Alexanders vari simplex discipline /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
0091-9248678078

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Alexanders vari simplex discipline /certified fixed orthodontic courses by Indian dental academy

  1. 1. VARI SIMPLEX DISCIPLINE www.indiandentalacademy.com INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com
  2. 2. ‘VARI’ Twin, Lang ,Lewis. ‘SIMPLEX’ KISS Principle ‘DISCIPLINE’ Edgewise mechanics www.indiandentalacademy.com
  3. 3. TWEED VARI SIMPLEX • Anchorage preservation • .022 Slot. • Treat mandibular arch first. DRIFTODONTICS. • Uprighting the mandibular first molars 6 degree tipwww.indiandentalacademy.com
  4. 4. • Upright lower incisor. • Headgear. RETRACTOR. • Non extraction Tweed concept and Contemporary developments QUALITY RESULTS www.indiandentalacademy.com
  5. 5. Key Objective Patient ends up with the face proportionately balanced and consistent with his skeletal pattern . The treatment should be completed in the stipulated time with a satisfied patient, parent and doctor www.indiandentalacademy.com
  6. 6. Unique Concepts. 1.First Straight wire type – Different designs of brackets in the same case, depending on the type of teeth. The – 5 degree lower anterior torque is different from other appliances. 2. Only 2 to 3 arch wires to be changed www.indiandentalacademy.com
  7. 7. 3. Bracket design and bracket effectiveness does not dictate the treatment technique. 4. Rectangular multistranded arch wires www.indiandentalacademy.com
  8. 8. DIAGNOSIS AND TREATMENT PLANNING . Patient information Diagnostic Chart Patient records Cephalometrics , patient examination Treatment planning Financial records www.indiandentalacademy.com
  9. 9. I.Patient history www.indiandentalacademy.com
  10. 10. I. Patient examination. II. Diagnostic records. 1) Intra oral and Panoramic radiographs. 2)Study models. 3)Facial photographs www.indiandentalacademy.com
  11. 11. 4)Cephalometric Analysis. a) General skeletal pattern. b)Tooth position. www.indiandentalacademy.com
  12. 12. Critical Factor in diagnosis Lower Incisor Position. 1.Incisor mandibular plane angle. 2.Holdaway Ratio. 3.Lower incisor to A-Pog www.indiandentalacademy.com
  13. 13. Treatment Plan. Two steps: 1.Determine the desired position of the mandibular incisor. 2.Determine the treatment needed to position the maxilla and maxillary dentition over the desired mandibular arch position. www.indiandentalacademy.com
  14. 14. Objective of Treatment: 1.Incisors upright over the basal bone . 2.Cuspids not expanded. 3.Level curve of spee. 4.Non extraction therapy . www.indiandentalacademy.com
  15. 15. VARI-SIMPLEX DESIGN Brackets are • Pretorqued • Preangulated • Built in In / Out [Pioneered by IVAN LEE and LARY ANDREWS] Different bracket design on particular teeth in the arch,but the system of brackets for each pt is identical.www.indiandentalacademy.com
  16. 16. IMPORTANT FACTORS IN DETERMINING THE DESIGN OF THE V.S.APPLIANCE 1. Shape and Size of the tooth. Mesiodistal width and curvature. 2. Accessibility. 3. Patient comfort and frequency of bracket wing breakage. www.indiandentalacademy.com
  17. 17. Factors Related To The Brackets 1. Bracket selection 2. Bracket placement 3. Bracket angulation 4. Bracket torque 5. In / Out www.indiandentalacademy.com
  18. 18. BRACKET SELECTION TWIN BRACKETS • Large ,flat surfaced teeth. • Mini Diamond brackets. • Accessibility • Additional hooks . www.indiandentalacademy.com
  19. 19. •Inter bracket distance. •Patient comfort. •Full archwire engagement. www.indiandentalacademy.com
  20. 20. LANG BRACKETS Dr.Howard Lang • Round surfaced teeth at the corners • Single bracket with a flat rotational wing. www.indiandentalacademy.com
  21. 21. • Wire deformation www.indiandentalacademy.com
  22. 22. LANG BRACKETS •Complete arch wire engagement. •Increased inter bracket width Wedge shaped in profile www.indiandentalacademy.com
  23. 23. LEWIS BRACKETS • Large round surfaced teeth and small flat surfaced teeth. • Single bracket with fixed rotation wing –built in labial curvature www.indiandentalacademy.com
  24. 24. LEWIS BRACKETS • Wedge shaped in profile • Excellent inter bracket width. www.indiandentalacademy.com
  25. 25. • Facilitates correction of severely rotated teeth. Activation www.indiandentalacademy.com
