Swa strap up & leveling /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,
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Swa strap up & leveling /certified fixed orthodontic courses by Indian dental academy

  1. 1. Straight wire appliance Principles, strap up & levelling. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. Principles.  Each br. – customised for tooth type.  Preangulated slots – accomplish MD tooth tip.  Bases of the br. Inclined – proper tooth torque.  Bases – contoured – verrt. & horizontally.  Dist. From slot base to br. Base varies for each tooth type.  Built in guidance – min. archwire manipulation.  Guidance features consistent with fnl. Occl. www.indiandentalacademy.com
  3. 3. Strap Up. Most imp. Mech. Procedure.  Most imp. Aspect of trt. After diagnosis & trt. Planning.  Built in features – expressed only if br. Are accurately placed.  Improper br. Placement – extra months of finishing..  Natural settlijg & tooth positioners – unrealistic options.  www.indiandentalacademy.com
  4. 4.  Bracketing must be performed by orthodontists.  2 systems: Direct: Light cure – reduced time immediate force application possible. Self cure – Faster. replacement of 1or 2 loose br. Indirect Bonding: Greater precision  Lesser chair side time.  www.indiandentalacademy.com
  5. 5. Andrews system of br. Placement.  Br. Placed on FA with twin wings – straddling the FACC & center of slot at FA point.  FACC: Vertical line alont the most prominent Portion – in the central area of the facial surface of tooth crown.  FACC for molars: Vertical line along the dominant buccal groove- at M-D & O-G center. In molars br. & tubes are placed // to occl. Surface. www.indiandentalacademy.com
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  7. 7.  Advantages of new systems: Yields uniform br. Siting. FACC & FA points are easliy identifiable & not sub. To environmental hazards.  Crowns used as base – our work is keyed to crown.  Not affected by variation in tooth size. If br. Is positioned at fixed dist. From the incisal edge / cusp tip, Angulation of slot to crown – varies with varying crown varies with varying crown sizes.  www.indiandentalacademy.com
  8. 8.  Errors in br. Positioning. Horizontal errors  Axial or paralleling errors.  Thickness errors.  Vertical errors.  www.indiandentalacademy.com
  9. 9. Horizontal errors: Due to br. Placement mesial or distal to FA pt. Head to improper tooth location. Avoided by –  Visualizing FACC from facial & incisal / occl. Surface..  Drawing line through FACC. www.indiandentalacademy.com
  10. 10.  Axial or Paralleling errors: Due to br. Wings not // FACC - head to imp. Crown tip.  Avoided same as before.  Thickness errors. Due to excess adhesive – left under one portion. Contour of tooth doesn’t correspond to contour pf br. Base. - heads to imp. Torque & rotn.   Avoided by pressing the br. Against the tooth at placement. Acurately contouring the br. base www.indiandentalacademy.com
  11. 11.  Vertical Errors. Due to pl. – occl. Or gingival to FA point.  Extrusion or intrusion of teeth.  Torque & in out errors. Uncommon in fully erupted & anatomically normal teeth.  Commonly occurs in:  Partially erupted teeth.  Teeth with gingival infl.  Teeth with palatally displ. Roots.  Teeth with facially displ. Roots.  Teeth with occl. Or incisal fr. www.indiandentalacademy.com
  12. 12.  Vertical placement of bracket is altered length of individual crown – incisal to FA pt length of individual crown – gingival to FA pt For aesthetic & functional purposes Minor error in torque & in-out rel’ns corrected in finishing stages Crowns with long tapered buccal cuspsgingival to FA pt Otherwise adjacent marginal ridges will not be aligned www.indiandentalacademy.com
  13. 13.  Bracket placement errors in individual teeth Upper central incisor Horizontal errors – not major problem Vertical errors – common & must be avoided Paralleling errors – common due to keying from incisal edge rather than long axis of crown Upper lateral incisor Vertical errors – common Owing to small size,must be placed gingival to FA pt Paralleling errors – common due to abnormal Shape Horizontal errors- if rounded in shape www.indiandentalacademy.com
  14. 14.  Upper canines:  Vertical error – common when canine is not fully erupted.  Horizontal error – more frequently than incisors due to greater curvature.  // errors also occur.  Upper premolars: Vertical error – common as they are partly erupted.  Horizontal errors – same frequency as canines.  // errors – if 2nd PM band is not seated properly in the distal side.  www.indiandentalacademy.com
