1
Bioprogressive Therapy
Part II
www.indiandentalacademy.com
INDIAN DENTAL ACADEMY
Leader in continuing dental education
w...
2
 Utility arch.
 Mixed dentition treatment
 Brackets & Prescriptions
 Class II div I
 Class II div II
 Mechanics fo...
3
Roles and functions of
the lower utility arch
 Position of the lower molar to allow for
Cortical Anchorage
 Manipulati...
4
Fabrication of the utility arch
www.indiandentalacademy.com
5
Physiologic Vs Mechanical
Response
 Tip back applied to lower
molar-30° to 40 °.
 No toe-in in non
extraction utility....
6
Physiologic Vs Mechanical
Response
 30° to 45° buccal
root torque applied
to the lower molar
www.indiandentalacademy.com
7
Physiologic Vs Mechanical
Response
www.indiandentalacademy.com
8
Physiologic Vs Mechanical
Response
 Long lever arm
applied to lower
incisors.
 75 gms of intrusive
force.(0.16 x 0.16)...
9
Modifications of the Utility Arch
 Expansion utility
arch
 Force :
1mm= 85 gm
2mm=140 gm
3mm=205 gm
www.indiandentalac...
10
Modifications of the Utility Arch
 Contraction utility arch
 Force:
1mm=50 gm
2mm =150 gm
3mm=230 gm
www.indiandental...
11
Modifications of the Utility Arch
 Utility arch with T or
L Horizontal loop
www.indiandentalacademy.com
12
Modifications of the Utility Arch
 Contraction or
advancing utility
arch
www.indiandentalacademy.com
13
Treatment in the Mixed
Dentition Phase
www.indiandentalacademy.com
14
Bioprogressive Mixed
Dentition Treatment
 Four basic objectives-
1. Resolve functional problems.
2. Resolve arch lengt...
15
Resolve functional problems
 Anything that disturbs the growth, health and
function of the TMJ complex.
 In 1950’s Ri...
16
Resolve functional problems
 Lack of rough surface , excessive thickening
www.indiandentalacademy.com
17
Resolve functional problems
 Submento-vertex
analysis
- Individual condylar
inclinations and
width.
www.indiandentalac...
18
Resolve functional problems
 Nine general categories-
1. Cross mouth interferences.
2. Anterior crossbite.
3. Open bit...
19
Resolve functional problems
6. Loss of posterior support.
7. Habits.
8. Breathing and airway problems.
9. True Class II...
20
Resolve Arch
Length Discrepancy
 This is accomplished
by three ways-
1. Lateral expansion of
the molars.
- Depends on ...
21
Resolve Arch
Length Discrepancy
 Expansion primarily by
change in axial inclination :
- Rickett’s quad helix
- .040 bl...
22
Resolve Arch
Length Discrepancy
 With 1cm expansion in the upper molars –
anterior segment are expanded 3cm overall.
...
23
Resolve Arch
Length Discrepancy
Arch length gained is result slow natural
expansive response created by muscles
www.ind...
24
Resolve Arch
Length Discrepancy
Modifications of the Quad Helix
www.indiandentalacademy.com
25
Resolve Arch
Length Discrepancy
 Expansion by mid palatal dysfunction:
- Hass type or modified Nance type expansion
ap...
26
Resolve Arch
Length Discrepancy
2. Advancement or forward movement of the
lower molars:
- If the VTO and physiologic fa...
27
Resolve Arch
Length Discrepancy
3. Uprighting and /or distal movement of the
lower molars:
- Accomplished by utility ar...
28
Correct Vertical/Overjet
Problems
 This is done after functional and arch length
corrections are achieved.
 Includes ...
29
Correct Vertical/Overjet
Problems
1. Orthopedic problems-
- In case where good alignment of lower arch exists and Class...
30
Correct Vertical/Overjet
Problems
3. Orthopedic problems with minor incisor
interferences.
- Upper utility arch with he...
31
Development of the
Bioprogressive Brackets
www.indiandentalacademy.com
32
Brackets
 Siamese twin bracket
on all the teeth.
 Slot size-.022 changed
to .018
www.indiandentalacademy.com
33
Brackets
 Slot size-.0185 x .030
1. Use of two light arches
2. Permits a champer or bevel.
3. Allows for a lever acces...
34
Development of Brackets
1. Rickett’s Standard Bioprogressive.
2. Rickett’s Full Torque Bioprogressive.
3. Triple Contro...
35
Development of Brackets
1. Rickett’s Standard
Bioprogressive.
