Ricketts

MECHANICS SEQUENCE FOR
CLASSII DIVISION I CASES
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Introduction-
• The bioprogressive therapy has long been
thought of as sectionalized approach.
• When a full compliment of teeth is
maintained,the possiblity of segmental
approach to mechanics is greatly
enhanced.
• It is important that basic principals of
bioprogressive therap be adhered to both

• in treatment planning and in chairside
decision making process.The universal
concept of control must be altered slightly
in mind of clinician to take into account the
individual movements of teeth in different
planes of space.

Thinking in terms of sectionalized
approach.
• Not only are teeth within each arch
considered to separate
segments,requiring individual movements
in their own plane of space,but the
individual arches,themselves are to be
considered as separate sections.It will be
noted that for pure simlicity and efficiency
of mechanics,each individual arch may be
in completely different phase of treatment.

Sequence of mechanics (non-
ex,classII div I Deep bite cases.
1)Upper-
-selection of head gear
lower-
.016 x.OI6 blue elgiloy utility
arch,designed to align,intrude lower
incisors.

2) UPPER
• band or bond canine
and
premolars.sections
placed to level and
consolidate the upper
buccal segments.

Lower
• .O16x.O16 blue
elgiloy is reactivated
or replaced.
• When cuspid needs
intrusion elastic
thread is tied from
cuspids to a small
vertical loop of utility
arch.

3)UPPER
• Upper levelling and
consolidation sections
are replaced with
traction sections.
• A small closed helix
or gable bend Is
incorporated to
maintain distal root
tip.

LOWER
• After incisors and
molars have aligned, .
016x.022 blue elgiloy
stablizing utility arch
is placed.

4)UPPER
• Band or bond incisors
• Place light round or
twistoflex anterior
section to align
incisors.
• .O16x.O22 utility
arch is placed.

LOWER
• Lower ideal arch
wire .O16x.O16
elgiloy.

5)UPPER
• Anterior spaces are
closed with overlay
arch-.O16x.O16 blue
elgiloy is placed.

LOWER
• Class II elastics to
the upper traction
continued during
upper space closure.

6)UPPER
• Upper ideal arch form
is placed to achieve
final arch form and
torque characteristics
in upper arch.

LOWER
• Class II elastics
limited to avoid
extruding upper
incisors.

Mechanics sequence for class II div
2 Cases.
• The principles of bioprogressive therapy
continue to be of extreme importance in
treatment of class II div 2
malocclusions.the management process
we use in order to individualize our
mechanics and establish the sequence
necessary for special case.

• Division 2 malocclussion
are frequently present in
brachyfacial patterns with
resulting strong
musculature. They
generally have moderate
to minimum convexity,
but occasionally do have
higher convexity resulting
orthopedic problems.

• There are six functions necessary in treating in class2
div2 mallocclusions which are general considerations
for evaluating the mechanics sequence:
1. Advancement ,torque control ,and intrusion of upper
incissors.
2. Intrusion of lower incissors and cuspids.
3. Allignment of buccal segments and class2
corrections.
4. Consolidation of upper incissors.
5. Idealizing the arches.
6. Finishing.

TREATMENT SEQUENCE OF MECHANICS.
NON EXTRACTION CLASSII DIV 2, DEEPBITE.
1. UPPER:
• Band or bond the upper
incisors. The upper incisors
are advanced , torqued and
intruded with .016 x .016 blue
elgiloy utility arch.
• The anterior section should
be deflected forward 5mm or
more.
• A”V” in the anterior arch for
will help keep this contour.

2. UPPER
• Continue use of utility
arch.
• Band or bond maxillary
cuspids and bicuspids.
• Level the buccal sections
with “T”sections or
“piggyback”, a round wire.
• If leveling is not
necessary place traction
section and initiate class2
elastics.

LOWER
• Place lower .016 x .016
blue elgiloy utility arch
with 65-75 gms of force.
• The bicuspids and
cuspids are banded or
bonded.

