The patient achieved significant expansion in the lower arch without extractions or surgery. The cuspids expanded 2.5 mm, 1st bicuspids 8.5 mm, and 2nd bicuspids 7 mm. This case demonstrates that adults can achieve excellent results with the Damon System approach.

1. Bio-Adaptive Therapy
A Breakthrough in
Orthodontic Treatment

2. The Damon System is more than
a new product – it’s an entirely
new orthodontic concept.
The Damon System delivers ideal
tooth position and improved
facial symmetry, usually
without the need for rapid
palatal expansion,
extraction, or surgery.

3. Three Pillars of Damon System
Bio-Adaptive Therapy
• Passive Self-Ligating Brackets –
Low friction, improved comfort, better
hygiene
• New Wire Technology –
Lighter forces, fewer adjustments
• Minimally Invasive Mechanics –
Far fewer extractions and the near-
elimination of headgear or rapid palatal
expansion

4. Q: Why are we talking
about a new system?

5. • Twin sisters
• Similar malocclusions
• Comparison of extraction vs. nonextraction

6. Traditional ceph and model analysis suggests extractions
to achieve “correct” tooth positioning and jaw relationships.
The nonextraction case was the experimental case.

7. One was treated with extractions.
Which is which?

8. Extracted Not Extracted

9. Q: Is conventional
orthodontics serving the
needs of today’s patient?

10. “I wish I
looked like
my sister.”

11. Dr. Dwight Damon – the Pioneer
in the Development of this
Treatment Approach
“Most extractions are done to make
space to eliminate crowding. But what
about the face, the roots of the teeth,
and the soft tissue? With the Damon
System, we use light forces to convert
crowding into posterior arch width,
yielding ideal tooth position AND
better facial aesthetics. There is also a
growing body of evidence that this
approach yields less root resorption
and a far better soft-tissue response.”

12. Force Management
Why light forces?
The following photos
should challenge every
clinician to lower their clinical
force mechanics.

13. Force Management
Why light forces?
Q: What happens
when roots are
driven against the
cortical plate with
high forces?

14. Force Management
Why light forces?
Capillaries entering the foraminae of the cortical bone

15. Treatment goal:
To achieve ideal tooth
position and facial harmony
while keeping the
vascular integrity of the
alveolar cortical plate.

16. Thought leaders have talked for
decades about how light forces would
stimulate rapid tooth movement. However,
conventional appliances forced clinicians
to use far higher forces due to wire alloys
and friction.
“Optimum force levels for orthodontic tooth movement
should be just high enough to stimulate cellular activity
without completely occluding blood vessels in the periodontal
ligament” – Dr. William Proffit
The new technology used in the
Damon System now allows us to
realize these goals.

17. Force Management
Why light forces?
Orthodontic
Tooth Movement

18. Force Management
Why light forces?
Note the amount of blood flow in the PDL, and
concentrated in the area of new bone
deposition

19. Force Management
Why light forces?
Two Distinct Types of
Pressure Side Dynamics
• Undermining Resorption –
Response to Heavier
Forces
• Frontal Resorption –
Response to Light Forces

20. Force Management
Why light forces?
Tooth Movement And Oxygen
 Oxygen is the trigger mechanism for
remodeling of the periodontium.
 If vascularity is interrupted in the
periodontal space, oxygen is no longer
available and cellular activity is slowed
or stopped.

21. “If the applied force is great enough to
totally occlude blood vessels and cut
off the blood supply, a hyalinized
avascular necrotic area is formed. This
area must revascularize before teeth
start to move.”
– Dr. William Proffit

22. Force Management
Why light forces?
Pressure Side
Traditional Heavy Forces
Note how blood vessels are crushed in the necrotic PDL
and how much bone must be eroded to cause movement
with undermining resorption.

23. Force Management
Why light forces?
Pressure Side
Characteristics of Light Forces
capillaries

24. Force Management
Why light forces?
“Light continuous forces
ensure more-effective
tooth movement in areas
with cortical bone or
Conventional forces with necrotic PDL
bone with few marrow
spaces. Use forces that
do not interrupt the
vascular supply.”
– Rygh
Low forces with vascular PDL

25. Force Management
Why light forces?
Time Course of Tooth Movement:
Frontal vs. Undermining Resorption
Light
(Damon)
Heavy
(conventional)

26. Friction Must Be Virtually Eliminated
In Order To Achieve Lower,
Biologically Optimal Forces
The Significance of Self-
Ligating Bracket
Technology

27. New Low-Force, Low-Friction
Orthodontic Therapy
Passive Self-Ligation vs.
Traditional Active
Elastomeric Ligation

28. Older style braces require elastics Damon System braces use a slide
to hold archwires in place. mechanism that eliminates the
friction and binding.
Elastics are like With the Damon
bungee cords – System, teeth
they cause friction
move more freely
and pressure ,
and comfortably.
making treatment
slower and less comfortable.

