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APPLIANCE AND MECHANICS
BY
RICHARD P MCLAUGHLIN
JOHN C BENNETT
HUGO J TREVISI
www.indiandentalacademy.com
SEMINAR DIVISION
INTRODUCTION HISTORY APPLIANCE SPECIFICATION
BRACKET POSITIONING AND CASE SET UP
ANCHOR CONTROL DURING LEVELLING AND ALIGNMENT
ARCH LEVELLING AND OVERBITE CONTROL
SPACE CLOSURE PRICEDURE
OVERVIEW OF CLASS II TREATMENT MECHANICS
OVERVIEW OF CLASS II TEATMENT MECHANICS AND NON
EXTRACTION TREATMENT
FINISHING AND DETAILING , APPLIANCE REMOVAL, AND
RETENTION PROTOCOL
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HISTORY AND OVERVIEW OF TREATMENT MECHANICS
APPLIANCE SPECIFICATION – VARITION AND VERSATILITY
ARCH FORM
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INTRODUCTION
•ANDREWS PUBLISHED HIS LAND MARK ARTICLE IN 1972
AND SUBSEQUENTLY DESIGNED AN APPLIANCE BASED ON
HIS FINDINGS.
•HOWEVER , SOON AFTER THE INTRODUCTION OF PEA , IT
BECAME CLEAR THAT THE BRACKET REQUIRED A WHOLE
NEW PROGRAM OF TREATMENT MECHANICS AND FORCE
LEVELS TO FULLY REALIZE ITS POTENTIAL .
•APPLIANCE DESIGN AND TREATMENT MECHANICS ARE
CLOSELY INTERRELATED . TO SOME EXTENT ,BRACKET
DESIGN CAN BE SCIENTIFIC AND BASED ON RESEARCH, SO
IT CAN BRE PRODUCED IN MATTER OF MONTHS .
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BUT DEVOLPMENT OF TREATMENT MECHANICS TAKES
YEARS AND HAVE TO BASED ON EXPERIENCE WITH
NUMEROUS TREATED CASES .
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FUNDAMENTALS OF TREATMENT MECHANICS
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THE WORK OF ANDREWS
ANDREWS IS REGARDED AS FATHER OF PEA SYSTEM
WHEN ORIGINAL SWA BECAME AVAILALABLE IN 1972 , IT
WAS BASED ON SCIENCE BUT INCLUDED MANY FEATURES
OF SIAMESE EDGEWISE BRACKETS .
ALTHOUGH SWA WAS RADICALLY NEW , TRADITIONAL
HEAVY FORCES CONTINUED TO BE USED .
NO ANCHORAGE CONTROL MEASURES .THIS MAY HAVE
BEEN DUE ANDREWS CLINICAL EXPERIENCE AS AN
EDGEWISE ORTHODONTIST.
HE ALSO EEMPHASISZED WAGON WHEEL EFFECT WHERE
TIP IS LOST DUE TO ADDITION OF TORGUE . HENC HE
CHOSE TO ADD TIP TO ANTERIOR BRACKETS.
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THE BRACKET POSITIONING WAS BASED ON CENTRE OF
CLINICAL CROWN
BECAUSE LESS WIRE BENDING WAS NEEDED , THERE WAS A
TREND TO STANDARDIZE ARCH FORM ,
ROTH RECOMMENDED BROAD OR SQUARE ARCH FORM
ANDREWS CONTINUED TO USE BASAL BONE OF MANDIBLE
AS AN ARCH FORM REFERENCE
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DIFFICULTIES WITH INCREASED TIP AND HEAVY FORCES
RESULTED IN LATERAL OPEN BITE THIS BECAME TO
KNOWN AS ROLLER COASTER EFFECT.
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THESE EXPERIENCE LED ANDREWS TO INTRODUCE A
SERIES OF MODIFICATIONS
FOE EXTRACTION CASES ,CANNINE BRACKET
ANTI TIP ,ANTI ROTATION AND POWER ARM
DIFFERENT INCISOR BRACKET FOR VARING DEGREE OF
TORQUE
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www.indiandentalacademy.com
THE WORK OF ROTH
FOLLOWING HIS EXPERIENCE WITH ORIGINAL SWA . ROTH
INTRODUCED MEASURES TO OVERCOME DAY TO DAY
SHORTCOMINGS .
