Mollenhaurs auxillary final /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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Mollenhaurs auxillary final /certified fixed orthodontic courses by Indian dental academy

  1. 1. MOLLENHAUER‟S ALIGNING AUXILIARY (MAA) AND ITS MODIFICATIONS www.indiandentalacademy.com
  2. 2. www.indiandentalacademy.com
  3. 3. During recent time, the Begg and Edgewise philosophies are coming closer to each other. www.indiandentalacademy.com
  4. 4. Light orthodontic forces Mechanics of ( controlled ) tipping followed by root movement (Segmented edgewise) Begg influence on edgewise practice: www.indiandentalacademy.com
  5. 5. Edgewise influence on the Begg practice Root control from the beginning (“ controlled tipping ” in the first two stages which simplifies the third stage mechanics) www.indiandentalacademy.com
  6. 6. Why clearcut division ( Crown tipping followed by root movement ) in classic Begg? Because lingual root torque on incisors antagonizes incisor intrusion. Lingual Root torque and distal root uprighting tax anchorage. www.indiandentalacademy.com
  7. 7. www.indiandentalacademy.com
  8. 8. MAA attempts root control from stage-I without significantly affecting intrusion and anchorage. „ A major advance in Begg appliance‟ www.indiandentalacademy.com
  9. 9. How ? Base wire –0.018” Premium Plus ( for intrusion, arch form control and molar control) MAA –0.009” Supreme ( Ultra fine wire for ultra light root moving forces). www.indiandentalacademy.com
  10. 10. 1.Significant deviation from classic Begg. 2. Enhanced treatment quality. 3. Shorter treatment time. www.indiandentalacademy.com
  11. 11. In this presentation, MAA as was originally conceived by Dr. Mollenhauer will be covered and then the slightly modified way in which we use it will be described. www.indiandentalacademy.com
  12. 12. Development Precursor “Specs” in 0.010” wire. Forces generated were relatively high. www.indiandentalacademy.com
  13. 13. www.indiandentalacademy.com
  14. 14. 0.009” Supreme wire become available in 1984. Initially used as aligning wire (AOJ‟87) then as aligning rectangles- MAA (AOJ‟90) www.indiandentalacademy.com
  15. 15. Requirements 1) Ultra light root moving forces. Hence a.) 0.009” wire b.) reciprocal torque not more than 450 . www.indiandentalacademy.com
  16. 16. 2.) Yet, wire must be resilient to resist deformation. Hence supreme grade,preferably pulse straightened. www.indiandentalacademy.com
  17. 17. 3.) Strong base wire to resist the vertical and transverse reactive forces. Hence 0.018” Premium plus. www.indiandentalacademy.com
  18. 18. Requirements ( contd.) Thickest possible lock pins or hook pins (e.g. Ceramaflex pin) for transmitting lingual root torque to teeth ( since auxiliaries are kept incisally for better hygiene). www.indiandentalacademy.com
  19. 19. ORIGINAL MAA FOR LINGUAL ROOT TORQUE www.indiandentalacademy.com
  20. 20. www.indiandentalacademy.com
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  23. 23. Advantages of MAA according to Mollenhauer: 1. Efficacy of intrusion and retraction. 2. Reciprocability of torque ( on instanding 2s or palatally placed 3s.). Hence periodontal benefits ( gingival dehiscence prevented). www.indiandentalacademy.com
  24. 24. 3.) Early root control with short stage III. 4.) Possibility of cortical bone growth ( at point A and point B). www.indiandentalacademy.com
  25. 25. Application of MAA: 1. Body alignment of crowded teeth by combination of a) Expansion + Crown alignment (looped arch wire like effect) & b) Root torque. www.indiandentalacademy.com
  26. 26. www.indiandentalacademy.com
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  28. 28. Application of MAA ( contd..) 2.) After stage I as braking mechanics ( by bending more positive torque) 3.) For labial root torque on a) Lower incisor in class II b) Upper incisor in class III (For cortical bone development)www.indiandentalacademy.com
  29. 29. 4.) MAA- tip for controlling Mesio- distal angulation of root apices in stage I ( superior to light uprighting springs for anchorage ?). Application of MAA ( contd..) www.indiandentalacademy.com
  30. 30. www.indiandentalacademy.com
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  32. 32. Biomechanics of MAA Class II or class I elastic force causes uncontrolled tipping of U incisors during stage I. Sufficient counter moment must be provided to obtain controlled tipping. One way to provide such counter moment is from the intrusive force of the archwire. www.indiandentalacademy.com
  33. 33. Very light forces generated by MAA can also provide torquing moments on the teeth to counter the moment generated by the class II or class I elastics, resulting in controlled tipping Biomechanics of MAA ( Contd..) www.indiandentalacademy.com
  34. 34. Lingual torquing couple of MAA is additive to the moment generated by intrusive force on incisors. Both together, produce the required M/F ratio. Biomechanics of MAA ( Contd..) www.indiandentalacademy.com
  35. 35. www.indiandentalacademy.com
  36. 36. For lower incisor intrusion during stage I, MAA for labial root torque is need to prevent proclination of lower incisors. www.indiandentalacademy.com
  37. 37. PROCLINATION WITHOUT MAA www.indiandentalacademy.com