29. Passive Self-Ligation

30. Damon Difference
Passive self-ligation
Friction Comparison
Conventional brackets
with elastomerics
produced 500 to 600
times more friction than
Damon brackets.

31. Damon Difference
Passive self-ligation
Q: Why is low friction so important?
A: By significantly
reducing friction,
now we can use
“biologically sensible”
forces with superior
results

32. Damon Difference
Passive self-ligation

33. Damon Difference
Passive self-ligation
Elastomerics and Hygiene
• O-rings are extremely plaque retentive
• Greatly increase the number of micro-organisms
attached to appliances during treatment
Forsberg, et al, Ligature Wires and Elastomeric Rings: Two Methods of Ligation and Their Association with Microbial Colonization, Eur J
of Orth, pp416-20, Oct. 1991

34. What about
other self-
ligating
brackets?
Aren’t they all
the same?

35. Self-Ligation
Self-ligation is not a new concept
• Dr. Jacob Stolzberg
developed the “Russell”
attachment in the 1930s
• Dr. Jim Wildman
developed the Edgelok
bracket in 1971 – with
limited commercial
success

36. Self-Ligation
SPEED * ® Time * ®
* Speed is a trademark of Speed Orthodontics. Time is a trademark of American Orthodontics.

37. Damon Difference
Passive Self-Ligation
Most Self-Ligating Brackets Feature
ACTIVE Clip Mechanisms
• Wires are engaged
or pressed into the In-Ovation® “R”
bracket slot,
producing greater
FRICTION
• Larger wires are
needed to overcome
the friction = heavier
forces

38. Damon Brackets
• Damon SL, 1996-1999
• Damon 2, 2001

39. Damon Difference
Passive Self-Ligation
2005 2004

40. Damon Difference
Passive Self-Ligation
Damon brackets have a slot with four solid
walls to allow the wire to slide freely in
ALL PHASES OF TREATMENT

41. Frictional Resistance
Comparison
Even other self-
ligating brackets
have significantly
more friction
because they use an
active clip to keep
the wire pressed into
the slot.

42. New Wire Technology
Enhancing the Clinical
Benefits of Passive Self-
Ligation

43. Damon Difference
High-Tech Archwires
Mechanical Principles in Orthodontic Force Control

44. Damon Difference
High-Tech Archwires
• Very light forces
• Faster tooth
movement
• Far greater spring-
back properties
• True heat activation

45. Treatment Time
Comparison
Compared with conventional treatment, the Damon
System is proven to treat over 6 months faster on
average…with lighter forces!

46. Patient Comfort Comparison
Due to the lighter
forces used in the
Damon System,
patients experience
far less discomfort.

48. Damon braces are
More
Smaller Comfortable Faster
Traditional Braces

49. Clinical Cases
Harnessing the Power of Low
Force and Low Friction

50. M.J.
14 yrs 6 mos Class I severe crowding, deep bite, all
Initial cuspids blocked out.

51. Initial

52. Initial

53. Initial

54. Initial

55. Initial

56. Initial

57. Initial

58. Q: Why is this
patient so crowded?
Small jaws?

59. Q: What is your treatment
plan for this case?
Extraction?

60. Initial
What would extractions do to the profile of this patient?

61. What is your treatment
plan for this case?
RPE? Surgery?

62. 2.5 Months 5 Months
Initial 1 appointment
st 2 appointment
nd
7.5 Months 12 Months Final
3rd appointment 5th appointment 14.5 Months
7th appointment
No extractions, RPE, headgear or surgery!

63. M.J.
Final
14 months – 2 weeks
7 appts upper
5 appts lower

65. Initial
16 years – 5 months
Class II, severe
crowding, bilateral
posterior crossbite

66. Treatment Planning
• Ceph numbers
• Model analysis
• Pano X-rays
• Facial analysis
• Impact of growth/aging
• Vestibular bone density
• Tongue position/airway
• How light a wire do I need to stimulate
blood flow?

67. Initial

68. Initial

69. Initial

70. Initial

71. Initial

72. Initial

73. Initial

74. Why is the upper so crowded?
Initial – Tongue position?

75. Initial – Tongue position?

76. What is your treatment plan?
What is this patient going to
look like at 50 years of age?

77. Damon Mechanics
Dramatically simplified approach
• No palatal expanders
• No distalizers or headgear
• No anchorage preparation
(TPAs, Nance buttons, etc.)

