1
Bioprogressive Therapy
Part III
www.indiandentalacademy.com
INDIAN DENTAL ACADEMY
Leader in continuing dental education
...
2
Mechanics Sequence for
Class II Div II
www.indiandentalacademy.com
3
Mechanics For Class II Div II
 Three treatment
possibilities:
1. Distalizing the
upper arch.
2. Advancing the lower
arc...
4
Mechanics For Class II Div II
1. Advancement, torque control, and intrusion
of the upper incisors.
2. Intrusion of the l...
5
Mechanics For Class II Div II
 Quad helix or W
arch
www.indiandentalacademy.com
6
Mechanics For Class II Div II
1. Advancement, torque control, and intrusion
of the upper incisors.
X Principle of bite b...
7
Mechanics For Class II Div II
Directional control
www.indiandentalacademy.com
8
Mechanics For Class II Div II
 Amount of pressure:
 125-160 gms
 16 x 22
 Stabilization of the
molars:
Quad helix
TP...
9
Mechanics For Class II Div II
 Intrusion of lower incisors:
 16 x 16 utility arch.
 65-75 gms.
 This is followed by ...
10
Mechanics For Class II Div II
 Advancement
of the lower
denture:
1. Utility arch
with 4 helical
loops
www.indiandental...
11
Mechanics For Class II Div II
2. Using three
vertical loops:
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12
Mechanics For Class II Div II
3. Alignment of the buccal
segment:
a) Stabilizing section
www.indiandentalacademy.com
13
Mechanics For Class II Div II
If buccal segment
are not aligned
 ―T‖ sections
 Twistoflex wire
 Cable wire
www.india...
14
Mechanics For Class II Div II
4. Consolidation of
the maxillary
incisors:
www.indiandentalacademy.com
15
Mechanics For Class II Div II
 Idealization and
arches and finishing
www.indiandentalacademy.com
16
Pentamorphic Arch Forms
www.indiandentalacademy.com
17
Finishing and Retention
www.indiandentalacademy.com
18
Finishing and Retention
 ―Begin with the end in
mind‖.
 Every orthodontist has a
visual picture in his mind
of the id...
19
Finishing and Retention
 Bioprogressive proposes the concept
overtreatment….
 No clinician can position teeth as deli...
20
Finishing and Retention
www.indiandentalacademy.com
21
Finishing and Retention
 Two phases of retention:
1. Guiding changes during initial adjustments.
2. Supporting bony su...
22
Finishing and Retention
 Initial stage of retention :
 First six weeks following appliance removal
 Retainers insert...
23
Finishing and Retention
Labial frame of typical
upper retainer (Ricketts)
passes between the lateral
and cuspid and has...
24
Finishing and Retention
 Lower arch:
 Fixed first bicuspid retainer is placed.
-maintain cross arch bicuspid width.
-...
25
Finishing and Retention
 Stabilizing stage of retention:
 First year following active treatment.
 Lower retainer is ...
26
Bioprogressive Simplified
James J. Hilgers
Jco 1987-part 1-4
www.indiandentalacademy.com
27
 Translating orthodontic skills into a bona fide
delivery system is one of the most difficult tasks
faced by clinician...
28
Visual Treatment Objective
 Orthodontic movements are more significant
than growth changes
 The VTO leads the clinici...
29
 An accurate
measurement of arch
length deficiency—
combined with the
clinician's judgment of
dental and facial
change...
30
Occlusal Paralleling Instrument
 Arch length deficiency is
one of the most critical
aspects of diagnosis.
 One of the...
31
Diagnostic procedures
 Grades the patient as-
A- enthusiastic
B- average
C- resistant
 Patient assurance about headge...
32
Appliance design
 End-of-treatment goals should be
dynamic, not based on statistical norms.
 This kind of overcorrect...
33
Appliance design
1. Type and severity of the original
malocclusion.
2. General approach to mechanics.
3. Size of the fi...
34
Appliance design
 Linear Dynamic system designed by the
Ormco 1979.
