The document discusses the Vari Simplex Discipline approach to orthodontic treatment. It provides details on:
- Different bracket designs (Twin, Lang, Lewis brackets) used for specific tooth shapes and sizes
- Bracket placement, angulation, torque, and in/out settings
- Use of extraoral forces like facebows and elastics
- Non-extraction and extraction treatment protocols
- Retention approaches and principles of the Alexander Discipline philosophy
The document emphasizes careful diagnosis, treatment planning, arch consolidation, and finishing for stable orthodontic results.
2. ‘VARI’ Twin, Lang ,Lewis.
‘SIMPLEX’ KISS Principle
‘DISCIPLINE’ Edgewise mechanics
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3. TWEED VARI SIMPLEX
• Anchorage preservation
• .022 Slot.
• Treat mandibular arch first.
DRIFTODONTICS.
• Uprighting the mandibular first molars
6 degree tipwww.indiandentalacademy.com
4. • Upright lower incisor.
• Headgear.
RETRACTOR.
• Non extraction
Tweed concept
and
Contemporary developments
QUALITY RESULTS
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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
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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
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7. 3. Bracket design and bracket effectiveness
does not dictate the treatment technique.
4. Rectangular multistranded arch wires
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8. DIAGNOSIS AND TREATMENT PLANNING
.
Patient information
Diagnostic Chart
Patient records
Cephalometrics , patient
examination
Treatment planning
Financial records
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10. I. Patient examination.
II. Diagnostic records.
1) Intra oral and Panoramic radiographs.
2)Study models.
3)Facial photographs
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12. Critical Factor in diagnosis
Lower Incisor Position.
1.Incisor mandibular plane angle.
2.Holdaway Ratio.
3.Lower incisor to A-Pog
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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.
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14. Objective of Treatment:
1.Incisors upright over the basal bone .
2.Cuspids not expanded.
3.Level curve of spee.
4.Non extraction therapy .
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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. 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.
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17. Factors Related To The Brackets
1. Bracket selection
2. Bracket placement
3. Bracket angulation
4. Bracket torque
5. In / Out
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22. LANG BRACKETS
•Complete arch wire
engagement.
•Increased inter bracket
width
Wedge shaped in
profile
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23. LEWIS BRACKETS
• Large round surfaced teeth and
small flat surfaced teeth.
• Single bracket with fixed
rotation wing –built in labial
curvature
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24. LEWIS BRACKETS
• Wedge shaped in profile
• Excellent inter bracket width.
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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. 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
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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
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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
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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
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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
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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
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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. 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. 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
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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
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67. Advantages of delaying treatment in
the mandibular arch:
1.Physiologic drifting. ‘DRIFTODONTICS’
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68. 2. No interference for retraction of
maxillary canines .
3. Additional time for second molars to
erupt.
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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 .
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70. Third archwire -
• Incisor retraction.
• 0.018-0.025 ss closing loop archwire*
• Loop activation –1mm per four weeks.
• Excellent torque control.
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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 .
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73. Third archwire
• 0.016-0.022ss closing loop archwire.
Final finishing arch wire
• 0.017-0.025 ss archwire.
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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.
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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.
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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
79. PRINCIPLES OF THE
ALEXANDER DISCIPLINE
1. ‘AS A MAN THINKETH’
JAMES ALLEN
EFFORTS = RESULTS
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80. 2. Dr .Hans Selye ‘Altruistic Egoism’
3. KISS Principle .
4. Plan your work .
Accurate Diagnosis and Treatment Planning
5. Goals for stability.
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81. 6.Specific bracket design.
7.Bracket positioning.
8.Face bow for Orthopedic correction .
9.Proven Arch form design and Arch wire
force system .
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83. References
• The Alexander Discipline – R.G. “Wick”
Alexander
• JCO June 1983
• Seminars in Orthodontics – Vol 7 June
2001
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