78. A.H.
13 months
Light forces –
no extractions, RPE
or surgery

79. 13 months

80. Initial 13 months

81. A.H.
13 months
Light forces –
no extractions, RPE
or surgery

82. Initial
Final

83. Final
22 months
3 weeks

84. Initial
Final – 22 months 3 weeks

85. Initial Final
Final
22 months
3 weeks

86. Note health of bone and tissue
with tremendous alveolar change

87. Initial Final

88. Initial Final

89. Initial Final

90. Initial 1yr 3mo posttreatment

91. Final

92. “…way more
than straight
teeth! I can
breathe through
my nose and
speak more
clearly.”

93. Retention 1
year 3 months

94. Power of the Transverse
Face-driven treatment
by converting anterior
crowding into posterior
adaptation of bone, muscle,
and soft tissues

95. Power of the
Transverse
• Low orthodontic forces
do not “overpower” the
lip musculature.
• Incisors are prevented
from “dumping”
forward.
• Teeth move laterally
and distally.

96. Archwire adapted to initial and final arch form

97. Initial and final arch forms

98. Initial to final arch length increased 13 mm
Arch width accounts for space gained

99. Skepticism of Bio-Adaptive
Therapy Treatment Results
• Buccal tipping of posterior teeth?
• Compromising anterior labial bone
support? Molar distalization?
• Pushing roots through buccal plate?

100. Q: Were anteriors flared
to resolve crowding?

101. Note final position of
incisors in spite of extensive
anterior crowding
Composite

102. Q: Was the arch
lengthened by molar
distalization?

103. Distal of first molars to labial of incisors 37

104. Distal of first molars to labial of incisors 38 mm

105. Q: Was transverse
development
achieved by tipping?

106. Width Initial Final Change
Cuspid 32 mm 34 mm 2 mm
1st bicuspid 32.5 mm 40.5 mm 8 mm
2nd bicuspid 37 mm 48 mm 11 mm
1st Molar 44 mm 53 mm 9 mm

107. Initial Final
(Note tremendous palatal change with minimal tipping)
First bicuspids changed 12 mm
Second bicuspids changed 11 mm
First molars changed 9 mm

108. Q: Have we blown teeth
out of cortical bone?

109. The following CT scans have been
provided courtesy of Dr. Damon

110. Maxillary Transpalatal Mandibular Transpalatal
Maxillary Sagittal Mandibular Sagittal
Transpalatal
horizontal
Reading CT Scans

111. Upper CT scans 7 mos in retention
Note
presence of
bone on
buccal and
lingual sides
of roots
Upper first molars width change 9 mm

112. Upper CT scans 7 mos posttreatment
Upper 2nd bicuspids width change 11 mm

113. Upper CT scans 7 mos posttreatment
Upper 1st bicuspids width change 12 mm

114. Change: Cuspids 2 mm, 1st Bicuspids 12 mm,
2nd Bicuspids 11 mm, Molars 9 mm

115. Mid-Face Development
Change: Cuspids 2 mm, 1st Bicuspids 12 mm,
2nd Bicuspids 11 mm, Molars 9 mm

116. Change: Cuspids 2 mm, 1st Bicuspids 12 mm,
2nd Bicuspids 11 mm, Molars 9 mm

117. Width Initial Final Change
Cuspid 27 mm 27 mm 0
mm
1st bicuspid 34 mm 36.5 mm 2.5 mm
2nd bicuspid 40 mm 42 mm 2 mm
1st Molar 46.5 mm 47 mm .5 mm

118. Change: Cuspids 0 mm, 1st Bicuspids 2.5 mm,
2nd Bicuspids 2 mm, Molars .5 mm
Lower CT scans
7 months post-
treatment

119. Q: Can we achieve the same
results with adults
without surgery?

120. T.B.
Initial
32 years – 9 months

121. Initial

122. Initial
What is your treatment plan?

123. Initial

124. Initial

125. Initial (Note depth of palate)
Q: Where does this patient’s tongue
lay in the mouth?

126. Initial
Q: In the palate, or….?

127. Initial
A: In the lower arch.

128. Initial

129. Initial

130. Initial

131. Initial

132. Initial

133. Initial 10 weeks 7 months
1st Appt 3rd Appt
12 mos 2 wks 16 mos 2 wks
Final
6th Appt 8th Appt
How can teeth move this rapidly?
With such light forces?

134. Initial 10 weeks 7 months
1st Appt 3rd Appt
12 mos 2 wks 16 mos 2 wks
Final
6th Appt 8th Appt
How can teeth move this rapidly?
With such light forces?