 These were the first set of
brackets which available.
(...
36
Development of Brackets
 Trend of building in treatment in the
appliance. (angulations)
 The original design had 5° f...
37
Development of Brackets
www.indiandentalacademy.com
38
Development of Brackets
2. Rickett’s Full Torque Bioprogressive.
 Torque was build in the lower molars and
pre molars....
39
Development of Brackets
www.indiandentalacademy.com
40
Development of Brackets
3. Triple control Bioprogressive.
 Raised bases
 Triple tube for upper molars
 Breakaway con...
41
Development of Brackets
www.indiandentalacademy.com
42
Development of Brackets
www.indiandentalacademy.com
43
Mechanics Sequence for
Extraction Treatment
www.indiandentalacademy.com
44
Extraction Mechanics
 Four general procedures :
1 Stabilization of upper and lower molar
anchorage.
2 Retraction and u...
45
Extraction Mechanics
1. Stabilization of upper
and lower molar
anchorage:
a) Maximum upper
molar anchorage.
 Nance arc...
46
Extraction Mechanics
b) Moderate upper molar
anchorage:
 Palatal bar.
 Quad helix.
 Upper utility arch.
www.indiande...
47
c) Minimum upper
molar anchorage:
 Vertical closing loop.
 Double delta loop.
www.indiandentalacademy.com
48
Extraction Mechanics
 Maximum lower molar
anchorage:
 Lower utility arch-four
mechanical
adjustments.
www.indiandenta...
49
Extraction Mechanics
 Moderate lower molar
anchorage:
 Lower utility with
adjustments.
www.indiandentalacademy.com
50
Extraction Mechanics
 Minimum lower molar
anchorage:
 Eliminate the four
mechanical factors.
 Round wires may be
use...
51
Extraction Mechanics
2. Retraction and uprighting of cuspids with
sectional arch mechanics.
 Cuspids need to be kept i...
52
Extraction Mechanics
www.indiandentalacademy.com
53
Extraction Mechanics
 Intrusion
www.indiandentalacademy.com
54
Extraction Mechanics
 Root uprighting
www.indiandentalacademy.com
55
Extraction Mechanics
 Rotation
www.indiandentalacademy.com
56
Extraction Mechanics
3. Retraction and consolidation of upper and
lower incisors.
Lower incisors:
 Very light continuo...
57
Extraction Mechanics
www.indiandentalacademy.com
58
Extraction Mechanics
 Upper Incisors:
 Regular contraction
utility.
 Upside down vertical
closing loop.
 Double del...
59
Extraction Mechanics
www.indiandentalacademy.com
60
Extraction Mechanics
www.indiandentalacademy.com
61
Mechanics Sequence for
Class II Div I
www.indiandentalacademy.com
62
Mechanics For Class II Div I
 Sequence:
 Lower Incisor intrusion.
 Lower Cuspid intrusion.
 Alignment of the lower ...
63
Mechanics For Class II Div I
 Upper arch –orthopedic reduction of the
maxilla.
 Lower arch-treatment starts with leve...
64
Mechanics For Class II Div I
www.indiandentalacademy.com
65
Mechanics For Class II Div I
 Lower stabilizing utility arch-after initial
purpose of the utility arch is accomplished...
66
Mechanics For Class II Div I
www.indiandentalacademy.com
67
Mechanics For Class II Div I
 Alignment of the lower
buccal segment starts:
 .015 or .0175
Twistoflex
 .012,.014 of ...
68
Mechanics For Class II Div I
 Upper arch
alignment:
 Incisors are not
included.
 Upper molars starts
Distalizing-ope...
69
Mechanics For Class II Div I
a) Consolidation section
b) Stabilizing section
www.indiandentalacademy.com
70
Mechanics For Class II Div I
 Segmental correction with Class II elastics:
 Three detrimental effects:
1. Skidding ef...
71
Mechanics For Class II Div I
 Tractions Sections-
 Gable bend distal to
canine.
 Rotation bend in the
anterior porti...
72
Mechanics For Class II Div I
 Functions –
1. Counteract downward backward
pull
2. Stabilizing function in the upper
bu...