ROTH WAS AXIOUS TO AVOID THE INVENTORY
DIFFICULTIES OF A MULTILE BRACKET SYSTEM . HE
THEREFORE RECOMMENDED A SINGLE APPLIANCE SYSTEM
WHICH WILL MANAGE BOTH EXTRACTION AND NON
EXTRACTION CASES .
HE EMPHASIZED THE USE OF ARTICULATORS FOR
DIAGNOSTIC RECORDS , FOR EARLY SPLINT CONTRUCTION
AND USE OF GNATHALOGICAL POSITIONERS
TO GET CORRECT CONDYLE POSITION.www.indiandentalacademy.com
www.indiandentalacademy.com
THE WORK OF MCLAUGLIN AND BENNETT BETWEEN
1975 AND 1993.
THEY WORKED MAINLY WITH STANDARD SWA
INSTEAD OF INTIALLY MODIFYING THE BASIC BRACKET
DESIGN , FOR MORE THAN 15 YEARS THEY DEVOLPED AND
REFINED TREATMENT MECHANICS BASED ON SLIDING
MECHANICS AND CONTIOUS LIGHT FORCES .
THESE MECHANIS WERE PUBLISHED INTIALLY AS SERIERS
OF PAPERS IN EARLY 1990 AND THEN AS A BOOK IN 1993.
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FIG 1.10
ALSO LACE BACKS ANDBENDBACKS FOR EARLY
ANCHORAGE CONTROL
SLIDING MECHANICS ON .019 X .025 STEEL RECTANGULAR
WIRES , WITH LIGHT .014 FINISHING WIRES.
UNLIKE ANDREWS NON EXTRACTION CASES , MANY
PATIENTS WERE CHILDREN
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•THE WORK OF MCLAUGHLIN ,BENNETT,AND TREVISI
B 1993 AND 1997
•MCLAUGHLIN AND BENNETT THEN WORKED WITH
TREVISI TO RE DESIGN THE ENTIRE BRACKET SYSTEM TO
COMPLEMENT THEIR PROVEN PHILOSPHY.
•THEY RE-EXAMINED ANDREWS ORIGINAL FINDINGS
AND TOOK INTO ACCOUNT RESEARCH INPUT FROM
JAPENESE SOURCES WHEN DESIGNING MBT BRACKET
SYSTEM.
•THIS IS THIRD GENERATION BRACKET SYSTEM , IT IS A
PEA SPECIFICALLY FOR USE WITH LIGHT ,CONTINOUS
FORCES, LACEBACKS AND BENDBACKS AND IT WAS
DESIGNED TO WORK IDEALLY WITH SLIDING MECHANICS
. www.indiandentalacademy.com
ADDITIONAL ANTERIOR TIP WAS A DISADVANTAGE
IN ROTH AND SWA :
• IT CREATED A SIGNIFICANT DRAIN ON ANTERIO
POSTERIOR ANCHORAGE
• IT INCREASED THE TENDANCY TO BITE DEEPENING
DURING ALIGMENT STAGE
•IT BROUGHT THE UPPER CANINE ROOT APEX TOO CLOSE
TO FIRST PREMOLAR IN SOME CASES.
• AS LIGHTER FORCES WERE BEING USED IN ALL STAGES OF
TREATMENT THIS ANTI TIP OR SECOND ORDER
COMPENSATION WASNOT NEEDED IN MBT SYSTEM
•A TOTAL OF 10 DEG LESS DISTAL ROOT TIP IN UPPER ANT
SEGMENT AND 12 DEG LESS TIP IN LOWER ANT SEGMENTIS
NEEDED. www.indiandentalacademy.com
www.indiandentalacademy.com
THE PEA SYSTEM IS A DEVOLPMENT OF EDGEWISE
BRACKET WHICH IS RELATIVELY IN EFFIENCENT IN
DELIVERING TORGUE.
SO IN MBT SYSTEM IT WAS NESSCARY TO BUILD EXTRA
TORQUE IN INCISOR AND MOLAR REGION .
