Bio progressive therapy /certified fixed orthodontic courses by Indian dental academy

1,677 views
1,472 views

Published on

Welcome to Indian Dental Academy
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 has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients

State of the art comprehensive training-Faculty of world wide repute &Very affordable.

Published in: Health & Medicine, Business
0 Comments
7 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
1,677
On SlideShare
0
From Embeds
0
Number of Embeds
18
Actions
Shares
0
Downloads
1
Comments
0
Likes
7
Embeds 0
No embeds

No notes for slide

Bio progressive therapy /certified fixed orthodontic courses by Indian dental academy

  1. 1. Bioprogressive Therapy INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com 1
  2. 2.  Part II www.indiandentalacademy.com 2
  3. 3.        Utility arch. Mixed dentition treatment Brackets & Prescriptions Class II div I Class II div II Mechanics for extraction cases. Finishing and retention. www.indiandentalacademy.com 3
  4. 4. Roles and functions of the lower utility arch      Position of the lower molar to allow for Cortical Anchorage Manipulation and Alignment of the lower incisor segments. Allowing segmental treatment of the buccal segments Physiologic roles of the lower utility arch. Role in mixed dentition www.indiandentalacademy.com 4
  5. 5. Fabrication of the utility arch www.indiandentalacademy.com 5
  6. 6. Physiologic Vs Mechanical Response    Tip back applied to lower molar-30° to 40 °. No toe-in in non extraction utility. Extraction cases-definite distal rotation must be placed . www.indiandentalacademy.com 6
  7. 7. Physiologic Vs Mechanical Response  30° to 45° buccal root torque applied to the lower molar www.indiandentalacademy.com 7
  8. 8. Physiologic Vs Mechanical Response www.indiandentalacademy.com 8
  9. 9. Physiologic Vs Mechanical Response    Long lever arm applied to lower incisors. 75 gms of intrusive force.(0.16 x 0.16). Labial root torque. www.indiandentalacademy.com 9
  10. 10. Modifications of the Utility Arch   Expansion utility arch Force : 1mm= 85 gm 2mm=140 gm 3mm=205 gm www.indiandentalacademy.com 10
  11. 11. Modifications of the Utility Arch   Contraction utility arch Force: 1mm=50 gm 2mm =150 gm 3mm=230 gm www.indiandentalacademy.com 11
  12. 12. Modifications of the Utility Arch  Utility arch with T or L Horizontal loop www.indiandentalacademy.com 12
  13. 13. Modifications of the Utility Arch  Contraction or advancing utility arch www.indiandentalacademy.com 13
  14. 14. Treatment in the Mixed Dentition Phase www.indiandentalacademy.com 14
  15. 15. Bioprogressive Mixed Dentition Treatment  1. 2. 3. 4. Four basic objectivesResolve functional problems. Resolve arch length discrepancy. Correct vertical problems. Correct overjet problems. www.indiandentalacademy.com 15
  16. 16. Resolve functional problems   Anything that disturbs the growth, health and function of the TMJ complex. In 1950’s Ricketts –used body section x rays (laminagrphy) www.indiandentalacademy.com 16
  17. 17. Resolve functional problems  Lack of rough surface , excessive thickening www.indiandentalacademy.com 17
  18. 18. Resolve functional problems Submento-vertex analysis - Individual condylar inclinations and width.  www.indiandentalacademy.com 18
  19. 19. Resolve functional problems  1. 2. 3. 4. 5. Nine general categoriesCross mouth interferences. Anterior crossbite. Open bite. Excessive range of function. Distal displacement. www.indiandentalacademy.com 19
  20. 20. Resolve functional problems 6. 7. 8. 9. Loss of posterior support. Habits. Breathing and airway problems. True Class III Growth pattern. www.indiandentalacademy.com 20
  21. 21. Resolve Arch Length Discrepancy  1. - This is accomplished by three waysLateral expansion of the molars. Depends on the inclination of the posterior teeth. www.indiandentalacademy.com 21
  22. 22. Resolve Arch Length Discrepancy  Expansion primarily by change in axial inclination : - Rickett’s quad helix - .040 blue elgiloy wire. www.indiandentalacademy.com 22
  23. 23. Resolve Arch Length Discrepancy   With 1cm expansion in the upper molars – anterior segment are expanded 3cm overall. Long term functional expansion for atleast a year or more for stable and demonstrable changes to occur in the lower arch. www.indiandentalacademy.com 23
