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Intrusion arches /certified fixed orthodontic courses by Indian dental academy
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Intrusion arches /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
00919248678078

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Intrusion arches /certified fixed orthodontic courses by Indian dental academy Intrusion arches /certified fixed orthodontic courses by Indian dental academy Presentation Transcript

  • •www.indiandentalacademy.com
  • INDIAN DENTAL ACADEMY • Leader in continuing dental education • www.indiandentalacademy.com •www.indiandentalacademy.com
  •  Bite opening can mainly be done by• Absolute intrusion • Relative intrusion • Extrusion of posterior teeth/distal tipping • Proclination of incisors • Combination •www.indiandentalacademy.com
  •  Tooth movements of bite opening• 1.Absolute intrusion of incisors-(after growth over) – Required when hyperdivergent growth pattern •www.indiandentalacademy.com
  • –In Adult patients-molar extrusion is not compensated by vertical ramal growth. •www.indiandentalacademy.com
  • 2.Relative intrusion of incisors- Inc kept where they are, mandible grows and posterior teeth erupt. • Eruption of posterior teeth is a normal molar vertical change in a growing individual-therefore stable •www.indiandentalacademy.com
  • • Increase in vertical face height-accommodates if any orthodontic extrusion occurs –leveling the Curve of Spee , intermaxillary elastics •www.indiandentalacademy.com
  • 3-a Extrusion of posterior teeth-not compensated in adults• Low mandibular plane angle-not stable-musculature resists extrusion • High angle cases-weaker musculature-teeth may remain stable-opening of the mandibular planeundesirable •www.indiandentalacademy.com
  • 3-b Distal tipping of posterior teeth-similar to the previous situation – wedging effect •www.indiandentalacademy.com
  • 4.Proclination of incisors-in case of retroclined incisorscorrects deep bite. •www.indiandentalacademy.com
  •  Combination of the aboveAnterior-Bite plate effect• Proclination • Incisor intrusion • Posterior extrusion •www.indiandentalacademy.com
  • The importance of 2nd molarsEarly banding esp. in low angle and deep bite cases. Inclusion of 2nd molars-lever for extrusion of premolars and assists molar intrusion. •www.indiandentalacademy.com
  •  Burstone’s Basic principles for intrusionLight , constant force – else resorption,here optimal forces on PDL & continuous movt with no reactivation Single point of force application – statically determinate system vs wire in brackets. Sequential intrusion-first most extruded tooth , centrals foll by laterals Good anchorage control Analysis of forces and moments in each biomechanical situation •www.indiandentalacademy.com
  • Mechanism of action •www.indiandentalacademy.com
  • Cetlin’s Intrusion arch •www.indiandentalacademy.com
  • Cetlin’ s Intrusion arch Normally inclined incisorsRectangular sectional on incisors www.indiandentalacademy.com
  • Intrusion arch tied to sectional wire-b/w central and lateral Light(2 oz) force-counter labial tipping www.indiandentalacademy.com
  • Labially inclined-PFA moved distally Rectangular-0.018x 0.025 inch/0.021 x 0.025 Wire extended distally-2 helices bent-Rt. angles to intrusion arch www.indiandentalacademy.com
  • Helices=point of force application-slightly in front of Cres. Light elastic force www.indiandentalacademy.com
  • Lingually inclined-PFA moved front Rigid rectangular -0.018 x 0.025/0.021 x 0.025sectional on centrals www.indiandentalacademy.com
  • Wire bent forward and upward-hooks bent Inserted into intrusion arch Light elastic force www.indiandentalacademy.com
  • 30 mm www.indiandentalacademy.com
  • Mulligan’ s appliance Mulligan’s 2 x 4 appliance –can be used in the Begg/Edgewise set upUpper molars do not require tipping-helix bent into arch wire2-3mm mesial Anchor bend ,continuation of the helix No cuspid circles required ‘Rowing effect’-strong www.indiandentalacademy.com moments at molars- retract incisors
  • Utility arches •www.indiandentalacademy.com
  • Utility arches- one of the most versatile auxiliary arch wiresOriginally developed to counteract the tipping occuring in the buccal segments in ext cases by utilizing the so-called immutable lower anteriors as anchor unit-to hold molar and 2nd PM upright during retraction. Noted that buccal segments not only held upright , also lower inc were intruded with the light,continuous pressure. ‘Step down base arch’ / ‘Ricketts lower utility arch’ to level the curve of Spee in lower arch by Ricketts www.indiandentalacademy.com
  • Basic components of utility arches- Wire material- -blue elgiloy - in .018 slot .016 x .022- slot (maxilla) & .016 x .016mandibular - in .022 slot-.019 x .019 www.indiandentalacademy.com Continuous rectangular steel wire-bypass mechanics