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UPPER CANINE BRACKET WOULD BE AVAILABLE WITH 7, 0
-7 DEG FOR LOWER CANINE 6, 0 AND –6 DEG .
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www.indiandentalacademy.com
THE WORK OF MCLAUGHLIN ,BENNETT,AND TREVISI
BETWEEN 1997 AND 2001
IT BECAME NESSCARY TO ADDRESS THE SUBJECTS OF
ARCH WIRE SELECTION AND FORCE LEVELS
ALTHOUGH AN OVOID ARCH FORM HAD PROVED USEFUL
IN THE EARLY YEARS THREE BASIC ARCH FORM TAPERED ,
SQUARE AND OVOID WOULD BE USE.
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OVERVIEW OF MBT TREATMENT PHILOSPHY
•BRACKET SELECTION
•VERSATILITY OF BRACKET SYSTEM
• ACCURACY OF BRACKET POSITIONING
• LIGHT CONTINOUS FORCES
• THE .022 VERSUS .018
•ANCHORAGE CONTROL EARLY IN TREATMENT
• GROUP MOVEMENT
•THE USE OF THREE ARCH FORMS
• ONE SIZE OF RECTANGULAR STEEL WIRE
• ARCHWIRE LIGATION
• AWARENESS OF TOOTH SIZE DISCREPANCIES
• PERSISTENCE IN FINISHING
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BRACKET SELECTION
STANDARD METAL , MID SIZED AND CLEAR BRACKET
VERSATILITY OF BRACKET SYSTEM
TO CONTROL INVENTORY COSTS AND AVOIDING NEEDLESS
WIRE BENDING.
ACCURACY OF BRACKET POSITINING
GAUGES AND INDIVIDUAL BRACKET REPOSITION CHARTS
ARE RECOMMENDED.
LIGHT CONTINOUS FORCES
NO CLEAR DEFINATION AND QUANTIFICATION .
USE OF ACTIVE TIE BACKS , AND .014 FINISHING WIRES.
.022 VS .018 SLOT
.022 IS BETTER AS ALLOWS MORE FREEDOM OF MOVEMENT
OF WIRES WITH SLIDING MECHANICS.www.indiandentalacademy.com
A
A
A
A
ANCHORAGE CONTROL EARLY IN TREATMENT
REDUCED TIP , LIGHT WIRE FORCES.
LACEBACKS AND BENDBACKS
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GROUP MOVEMENT
CROWDING IS RESOLVED AND THEN ANTERIOR SEGMENT
MOVED AS ENMASSE AS GROUP OF SIX OR EIGHT ANTERIOR
TEETH
THE USE OF THREE ARCH FORMS
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ONE SIZE OF RECTANGULAR STEEL WIRE
.019X.025
THEORETICALLY , THERE IS APPROX 10 DEG OF SLOP , BUT
CLINICALLY WIRE PERFORMS BETTER DUE TO THE
RESIDUAL TIP IN WIRE
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www.indiandentalacademy.com
ARCH WIRE HOOKS
• METHOD OF LIGATION
•PERSISTANCE IN FINISHING
•.014 WIRE AND BENDS IN WIRE IN FINAL STAGESwww.indiandentalacademy.com
APPLIANCE SPECIFICATION
VARIATION AND VERSATILITY
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DESIGN FEATURES OF MODERN BRACKET SYSTEM
RANGE OF BRACKET SYSTEM .
