Bioprogressive Therapy


Part III

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1
Mechanics Sequence for
Class II Div II

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2
Mechanics For Class II Div II
Three treatment
possibilities:
1. Distalizing the
upper arch.
2. Advancing the lower
arch.
3...
Mechanics For Class II Div II
1. Advancement, torque control, and intrusion of
the upper incisors.
2. Intrusion of the low...
Mechanics For Class II Div II


Quad helix or W
arch

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5
Mechanics For Class II Div II
1.

Advancement, torque control, and intrusion
of the upper incisors.

X Principle of bite b...
Mechanics For Class II Div II

Directional control
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7
Mechanics For Class II Div II
Amount of pressure:
 125-160 gms
 16 x 22
 Stabilization of the
molars:
Quad helix
TPA
St...
Mechanics For Class II Div II





Intrusion of lower incisors:
16 x 16 utility arch.
65-75 gms.
This is followed by c...
Mechanics For Class II Div II


1.

Advancement
of the lower
denture:
Utility arch with
4 helical loops

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Mechanics For Class II Div II
2.

Using three
vertical loops:

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11
Mechanics For Class II Div II
Alignment of the buccal
segment:
a) Stabilizing section
3.

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12
Mechanics For Class II Div II
If buccal segment
are not aligned


“T” sections



Twistoflex wire



Cable wire

www.in...
Mechanics For Class II Div II
4.

Consolidation of
the maxillary
incisors:

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14
Mechanics For Class II Div II


Idealization and
arches and finishing

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15
Pentamorphic Arch Forms
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16
Finishing and Retention

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17
Finishing and Retention




“Begin with the end in
mind”.
Every orthodontist has a
visual picture in his mind
of the ide...
Finishing and Retention






Bioprogressive proposes the concept
overtreatment….
No clinician can position teeth as de...
Finishing and Retention

www.indiandentalacademy.com

20
Finishing and Retention


Two phases of retention:

1.

Guiding changes during initial adjustments.

2.

Supporting bony ...
Finishing and Retention


Initial stage of retention :



First six weeks following appliance removal



Retainers inse...
Finishing and Retention
Labial frame of typical
upper retainer (Ricketts)
passes between the lateral
and cuspid and has a
...
Finishing and Retention
Lower arch:
 Fixed first bicuspid retainer is placed.
-maintain cross arch bicuspid width.
-lower...
Finishing and Retention





Stabilizing stage of retention:
First year following active treatment.
Lower retainer is k...
Bioprogressive Simplified
James J. Hilgers
Jco 1987-part 1-4

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26






Translating orthodontic skills into a bona fide
delivery system is one of the most difficult tasks
faced by clini...
Visual Treatment Objective




Orthodontic movements are more significant
than growth changes
The VTO leads the clinicia...


An accurate
measurement of arch
length deficiency—
combined with the
clinician's judgment of
dental and facial
changes ...
Occlusal Paralleling Instrument




Arch length deficiency is
one of the most critical
aspects of diagnosis.
One of the ...
Diagnostic procedures
Grades the patient asA- enthusiastic
B- average
C- resistant
 Patient assurance about headgear usag...
Appliance design




End-of-treatment goals should be dynamic,
not based on statistical norms.
This kind of overcorrecte...
Appliance design
1.

2.
3.
4.
5.

Type and severity of the original
malocclusion.
General approach to mechanics.
Size of t...
Appliance design








Linear Dynamic system designed by the
Ormco 1979.
17-4 grade of stainless steel, which has mo...
Appliance design

The key to a Class I buccal segment is the
proper positioning of the lower first molars
www.indiandental...
Linear Dynamic System





Ideal orthodontic tooth position.
Anticipated rebound and required
overcorrection.
Appliance...
Linear Dynamic System
C.I

Max
Man
d

L.I

Canin
e

22/5
-1/0

14/8 7/10
-1/0 7/5

1st
pm

2nd
pm

1st
2nd
molar molar

-7...
Basic principles






Treatment of overbite before overjet.
Sectional arch mechanics
Progressive unlocking of malocc...
Extraction Therapy







Initiation
Cuspid retraction and uprighting.
Transition and final cuspid space
closure.
Con...
Extraction Therapy





Initiation
Lower arch-utility arch
- band 2nd molars.
Upper arch - TPA
-headgear
-utility
-2nd ...
Extraction Therapy


-

Cuspid retraction and uprighting
Angulation of the cuspid
Mesially tipped-1/3 of the extraction ...
Extraction Therapy




Bicuspid and cuspid – initial overlay wire
followed by a simple helical loop.(0.16
NiTi)
Remainin...
Extraction Therapy



a)

b)

Upper arch
Upper arch-depends on the position of the
incisors
Good position-16 x16 vertica...
Extraction Therapy



1.
2.
3.

Traction and final cuspid space closure
Cuspids have almost retracted and bite has
opene...
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45
Extraction Therapy
Consolidation
 This is done achievement of good arch form.
 Lower retraction-1 or 2 month ahead.
-16 ...
Extraction Therapy
-if in good relation-16 square or 16 x 22

closing loop
-if additional torque is needed –retraction uti...
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48
Extraction Therapy
Idealization
 Rigid edgewise coordinated arches (17x25
PAR).
 Light round wires.(0.14 or 0.16 Wallaby...
Non extraction therapy





Initiation.
Transition.
Traction.
Idealization.