  24. 24. Resolve Arch Length Discrepancy Arch length gained is result slow natural expansive response created by muscles www.indiandentalacademy.com 24
  25. 25. Resolve Arch Length Discrepancy Modifications of the Quad Helix www.indiandentalacademy.com 25
  26. 26. Resolve Arch Length Discrepancy  Expansion by mid palatal dysfunction: - Hass type or modified Nance type expansion appliance. www.indiandentalacademy.com 26
  27. 27. Resolve Arch Length Discrepancy 2. - Advancement or forward movement of the lower molars: If the VTO and physiologic factors warrant. Expansion utility arch. 1mm forward movement of LI yields 2mm of arch length. www.indiandentalacademy.com 27
  28. 28. Resolve Arch Length Discrepancy 3. Uprighting and /or distal movement of the lower molars: - Accomplished by utility arch. - 2 mm per side can be gained by uprighting. www.indiandentalacademy.com 28
  29. 29. Correct Vertical/Overjet Problems   This is done after functional and arch length corrections are achieved. Includes different approaches are used for the first phase of non extraction treatment. www.indiandentalacademy.com 29
  30. 30. Correct Vertical/Overjet Problems 1. - 2. - Orthopedic problemsIn case where good alignment of lower arch exists and Class II is on account of Max.protrusion. Orthopedic problems with lower arch therapywith maxillary protrusion but incisors and molars in deep bite or need advancement. www.indiandentalacademy.com 30
  31. 31. Correct Vertical/Overjet Problems 3. Orthopedic problems with minor incisor interferences. - Upper utility arch with headgear . 4. Orthodontic problems alone. - Upper utility arch with Class II elastics . www.indiandentalacademy.com 31
  32. 32. Development of the Bioprogressive Brackets www.indiandentalacademy.com 32
  33. 33. Brackets   Siamese twin bracket on all the teeth. Slot size-.022 changed to .018 www.indiandentalacademy.com 33
  34. 34. Brackets  1. 2. 3. 4. Slot size-.0185 x .030 Use of two light arches Permits a champer or bevel. Allows for a lever access. Adequate distance for the torque grooves. www.indiandentalacademy.com 34
  35. 35. Development of Brackets 1. 2. 3. Rickett’s Standard Bioprogressive. Rickett’s Full Torque Bioprogressive. Triple Control Bioprogressive. www.indiandentalacademy.com 35
  36. 36. Development of Brackets 1.    Rickett’s Standard Bioprogressive. These were the first set of brackets which available. (1960) Banding was done on all the teeth. Line of occlusion –through the contact points. www.indiandentalacademy.com 36
  37. 37. Development of Brackets    Trend of building in treatment in the appliance. (angulations) The original design had 5° for all the canines and 8° for the upper lateral incisors and 5° for the lower first molar Torque was present only in-upper incisors, laterals and canines. www.indiandentalacademy.com 37
  38. 38. Development of Brackets www.indiandentalacademy.com 38
  39. 39. Development of Brackets 2.    Rickett’s Full Torque Bioprogressive. Torque was build in the lower molars and pre molars. Brackets were placed with 5 angulation. 12 rotation was also built in the tube. www.indiandentalacademy.com 39
  40. 40. Development of Brackets www.indiandentalacademy.com 40
  41. 41. Development of Brackets 3.      Triple control Bioprogressive. Raised bases Triple tube for upper molars Breakaway convertible lower molar tube. Direct bonding base/contoured. Slots cut at an angle www.indiandentalacademy.com 41
  42. 42. Development of Brackets www.indiandentalacademy.com 42
  43. 43. Development of Brackets www.indiandentalacademy.com 43
  44. 44. Mechanics Sequence for Extraction Treatment www.indiandentalacademy.com 44
  45. 45. Extraction Mechanics Four general procedures : 1 Stabilization of upper and lower molar anchorage. 2 Retraction and uprighting of cuspids with sectional arch mechanics. 3 Retraction and consolidation of upper and lower incisors. 4 Continuous arches for details of ideal and finishing occlusion.  www.indiandentalacademy.com 45
  46. 46. Extraction Mechanics 1. Stabilization of upper a)   and lower molar anchorage: Maximum upper molar anchorage. Nance arch with modifications. Headgear . www.indiandentalacademy.com 46
  47. 47. Extraction Mechanics b) Moderate upper molar anchorage:  Palatal bar.  Quad helix.  Upper utility arch. www.indiandentalacademy.com 47