73
Mechanics For Class II Div I
 Upper incisors alignment
and Intrusion
 Upper incisors are
aligned before placement
wit...
74
Mechanics For Class II Div I
 Consolidation of Upper
Incisors
 Retraction of the upper
incisors .
 Over treatment -2...
75
Mechanics For Class II Div I
 Idealization of
arches and finishing.
 16 or 17 square,16 x
22 or 17 x 25 nitinol.
 Cl...
76
Mechanics Sequence for
Class II Div II
www.indiandentalacademy.com
77
Mechanics For Class II Div II
 Three treatment
possibilities:
1. Distalizing the
upper arch.
2. Advancing the lower
ar...
78
Mechanics For Class II Div II
1. Advancement, torque control, and intrusion of
the upper incisors.
2. Intrusion of the ...
79
Mechanics For Class II Div II
 Quad helix or W
arch
www.indiandentalacademy.com
80
Mechanics For Class II Div II
1. Advancement, torque control, and intrusion
of the upper incisors.
X Principle of bite ...
81
Mechanics For Class II Div II
Directional control
www.indiandentalacademy.com
82
Mechanics For Class II Div II
 Amount of pressure:
 125-160 gms
 16 x 22
 Stabilization of the
molars:
Quad helix
T...
83
Mechanics For Class II Div II
 Intrusion of lower incisors:
 16 x 16 utility arch.
 65-75 gms.
 This is followed by...
84
Mechanics For Class II Div II
 Advancement
of the lower
denture:
1. Utility arch with
4 helical loops
www.indiandental...
85
Mechanics For Class II Div II
2. Using three
vertical loops:
www.indiandentalacademy.com
86
Mechanics For Class II Div II
3. Alignment of the buccal
segment:
a) Stabilizing section
www.indiandentalacademy.com
87
Mechanics For Class II Div II
If buccal segment
are not aligned
 “T” sections
 Twistoflex wire
 Cable wire
www.india...
88
Mechanics For Class II Div II
4. Consolidation of
the maxillary
incisors:
www.indiandentalacademy.com
89
Mechanics For Class II Div II
 Idealization and
arches and finishing
www.indiandentalacademy.com
90
Pentamorphic Arch Forms
www.indiandentalacademy.com
91
Finishing and Retention
www.indiandentalacademy.com
92
Finishing and Retention
 “Begin with the end in
mind”.
 Every orthodontist has a
visual picture in his mind
of the id...
93
Finishing and Retention
 Bioprogressive proposes the concept
overtreatment….
 No clinician can position teeth as deli...
94
Finishing and Retention
www.indiandentalacademy.com
95
Finishing and Retention
 Two phases of retention:
1. Guiding changes during initial adjustments.
2. Supporting bony su...
96
Finishing and Retention
 Initial stage of retention :
 First six weeks following appliance removal
 Retainers insert...
97
Finishing and Retention
Labial frame of typical
upper retainer (Ricketts)
passes between the lateral
and cuspid and has...
98
Finishing and Retention
 Lower arch:
 Fixed first bicuspid retainer is placed.
-maintain cross arch bicuspid width.
-...
99
Finishing and Retention
 Stabilizing stage of retention:
 First year following active treatment.
 Lower retainer is ...