  26. 26. OTHER ATTACHMENTS •Twin bracket with a Convertible sheath . •Head gear tubes placed occlusally*. •15 degree offset –upper first molar . 5 degree – mandibular first molar. •Ball hooks . www.indiandentalacademy.com
  27. 27. OTHER ATTACHMENTS • Single buccal tubes second molars • 6 degree distal offset built in the lower second molar. • Lingual hooks on all molar bands. Appliance does not dictate the treatment technique www.indiandentalacademy.com
  28. 28. Bracket height • Bicuspid bracket height [x] key www.indiandentalacademy.com
  29. 29. Bracket angulation • Ideal axial inclination. Roots parallel Crown in most esthetic &functional position. DIAMOND BRACKET VERTICAL LINES PARALLEL TO THE LONG AXIS OF THE TOOTH www.indiandentalacademy.com
  30. 30. www.indiandentalacademy.com
  31. 31. 1 st Bicuspid Extraction www.indiandentalacademy.com
  32. 32. Dr Dwayne Trammell BAYLOR UNIVERSITY • Laminographic x- ray of the molars • 3 months • Superimposition showed Root tips moved anteriorly by , 0.5 mm Crowns tipped distally on an average of 1mm • 2 mm of arch length www.indiandentalacademy.com
  33. 33. BRACKET TORQUE DEVELOPED Finishing rectangular wires of 50 cases www.indiandentalacademy.com
  34. 34. • - 30 torque maxillary cuspids • No torque mandibular second molar tube • - 50 lingual crown torque mandibular incisors www.indiandentalacademy.com
  35. 35. DR. TRAMELL • Class II non extraction cases • 0.017’’ x .025’’ D RECT MULTISTRANDED - 3 MONTHS • Superimposition showed incisal edges moved lingually by less than 0.5mm • Root apices moved labially on an average of 1mm • Main aim Hold the incisors in its original position www.indiandentalacademy.com
  36. 36. Bracket in – out www.indiandentalacademy.com
  37. 37. EXTRA-ORAL FORCES ‘RETRACTOR’ Dr.Fred Schudy Sagittal Control Vertical Transverse Skeletal Dental www.indiandentalacademy.com
  38. 38. Three different type of retractors 1. Cervical traction • Force vector -10 degrees • SN- MP- < 37 degrees www.indiandentalacademy.com
  39. 39. 2. Combination pull • Force vector 30 degrees • SN- MP 37 to 41 degrees www.indiandentalacademy.com
  40. 40. 3. High pull retractor • Force vector 60 to 70 degrees • SN-MP > 42 degrees www.indiandentalacademy.com
  41. 41. Components of a facebow system 1. Molar buccal tubes.* www.indiandentalacademy.com
  42. 42. 2. Inner bow Adjustments in six directions • Bucco-lingually • Superio- inferiorly • Anterio - posteriorly www.indiandentalacademy.com
  43. 43. 3. Outer bow www.indiandentalacademy.com
  44. 44. • 4. Retractor system www.indiandentalacademy.com
  45. 45. Retractor force • 8 ounces • 16 ounces Time worn Depending on severity of A-P discrepancy • ANB – 3 7-8 HOURS • ANB – 3- 5 10 HOURS • ANB - > 10 14 HOURS Orthodontic vs Orthopedic force www.indiandentalacademy.com
  46. 46. Class III Extra oral forces • Face masks • Vertical pull chin cup • Reverse headgear www.indiandentalacademy.com
  47. 47. Co-operation* Successful treatment Growth Arch consolidation www.indiandentalacademy.com
  48. 48. Elastics in Vari – simplex discipline • To align the maxillary dentition with the mandibular dentition and correcting an centric occlusion / centric relation discrepancy. • Correction of cross bite and midline • Finalize the occlusion 3 to 6 ounces www.indiandentalacademy.com
  49. 49. Elastic Specifications • Class II - ¼ “, 6 oz www.indiandentalacademy.com
  50. 50. • Class III - ¼” , 3 ½ oz www.indiandentalacademy.com
  51. 51. • Midline elastics – ¼ “ , 6 oz www.indiandentalacademy.com
  52. 52. Box elastics • Anterior box elastics – 3/16“ 6 oz www.indiandentalacademy.com
  53. 53. Box elastics • Lateral box • Buccal box www.indiandentalacademy.com
  54. 54. • Trapezoid elastics – ¼ “ , 6 oz www.indiandentalacademy.com
  55. 55. • Triangular elastics 1/8 ”, 3 ½ oz www.indiandentalacademy.com
  56. 56. • Cross bite elastics – 3/16 “ , 6 oz www.indiandentalacademy.com
  57. 57. • Finishing elastics – [ UP AND DOWN] ¾ “ , 2 oz www.indiandentalacademy.com
  58. 58. M with tail W with tail www.indiandentalacademy.com
  59. 59. • Head gear elastics • Coil springs ½ “, 140z www.indiandentalacademy.com
  60. 60. Non-Extraction Treatment Photographs Learning Experiences Case Record BORDERLINE CASES Fifty percent of cases Treated Non www.indiandentalacademy.com