  38. 38. www.indiandentalacademy.com
  39. 39. Moment resulting from intrusive force diminishes in stage II. Therefore MAA is must to provide moment for controlled tipping. www.indiandentalacademy.com
  40. 40. UNCONTROLLED TIPPING WITHOUT MAA www.indiandentalacademy.com
  41. 41. ADDITIVE MOMENT www.indiandentalacademy.com
  42. 42. For retracting lower incisors in stage II , MAA with lingual root torque is needed for controlled tipping ( like upper) Thus lower incisors may need different MAA for stage I & II. www.indiandentalacademy.com
  43. 43. Can MAA in 0.009” wire be used for torquing the roots in stage III ? www.indiandentalacademy.com
  44. 44. NO. Because for controlled root movements, higher M/F ratios ( 12/1) is required . But similar ( Boxed) design in 0.011”wire can be use. www.indiandentalacademy.com
  45. 45. www.indiandentalacademy.com
  46. 46. How our MAA application differs ? a) Lingual torque delivered indirectly through pin caused difficulties. (Of course we did not try Ceramaflex pins). Pin tails can rotate. Pins can move up and down. www.indiandentalacademy.com
  47. 47. www.indiandentalacademy.com
  48. 48. www.indiandentalacademy.com
  49. 49. Hence MAA was modified to press directly on incisal area for labial root torque and gingival area for lingual root torque. www.indiandentalacademy.com
  50. 50. Original MAA was always engaged first in the brackets and base arch wire was piggy back. In our modification, when lingual root torque is needed on all the teeth or reciprocal root torque on some teeth, base wire is engaged first and the MAA is piggy back. www.indiandentalacademy.com
  51. 51. Original MAA for lingual root torque Modification MAA for lingual root torquewww.indiandentalacademy.com
  52. 52. Modifications for reciprocal root torque www.indiandentalacademy.com
  53. 53. When labial root torque is needed on all teeth, we use the original design and also place it first in the bracket similar to original application www.indiandentalacademy.com
  54. 54. MAA for labial root torque www.indiandentalacademy.com
  55. 55. For reciprocal root torque on some teeth ,(e.g. in standing laterals), cross over bends are made. www.indiandentalacademy.com
  56. 56. www.indiandentalacademy.com
  57. 57. Since our experience with pins was not favorable, we do not use MAA tips. www.indiandentalacademy.com
  58. 58. MAA for expansion like multiloop wire ? May cause unpredictable action or round tripping. Hence we use MAA only for torque control after crowns are aligned. www.indiandentalacademy.com
  59. 59. www.indiandentalacademy.com
  60. 60. Steps in making the MAA www.indiandentalacademy.com
  61. 61. www.indiandentalacademy.com
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  64. 64. www.indiandentalacademy.com
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  66. 66. www.indiandentalacademy.com
  67. 67. How to make cross over bends. www.indiandentalacademy.com
  68. 68. www.indiandentalacademy.com
  69. 69. www.indiandentalacademy.com
  70. 70. Wire bent parallel to the boxes but in opposite direction. www.indiandentalacademy.com
  71. 71. Then give another bend close to the first bend but at right angle. Complete the box. Make another cross over. Complete the blank. www.indiandentalacademy.com
  72. 72. www.indiandentalacademy.com
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  79. 79. Use of MAA or its variations in Edgewise brackets www.indiandentalacademy.com
  80. 80. www.indiandentalacademy.com
  81. 81. Substitution of braided rectangular wire for MAA in order to reduce the time and efforts involved in wire bending. www.indiandentalacademy.com
  82. 82. www.indiandentalacademy.com
  83. 83. www.indiandentalacademy.com
  84. 84. Rectangular wires engaged before the base wire Diameter Lateral Central Central Lateral Of the wire Root Root Root Root Stainless Steel 0.022 x 0.016 18 20.5 21 17.5 0.025 x 0.017 20 23 22.5 20 Braided Steel 0.022 x 0.016 11.5 14.5 14 11.5 0.025 x 0.017 13.5 16.5 16 14 0.025 x 0.018 15 18 18 15.5 0.025 x 0.019 16 19.5 20 16 NiTi 0.022 x 0.016 11 14 14 11 0.025 x 0.017 12.5 16 16 12.5 0.025 x 0.018 14 18.5 18 13.5 0.025 x 0.019 16.5 20 19.5 16.5 www.indiandentalacademy.com
  85. 85. Br- NITI 0.025X0.017 11 12.5 12.5 11 Cu- NITI 0.025X0.017 14 16 16.5 14 0.025X0.019 15.5 18.5 18 15.5 .a – Titanium 0.022X0.018 13.5 16 16 14 Four spur 0.12 pre+ 14 16 17 14 MAA 0.009 SUP 10.5 12.5 12.5 11 Torque bar 0.022 X0.018 11 12.5 13 11 www.indiandentalacademy.com
  86. 86. www.indiandentalacademy.com
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  88. 88. www.indiandentalacademy.com
  89. 89. www.indiandentalacademy.com
  90. 90. www.indiandentalacademy.com
  91. 91. The disadvantage of such an application is that it cannot be used for reciprocal torque on adjacent teeth. Use Begg brackets with built in torque (Kameda‟s design )? www.indiandentalacademy.com
  92. 92. In conclusion, it could be said that the MAA and its modification have proved a major advance in refining the Begg mechanics. The rectangular wire substitutes for the MAA ( and the torquing auxiliary) have made it possible to apply them even in a busy practice. www.indiandentalacademy.com
  93. 93. THANK YOU For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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