Tackling an
iatrogenic
problem!!

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
...
•

Introduction

All modern mechanics have a double scale of
ladder ascendant & descendant , ascending from
experiment to ...
Reasons for anchor loss
during aligning
•Lower molars normally drift mesially to
occupy the lee-way space after shedding o...
Reasons for anchor loss
during retraction
excessive forces
used during
retraction .

Improper bracket
positioning

iatroge...
Use light
Continuous
force

During
aligning….

Anchorage
reinforceme
nt

HOW TO
PREVENT
ANCHOR
LOSS ?
When in doubt use
a ...
How to control anchorage
during leveling ?
• Using light continuous forces
• Maintain the direction of force
• Rein force ...
Anchorage control during
retraction

individual
retraction
enmasse

Walking of
canine

Rein force
anchorage
www.indiandent...
Anchorage
reinforcement
IO

high
cervi EO com
bi
cal

TPA
Nance button
Class –II elastics
Lingual arch www.indiandentalaca...
how to correct
anchor loss ?
Anchor loss
occurs by mesial
tipping of molars
Extra oral
Intra oral

www.indiandentalacademy...
Cervical pull

High pull

Extra oral

Combi pull

distalizing effect
on molars and
premolars

www.indiandentalacademy.
com
Inter maxillary

Intra oral

Intra maxillary
Absolute
anchorage
www.indiandentalacademy.
com
Intermaxillary
Elastics
Modular appliance

IO non compliance
appliances
Intra maxillary
Modified nance arch with NiTi coil...
APPLIANCE
DESIGN:
• Modular appliance is made up of 0.016
x0.0 22 rectangular SS / TMA wire
• Modular appliance consists o...
•The gingival part of the hook is
helicoidally recurred with the end inward
to avoid erosion of the vestibular mucosa.
•Ti...
APPLIANCE DESIGN
hook to
engage
elastics

omega
loop

tip back bend of
45 degrees

www.indiandentalacademy.
com
•Class II elastics ( preferably blue
or green ) applying 100 – 150 gm
force are used from the hook mesial
to canine and to...
BIOMECHANICS
• Based on cantilever mechanism

Mechanics
of spring

elastics

www.indiandentalacademy.
com
•These mechanics can
effectively tip back an upper
molar and rotate the molar
mesial out.
•Distal end of omega loop acts
a...
• A light class II elastic is
placed from lower arch
• Class –II elastic is effective ,
not only because of its distal
for...
• Class – II elastics can flare the lower
arch, increase the vertical and steepen
the occlusal plane.
• Hence elastics are...
www.indiandentalacademy.
com
Case I

www.indiandentalacademy.
com
Pre treatment

www.indiandentalacademy.
com
www.indiandentalacademy.
com
www.indiandentalacademy.
com
Pre treatment

www.indiandentalacademy.
com
Pr
etre
atm
e

www.indiandentalacademy.
com

nt
Upper
5’s
lower
4’s

www.indiandentalacademy.
com
Pre surgical

www.indiandentalacademy.
com
Post surgical

www.indiandentalacademy.
com
Post surgical

www.indiandentalacademy.
com
www.indiandentalacademy.
com
Case 3

www.indiandentalacademy.
com
Case - 3

www.indiandentalacademy.
com
www.indiandentalacademy.
com
Po

st

www.indiandentalacademy.
com

tre

atm

ent
Modular
appliance
Fabr
icatio
n
quite
simpl
e

Less time
consuming

re with
’t interfe t
Won
treatmen
other
echanics
m

ww...
•Distalisation is brought
about in short duration
of time……..

fixed into the
auxiliary tube
advantages

versatile
Unilate...
Conclusion
If anchor loss is noticed
early and timely
intervention of modular
appliance is made, it saves
a lot of drudger...
Acknowledgement
Dr. E. MUNIRATNAM NAIDU,
Principal,

Dr. P. JAYA KUMAR,
Vice principal,

PROF&HEAD OF DEPARTMENT,
ORTHODON...
www.indiandentalacademy.
com
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Tackling aniatrogenic problem /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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Tackling aniatrogenic problem /certified fixed orthodontic courses by Indian dental academy