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50
Synopsis Non Extraction
Therapy






Initiation –
Orthopedic appliances.
Base arches to set up the
anchorage.
Overlay...
Synopsis Non Extraction
Therapy







Transition
After leveling and
aligning of the arches.
Correct rotation and
spac...
Synopsis Non Extraction
Therapy







Traction
Lower arch set up –to
allow Class II elastics.
Upper buccal segments
a...
Synopsis Non Extraction
Therapy





Idealization
Final arches used to
achieve arch
coordination.
Use of light round wi...
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55
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56
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57
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58
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59
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60
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61
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62
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63
Thank
you

www.indiandentalacademy.com
Leader in continuing dental education

www.indiandentalacademy.com

64
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Bioprogressive therapy /certified fixed orthodontic courses by Indian dental academy

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Transcript of "Bioprogressive therapy /certified fixed orthodontic courses by Indian dental academy "

  1. 1. Bioprogressive Therapy  Part III www.indiandentalacademy.com 1
  2. 2. Mechanics Sequence for Class II Div II www.indiandentalacademy.com 2
  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 3
  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 4
  5. 5. Mechanics For Class II Div II  Quad helix or W arch www.indiandentalacademy.com 5
  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 6
  7. 7. Mechanics For Class II Div II Directional control www.indiandentalacademy.com 7
  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 8
  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 9
  10. 10. Mechanics For Class II Div II  1. Advancement of the lower denture: Utility arch with 4 helical loops www.indiandentalacademy.com 10
  11. 11. Mechanics For Class II Div II 2. Using three vertical loops: www.indiandentalacademy.com 11
  12. 12. Mechanics For Class II Div II Alignment of the buccal segment: a) Stabilizing section 3. www.indiandentalacademy.com 12
  13. 13. Mechanics For Class II Div II If buccal segment are not aligned  “T” sections  Twistoflex wire  Cable wire www.indiandentalacademy.com 13
  14. 14. Mechanics For Class II Div II 4. Consolidation of the maxillary incisors: www.indiandentalacademy.com 14
  15. 15. Mechanics For Class II Div II  Idealization and arches and finishing www.indiandentalacademy.com 15
  16. 16. Pentamorphic Arch Forms www.indiandentalacademy.com 16
  17. 17. Finishing and Retention www.indiandentalacademy.com 17
  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 18
  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 19
  20. 20. Finishing and Retention www.indiandentalacademy.com 20
  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 21
  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 22
  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 23
  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 24
  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 25
  26. 26. Bioprogressive Simplified James J. Hilgers Jco 1987-part 1-4 www.indiandentalacademy.com 26
  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 27
  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 28
  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 29
  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 xray www.indiandentalacademy.com 30
  31. 31. Diagnostic procedures Grades the patient asA- enthusiastic B- average C- resistant  Patient assurance about headgear usage.  www.indiandentalacademy.com 31
  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 32
  33. 33. Appliance design 1. 2. 3. 4. 5. Type and severity of the original malocclusion. General approach to mechanics. Size of the final arches. Timing of torque control Bracket placement and design. www.indiandentalacademy.com 33
  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 34
  35. 35. Appliance design The key to a Class I buccal segment is the proper positioning of the lower first molars www.indiandentalacademy.com 35
  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 36
  37. 37. Linear Dynamic System C.I Max Man d L.I Canin e 22/5 -1/0 14/8 7/10 -1/0 7/5 1st pm 2nd pm 1st 2nd molar molar -7/0 -7/0 -10/0 -10/0 -11/0 -17/0 -27/5 -27/5 www.indiandentalacademy.com 37
  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 38
  39. 39. Extraction Therapy      Initiation Cuspid retraction and uprighting. Transition and final cuspid space closure. Consolidation. Idealization www.indiandentalacademy.com 39
  40. 40. Extraction Therapy    Initiation Lower arch-utility arch - band 2nd molars. Upper arch - TPA -headgear -utility -2nd molars www.indiandentalacademy.com 40
  41. 41. Extraction Therapy   - Cuspid retraction and uprighting Angulation of the cuspid Mesially tipped-1/3 of the extraction space www.indiandentalacademy.com 41
  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 42
  43. 43. Extraction Therapy   a) b) Upper arch Upper arch-depends on the position of the incisors Good position-16 x16 vertical closing helical loop. Need to be engaged at the onset of the treatment-0.16 round overlay wire. www.indiandentalacademy.com 43
  44. 44. Extraction Therapy   1. 2. 3. Traction and final cuspid space closure Cuspids have almost retracted and bite has opened sufficiently-traction arches are placed.(17x 25 NiTi or TMA) Allow final incisor alignment Correct details of the arch form Allow for final root paralleling ,torquing in cuspid and bicuspid region. www.indiandentalacademy.com 44
  45. 45. www.indiandentalacademy.com 45
  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 46
  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 47
  48. 48. www.indiandentalacademy.com 48
  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 49
  50. 50. Non extraction therapy     Initiation. Transition. Traction. Idealization. www.indiandentalacademy.com 50
  51. 51. Synopsis Non Extraction Therapy     Initiation – Orthopedic appliances. Base arches to set up the anchorage. Overlay wires. www.indiandentalacademy.com 51
  52. 52. Synopsis Non Extraction Therapy     Transition After leveling and aligning of the arches. Correct rotation and spacing Resilient arches. www.indiandentalacademy.com 52
  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 53
  54. 54. Synopsis Non Extraction Therapy    Idealization Final arches used to achieve arch coordination. Use of light round wires. www.indiandentalacademy.com 54
  55. 55. www.indiandentalacademy.com 55
  56. 56. www.indiandentalacademy.com 56
  57. 57. www.indiandentalacademy.com 57
  58. 58. www.indiandentalacademy.com 58
  59. 59. www.indiandentalacademy.com 59
  60. 60. www.indiandentalacademy.com 60
  61. 61. www.indiandentalacademy.com 61
  62. 62. www.indiandentalacademy.com 62
  63. 63. www.indiandentalacademy.com 63
  64. 64. Thank you www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com 64

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