  • Functions Position lower molar to allow for cortical anchorage Manipulation & alignment of lower inc segment from the lower molars – align/extrude/intrude/advance/retract without disturbing/depending on canines/PM. Stabilization of L arch-allos segmental treatment of buccal segments-intrude lower segment without inv canines,then include canines at later stage.separate leveling and rotation correction of buccal segments possible. www.indiandentalacademy.com
  • Physiological roles of the lower arch – when incisal contact lost,Mn reached forward to search out proprioceptive input – activator/reaching effect –beneficial muscular response for treating Cl II MO. Overtreatment – avoids tying overbite control to overjet control. Role in Mixed dentition-allows inc alignment & molar control by stepping around deci buccal occlusion. Arch length control-Uprighting lower molar – 2mm space on each side -Advancement of lower incisors – 2mm space gain for every 1mm of proclination -Expansion in buccal segment teeth – canines – 1mm exp=1mm arch length gain PM/ deci molars-1mm exp=1/2 mm gain molars – 1mm exp=1/3mm gain. www.indiandentalacademy.com
  • Basic mechanism of action www.indiandentalacademy.com
  • •Passive utility arch www.indiandentalacademy.com
  • Through the incorporation of loops –performs more functions than intrusion. 1. Expansion 2. Contraction 3. Protrusion 4. Retrusion 5. Intrusion www.indiandentalacademy.com
  • Intrusion utilityStepped gingivally at the molars 5mm space between anterior border of auxiliary tube and post. vertical segment. www.indiandentalacademy.com
  • Activation-2 ways Bench (1988) –tip back bend in molar – wire sinced after pulling 2-3 mm posteriors from the distal end of the molar tube. Posterior tipping of molars seen www.indiandentalacademy.com
  • Gable bend directed occlusally- another method of activation -unwanted posterior tipping avoided www.indiandentalacademy.com
  • Intrusion utility arch – With-Retrusion utility Protrusion utility www.indiandentalacademy.com
  • www.indiandentalacademy.com
  • www.indiandentalacademy.com
  • Three piece intrusion (base) arch Bhavna Shroff, Won M. Yoon Steven J. Lindauer Charles J. Burstone Angle Orthodontist 1997 No. 6, 455 - 461: Simultaneous intrusion and retraction using a three-piece base arch www.indiandentalacademy.com
  • Continuous arch wire In a case with flared incisors-continuous arch wireworsens the axial inclinations of anterior teeth. www.indiandentalacademy.com
  • Advantages over continuous intrusion arch:Prevent further proclination of already proclined incisors Simultaneous correction of deep bite correction and space closure in patients with flared incisors. Allows for redirecting the force parallel to L A of incisor -Intrusive force and its direction-effectively controlled. Allows variation of force from one side to another – if required Simultaneous control in vertical & anteroposterior planes Low load deflection rate- constant force Predictable, reproducible,& Statically determinate force system www.indiandentalacademy.com
  • Solution- Segmented mechanics 1st solution-distal extensions www.indiandentalacademy.com
  • 2nd solution – Three-piece intrusion base arch www.indiandentalacademy.com
  • Design The intrusion archRigid wire - .018 x .025 or .021 x .25 SS wire extending distally to the lateral incisor–placed passively-anterior brackets. Stepped around canine Distal extensions-end 2-3 mm distal to Cres Anterior segment-stepped around the canine bracket to avoid interference during intrusion www.indiandentalacademy.com
  • Bilateral tipback spring -.017 x.025 TMA Amount of intrusive force -4 Mx incisors=60g in midline www.indiandentalacademy.com
  • Segmented mechanics Right and left buccal segments-aligned-.017 x .025 SS TPA- custom made-0.036” SS 0.032 x0.032 SS-preformed Controls molar position In extraction cases - Canines retracted separately –included in the buccal segments on each side – allow space for intrusion. E-chain from anterior segment to molar hook. www.indiandentalacademy.com
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  • Decision to intrude Mx &/or Mn incisors depends on: 1. Amount of Mx inc show at rest 2. Length of upper lip 3. Interlabial gap at rest 4. Severity of curve of Spee 5. Presence of palatal impingement www.indiandentalacademy.com
  • Segmented mechanics Assessment of location of C res: Lateral cephalogram-to determine A-P & vertical position of C res 4 incisors –usually estimated-half way b/w crest of alveolar bone and root apex of lateral incisor-sagittal plane www.indiandentalacademy.com
  • Biomechanics To intrude along LA of inc: Point of force application(PFA) moved anteriorly +small distal force=redirect the intrusive force along the long axis of inc – pure intrusion. www.indiandentalacademy.com
  • For simultaneous intrusion & retraction: Intrusive force applied lingual to C res along with small distal force. Resultant force – parallel to L A of incisors but lingual. Retraction – result of moment around anterior segment www.indiandentalacademy.com
  • Action of elastic force between anterior and posterior segments www.indiandentalacademy.com
  • Biomechanics www.indiandentalacademy.com
  • www.indiandentalacademy.com • Leader in continuing dental education • www.indiandentalacademy.com