2. Contents
Introduction
Alignment
Principles in the choice of alignment wires
Properties of alignment archwires
Variables in the selection of alignment archwires
Special problems in alignment
Alignment in different techniques
Leveling
Leveling in different techniques
Anchorage control during alignment and leveling
Exception to full bracket placement
2
5. DEFINITION
The tooth movements needed to achieve passive engagement
of a steel rectangular arch wire of 0.019” X 0.025”
dimension and of suitable arch form, into a correctly placed
preadjusted 0.022” bracket system.
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•Systemized orthodontic treatment mechanics – McLaughlin Bennett Trevisi
6. Objectives
Short term
Achieve proper
leveling and
alignment into
passive
rectangular steel
wires
Long term
Achieve ideal
dentition
Achieve six keys
to normal
occlusion
With dentition
achieve properly
positioned facial
profile
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•Systemized orthodontic treatment mechanics – McLaughlin Bennett Trevisi
7. Alignment
First orthodontic objective during
the initial stage of treatment.
ALIGNMENT
Bring malposed
teeth into arch
AP position
of incisors
Width of
posterior arch
Dental arch
form
Control
anchorage in
all 3 planes
7
8. PRINCIPLES
IN THE
CHOICE OF
ALIGNING
WIRES
1)Light continuous forces
2) Free movement of the archwire
3) Use round wire
4) Address one plane at a time
5) Excess crowding is present , create space
first
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•Systemized orthodontic treatment mechanics – McLaughlin Bennett Trevisi
10. Stanley and Braun mentioned one benefit of using the
rectangular archwire would be of prevention of flaring
of the incisors , due to in built labial root torque
The principle is that it is better to tip crowns to
position during initial alignment rather than
displacing root apices
3) Use round wire
10
11. 4) Address one plane at a time
5) Excess crowding is present , create
space first
11
12. Properties of
alignment
arch wires
STRENGTH
SPRINGINESS
LONG RANGE OF ACTION
FLAT LOAD DEFLECTION CURVE
Providing 50gm force(optimum tipping force) for any degree of deflection
12
13. A- NiTi are the most efficient :-
light forces provided over long range
Low torsional strength so no root Torquing
Flat load deflection curve
For super elastic wires the
manufacturers preparation not the
wire size determines force
delivery
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•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
14. Variables in the
selection of
alignment arch
wires
ARCHWIRE MATERIAL
WIRE SIZE
INTERBRACKET SPAN
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•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
15. The wire in reducing
order preference for
aligning severely
malaligned are
Archwire
material Wire Size
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•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
16. If a beam is rigidly attached on both ends(last diagram) it is twice as strong
but only one fourth as springy as a beam of the same material and length
that can slide over the abutments (diagram 3)thus orthodontic property of
arch wire is affected based on how tightly or loosely it is tied
Inter bracket span
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•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
18. Wider brackets Narrow brackets
Decreased Increased
interbracket span interbracket span
Decreased wire Wire more flexible, less force
effectiveness and and more mechanical
less mechanical efficiency
efficiency
18
19. Alignment of
symmetric
crowding
Arch wire choices
Superelastic NiTi – ideal for initial alignment
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•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
20. Problem with Superelastic NiTi
Crimp split tube segment to prevent
sliding excessively
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•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
21. •Long range not necessary – 17.5 mil multistrand offers
properties at fraction of cost
•M-NiTi, co-axial wires or steel wires with loops – similar
performance to multistrand
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•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
22. Alignment in
Non-
extraction
Requires increase in arch length
for alignment
Loop mesial to molar in
multistrand wire
Stop mesial to molar with
Superelastic wire to hold wire in
front of incisors
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•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
23. Alignment in
asymmetric
crowding
Alignment of single blocked out teeth
CuNiTi can be directly engaged in the
blocked out teeth
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•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
26. Consistent and Inconsistent force system
26
A, A maxillary second molar extruded with distal-crown tipping. Upon inserting a straight wire into the second molar tube
(black line) and placing a force to engage it to the other brackets (blue arrow), an intrusive (desired) force with a mesial-crown
tipping tendency (desired) is expected to occur. Because the estimated load system matches the one desired to correct the tooth,
the load system is called consistent. B, A maxillary second molar extruded with mesial-crown tipping. Upon inserting a
continuous arch into the second molar tube (black line) and placing a force to engage it to the other brackets (blue arrow), an
extrusive force (unwanted) with a distal-crown tipping tendency (desired) is expected to occur. Since the estimated load system
does not match the desired one to correct the second molar, the load system is termed inconsistent.