3 UPPER
• Intra oral utility arch
activation to continue
incisor intrusion.
• If class2 elastics has not
been initiated,start at this
time.

LOWER
• Elastic thread is ligated
from lower cuspid.
• Place .016 x.022
stabilizing utility arch to
enhance torque control.
Stabilizing section should
be used during cuspid
intrusion.

4 UPPER
• After buccal segments
are corrected torqing
utility arch is used for
torque control, intrusion,
contraction and leveling
of incisors.

LOWER
• Place a stabilizing utility
arch to idealize and
maintain torque control.
Place piggyback or
overlay arches for
continued effect of
rotation,space closure
and leveling of buccal
sections.

5 UPPER
• Ideal upper arch wire .
016x.016 or .016x .022
blue elgiloy . In standered
bioprogressive lateral
gablebends, bicuspid
offsets and molar
bayonets are placed.

LOWER
• Ideal lower arch wire .
016x.016, .016x.022 or .
018x .022 blue elgiloy .
• Buccal root torque is bent
into ideal arch distal to
first bicuspids.

6 UPPER
• Finishing and band space
closure arch is placed.
Closing “L” arch wire .
018x.022 blue elgiloy.
• If bonding techniques are
used space closure
arches would not be
necessary.

LOWER
• Finishing and band space
closure arch is placed.
Closing horizontal “L”arch
wire .016x.022 blue
elgiloy. Activation of 1- 2
mm.
• 5/16’’ Heavy class2
elastics 20 hrs per day.
• Two week intervals
appointments.

FINISHING PROCEDURES AND
RETENTION.
• The finishing and retention procedure of
the bioprogressive therapy are
considered,from the beginning stages of
treatment,as a part of the total scheme of
treatment.
• One of greatest values of VTO is the
establishing of specific end results from
the beginning.

Basic boprogressive appliances
• Standard bioprogressive appliance has
had torque in upper central and lateral
incisors as well as all four cuspids.
• Full torque bioprogressive adds additional
torque,by placing torque in lower 2nd
bicuspids and lower ist and 2nd
molars.this
added torque is used in accomplishing the
same objectives as the original standard
appliance.

• Triple control bioprogressive appliance
now combines offset first order bends with
second order tip and the third order
torque, to present the complete “triple
control” needed to place teeth in all three
planes of space to accomplish the
necessary movements to reach the
objective of the over treated orthodontic
occlusion.

Occlusal check list in finishing
1. Intermolar width at
lower 2nd
molar,together with
uprightness and
rotation of that tooth.
2. Using 2nd
molar as
guide, is lower 1st
molar contact at
distal cucp.

3. Distal contact 2nd
premolar. It would
appear slightly
depressed.
4. The lower 1st
pm is
very critical.it should
appear to be buccal
to canine.

5. Torque
consideration from
2nd
pm backward
there is progressive
lingual crown torque.
6. Pm offset is given to
bring in contact with
distal lingual incline
of upper canine.

7. Mesial of cuspid is
tucked slightly
behind the lateral
incisor,distal of
cuspid buccal of 1st
pm.
8. The incisors and
canines are oriented
to occlusal plane at
about 14-16 deg.

UPPER ARCH FINISHING CHECK
LIST.
1. 1st
molar and 2nd
molar
width.
2. Upper molar rotation.
3. This is considerd key of
finishing because lower
1st
molar and the upper
1st
molar must be correct
before its proper
position can be attained.

4. It should be parallel
to occlusal plane
buccolingually .it
may also appear to
be slightly distally
inclined because
mesial marginal
ridge is broken and
lower than distal
marginal ridge.

5. In the upper arch is
to consider the
contour and over
treatment of buccal
occlusion.
6. Canine should be
over treated in
finishing stages of
class 1 and class 11
malocclusion
corrections.

7. A gingival step of1/2
to 2mm would be
required to clear the
longer cuspid in
excursions of
mandible.
8. Upper centrals
contact are
considred and
midlines of the
denture

Ricketts

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