  1. 1. Tackling an iatrogenic problem!! INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. • Introduction All modern mechanics have a double scale of ladder ascendant & descendant , ascending from experiment to the invention of causes & descending from causes to the invention of new experiments • Anchorage plays a very vital role in orthodontics. Loss of anchorage can take place during • Aligning, leveling and retraction stages. www.indiandentalacademy. com
  3. 3. Reasons for anchor loss during aligning •Lower molars normally drift mesially to occupy the lee-way space after shedding of lower primary second molars which can be restricted by timely placement of lingual arch. •Anchorage requirement in upper arch is s re greater compared to lower arch e ma ti ng ti re d ge n ra U •Improper positioning of brackets. ho nc a www.indiandentalacademy. com ui q me re
  4. 4. Reasons for anchor loss during retraction excessive forces used during retraction . Improper bracket positioning iatrogenic factors posterior segments are not consolidated during retraction . www.indiandentalacademy. com incorrect alpha & beta bends Improper positioning of loop
  5. 5. Use light Continuous force During aligning…. Anchorage reinforceme nt HOW TO PREVENT ANCHOR LOSS ? When in doubt use a wire applying lighter forces www.indiandentalacademy. com Bracke t tip
  6. 6. How to control anchorage during leveling ? • Using light continuous forces • Maintain the direction of force • Rein force anchorage • Proper bracket positioning. www.indiandentalacademy. com
  7. 7. Anchorage control during retraction individual retraction enmasse Walking of canine Rein force anchorage www.indiandentalacademy. com
  8. 8. Anchorage reinforcement IO high cervi EO com bi cal TPA Nance button Class –II elastics Lingual arch www.indiandentalacademy. com straight
  9. 9. how to correct anchor loss ? Anchor loss occurs by mesial tipping of molars Extra oral Intra oral www.indiandentalacademy. com Hence distalize molars
  10. 10. Cervical pull High pull Extra oral Combi pull distalizing effect on molars and premolars www.indiandentalacademy. com
  11. 11. Inter maxillary Intra oral Intra maxillary Absolute anchorage www.indiandentalacademy. com
  12. 12. Intermaxillary Elastics Modular appliance IO non compliance appliances Intra maxillary Modified nance arch with NiTi coils distalising bow www.indiandentalacademy. com Absolute anchorage Palatal implants
  13. 13. APPLIANCE DESIGN: • Modular appliance is made up of 0.016 x0.0 22 rectangular SS / TMA wire • Modular appliance consists of an omega loop touching the mesial aspect of buccal tube and there is an upward curve in the mesial part of the canine bracket, which ends in a hook on the upper or gingival part. www.indiandentalacademy. com
  14. 14. •The gingival part of the hook is helicoidally recurred with the end inward to avoid erosion of the vestibular mucosa. •Tip back bend of 45 degrees is given distal to omega loop . •The wire should be cinched distal to the molar buccal tube •The buccal segment should be contoured to prevent tissue impingement. www.indiandentalacademy. com
  15. 15. APPLIANCE DESIGN hook to engage elastics omega loop tip back bend of 45 degrees www.indiandentalacademy. com
  16. 16. •Class II elastics ( preferably blue or green ) applying 100 – 150 gm force are used from the hook mesial to canine and to the lower molar hook. •The modular sectional arch blocks the segment between the canine and the upper first molar in one unit , which it moves in distal direction. www.indiandentalacademy. com
  17. 17. BIOMECHANICS • Based on cantilever mechanism Mechanics of spring elastics www.indiandentalacademy. com
  18. 18. •These mechanics can effectively tip back an upper molar and rotate the molar mesial out. •Distal end of omega loop acts as a stop and applies the tipping force on upper molar. www.indiandentalacademy. com
  19. 19. • A light class II elastic is placed from lower arch • Class –II elastic is effective , not only because of its distal force but because a very large moment is produced tipping the molar distally. www.indiandentalacademy. com
  20. 20. • Class – II elastics can flare the lower arch, increase the vertical and steepen the occlusal plane. • Hence elastics are used for a short period of time. • Because the molars tip back rapidly, only a short period of class – II elastic wear is required leading to negligible side effects www.indiandentalacademy. com
  21. 21. www.indiandentalacademy. com
  22. 22. Case I www.indiandentalacademy. com
  23. 23. Pre treatment www.indiandentalacademy. com
  24. 24. www.indiandentalacademy. com
  25. 25. www.indiandentalacademy. com
  26. 26. Pre treatment www.indiandentalacademy. com
  27. 27. Pr etre atm e www.indiandentalacademy. com nt
  28. 28. Upper 5’s lower 4’s www.indiandentalacademy. com
  29. 29. Pre surgical www.indiandentalacademy. com
  30. 30. Post surgical www.indiandentalacademy. com
  31. 31. Post surgical www.indiandentalacademy. com
  32. 32. www.indiandentalacademy. com
  33. 33. Case 3 www.indiandentalacademy. com
  34. 34. Case - 3 www.indiandentalacademy. com
  35. 35. www.indiandentalacademy. com
  36. 36. Po st www.indiandentalacademy. com tre atm ent
  37. 37. Modular appliance Fabr icatio n quite simpl e Less time consuming re with ’t interfe t Won treatmen other echanics m www.indiandentalacademy. com
  38. 38. •Distalisation is brought about in short duration of time…….. fixed into the auxiliary tube advantages versatile Unilateral or bilateral Class II www.indiandentalacademy. com
  39. 39. Conclusion If anchor loss is noticed early and timely intervention of modular appliance is made, it saves a lot of drudgery. www.indiandentalacademy. com
  40. 40. Acknowledgement Dr. E. MUNIRATNAM NAIDU, Principal, Dr. P. JAYA KUMAR, Vice principal, PROF&HEAD OF DEPARTMENT, ORTHODONTICS. STAFF MEMBERS & P.G. STUDENTS Department Of orthodontics MEENAKSHI AMMAL DENTAL www.indiandentalacademy. COLLEGE. com
  41. 41. www.indiandentalacademy. com

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