www.indiandentalacademy.com 100
Thank you
For more details please visit
www.indiandentalacademy.com
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Bpt part ii /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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Bpt part ii /certified fixed orthodontic courses by Indian dental academy

  1. 1. 1 Bioprogressive Therapy Part II www.indiandentalacademy.com INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com
  2. 2. 2  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. 3. 3 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. 4. 4 Fabrication of the utility arch www.indiandentalacademy.com
  5. 5. 5 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. 6. 6 Physiologic Vs Mechanical Response  30° to 45° buccal root torque applied to the lower molar www.indiandentalacademy.com
  7. 7. 7 Physiologic Vs Mechanical Response www.indiandentalacademy.com
  8. 8. 8 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. 9. 9 Modifications of the Utility Arch  Expansion utility arch  Force : 1mm= 85 gm 2mm=140 gm 3mm=205 gm www.indiandentalacademy.com
  10. 10. 10 Modifications of the Utility Arch  Contraction utility arch  Force: 1mm=50 gm 2mm =150 gm 3mm=230 gm www.indiandentalacademy.com
  11. 11. 11 Modifications of the Utility Arch  Utility arch with T or L Horizontal loop www.indiandentalacademy.com
  12. 12. 12 Modifications of the Utility Arch  Contraction or advancing utility arch www.indiandentalacademy.com
  13. 13. 13 Treatment in the Mixed Dentition Phase www.indiandentalacademy.com
  14. 14. 14 Bioprogressive Mixed Dentition Treatment  Four basic objectives- 1. Resolve functional problems. 2. Resolve arch length discrepancy. 3. Correct vertical problems. 4. Correct overjet problems. www.indiandentalacademy.com
  15. 15. 15 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. 16. 16 Resolve functional problems  Lack of rough surface , excessive thickening www.indiandentalacademy.com
  17. 17. 17 Resolve functional problems  Submento-vertex analysis - Individual condylar inclinations and width. www.indiandentalacademy.com
  18. 18. 18 Resolve functional problems  Nine general categories- 1. Cross mouth interferences. 2. Anterior crossbite. 3. Open bite. 4. Excessive range of function. 5. Distal displacement. www.indiandentalacademy.com
  19. 19. 19 Resolve functional problems 6. Loss of posterior support. 7. Habits. 8. Breathing and airway problems. 9. True Class III Growth pattern. www.indiandentalacademy.com
  20. 20. 20 Resolve Arch Length Discrepancy  This is accomplished by three ways- 1. Lateral expansion of the molars. - Depends on the inclination of the posterior teeth. www.indiandentalacademy.com
  21. 21. 21 Resolve Arch Length Discrepancy  Expansion primarily by change in axial inclination : - Rickett’s quad helix - .040 blue elgiloy wire. www.indiandentalacademy.com
  22. 22. 22 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. 23. 23 Resolve Arch Length Discrepancy Arch length gained is result slow natural expansive response created by muscles www.indiandentalacademy.com
  24. 24. 24 Resolve Arch Length Discrepancy Modifications of the Quad Helix www.indiandentalacademy.com
  25. 25. 25 Resolve Arch Length Discrepancy  Expansion by mid palatal dysfunction: - Hass type or modified Nance type expansion appliance. www.indiandentalacademy.com
  26. 26. 26 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. 27. 27 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. 28. 28 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. 29. 29 Correct Vertical/Overjet Problems 1. Orthopedic problems- - In case where good alignment of lower arch exists and Class II is on account of Max.protrusion. 2. Orthopedic problems with lower arch therapy- - with maxillary protrusion but incisors and molars in deep bite or need advancement. www.indiandentalacademy.com
  30. 30. 30 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. 31. 31 Development of the Bioprogressive Brackets www.indiandentalacademy.com
  32. 32. 32 Brackets  Siamese twin bracket on all the teeth.  Slot size-.022 changed to .018 www.indiandentalacademy.com
  33. 33. 33 Brackets  Slot size-.0185 x .030 1. Use of two light arches 2. Permits a champer or bevel. 3. Allows for a lever access. 4. Adequate distance for the torque grooves. www.indiandentalacademy.com
  34. 34. 34 Development of Brackets 1. Rickett’s Standard Bioprogressive. 2. Rickett’s Full Torque Bioprogressive. 3. Triple Control Bioprogressive. www.indiandentalacademy.com
  35. 35. 35 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. 36. 36 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. 37. 37 Development of Brackets www.indiandentalacademy.com
  38. 38. 38 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. 39. 39 Development of Brackets www.indiandentalacademy.com
  40. 40. 40 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. 41. 41 Development of Brackets www.indiandentalacademy.com
  42. 42. 42 Development of Brackets www.indiandentalacademy.com
  43. 43. 43 Mechanics Sequence for Extraction Treatment www.indiandentalacademy.com