 17-4 grade of stainless steel, which has more
th...
35
Appliance design
The key to a Class I buccal segment is the
proper positioning of the lower first molars
www.indiandent...
36
Linear Dynamic System
 Ideal orthodontic tooth position.
 Anticipated rebound and required
overcorrection.
 Applianc...
37
Linear Dynamic System
C.I L.I Canine 1st
pm
2nd
pm
1st
molar
2nd
molar
Max 22/5 14/8 7/10 -7/0 -7/0 -10/0 -10/0
Mand -1...
38
Basic principles
 Treatment of overbite before overjet.
 Sectional arch mechanics
 Progressive unlocking of malocclu...
39
Extraction Therapy
 Initiation
 Cuspid retraction and uprighting.
 Transition and final cuspid space
closure.
 Cons...
40
Extraction Therapy
 Initiation
 Lower arch-utility arch
- band 2nd molars.
 Upper arch - TPA
-headgear
-utility
-2nd...
41
Extraction Therapy
 Cuspid retraction and uprighting
 Angulation of the cuspid
- Mesially tipped-1/3 of the extractio...
42
Extraction Therapy
 Bicuspid and cuspid – initial overlay wire
followed by a simple helical loop.(0.16
NiTi)
 Remaini...
43
Extraction Therapy
 Upper arch
 Upper arch-depends on the position of the
incisors
a) Good position-16 x16 vertical c...
44
Extraction Therapy
 Traction and final cuspid space closure
 Cuspids have almost retracted and bite has
opened suffic...
45www.indiandentalacademy.com
46
Extraction Therapy
 Consolidation
 This is done achievement of good arch form.
 Lower retraction-1 or 2 month ahead....
47
Extraction Therapy
-if in good relation-16 square or 16 x 22
closing loop
-if additional torque is needed –retraction u...
48www.indiandentalacademy.com
49
Extraction Therapy
 Idealization
 Rigid edgewise coordinated arches (17x25
PAR).
 Light round wires.(0.14 or 0.16 Wa...
50
Non extraction therapy
 Initiation.
 Transition.
 Traction.
 Idealization.
www.indiandentalacademy.com
51
Synopsis Non Extraction Therapy
 Initiation –
 Orthopedic appliances.
 Base arches to set up the
anchorage.
 Overla...
52
Synopsis Non Extraction Therapy
 Transition
 After leveling and
aligning of the arches.
 Correct rotation and
spacin...
53
Synopsis Non Extraction Therapy
 Traction
 Lower arch set up –to
allow Class II elastics.
 Upper buccal segments
are...
54
Synopsis Non Extraction Therapy
 Idealization
 Final arches used to
achieve arch
coordination.
 Use of light round
w...
55www.indiandentalacademy.com
56www.indiandentalacademy.com
57www.indiandentalacademy.com
58www.indiandentalacademy.com
59www.indiandentalacademy.com
60www.indiandentalacademy.com
61www.indiandentalacademy.com
62www.indiandentalacademy.com
63www.indiandentalacademy.com
64
Thank you
For more details please visit
www.indiandentalacademy.com
www.indiandentalacademy.com
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Bioprogessive therapy 3 /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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Bioprogessive therapy 3 /certified fixed orthodontic courses by Indian dental academy

  1. 1. 1 Bioprogressive Therapy Part III www.indiandentalacademy.com INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com
  2. 2. 2 Mechanics Sequence for Class II Div II www.indiandentalacademy.com
  3. 3. 3 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
  4. 4. 4 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
  5. 5. 5 Mechanics For Class II Div II  Quad helix or W arch www.indiandentalacademy.com
  6. 6. 6 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
  7. 7. 7 Mechanics For Class II Div II Directional control www.indiandentalacademy.com
  8. 8. 8 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
  9. 9. 9 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
  10. 10. 10 Mechanics For Class II Div II  Advancement of the lower denture: 1. Utility arch with 4 helical loops www.indiandentalacademy.com
  11. 11. 11 Mechanics For Class II Div II 2. Using three vertical loops: www.indiandentalacademy.com