Shintcovsk et al Continuous arch and rectangular loops for the correction of consistent and inconsistent load systems in extruded and tipped maxillary second molars AJODO March 2018 Vol 153
Issue 3
27. Special
problems in
alignment
Cross bite correction
Individual teeth displaced into anterior cross bite
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•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
28. Skeletal cross bite - Transverse maxillary expansion by opening mid palatal
suture - 10- 20 pounds force for 2 weeks – retention for 3-4 months
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•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
29. Dental cross bite –
1. Heavy labial expansion arch – Mulligan (JCO1979)
2. Inner bow of the face bow- expanded
3. Cross elastics
4. Expansion lingual arch
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•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
30. 30
1) SURGICAL
EXPOSURE
2)ATTACHMENT
TO THE TOOTH
3)
MECHANICS
APPLIED
Impacted or unerupted tooth
Management includes :
•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
32. Orthodontic mechanics to bring the tooth into arch
1. NiTi tied directly to attachment
2. Traction applied with ligature wire or elastic chain
attached to stiff base arch wire
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•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
33. 3. Auxiliary spring soldered to the base arch wire
4. Vertical spring bent in 0.014 ss (ballista spring – Jacoby AJO 1979)
33
34. Management of impacted second molar
Severely tipped teeth – auxiliary spring
NiTi from auxiliary tube on first molar to tube on the second molar
34
35. Align teeth before frenectomy
Then close space immediately after frenectomy
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•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
Diastema closure
41. Leveling by
extrusion
Involves supra eruption of molars and premolars
Accomplished with continuous arch wire
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•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
45. 45
Leveling by
intrusion
Bypass archwires Segmented archwires
Aligners having
attachments on
posterior teeth
•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
46. Three different arrangements available
1. Mulligan common sense mechanics(JCO 1980
2. In amalgamated technique
46
Bypass archwires
•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
47. Rickett’s utility arch
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•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
49. Weakness of bypass arches
Only first molar is available for anchorage – significant extrusion of 1st molar can occur
Intrusive force applied anterior to the Cres- hence incisors tend to tip forward as they
intrude – undesirable in extraction cases
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•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
50. 50
Segmented archwires - Developed by Burstone
•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
54. Force system for incisor flaring. CTA is not cinched back, and can be
ligated directly into incisor brackets for maximum flaring.
54
55. Force system for incisor extrusion, with CTA is inserted into molar
brackets upside down. Vertical forces shown are ideal for correction of
minor open bites.
55
56. Strategies used with segmented arches to prevent
forward movement of the incisors
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•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
57. A space closing force can be created by tying the auxillary arch back
against the posterior segments
57
60. Importance of second molars
In low angle deep bite cases banding of second molars in most
beneficial in bite opening and leveling of curve of spee
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•Systemized orthodontic treatment mechanics – McLaughlin Bennett Trevisi
63. 63
Recognizing
anchorage
needs of a case
Class II div 1
example
Class III example
Bimaxillary
protrusion
example
•Systemized orthodontic treatment mechanics – McLaughlin Bennett Trevisi
64. ANCHORAGE SUPPORT
In anteroposterior direction
64
1. Lacebacks
•Systemized orthodontic treatment mechanics – McLaughlin Bennett Trevisi
66. 66
3. Lingual arch
4. Class III elastics
and headgear
•Systemized orthodontic treatment mechanics – McLaughlin Bennett Trevisi
67. 67
5. Head gear for
upper molars
•Systemized orthodontic treatment mechanics – McLaughlin Bennett Trevisi
68. 1. Vertical control of incisors
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•Systemized orthodontic treatment mechanics – McLaughlin Bennett Trevisi
Vertical anchorage control
69. 2. Vertical control of canines
In highly placed canines
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•Systemized orthodontic treatment mechanics – McLaughlin Bennett Trevisi
High labial canines mat be loosely tied to the .015 multistranded or .016 HANT wire in early stages of
treatment . If the starting archwire is fully engaged in the canine bracket slot , it can produce unwanted tooth
movements in the adjacent lateral incisor and premolar regions.
70. 3. Vertical control of molars in high angle cases
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•Systemized orthodontic treatment mechanics – McLaughlin Bennett Trevisi
If the upper palatal bar is placed 2 mm away from the palate, tongue forces can assist in
vertical control of the molars
71. Anchorage control in lateral plane
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•Systemized orthodontic treatment mechanics – McLaughlin Bennett Trevisi
Upper molar expansion should be carried out by bodily
movement rather than tipping . Minimal molar crossbites
can be corrected using rectangular steel wire which are
slightly expanded from the normal form and which carry
buccal root torque.
72. 72
•Systemized orthodontic treatment mechanics – McLaughlin Bennett Trevisi
Exceptions of full bracket placement
Cases with unerupted
teeth or teeth out of the
arch form
High angle deep bite
cases
75. References
75
•Wiiliam R Proffit textbook of comtemporary orthodontics Fifth edition
•Systemized orthodontic treatment mechanics – McLaughlin Bennett Trevisi
•Shintcovsk et al Continuous arch and rectangular loops for the correction of
consistent and inconsistent load systems in extruded and tipped maxillary
second molars AJODO March 2018 Vol 153 Issue 3
• Leveling and Aligning: Challenges and Solutions Bhavna Shroff and Steven
J. Lindauer Seminars in Orthodontics, Vol 7, No 1 (March), 2001