  15. 15.  Upper molars:  // error – vert. Ref line is buccal groove.  Buccal groove angulated at 5° to occl. Plane. If 5° tip br./ tube Is used – band must be seated more on mesial than distal surfce. Error avided by 0° tip br/tube which is welded onto band that is seated // to occl. Plane.  Vertical error- placed too gingivally.  Horizontal error – uncommon. www.indiandentalacademy.com
  16. 16.  Lower incisors: Vertical error – ususally placed too incisally – opening bites in finishing stages.  Horizontal errors – uncommon.  // error – leads to inter proximal spaces b/s incisors in gingival area.   Lower canines: Vertical error – placed too incisally.  Horizontal error – occurs.  // errors – uncommon.  www.indiandentalacademy.com
  17. 17.  Lower premolars: Vertical errors – placed too occl. Due to incomplete eruption. marginal ridg discrepancy b/w PM & 1st Molar.  // error – also causes marginal ridge disc. - due to incomplete seating of band on distal side.  www.indiandentalacademy.com
  18. 18.  Lower molars.  Vertical errors – placed too gingivaly to avoid occl. Interference- in 1st molar, too occl in 2nd molar.  // error.- due to more gingival placement of br. On mesial end.  Rotational errors – few. www.indiandentalacademy.com
  19. 19. Aids in reducing bracketing errors: Positioning jigs.  Brackt placement charts.  Proper separation.  www.indiandentalacademy.com
  20. 20.  Levelling & aligning. Division of trt. Into stages – originally in Begg tech. St. wire tech – divided iinto 3 stages. Levelling & aligning.  Correction of molar reln.& space closure.  Finishing.  www.indiandentalacademy.com
  21. 21. Levelling & Aligning: Defn. comprises of tooth movt. Needed to achieve passive engagement of plain rect. Wire of 19 x 25 dimn. With std. Archform into correctly placed preadjusted 0.022 slot br.sys.  Goals: Correct vertical disc.  Bring malposed tooeth into arch.  Control A-P posn. Of incisors  Control width of arches – post.  Control arch form.  www.indiandentalacademy.com
  22. 22. Principles in choice of leveling & aligning wires: Provide light continuous forces – efficent tooth tipping movt.  Move freely within the br. Slot. 2-4 mm clearance needed. 0.014 ideal in 0.018 slot. loose lig. Necessary.  www.indiandentalacademy.com
  23. 23. Rect. Wires, even resilent 17 x 25 niti avoided. to prevent undesirable root movt. alignment becomes slower & more damaging to roots.  In asymmetric crowding cases – comb. Of rigid wire & springy aux. wire to be used.  www.indiandentalacademy.com
  24. 24.  Properties of levelling & aligning wires Excellent strength Excellent springiness Long range of action The above properties are affected by A/wire material Size of wire Interbracket distance www.indiandentalacademy.com
  25. 25.  A/wire material Niti & TMA – better comb of strength & springiness Niti – added adv of flat LDR SS – multistranded or looped  Size of wire A- Niti – wire size doesn’t affect properties affected by manu. preparation Imp with regards to slot size www.indiandentalacademy.com
  26. 26.  Levelling & aligning wires Superelastic Niti Remarkable range & low LDR .014 or .016 in .018 slot which delivers 50 gm force Avoid tying too tightly Drawbacks: Expensive Travel around the arch Thermal NitiTotally passive when cold,making engagement easier At mouth temp.,becomes active www.indiandentalacademy.com
  27. 27.  TMA & SS – properties greatly affected by wire size As size , strength , springiness Smallest size wire with adequate strength used  Multistranded – strength added, springiness relatively unaffected  Distance between attachments Affected by bracket width Affects strength & springiness of wire www.indiandentalacademy.com
  28. 28. Multistranded SS .0175 both in.018 & .022 slots Indicated when large range is not necessary Adv: Cheap Equally effective Disadv: Force levels variable Pat discomfirt greater Addl. clinical time www.indiandentalacademy.com
  29. 29. M-Niti,Coaxial SS & looped small diam SS Std. Of trt few years ago Obsolete now As expensive as A-Niti But performance of cheaper multistranded wire www.indiandentalacademy.com
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  31. 31. Alignement in symmetrical crowding cases  Pm extn cases Severe crowding Retract canines first by – Segmental retraction loops in 19 x 25 TMA in high anchorage cases Sliding along .016 wire Moderate crowding cases Simultaneously tip canines distally & align incisors by Looped a/wires – Drag loop by Stoner Loops placed mesial & distal to canine www.indiandentalacademy.com
  32. 32.  Non-extn cases Tying superelastic wire to slot is effective & space is created by moving incisors further from molars Looped multistranded wire with loops mesial to molars & wire held ant’r to incisors before it is tied in www.indiandentalacademy.com