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RHOMBOIDAL SHAPE
REDUCES BULK OF EACH BRACKET
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TORQUE IN BASE THE COMPUTER AIDED DESIGN
FULL SIZE AND CLEAR TORQUE IN BASE
MID SIZE TORQUE IN FACE AND IN BASE COMBINATION
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IN OUT SPECIFICATION
UPPER SECOND PREMOLARS HAVE SMALL CROWNS
A BRACKET WHICH IS 0.5mm THICK
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TIP SPECIFICATION
EXPRESSION OF TIP
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www.indiandentalacademy.com
TORQUE SPCEFICATION
TORQUE IS NOT FULLY EXPRESSED IN PEA
SMALL AREA OF TORQUE APPLICATION
DUE TO SLOP OF 10 DEG
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INCISOR TORQUE
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CANINE TORQUE
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UPPER PREMOLAR AND MOLAR TORQUE
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LOWER PREMOLAR AND MOLAR TORQUE
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THE VERSATILITY OF BRACKET SYSTEM
SEVEN MAIN VERSATILITY FEATURES
• OPTIONS FOR PALATALLY DISPLACED LATERAL INCISOR
•THREE TORQUE OPTIONS FOR UPPPER CANINE
• THREE TORQUE OPTIONS FOR LOWER CANINE
• INTERCHANGEABLE LOWER INCISOR BRACKETS
• INTERCHANGEBLE UPPER PREMOLAR BRACKET
• USE OF UPPER SECOND MOLAR TUBES ON FIRST MOLAR IN
NON HG CASES
• USE OF LOWER SECOND MOLAR TUBES FOR UPPER FIRST
AND SECOND MOLARS OF OPPOSITE SIDE
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PALATALLY DISPLACED LATERAL INCISOR
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TORQUE OPTIONS FOR UPPER CANINE
LOWER CANINE
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INTERCHANGEBLE LOWER INCISOR BRACKET
UPPER PREMOLAR BRACKET
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USE OF UPPER SECOND MOLAR TUBES ON FIRST MOLARS
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USE OF LOWER SECOND MOLAR TUBES FOR THE FIRST
AND SECOND MOLARS OF THE OPPOSITE SIDE
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ARCH FORM
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INTRODUCTION
DURING STD EDGEWISE MOST ORTHODONTIST CUSTAMIZED
ARCH FORM
WHEN PEA BECAMEAVAILABLE THERE WAS ASSUMPTIOBN
THAT ONE ARCHFORM WAS APPORPIATE FOR FOR ALL
PATIENTS
RELAPSE TENDANCY
RIEDEL POSTULATED THE ARCH FORM PARTICULARLY IN
MANDIBULAR CANNOT BE ALTERED DURING APPLIANCE
THERAPY
1995 DE LA CRUZ et al CONCLUDE THAT GREATER THE
TREATMENT CHANGE GREATER THE TENDANCY TOWARDS
RELAPSE
1998 BURKE et al CONCLUDED THAT MANDIBULAR
INTERCANINE WIDTH CANNOT BE CHANGED
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PRACTICAL SOLUTION
CHUCK et al 1932 TAPERED , SQUARE , OVOID
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www.indiandentalacademy.com
TAPERED ARCH FORM
NARROW INTER CANINE WIDTH
SQUARE ARCH FORM
WITH BROAD ARCH FORM