  48. 48. c) Minimum upper molar anchorage:  Vertical closing loop.  Double delta loop. www.indiandentalacademy.com 48
  49. 49. Extraction Mechanics   Maximum lower molar anchorage: Lower utility arch-four mechanical adjustments. www.indiandentalacademy.com 49
  50. 50. Extraction Mechanics   Moderate lower molar anchorage: Lower utility with adjustments. www.indiandentalacademy.com 50
  51. 51. Extraction Mechanics    Minimum lower molar anchorage: Eliminate the four mechanical factors. Round wires may be used. www.indiandentalacademy.com 51
  52. 52. Extraction Mechanics 2. Retraction and uprighting of cuspids with sectional arch mechanics.   Cuspids need to be kept in the narrow trough of trabecular bone and avoid the severe tipping or displacement The activation of the cuspid retraction springs should produce 100 to 150 grams of force www.indiandentalacademy.com 52
  53. 53. Extraction Mechanics www.indiandentalacademy.com 53
  54. 54. Extraction Mechanics  Intrusion www.indiandentalacademy.com 54
  55. 55. Extraction Mechanics  Root uprighting www.indiandentalacademy.com 55
  56. 56. Extraction Mechanics  Rotation www.indiandentalacademy.com 56
  57. 57. Extraction Mechanics 3. Retraction and consolidation of upper and lower incisors. Lower incisors:  Very light continuous forces (150 grams)  Contraction utility  Double delta retraction loops www.indiandentalacademy.com 57
  58. 58. Extraction Mechanics www.indiandentalacademy.com 58
  59. 59. Extraction Mechanics     Upper Incisors: Regular contraction utility. Upside down vertical closing loop. Double delta loop. www.indiandentalacademy.com 59
  60. 60. Extraction Mechanics www.indiandentalacademy.com 60
  61. 61. Extraction Mechanics www.indiandentalacademy.com 61
  62. 62. Mechanics Sequence for Class II Div I www.indiandentalacademy.com 62
  63. 63. Mechanics For Class II Div I        Sequence: Lower Incisor intrusion. Lower Cuspid intrusion. Alignment of the lower buccal segment. Alignment of the upper buccal segment. Segmental correction of Class II with elastics. Upper incisor alignment and intrusion. www.indiandentalacademy.com 63
  64. 64. Mechanics For Class II Div I   Upper arch –orthopedic reduction of the maxilla. Lower arch-treatment starts with levelling the spee.-utility arch www.indiandentalacademy.com 64
  65. 65. Mechanics For Class II Div I www.indiandentalacademy.com 65
  66. 66. Mechanics For Class II Div I   Lower stabilizing utility arch-after initial purpose of the utility arch is accomplished –it no longer serves as an efficient function 16 x 22 stabilizing arch is placed www.indiandentalacademy.com 66
  67. 67. Mechanics For Class II Div I www.indiandentalacademy.com 67
  68. 68. Mechanics For Class II Div I      Alignment of the lower buccal segment starts: .015 or .0175 Twistoflex .012,.014 of 018 wires 16x 16 triple T section .016 or.018 nitinol www.indiandentalacademy.com 68
  69. 69. Mechanics For Class II Div I    Upper arch alignment: Incisors are not included. Upper molars starts Distalizing-opening spaces in the buccal segment. www.indiandentalacademy.com 69
  70. 70. Mechanics For Class II Div I a) Consolidation section b) Stabilizing section www.indiandentalacademy.com 70
  71. 71. Mechanics For Class II Div I   1. 2. 3. Segmental correction with Class II elastics: Three detrimental effects: Skidding effect. Tendency for a deep bite. Difficult to overcorrect buccal segment. www.indiandentalacademy.com 71
  72. 72. Mechanics For Class II Div I     Tractions SectionsGable bend distal to canine. Rotation bend in the anterior portion. Molar bayonet bend www.indiandentalacademy.com 72
  73. 73. Mechanics For Class II Div I  1. 2. Functions – Counteract downward backward pull Stabilizing function in the upper buccal segment. www.indiandentalacademy.com 73
  74. 74. Mechanics For Class II Div I    Upper incisors alignment and Intrusion Upper incisors are aligned before placement with light round wires. 16 X 22 utility arch is placed www.indiandentalacademy.com 74
  75. 75. Mechanics For Class II Div I     Consolidation of Upper Incisors Retraction of the upper incisors . Over treatment -2mm Closing utility/upside down closing arch/vertical helical arch. www.indiandentalacademy.com 75
