Modular appliance
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This document discusses anchorage loss during orthodontic treatment and methods to prevent it. It notes that anchorage plays a vital role in orthodontics and can be lost during aligning, leveling, and retraction stages due to factors like improper bracket positioning, excessive forces, and lack of posterior consolidation. Methods to reinforce anchorage include light continuous forces, proper bracket placement, lingual arches, TPA, Nance buttons, and elastics. The modular appliance design presented uses elastics to tip molars distally via a cantilever mechanism, preventing anchorage loss. The modular appliance is simple to fabricate and can effectively distalize molars in a short time period to correct anchorage loss.
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Modular appliance
- 2. Introduction • All modern mechanics have a double scale of ladder ascendant & descendant , ascending from experiment to the invention of causes & descending from causes to the invention of new experiments • Anchorage plays a very vital role in orthodontics. Loss of anchorage can take place during • Aligning, leveling and retraction stages. www.indiandentalacademy. com
- 3. Reasons for anchor loss during aligning •Lower molars normally drift mesially to occupy the lee-way space after shedding of lower primary second molars which can be restricted by timely placement of lingual arch. •Anchorage requirement in upper arch is greater compared to lower arch •Improper positioning of brackets. Under estimating anchorage requireme www.indiandentalacademy. com
- 4. Reasons for anchor loss during retraction iatrogenic factors incorrect alpha & beta bends excessive forces used during retraction. posterior segments are not consolidated during retraction. Improper positioning of loop Improper bracket positioning www.indiandentalacademy. com
- 5. HOW TO PREVENT ANCHOR LOSS ? When in doubt use a wire applying lighter forces Bracket tip Anchorage reinforceme nt Use light Continuous force During aligning…. www.indiandentalacademy. com
- 6. How to control anchorage during leveling ? •Using light continuous forces •Maintain the direction of force •Rein force anchorage •Proper bracket positioning. www.indiandentalacademy. com
- 7. Anchorage control during retraction retractionretraction individualindividual enmasseenmasse Walking of canine Walking of canine Rein force anchorage Rein force anchorage www.indiandentalacademy. com
- 8. Anchorage reinforcement EO high cervi cal straight com bi IO TPA Nance button Class –II elastics Lingual arch www.indiandentalacademy. com
- 9. how to correct anchor loss ? Anchor loss occurs by mesial tipping of molars Hence distalize molars Extra oral Intra oral www.indiandentalacademy. com
- 10. Extra oral High pull Cervical pull Combi pull distalizing effect on molars and premolars www.indiandentalacademy. com
- 11. Intra oral Inter maxillary Intra maxillary Absolute anchorage www.indiandentalacademy. com
- 12. IO non compliance appliances Intermaxillary Elastics Modular appliance Intra maxillary Modified nance arch with NiTi coils distalising bow Absolute anchorage Palatal implantswww.indiandentalacademy. com
- 13. APPLIANCE DESIGN: • Modular appliance is made up of 0.016 x0.0 22 rectangular SS / TMA wire • Modular appliance consists of an omega loop touching the mesial aspect of buccal tube and there is an upward curve in the mesial part of the canine bracket, which ends in a hook on the upper or gingival part. www.indiandentalacademy. com
- 14. •The gingival part of the hook is helicoidally recurred with the end inward to avoid erosion of the vestibular mucosa. •Tip back bend of 45 degrees is given distal to omega loop . •The wire should be cinched distal to the molar buccal tube •The buccal segment should be contoured to prevent tissue impingement. www.indiandentalacademy. com
- 15. APPLIANCE DESIGN omega loop hook to engage elastics tip back bend of 45 degrees www.indiandentalacademy. com
- 16. •Class II elastics ( preferably blue or green ) applying 100 – 150 gm force are used from the hook mesial to canine and to the lower molar hook. •The modular sectional arch blocks the segment between the canine and the upper first molar in one unit , which it moves in distal direction. www.indiandentalacademy. com
- 17. BIOMECHANICS •Based on cantilever mechanism Mechanics of spring elastics www.indiandentalacademy. com
- 18. •These mechanics can effectively tip back an upper molar and rotate the molar mesial out. •Distal end of omega loop acts as a stop and applies the tipping force on upper molar.www.indiandentalacademy. com
- 19. •A light class II elastic is placed from lower arch •Class –II elastic is effective , not only because of its distal force but because a very large moment is produced tipping the molar distally. www.indiandentalacademy. com
- 20. • Class – II elastics can flare the lower arch, increase the vertical and steepen the occlusal plane. • Hence elastics are used for a short period of time. • Because the molars tip back rapidly, only a short period of class – II elastic wear is required leading to negligible side effects www.indiandentalacademy. com
- 37. Modular appliance Fabricationquite simple Less time consuming Won’t interfere with other treatment mechanics www.indiandentalacademy. com
- 38. advantages fixed into the auxiliary tube •Distalisation is brought about in short duration of time…….. versatile Unilateral or bilateral Class II www.indiandentalacademy. com
- 39. Conclusion If anchor loss is noticed early and timely intervention of modular appliance is made, it saves a lot of drudgery. www.indiandentalacademy. com