  12. 12. 12 Mechanics For Class II Div II 3. Alignment of the buccal segment: a) Stabilizing section www.indiandentalacademy.com
  13. 13. 13 Mechanics For Class II Div II If buccal segment are not aligned  ―T‖ sections  Twistoflex wire  Cable wire www.indiandentalacademy.com
  14. 14. 14 Mechanics For Class II Div II 4. Consolidation of the maxillary incisors: www.indiandentalacademy.com
  15. 15. 15 Mechanics For Class II Div II  Idealization and arches and finishing www.indiandentalacademy.com
  16. 16. 16 Pentamorphic Arch Forms www.indiandentalacademy.com
  17. 17. 17 Finishing and Retention www.indiandentalacademy.com
  18. 18. 18 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
  19. 19. 19 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
  20. 20. 20 Finishing and Retention www.indiandentalacademy.com
  21. 21. 21 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
  22. 22. 22 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
  23. 23. 23 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
  24. 24. 24 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
  25. 25. 25 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
  26. 26. 26 Bioprogressive Simplified James J. Hilgers Jco 1987-part 1-4 www.indiandentalacademy.com
  27. 27. 27  Translating orthodontic skills into a bona fide delivery system is one of the most difficult tasks faced by clinicians.  The best orthodontic managers are able to identify the necessary information and leave out the extraneous.  ―After studying many treatment disciplines, I chose the Bioprogressive approach because it was flexible‖. www.indiandentalacademy.com
  28. 28. 28 Visual Treatment Objective  Orthodontic movements are more significant than growth changes  The VTO leads the clinician toward a viable treatment plan by organizing factors The superimpositions that define the practical part of the mechanical procedures www.indiandentalacademy.com
  29. 29. 29  An accurate measurement of arch length deficiency— combined with the clinician's judgment of dental and facial changes required— is used in the simplified VTO to produce a reasonable treatment goal www.indiandentalacademy.com
  30. 30. 30 Occlusal Paralleling Instrument  Arch length deficiency is one of the most critical aspects of diagnosis.  One of the most accurate measuring devices is the mandibular occlusal x- ray www.indiandentalacademy.com
  31. 31. 31 Diagnostic procedures  Grades the patient as- A- enthusiastic B- average C- resistant  Patient assurance about headgear usage. www.indiandentalacademy.com
  32. 32. 32 Appliance design  End-of-treatment goals should be dynamic, not based on statistical norms.  This kind of overcorrected result can be called an ideal orthodontic occlusion— one that will settle after positioner treatment, retention, and normal physiologic rebound into an ideal occlusion and thereafter into a normal occlusion www.indiandentalacademy.com
  33. 33. 33 Appliance design 1. Type and severity of the original malocclusion. 2. General approach to mechanics. 3. Size of the final arches. 4. Timing of torque control 5. Bracket placement and design. www.indiandentalacademy.com
  34. 34. 34 Appliance design  Linear Dynamic system designed by the Ormco 1979.  17-4 grade of stainless steel, which has more than three times the yield strength of the standard 303 grade  30% smaller bracket that is stronger than its full-size counterpart.  20% size reduction in molar region. www.indiandentalacademy.com
  35. 35. 35 Appliance design The key to a Class I buccal segment is the proper positioning of the lower first molars www.indiandentalacademy.com
  36. 36. 36 Linear Dynamic System  Ideal orthodontic tooth position.  Anticipated rebound and required overcorrection.  Appliance design features that contribute to patient comfort, clinical simplicity, and optimum utility. www.indiandentalacademy.com