IN CASES WITH RME
OVOID ARCH FORM
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SYSTEMETIZED MANAGEMENT OF ARCH FORMS
STANDARDIZE VERSUS CUSTOMIZED ARCH FORM
ITS NOT PRACTICAL TO CUSTOMIZE WIRE FOR EACH
PATIENT
ARCH FORM CONTROL WITH RECTANGULAR HANT WIRE
CUSTOMIZING STEEL RECTANGULAR WIRE DETERMINNG
THE IAF FOR EACH PATIENT
www.indiandentalacademy.com
MODIFICATIONS TO ARCH FORM AND ARCHWIRE
COORDINATION
DUE TO POSTERIOR TORQUE CONSIDERATION
MAXILLARY EXPANSION
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UPPER ARCH EXPANSION WITH ARCH WIRES
UPPER ARCH EXPANSION WITH JOCKEY WIRES
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ARCH FORM DURING FINISHING AND DETAILING THE
NEED FOR SETTLING
THE PATIENTS SHOULD NOT PROGRESS DIRECTLY FROM
RECTANGULAR WIRES TO RETAINERS
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STOCK CONTROL PROTOCOL FOR ARCH WIRES
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THANK YOU
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Mbt seminar

  • 1. APPLIANCE AND MECHANICS BY RICHARD P MCLAUGHLIN JOHN C BENNETT HUGO J TREVISI www.indiandentalacademy.com
  • 2. SEMINAR DIVISION INTRODUCTION HISTORY APPLIANCE SPECIFICATION BRACKET POSITIONING AND CASE SET UP ANCHOR CONTROL DURING LEVELLING AND ALIGNMENT ARCH LEVELLING AND OVERBITE CONTROL SPACE CLOSURE PRICEDURE OVERVIEW OF CLASS II TREATMENT MECHANICS OVERVIEW OF CLASS II TEATMENT MECHANICS AND NON EXTRACTION TREATMENT FINISHING AND DETAILING , APPLIANCE REMOVAL, AND RETENTION PROTOCOL www.indiandentalacademy.com
  • 3. HISTORY AND OVERVIEW OF TREATMENT MECHANICS APPLIANCE SPECIFICATION – VARITION AND VERSATILITY ARCH FORM www.indiandentalacademy.com
  • 4. INTRODUCTION •ANDREWS PUBLISHED HIS LAND MARK ARTICLE IN 1972 AND SUBSEQUENTLY DESIGNED AN APPLIANCE BASED ON HIS FINDINGS. •HOWEVER , SOON AFTER THE INTRODUCTION OF PEA , IT BECAME CLEAR THAT THE BRACKET REQUIRED A WHOLE NEW PROGRAM OF TREATMENT MECHANICS AND FORCE LEVELS TO FULLY REALIZE ITS POTENTIAL . •APPLIANCE DESIGN AND TREATMENT MECHANICS ARE CLOSELY INTERRELATED . TO SOME EXTENT ,BRACKET DESIGN CAN BE SCIENTIFIC AND BASED ON RESEARCH, SO IT CAN BRE PRODUCED IN MATTER OF MONTHS . www.indiandentalacademy.com
  • 5. BUT DEVOLPMENT OF TREATMENT MECHANICS TAKES YEARS AND HAVE TO BASED ON EXPERIENCE WITH NUMEROUS TREATED CASES . www.indiandentalacademy.com
  • 6. FUNDAMENTALS OF TREATMENT MECHANICS www.indiandentalacademy.com
  • 7. THE WORK OF ANDREWS ANDREWS IS REGARDED AS FATHER OF PEA SYSTEM WHEN ORIGINAL SWA BECAME AVAILALABLE IN 1972 , IT WAS BASED ON SCIENCE BUT INCLUDED MANY FEATURES OF SIAMESE EDGEWISE BRACKETS . ALTHOUGH SWA WAS RADICALLY NEW , TRADITIONAL HEAVY FORCES CONTINUED TO BE USED . NO ANCHORAGE CONTROL MEASURES .THIS MAY HAVE BEEN DUE ANDREWS CLINICAL EXPERIENCE AS AN EDGEWISE ORTHODONTIST. HE ALSO EEMPHASISZED WAGON WHEEL EFFECT WHERE TIP IS LOST DUE TO ADDITION OF TORGUE . HENC HE CHOSE TO ADD TIP TO ANTERIOR BRACKETS. www.indiandentalacademy.com