  61. 61. Borderline Non extraction • Negative torque on the lower incisors bracket • Negative tip on the lower molar bracket • Flexible D RECT wire initial • Bonding instead of banding • Ability to perform selective interproximal reduction www.indiandentalacademy.com
  62. 62. MAXILLARY ARCH. Bonding and Banding First Wire • Multistrandard spiral round archwire • Retractor Second Wire • 0.016 ss with omega stops. Space closure with power chains. Third final wire • 0.017 x 0.025 ss rectangularwww.indiandentalacademy.com
  63. 63. MANDIBULAR ARCH First wire  0.017 x 0.025 multistranded rectangular wire  Slenderizing followed by 0.016 x 0.022 D-Rect  0.016 Ni ti and class III elastics Second wire  0.016 x 0.022 ss with omega Third wire  0.017 x0.025 ss www.indiandentalacademy.com
  64. 64. CLASS II DIV 2  0.0175 Multistranded or Ni ti  0.016 ss wire  Bite blocks  Mandibular arch- Initial round wires - 0.016 x 0.022 ss finishing wires - Invert bracket or zero degree torque DEEP BITE CASES • Bite plate. • Cervical retractor www.indiandentalacademy.com
  65. 65. CLASS III CASES • Start treatment in both arches. • Early use of class III elastics. • Extra oral forces. OPEN BITE • Bracket positioning. • Extra oral forces www.indiandentalacademy.com
  66. 66. Extraction Treatment Indications: 1. Severe mandibular arch length discrepancy. 2. Severe bimaxillary protrusion. •25 percent* www.indiandentalacademy.com
  67. 67. Advantages of delaying treatment in the mandibular arch: 1.Physiologic drifting. ‘DRIFTODONTICS’ www.indiandentalacademy.com
  68. 68. 2. No interference for retraction of maxillary canines . 3. Additional time for second molars to erupt. www.indiandentalacademy.com
  69. 69. STANDARD CLASS II DIV 1 MAXILLA Initial wire - 0.0175 Respond multistranded or 0.017” –0.025”D-Rect rectangular braided arch wire Second archwire- Canine retraction. 0.016 ss round with omega stops . 0.016 –0.022ss closing loop arch wire . www.indiandentalacademy.com
  70. 70. Third archwire - • Incisor retraction. • 0.018-0.025 ss closing loop archwire* • Loop activation –1mm per four weeks. • Excellent torque control. www.indiandentalacademy.com
  71. 71. Final finishing arch wire • 0.017-0.025 ss wire. www.indiandentalacademy.com
  72. 72. MANDIBLE: 4 to 6 months of Driftodontics Initial wire Multi-stranded .0175 respond. or 0.016 Ni-ti or 0.017 –0.025 D-rect. Second wire 0.016 ss wire . www.indiandentalacademy.com
  73. 73. Third archwire • 0.016-0.022ss closing loop archwire. Final finishing arch wire • 0.017-0.025 ss archwire. www.indiandentalacademy.com
  74. 74. RETENTION IN VSD Criteria for completion of treatment. 1. Centric relation and Centric occlusion should coincide. 2. ClassI Cuspid relation. 3. Mand intercuspid width. 4. Interincisal angle with proper torque. 5. Normal ant overbite and overjet. www.indiandentalacademy.com
  75. 75. 6. Normal buccal overjet. 7. Levelled upper and lower arches . 8. Rotations eliminated and all Spaces closed 9. Roots parallel near extraction. 10. Good cuspid interdigitation. www.indiandentalacademy.com
  76. 76. COUNT DOWN TO RETENTION 6 WEEKS - Active treatment to Retention. Posterior settling --- Sectioning the arch wire. 1. Mandibular arch wire - Class II deep bite 2. Maxillary arch wire - Class III open bite 3. Both the arches - Class Iwww.indiandentalacademy.com
  77. 77. Band removal appointment ¾” ,2 oz www.indiandentalacademy.com
  78. 78. Retainer design and fabrication www.indiandentalacademy.com
  79. 79. PRINCIPLES OF THE ALEXANDER DISCIPLINE 1. ‘AS A MAN THINKETH’ JAMES ALLEN EFFORTS = RESULTS www.indiandentalacademy.com
  80. 80. 2. Dr .Hans Selye ‘Altruistic Egoism’ 3. KISS Principle . 4. Plan your work . Accurate Diagnosis and Treatment Planning 5. Goals for stability. www.indiandentalacademy.com
  81. 81. 6.Specific bracket design. 7.Bracket positioning. 8.Face bow for Orthopedic correction . 9.Proven Arch form design and Arch wire force system . www.indiandentalacademy.com
  82. 82. 10.Consolidate arches. 11.Complete bracket engagement. 12.Level the arches. 13.Progressing into finishing archwires . www.indiandentalacademy.com
  83. 83. References • The Alexander Discipline – R.G. “Wick” Alexander • JCO June 1983 • Seminars in Orthodontics – Vol 7 June 2001 www.indiandentalacademy.com
  84. 84. www.indiandentalacademy.com
  85. 85. www.indiandentalacademy.com
  86. 86. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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