135. Initial
32 years – 9 months

136. Final
18 Months – 2 weeks
10 appointments

137. Final
18 Months 2 weeks
10 Appointments

138. Final
18 Months 2 weeks
10 Appointments

139. Final
18 Months 2 weeks
10 Appointments

140. Initial Final

141. Initial Final

142. Composite

143. Width Initial Final Change
Cuspid 32 mm 34.5 mm 2.5 mm
1st bicuspid 35 mm 43.5 mm 8.5 mm
2nd bicuspid 41 mm 48 mm 7 mm
1st Molar 48 mm 52 mm 4 mm

144. Initial Final
Note change in shape of the palate –
tongue can now move into balance

145. Q: Are we moving teeth
through bone, or is the bone
adapting and moving with the
teeth with these light forces?

146. Change: Cuspids 2.5 mm, 1st Bi’s 8 mm,
2nd Bi’s 7 mm, Molars 4 mm
16 months
post-
treatment
1st Molars – 4 mm Transverse

147. Change: Cuspids 2.5 mm, 1st Bi’s 8 mm,
2nd Bi’s 7 mm, Molars 4 mm
16 months
post-
Roots are upright
treatment in bone on both
buccal and lingual
side after
significant
transverse
movement
2nd Bicuspids – 7 mm transverse
Q: Does this image change your thinking on what is possible?

148. Change: Cuspids 2.5 mm, 1st Bi’s 8 mm,
2nd Bi’s 7 mm, Molars 4 mm
16 months
post-
treatment
1st Bicuspids – 8 mm transverse
Q: Does this image change your thinking on what is possible?

149. Change: Cuspids 2.5 mm, 1st Bi’s 8 mm,
2nd Bi’s 7 mm, Molars 4 mm
16 months
post-
treatment
Observe the presence of bone on
the labial, buccal, and lingual of this adult

150. Evaluate bone and tissue contours
6 months posttreatment

151. Change: Cuspids 2.5 mm, 1st Bi’s 8 mm,
2nd Bi’s 7 mm, Molars 4 mm
16 months
post-
treatment
Remember that the cuspids
were out of the arch!
Note the presence of bone on
the labial, buccal, and lingual of this adult

152. Remember that the cuspids
were out of the arch!
Evaluate tissue 6 months retention

153. 2 years 1 month
posttreatment

154. How Can Light Forces
Cause Such a Dramatic
Adaptation of the
Alveolar Bone?
Insights Gained By
Observing Naturally
Occurring Bodily
Processes

155. Orthodontic Forces:
How Low Can You Go?

156. 4-2-03
Q: Can a 3rd Molar move distal
2/3 width of 2nd Molar in 2-3 months?

157. 06-23-04 Cyst growth exerts a fraction of
the forces used in traditional
orthodontics, yet it can move
teeth much more rapidly.
A: It can when there is a growing cyst.

158. Note how cortical
bone compensates
for cyst growth

159. Should this be a wakeup call
to our concepts of force?
Once the cyst is removed, the
alveolar bone moved back

160. Q: If the muscles of the face and
tongue are helping to determine
arch form, will the arch forms of
all patients be different?

161. Standard Arch Form
One Size Fits All?

162. Customizing Arch Form For
Each Patient

163. K.M. Final C.B. Final
UPPERS
Two people, two very different arch forms.

164. Q: Is there ever a time
when you need to extract?

165. Face-Driven Treatment Planning

166. There is a time to extract
• Patient has very little
crowding
• Bi-max protrusion
• Patient’s chief complaint is
the protrusive nature of her
profile.
• This is a case where
extraction will help to
establish an improved facial
profile.

167. With the Damon System we
“Extract for the face, not for the space.”

168. Light elastics and/or springs are used
to close space

169. Low-friction Damon
brackets allow
spaces to be closed
far more quickly and
easily.

170. Treatment time:
21 months

171. Treatment time: 21 months

173. Selective Application
vs.
All or None
• This technology must
be used in all cases to
see the true efficiency
gains
• You never know who
your best advocates
will be
• If you know it is better
for patients, how do
you choose?

174. Mom only sees diastema
Note posterior teeth tipped
lingual – dark triangles
We could use brackets or aligners to make minor
anterior corrections, but what about the facial impact?

175. A.M.
Final

176. Final
Note change in
arch form

177. Initial Final
Note change in mid-face support and smile
vs. simple diastema closure

178. K.W.
Initial

179. Initial

180. Initial

181. Initial

182. Initial
K.W. at 53 years 3 months

184. 4 yrs 1 mo
post-
treatment
No night
retention
for 2 yrs

185. 53 years 3 months 59 years 1 month

186. K.W.
59 years of age

187. “The interesting thing
about the Damon System
isn’t just the quality of the
cases, it’s the consistent
quality of the cases.”
– Damon user

188. Before
After

189. It’s More Than Just
Straight Teeth.

190. It’s all about the face.

191. “As orthodontists we
can do more for our
patients, more
quickly, and more
comfortably than ever
before.”
– Dwight Damon

192. • Extraordinary Results
• Shorter Treatment Time
• Fewer Appointments
• Greater Comfort
• Most Cases Treated
Without Extractions
For more
information, visit
www.damonbraces.com