  • 8. THE BRACKET POSITIONING WAS BASED ON CENTRE OF CLINICAL CROWN BECAUSE LESS WIRE BENDING WAS NEEDED , THERE WAS A TREND TO STANDARDIZE ARCH FORM , ROTH RECOMMENDED BROAD OR SQUARE ARCH FORM ANDREWS CONTINUED TO USE BASAL BONE OF MANDIBLE AS AN ARCH FORM REFERENCE www.indiandentalacademy.com
  • 10. DIFFICULTIES WITH INCREASED TIP AND HEAVY FORCES RESULTED IN LATERAL OPEN BITE THIS BECAME TO KNOWN AS ROLLER COASTER EFFECT. www.indiandentalacademy.com
  • 12. THESE EXPERIENCE LED ANDREWS TO INTRODUCE A SERIES OF MODIFICATIONS FOE EXTRACTION CASES ,CANNINE BRACKET ANTI TIP ,ANTI ROTATION AND POWER ARM DIFFERENT INCISOR BRACKET FOR VARING DEGREE OF TORQUE www.indiandentalacademy.com
  • 14. THE WORK OF ROTH FOLLOWING HIS EXPERIENCE WITH ORIGINAL SWA . ROTH INTRODUCED MEASURES TO OVERCOME DAY TO DAY SHORTCOMINGS . ROTH WAS AXIOUS TO AVOID THE INVENTORY DIFFICULTIES OF A MULTILE BRACKET SYSTEM . HE THEREFORE RECOMMENDED A SINGLE APPLIANCE SYSTEM WHICH WILL MANAGE BOTH EXTRACTION AND NON EXTRACTION CASES . HE EMPHASIZED THE USE OF ARTICULATORS FOR DIAGNOSTIC RECORDS , FOR EARLY SPLINT CONTRUCTION AND USE OF GNATHALOGICAL POSITIONERS TO GET CORRECT CONDYLE POSITION.www.indiandentalacademy.com
  • 16. THE WORK OF MCLAUGLIN AND BENNETT BETWEEN 1975 AND 1993. THEY WORKED MAINLY WITH STANDARD SWA INSTEAD OF INTIALLY MODIFYING THE BASIC BRACKET DESIGN , FOR MORE THAN 15 YEARS THEY DEVOLPED AND REFINED TREATMENT MECHANICS BASED ON SLIDING MECHANICS AND CONTIOUS LIGHT FORCES . THESE MECHANIS WERE PUBLISHED INTIALLY AS SERIERS OF PAPERS IN EARLY 1990 AND THEN AS A BOOK IN 1993. www.indiandentalacademy.com
  • 17. FIG 1.10 ALSO LACE BACKS ANDBENDBACKS FOR EARLY ANCHORAGE CONTROL SLIDING MECHANICS ON .019 X .025 STEEL RECTANGULAR WIRES , WITH LIGHT .014 FINISHING WIRES. UNLIKE ANDREWS NON EXTRACTION CASES , MANY PATIENTS WERE CHILDREN www.indiandentalacademy.com
  • 18. •THE WORK OF MCLAUGHLIN ,BENNETT,AND TREVISI B 1993 AND 1997 •MCLAUGHLIN AND BENNETT THEN WORKED WITH TREVISI TO RE DESIGN THE ENTIRE BRACKET SYSTEM TO COMPLEMENT THEIR PROVEN PHILOSPHY. •THEY RE-EXAMINED ANDREWS ORIGINAL FINDINGS AND TOOK INTO ACCOUNT RESEARCH INPUT FROM JAPENESE SOURCES WHEN DESIGNING MBT BRACKET SYSTEM. •THIS IS THIRD GENERATION BRACKET SYSTEM , IT IS A PEA SPECIFICALLY FOR USE WITH LIGHT ,CONTINOUS FORCES, LACEBACKS AND BENDBACKS AND IT WAS DESIGNED TO WORK IDEALLY WITH SLIDING MECHANICS . www.indiandentalacademy.com
  • 19. ADDITIONAL ANTERIOR TIP WAS A DISADVANTAGE IN ROTH AND SWA : • IT CREATED A SIGNIFICANT DRAIN ON ANTERIO POSTERIOR ANCHORAGE • IT INCREASED THE TENDANCY TO BITE DEEPENING DURING ALIGMENT STAGE •IT BROUGHT THE UPPER CANINE ROOT APEX TOO CLOSE TO FIRST PREMOLAR IN SOME CASES. • AS LIGHTER FORCES WERE BEING USED IN ALL STAGES OF TREATMENT THIS ANTI TIP OR SECOND ORDER COMPENSATION WASNOT NEEDED IN MBT SYSTEM •A TOTAL OF 10 DEG LESS DISTAL ROOT TIP IN UPPER ANT SEGMENT AND 12 DEG LESS TIP IN LOWER ANT SEGMENTIS NEEDED. www.indiandentalacademy.com
