- If the orthodontist intends to perform a quick and stable treatment, he must begin backwards, i.e., establish the best molar intercuspation as soon as possible, then premolars, enabling the perfect canine occlusion. - A stable and reproducible occlusion, with no premature contacts, is established first.  The height of the central incisor varies from 10.4 to 11.2 mm while its width varies from 8.73 to 9.3 mm, and, usually, these references are used in prosthetic reconstructions, when no other parameters are available. the golden proportion rises from an algebraic constant denoted by the greek letter φ (phi), with approximate value of 1.618, and it is used in arts the lateral incisors must appear proportionally smaller (62%) in relation to the central incisors. Prosthetic increase ,, the porcelain veneers Gingivectomy including the papilla Ameloplasty ,, by interdental wear, The gingival zenith is the highest point of the gingival contour curvature, and may vary significantly in anterior teeth.  - Two weeks prior to debonding a case, use articulation paper to check for any occlusal discrepancies that may be preventing the occlusion from settling together. - Use finishing elastics as an end-of-case detailing technique, where we’ll cut or clip the archwire in the posterior segment and run finishing elastics to get a better occlusion. After the brackets are removed, use polishing burs to address any uneven edges and recontouring needed. Use a diamond bur, a handpiece, articulating paper, & sandpaper discs on hand to recontour cuspids and reshape any teeth that need to be refined further. These types of steps that help finish cases not only on-point with treatment plan, but beyond many of patients’ orthodontic treatment expectations. - Alginate impression for final records - The level of results today’s orthodontics can deliver—from broader smiles to fuller lips—patients become firm believers in the power behind brackets and wires, sharing their experience with friends and family, which in turn helps boost leads coming to my practice.

1. Finishing Orthodontics Treatment
ACHIEVED BY: Dr.Maen Dawodi

2. INTRODUCTION
- If the orthodontist intends to perform a quick and stable treatment,
he must begin backwards, i.e., establish the best molar intercuspation
as soon as possible, then premolars, enabling the perfect canine
occlusion.
- A stable and reproducible occlusion, with no premature contacts, is
established first.

3. Division of esthetics in Orthodontics
1 Microesthetics dental, the arrangement of teeth on the
arches, color, shape, dimensions
2 Miniesthetics smile esthetics, teeth are exposed and in
smile with the lips
3 Macroesthetics Refer to the face

4. WIDTH AND HEIGHT OF CROWNS
The height of the central incisor varies
from 10.4 to 11.2 mm while its width
varies from 8.73 to 9.3 mm, and,
usually, these references are used in
prosthetic reconstructions, when no
other parameters are available.

5. CROWN VIRTUAL WIDTHS
the golden proportion rises from an
algebraic constant denoted by the
greek letter φ (phi), with approximate
value of 1.618, and it is used in arts
the lateral incisors must appear
proportionally smaller (62%) in
relation to the central incisors.

6. HEIGHT OF CONTACT POINTS
1) Prosthetic increase ,, the porcelain veneers
2) Gingivectomy including the papilla
3) Ameloplasty ,, by interdental wear,

8. Zenith
The gingival zenith is the highest
point of the gingival contour
curvature, and may vary
significantly in anterior teeth.

12. Cephalometric tracing
Pre-treatment
Post-treatment
Pre & post treatment superimposition

14. Debonding and Finishing the Case
- Two weeks prior to debonding a
case, use articulation paper to
check for any occlusal
discrepancies that may be
preventing the occlusion from
settling together.
- Use finishing elastics as an end-
of-case detailing technique, where
we’ll cut or clip the archwire in the
posterior segment and run
finishing elastics to get a better
occlusion.

15. • After the brackets are removed, use polishing burs to address any
uneven edges and recontouring needed.
• Use a diamond bur, a handpiece, articulating paper, & sandpaper
discs on hand to recontour cuspids and reshape any teeth that need
to be refined further.
• These types of steps that help finish cases not only on-point with
treatment plan, but beyond many of patients’ orthodontic treatment
expectations.

16. - Alginate impression for final records
- The level of results today’s orthodontics can deliver—
from broader smiles to fuller lips—patients become firm
believers in the power behind brackets and wires, sharing
their experience with friends and family, which in turn
helps boost leads coming to my practice.

17. Retainer Splint

18. camera with ring flash
Posttreatment extraoral/intraoral photographs and panoramic radiograph.
Pa tient was referred for composite buildup of maxillary right lateral
incisors and gingivectomy/crown lengthening of maxillary right canine

19. Efficacy of 2 finishing protocols in
the quality of orthodontic treatment
outcome
American Journal of Orthodontics and Dentofacial
Orthopedics November 2011 Vol 140 Issue 5

20. Introduction
The objectives of this prospective clinical study were to evaluate
the quality of treatment outcomes achieved with a complex
orthodontic finishing protocol involving serpentine wires and a
tooth positioner, and to compare it with the outcomes of a
standard finishing protocol involving archwire bends used to
detail the occlusion near the end of active treatment.

21. Methods
The complex finishing protocol sample consisted of 34 consecutively
treated patients; 1 week before debonding, their molar bands were
removed, and serpentine wires were placed; this was followed by
active wear of a tooth positioner for up to 1 month after debonding.
The standard finishing protocol group consisted of 34 patients; their
dental arches were detailed with archwire bends and vertical elastics.
The objective grading system of the American Board of Orthodontics
was used to quantify the quality of the finish at each time point. The
Wilcoxon signed rank test was used to compare changes in the
complex finishing protocol; the Mann-Whitney U test was used to
compare changes between groups.

22. Placement of serpentine wires. One week before debonding, the archwires were
removed as were the bands on the molars. Ligature wire then was placed in a
figure-8 manner from second premolar to second premolar in both arches.

23. The tooth positioner. Impressions of both
arches were taken with the fixed appliances
in place. Work models were poured, trimmed,
and then sent to the laboratory.
The laboratory technician carved away the
brackets and bands, and then reset the teeth
in wax to an ideal occlusion, based on the
orthodontist’s instructions.
The positioner then was fabricated from a
resilient material such as silicone

24. Results
The complex finishing protocol group experienced a clinically
significant improvement in objective grading system scores after
treatment with the positioner.
Mild improvement in posterior space closure was noted after molar
band removal, but no improvement in the occlusion was observed after
placement of the serpentine wires.
Patients managed with the complex finishing protocol also had a lower
objective grading system score (14.7) at the end of active treatment
than did patients undergoing the standard finishing protocol (23.0).

25. Conclusions
Tooth positioners caused a clinically significant improvement in
interocclusal contacts, interproximal contacts, and net objective
grading system score; mild improvement in posterior band space
was noted after molar band removal 1 week before debond.

26. • http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2176-
94512013000500006
• Excellent in finishing JIOS
• http://www.orthodonticproductsonline.com/2014/01/contempo
rary-finishing-techniques/
• Atlas of Complex Orthodontics
• Efficacy of 2 finishing protocols in the quality of orthodontic
treatment outcome , American Journal of Orthodontics and
Dentofacial Orthopedics November 2011 Vol 140 Issue 5
REFERENCES