  76. 76. Mechanics For Class II Div I     Idealization of arches and finishing. 16 or 17 square,16 x 22 or 17 x 25 nitinol. Class II elastics to be discontinued atleast 2 months. Light round wires finishing www.indiandentalacademy.com 76
  77. 77. Mechanics Sequence for Class II Div II www.indiandentalacademy.com 77
  78. 78. Mechanics For Class II Div II Three treatment possibilities: 1. Distalizing the upper arch. 2. Advancing the lower arch. 3. A reciprocal movement.  www.indiandentalacademy.com 78
  79. 79. Mechanics For Class II Div II 1. Advancement, torque control, and intrusion of the upper incisors. 2. Intrusion of the lower incisors and cuspids. 3. Alignment of the buccal segments and Class II correction. 4. Consolidation of the upper incisors. 5. Idealizing the arches. 6. Finishing. www.indiandentalacademy.com 79
  80. 80. Mechanics For Class II Div II  Quad helix or W arch www.indiandentalacademy.com 80
  81. 81. Mechanics For Class II Div II 1. Advancement, torque control, and intrusion of the upper incisors. X Principle of bite before jet  Jet is created followed by intrusion. 16x22 utility arch www.indiandentalacademy.com 81
  82. 82. Mechanics For Class II Div II Directional control www.indiandentalacademy.com 82
  83. 83. Mechanics For Class II Div II Amount of pressure:  125-160 gms  16 x 22  Stabilization of the molars: Quad helix TPA Stab. sections  www.indiandentalacademy.com 83
  84. 84. Mechanics For Class II Div II     Intrusion of lower incisors: 16 x 16 utility arch. 65-75 gms. This is followed by cuspid intrusion. www.indiandentalacademy.com 84
  85. 85. Mechanics For Class II Div II  1. Advancement of the lower denture: Utility arch with 4 helical loops www.indiandentalacademy.com 85
  86. 86. Mechanics For Class II Div II 2. Using three vertical loops: www.indiandentalacademy.com 86
  87. 87. Mechanics For Class II Div II Alignment of the buccal segment: a) Stabilizing section 3. www.indiandentalacademy.com 87
  88. 88. Mechanics For Class II Div II If buccal segment are not aligned  “T” sections  Twistoflex wire  Cable wire www.indiandentalacademy.com 88
  89. 89. Mechanics For Class II Div II 4. Consolidation of the maxillary incisors: www.indiandentalacademy.com 89
  90. 90. Mechanics For Class II Div II  Idealization and arches and finishing www.indiandentalacademy.com 90
  91. 91. Pentamorphic Arch Forms www.indiandentalacademy.com 91
  92. 92. Finishing and Retention www.indiandentalacademy.com 92
  93. 93. Finishing and Retention   “Begin with the end in mind”. Every orthodontist has a visual picture in his mind of the ideal occlusion into which the teeth should fit and mesh in the final finished occlusion. www.indiandentalacademy.com 93
  94. 94. Finishing and Retention    Bioprogressive proposes the concept overtreatment…. No clinician can position teeth as delicately as the functioning incline plane and cusp action can accomplish naturally when it is adequately set up to operate correctly. Allow natural function to guide the teeth into the best functioning occlusion for each individual www.indiandentalacademy.com 94
  95. 95. Finishing and Retention www.indiandentalacademy.com 95
  96. 96. Finishing and Retention  Two phases of retention: 1. Guiding changes during initial adjustments. 2. Supporting bony sutural and muscular accommodations to changing environment and considering long range influences. www.indiandentalacademy.com 96
  97. 97. Finishing and Retention  Initial stage of retention :  First six weeks following appliance removal  Retainers inserted-designed not to hold but to guide the teeth in settling. www.indiandentalacademy.com 97
  98. 98. Finishing and Retention Labial frame of typical upper retainer (Ricketts) passes between the lateral and cuspid and has a distal loop at each end to tuck in the distal of the expanded overtreated upper cuspid www.indiandentalacademy.com 98
  99. 99. Finishing and Retention Lower arch:  Fixed first bicuspid retainer is placed. -maintain cross arch bicuspid width. -lower cuspid freedom of adjustment against upper occlusion. -maintain lower incisor alignment and rotation correction.  www.indiandentalacademy.com 99
  100. 100. Finishing and Retention    Stabilizing stage of retention: First year following active treatment. Lower retainer is kept in place and upper is worn most of the time. www.indiandentalacademy.com 100
  101. 101. Thank you www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com 101

×