  • 21. THE PEA SYSTEM IS A DEVOLPMENT OF EDGEWISE BRACKET WHICH IS RELATIVELY IN EFFIENCENT IN DELIVERING TORGUE. SO IN MBT SYSTEM IT WAS NESSCARY TO BUILD EXTRA TORQUE IN INCISOR AND MOLAR REGION . www.indiandentalacademy.com
  • 22. UPPER CANINE BRACKET WOULD BE AVAILABLE WITH 7, 0 -7 DEG FOR LOWER CANINE 6, 0 AND –6 DEG . www.indiandentalacademy.com
  • 24. THE WORK OF MCLAUGHLIN ,BENNETT,AND TREVISI BETWEEN 1997 AND 2001 IT BECAME NESSCARY TO ADDRESS THE SUBJECTS OF ARCH WIRE SELECTION AND FORCE LEVELS ALTHOUGH AN OVOID ARCH FORM HAD PROVED USEFUL IN THE EARLY YEARS THREE BASIC ARCH FORM TAPERED , SQUARE AND OVOID WOULD BE USE. www.indiandentalacademy.com
  • 25. OVERVIEW OF MBT TREATMENT PHILOSPHY •BRACKET SELECTION •VERSATILITY OF BRACKET SYSTEM • ACCURACY OF BRACKET POSITIONING • LIGHT CONTINOUS FORCES • THE .022 VERSUS .018 •ANCHORAGE CONTROL EARLY IN TREATMENT • GROUP MOVEMENT •THE USE OF THREE ARCH FORMS • ONE SIZE OF RECTANGULAR STEEL WIRE • ARCHWIRE LIGATION • AWARENESS OF TOOTH SIZE DISCREPANCIES • PERSISTENCE IN FINISHING www.indiandentalacademy.com
  • 26. BRACKET SELECTION STANDARD METAL , MID SIZED AND CLEAR BRACKET VERSATILITY OF BRACKET SYSTEM TO CONTROL INVENTORY COSTS AND AVOIDING NEEDLESS WIRE BENDING. ACCURACY OF BRACKET POSITINING GAUGES AND INDIVIDUAL BRACKET REPOSITION CHARTS ARE RECOMMENDED. LIGHT CONTINOUS FORCES NO CLEAR DEFINATION AND QUANTIFICATION . USE OF ACTIVE TIE BACKS , AND .014 FINISHING WIRES. .022 VS .018 SLOT .022 IS BETTER AS ALLOWS MORE FREEDOM OF MOVEMENT OF WIRES WITH SLIDING MECHANICS.www.indiandentalacademy.com
  • 27. A A A A ANCHORAGE CONTROL EARLY IN TREATMENT REDUCED TIP , LIGHT WIRE FORCES. LACEBACKS AND BENDBACKS www.indiandentalacademy.com
  • 28. GROUP MOVEMENT CROWDING IS RESOLVED AND THEN ANTERIOR SEGMENT MOVED AS ENMASSE AS GROUP OF SIX OR EIGHT ANTERIOR TEETH THE USE OF THREE ARCH FORMS www.indiandentalacademy.com
  • 29. ONE SIZE OF RECTANGULAR STEEL WIRE .019X.025 THEORETICALLY , THERE IS APPROX 10 DEG OF SLOP , BUT CLINICALLY WIRE PERFORMS BETTER DUE TO THE RESIDUAL TIP IN WIRE www.indiandentalacademy.com
  • 31. ARCH WIRE HOOKS • METHOD OF LIGATION •PERSISTANCE IN FINISHING •.014 WIRE AND BENDS IN WIRE IN FINAL STAGESwww.indiandentalacademy.com
  • 32. APPLIANCE SPECIFICATION VARIATION AND VERSATILITY www.indiandentalacademy.com
  • 33. DESIGN FEATURES OF MODERN BRACKET SYSTEM RANGE OF BRACKET SYSTEM . www.indiandentalacademy.com
  • 34. RHOMBOIDAL SHAPE REDUCES BULK OF EACH BRACKET www.indiandentalacademy.com
  • 35. TORQUE IN BASE THE COMPUTER AIDED DESIGN FULL SIZE AND CLEAR TORQUE IN BASE MID SIZE TORQUE IN FACE AND IN BASE COMBINATION www.indiandentalacademy.com