  37. 37. 37 Linear Dynamic System C.I L.I Canine 1st pm 2nd pm 1st molar 2nd molar Max 22/5 14/8 7/10 -7/0 -7/0 -10/0 -10/0 Mand -1/0 -1/0 7/5 -11/0 -17/0 -27/5 -27/5 www.indiandentalacademy.com
  38. 38. 38 Basic principles  Treatment of overbite before overjet.  Sectional arch mechanics  Progressive unlocking of malocclusion  Cortical and muscular anchorage  Torque control throughout treatment. www.indiandentalacademy.com
  39. 39. 39 Extraction Therapy  Initiation  Cuspid retraction and uprighting.  Transition and final cuspid space closure.  Consolidation.  Idealization www.indiandentalacademy.com
  40. 40. 40 Extraction Therapy  Initiation  Lower arch-utility arch - band 2nd molars.  Upper arch - TPA -headgear -utility -2nd molars www.indiandentalacademy.com
  41. 41. 41 Extraction Therapy  Cuspid retraction and uprighting  Angulation of the cuspid - Mesially tipped-1/3 of the extraction space www.indiandentalacademy.com
  42. 42. 42 Extraction Therapy  Bicuspid and cuspid – initial overlay wire followed by a simple helical loop.(0.16 NiTi)  Remaining 2/3 – rigid overlay wire.(0.16 Wallaby) www.indiandentalacademy.com
  43. 43. 43 Extraction Therapy  Upper arch  Upper arch-depends on the position of the incisors a) Good position-16 x16 vertical closing helical loop. b) Need to be engaged at the onset of the treatment-0.16 round overlay wire. www.indiandentalacademy.com
  44. 44. 44 Extraction Therapy  Traction and final cuspid space closure  Cuspids have almost retracted and bite has opened sufficiently-traction arches are placed.(17x 25 NiTi or TMA) 1. Allow final incisor alignment 2. Correct details of the arch form 3. Allow for final root paralleling ,torquing in cuspid and bicuspid region. www.indiandentalacademy.com
  45. 45. 45www.indiandentalacademy.com
  46. 46. 46 Extraction Therapy  Consolidation  This is done achievement of good arch form.  Lower retraction-1 or 2 month ahead. -16 square helical continuous closing arch.  Upper retraction- - if they are proclined with no torque requirement -016 round wire www.indiandentalacademy.com
  47. 47. 47 Extraction Therapy -if in good relation-16 square or 16 x 22 closing loop -if additional torque is needed –retraction utility is used. -if ant intrusion and post extrusion – combination crossed ―T‖ horizontal closing loop is used. www.indiandentalacademy.com
  48. 48. 48www.indiandentalacademy.com
  49. 49. 49 Extraction Therapy  Idealization  Rigid edgewise coordinated arches (17x25 PAR).  Light round wires.(0.14 or 0.16 Wallaby) X ―Start with round wires, finish with edgewise‖ www.indiandentalacademy.com
  50. 50. 50 Non extraction therapy  Initiation.  Transition.  Traction.  Idealization. www.indiandentalacademy.com
  51. 51. 51 Synopsis Non Extraction Therapy  Initiation –  Orthopedic appliances.  Base arches to set up the anchorage.  Overlay wires. www.indiandentalacademy.com
  52. 52. 52 Synopsis Non Extraction Therapy  Transition  After leveling and aligning of the arches.  Correct rotation and spacing  Resilient arches. www.indiandentalacademy.com
  53. 53. 53 Synopsis Non Extraction Therapy  Traction  Lower arch set up –to allow Class II elastics.  Upper buccal segments are leveled  Traction sections in upper arch www.indiandentalacademy.com
  54. 54. 54 Synopsis Non Extraction Therapy  Idealization  Final arches used to achieve arch coordination.  Use of light round wires. www.indiandentalacademy.com
  55. 55. 55www.indiandentalacademy.com
  56. 56. 56www.indiandentalacademy.com
  57. 57. 57www.indiandentalacademy.com
  58. 58. 58www.indiandentalacademy.com
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  60. 60. 60www.indiandentalacademy.com
  61. 61. 61www.indiandentalacademy.com
  62. 62. 62www.indiandentalacademy.com
  63. 63. 63www.indiandentalacademy.com
  64. 64. 64 Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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