  44. 44. 44 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. 45. 45 Extraction Mechanics 1. Stabilization of upper and lower molar anchorage: a) Maximum upper molar anchorage.  Nance arch with modifications.  Headgear . www.indiandentalacademy.com
  46. 46. 46 Extraction Mechanics b) Moderate upper molar anchorage:  Palatal bar.  Quad helix.  Upper utility arch. www.indiandentalacademy.com
  47. 47. 47 c) Minimum upper molar anchorage:  Vertical closing loop.  Double delta loop. www.indiandentalacademy.com
  48. 48. 48 Extraction Mechanics  Maximum lower molar anchorage:  Lower utility arch-four mechanical adjustments. www.indiandentalacademy.com
  49. 49. 49 Extraction Mechanics  Moderate lower molar anchorage:  Lower utility with adjustments. www.indiandentalacademy.com
  50. 50. 50 Extraction Mechanics  Minimum lower molar anchorage:  Eliminate the four mechanical factors.  Round wires may be used. www.indiandentalacademy.com
  51. 51. 51 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. 52. 52 Extraction Mechanics www.indiandentalacademy.com
  53. 53. 53 Extraction Mechanics  Intrusion www.indiandentalacademy.com
  54. 54. 54 Extraction Mechanics  Root uprighting www.indiandentalacademy.com
  55. 55. 55 Extraction Mechanics  Rotation www.indiandentalacademy.com
  56. 56. 56 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. 57. 57 Extraction Mechanics www.indiandentalacademy.com
  58. 58. 58 Extraction Mechanics  Upper Incisors:  Regular contraction utility.  Upside down vertical closing loop.  Double delta loop. www.indiandentalacademy.com
  59. 59. 59 Extraction Mechanics www.indiandentalacademy.com
  60. 60. 60 Extraction Mechanics www.indiandentalacademy.com
  61. 61. 61 Mechanics Sequence for Class II Div I www.indiandentalacademy.com
  62. 62. 62 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. 63. 63 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. 64. 64 Mechanics For Class II Div I www.indiandentalacademy.com
  65. 65. 65 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. 66. 66 Mechanics For Class II Div I www.indiandentalacademy.com
  67. 67. 67 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. 68. 68 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. 69. 69 Mechanics For Class II Div I a) Consolidation section b) Stabilizing section www.indiandentalacademy.com
  70. 70. 70 Mechanics For Class II Div I  Segmental correction with Class II elastics:  Three detrimental effects: 1. Skidding effect. 2. Tendency for a deep bite. 3. Difficult to overcorrect buccal segment. www.indiandentalacademy.com
  71. 71. 71 Mechanics For Class II Div I  Tractions Sections-  Gable bend distal to canine.  Rotation bend in the anterior portion.  Molar bayonet bend www.indiandentalacademy.com
  72. 72. 72 Mechanics For Class II Div I  Functions – 1. Counteract downward backward pull 2. Stabilizing function in the upper buccal segment. www.indiandentalacademy.com
  73. 73. 73 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. 74. 74 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. 75. 75 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. 76. 76 Mechanics Sequence for Class II Div II www.indiandentalacademy.com
  77. 77. 77 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. 78. 78 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. 79. 79 Mechanics For Class II Div II  Quad helix or W arch www.indiandentalacademy.com
  80. 80. 80 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. 81. 81 Mechanics For Class II Div II Directional control www.indiandentalacademy.com
  82. 82. 82 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. 83. 83 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. 84. 84 Mechanics For Class II Div II  Advancement of the lower denture: 1. Utility arch with 4 helical loops www.indiandentalacademy.com
  85. 85. 85 Mechanics For Class II Div II 2. Using three vertical loops: www.indiandentalacademy.com
  86. 86. 86 Mechanics For Class II Div II 3. Alignment of the buccal segment: a) Stabilizing section www.indiandentalacademy.com
  87. 87. 87 Mechanics For Class II Div II If buccal segment are not aligned  “T” sections  Twistoflex wire  Cable wire www.indiandentalacademy.com
  88. 88. 88 Mechanics For Class II Div II 4. Consolidation of the maxillary incisors: www.indiandentalacademy.com
  89. 89. 89 Mechanics For Class II Div II  Idealization and arches and finishing www.indiandentalacademy.com
  90. 90. 90 Pentamorphic Arch Forms www.indiandentalacademy.com
  91. 91. 91 Finishing and Retention www.indiandentalacademy.com
  92. 92. 92 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. 93. 93 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. 94. 94 Finishing and Retention www.indiandentalacademy.com
  95. 95. 95 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. 96. 96 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. 97. 97 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. 98. 98 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. 99. 99 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. 100. www.indiandentalacademy.com 100 Thank you For more details please visit www.indiandentalacademy.com

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