  • 36. IN OUT SPECIFICATION UPPER SECOND PREMOLARS HAVE SMALL CROWNS A BRACKET WHICH IS 0.5mm THICK www.indiandentalacademy.com
  • 37. TIP SPECIFICATION EXPRESSION OF TIP www.indiandentalacademy.com
  • 39. TORQUE SPCEFICATION TORQUE IS NOT FULLY EXPRESSED IN PEA SMALL AREA OF TORQUE APPLICATION DUE TO SLOP OF 10 DEG www.indiandentalacademy.com
  • 43. UPPER PREMOLAR AND MOLAR TORQUE www.indiandentalacademy.com
  • 44. LOWER PREMOLAR AND MOLAR TORQUE www.indiandentalacademy.com
  • 45. THE VERSATILITY OF BRACKET SYSTEM SEVEN MAIN VERSATILITY FEATURES • OPTIONS FOR PALATALLY DISPLACED LATERAL INCISOR •THREE TORQUE OPTIONS FOR UPPPER CANINE • THREE TORQUE OPTIONS FOR LOWER CANINE • INTERCHANGEABLE LOWER INCISOR BRACKETS • INTERCHANGEBLE UPPER PREMOLAR BRACKET • USE OF UPPER SECOND MOLAR TUBES ON FIRST MOLAR IN NON HG CASES • USE OF LOWER SECOND MOLAR TUBES FOR UPPER FIRST AND SECOND MOLARS OF OPPOSITE SIDE www.indiandentalacademy.com
  • 46. PALATALLY DISPLACED LATERAL INCISOR www.indiandentalacademy.com
  • 47. TORQUE OPTIONS FOR UPPER CANINE LOWER CANINE www.indiandentalacademy.com
  • 48. INTERCHANGEBLE LOWER INCISOR BRACKET UPPER PREMOLAR BRACKET www.indiandentalacademy.com
  • 49. USE OF UPPER SECOND MOLAR TUBES ON FIRST MOLARS www.indiandentalacademy.com
  • 50. USE OF LOWER SECOND MOLAR TUBES FOR THE FIRST AND SECOND MOLARS OF THE OPPOSITE SIDE www.indiandentalacademy.com
  • 52. INTRODUCTION DURING STD EDGEWISE MOST ORTHODONTIST CUSTAMIZED ARCH FORM WHEN PEA BECAMEAVAILABLE THERE WAS ASSUMPTIOBN THAT ONE ARCHFORM WAS APPORPIATE FOR FOR ALL PATIENTS RELAPSE TENDANCY RIEDEL POSTULATED THE ARCH FORM PARTICULARLY IN MANDIBULAR CANNOT BE ALTERED DURING APPLIANCE THERAPY 1995 DE LA CRUZ et al CONCLUDE THAT GREATER THE TREATMENT CHANGE GREATER THE TENDANCY TOWARDS RELAPSE 1998 BURKE et al CONCLUDED THAT MANDIBULAR INTERCANINE WIDTH CANNOT BE CHANGED www.indiandentalacademy.com
  • 53. PRACTICAL SOLUTION CHUCK et al 1932 TAPERED , SQUARE , OVOID www.indiandentalacademy.com
  • 55. TAPERED ARCH FORM NARROW INTER CANINE WIDTH SQUARE ARCH FORM WITH BROAD ARCH FORM IN CASES WITH RME OVOID ARCH FORM www.indiandentalacademy.com
  • 56. SYSTEMETIZED MANAGEMENT OF ARCH FORMS STANDARDIZE VERSUS CUSTOMIZED ARCH FORM ITS NOT PRACTICAL TO CUSTOMIZE WIRE FOR EACH PATIENT ARCH FORM CONTROL WITH RECTANGULAR HANT WIRE CUSTOMIZING STEEL RECTANGULAR WIRE DETERMINNG THE IAF FOR EACH PATIENT www.indiandentalacademy.com
  • 57. MODIFICATIONS TO ARCH FORM AND ARCHWIRE COORDINATION DUE TO POSTERIOR TORQUE CONSIDERATION MAXILLARY EXPANSION www.indiandentalacademy.com
  • 58. UPPER ARCH EXPANSION WITH ARCH WIRES UPPER ARCH EXPANSION WITH JOCKEY WIRES www.indiandentalacademy.com
  • 59. ARCH FORM DURING FINISHING AND DETAILING THE NEED FOR SETTLING THE PATIENTS SHOULD NOT PROGRESS DIRECTLY FROM RECTANGULAR WIRES TO RETAINERS www.indiandentalacademy.com
  • 60. STOCK CONTROL PROTOCOL FOR ARCH WIRES www.indiandentalacademy.com