  33. 33. Alignement in asymmetrical crowding cases  A/wire has to be rigid where teeth are aligned & springy where crowding is present  2 methods : Looped SS a/wire with loop in area of crowding- formerly used Superelastic aux in conjunction with stiff SS main wire Lighter forces- useful in adults Greater control against distortion of arch form www.indiandentalacademy.com
  34. 34. Special problems in alignement  Crossbite Correction Ant’r crossbite: Mild crossbite corrected in L & A stage Expression of severe crowding Correction involves opening of space & bringing into proper position in arch Occlusal interference may make this difficultAnt’r bite plate needed www.indiandentalacademy.com
  35. 35. Pos’r crossbite Skeletal pos’r crossbite – Transverse max expn by opening midpalatal suture Achieved by Slow expn Rapid expn 100% success before 15 yrs of age Often crowding is present that warrants extn, Extn performed after expn cause pm’s act as anchorage for lateral expn addl space might make extn unnecessary www.indiandentalacademy.com
  36. 36. Types of expanders : Haas type – metal framework + plastic shelves Hyrax – metal framework only Minn type – less force The above expanders can be either bonded or banded www.indiandentalacademy.com
  37. 37.  Dental pos’r crossbite Correction achieved with Heavy labial arch : Inner bow of facebow- in Cl II cases & when molars are tipped lingually Heavy labial aux – if distal movt of molars not desired www.indiandentalacademy.com
  38. 38. Exp’n lingual arch : Quad helix- if anchorage is of no concern Transpalatal lingual arches – 36 mil SS 32 x 32 SS/TMA Crosselastics : From lingual of U/molar to buccal of L/molar Strong extrusive component, Accentuating  in vertical dimension www.indiandentalacademy.com
  39. 39.  Impacted / unerupted teeth Trt consists of : Surgical exposure Attachment to tooth Mechanical apprpaches for aligning unerupted tooth www.indiandentalacademy.com
  40. 40.  Surgical exposure Important for tooth to erupt through attached gingiva If labially impacted,flap must be raised from alveolar crest Flap design not critical in palatally impacted tooth Once obstacle is removed, tooth might erupt without intervention if root form’n is incomplete www.indiandentalacademy.com
  41. 41.  Method of attachment Bonding of button or hook to exposed labial surface Smaller size, better than std bracket Gold chain tied to attachment Mechanical approaches for aligning the tooth Should begin immediately Space creation & alignement of other teeth must be complete Aligning aux or magnetic attraction can be used www.indiandentalacademy.com
  42. 42.  Impacted L/2nd molar Occurs as a result of ortho trt Tooth has to be moved pos’rly & uprighted If mildly tipped – Separators sufficient If severely tipped – Aux spring extending into Embrasure between 1st & 2nd molar Buccal tube bonded on 2nd molar after exposure www.indiandentalacademy.com
  43. 43.  Levelling Can occur by Extrusion of pos’rs/relative intrusion Intrusion of incisors/absolute intrusion Combination of the two www.indiandentalacademy.com
  44. 44.  Levelling by extrusion By continuous a/wire with exagerrated curve of spee in max & reverse of curve of spee in mand 18 slot,narrow bracekts 16mil steel – usually sufficient 16 or 18mil M-Niti – in severe cases 17 x 25 mil TMA/ steel aux. For complete levelling 22 slot, wide brackets – 16 mil steel – initial levelling 18 mil steel – final levelling. www.indiandentalacademy.com
  45. 45.  Levelling by intr. Succesful int. – light continuous forces directed to tooth apex  Intrusion not to be pitted against extrusion  Two methods –    By pass arches. Segmented base wire with aux. depressing arch. www.indiandentalacademy.com
  46. 46.  Bypass arches Continuous wires that bypass pm’s Indicated in growing patients Mechanical principle – Incisor intrusion pitted against uprighting & distal tipping of molars Two types – Mulligan’s levelling a/wire - .016 wire with anchor bends in 2x4 appliance Rickett’s utility arch www.indiandentalacademy.com
  47. 47.  Segmented a/wires for levelling Depend on establishing stabilized pos’r segments & controlling pt. of force application against ant’r segment Full size rectangular wire in pos’r segment, Rectangular TMA in ant’r segment & Depressing arch 18x25SS/19x25TMAFrom aux molar tube to gingival of incisors(passive) Applies light force when brought beneath incisor brackets www.indiandentalacademy.com
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  56. 56. Conclusion  Strap up is the most imp. Step in the straight wire technique, that will ultimately reflect in the finish of the case.  Extra attention spend during this stage will reduce amount of labour during finishing stages. www.indiandentalacademy.com
  57. 57. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com