiandentalacademy.com
  23. 23. Retention • means of fixed retainers • To prevent vereruption of the mandibular second molars, local retention wires are bonded buccally between the mandibular first and second molars • These sectionals are removed when the maxillary third molars are in occlusal contact with the mandibular second molars www.indiandentalacademy.com
  24. 24. The bonded wire between the mandibular first and second molars is removed after settling in of the maxillary third molar. www.indiandentalacademy.com
  25. 25. Beginning of treatment www.indiandentalacademy.com
  26. 26. Beginning of Class II correction after extraction of the maxillary first molars www.indiandentalacademy.com
  27. 27. Beginning of space closure and torque; the maxillary premolars are bonded, and the maxillary 0.016-in archwire is adjusted www.indiandentalacademy.com
  28. 28. A 0.018-in maxillary archwire with a 0.014-in torquing auxilliary www.indiandentalacademy.com
  29. 29. Completion of treatment www.indiandentalacademy.com
  30. 30. Five years post treatment www.indiandentalacademy.com
  31. 31. Discussion www.indiandentalacademy.com
  32. 32. Conclusion Extraction of maxillary first molars, followed by fixed appliance treatment with low-friction brackets with thin round wires and a palatal bar, is an effective and efficient treatment modality for Class II Division 1 malocclusions, especially for less compliant patients. www.indiandentalacademy.com
  33. 33. For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com