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Class I Deep Bite

Suggested Treatment Protocol

Duration Interval Early Light Elastics Guideposts


Phase Archwires Objectives Notes
in Weeks in Weeks Begun at Initial Bonding1 for Next Phase

I. Damon Optimal-Force • Begin leveling and 10 10 As bite opens, cases Quail 3/16", 2 oz – Shorty CL II When 90% of rotations
Initial Copper Ni-Ti® alignment become CL II dentally, L6 to U4 – Full time are resolved.
Light-Wire • Initiate arch development explaining use of CL II
.014 U/L without RPEs or W-arches elastics configurations. Do not rush this Phase. It
• Resolve 90% of rotations
must be possible to insert
PRN, .013 U/L if crowding Always place stops the first edgewise wires
• Extrude buccal segments
is severe or periodontal anterior to crowding. with minimal active
support is compromised • Begin A/P and vertical engagement. If not, let the
correction Use Bite Turbos (preferably current wire work longer.
behind U1s) to allow Avoid the use of any wire
.018 U/L 6–8 6–8 buccal segments to “icing” product that
extrude. Disarticulation is would apply too high a
also TMJ favorable. force when the wire
warms.
Reverse curve Ni-Ti is not
recommended on upper
arch.2

II. Damon Optimal-Force • Complete leveling and 10 10 Typically use power chain Kangaroo 3/16", 4.5 oz – Shorty When all brackets and
High-Tech Copper Ni-Ti alignment under wire to consolidate CL II – L6 to U4 – Full time teeth are aligned.
Edgewise • Continue arch minor spaces U/L 3 to 3. If
.014 x .025 U/L development consolidating minor It should be possible to
10 weeks into this stage: spaces U/L 6 to 6, run wire insert the working wires
• Resolve remaining
Take Panorex & reposition 7 to 7. If 7s are not with minimal active
rotations
brackets. Follow with .018 erupted, consolidate 5 to engagement. If not, the
• Begin torque control
Cu Ni-Ti if brackets are 5. Run wire 6 to 6.4 case is not ready for Phase
drastically repositioned. • Consolidate minor spacing III. Avoid “icing” products.

.018 x .025 U/L 6–8 6–8


or
PRN, .018 x .025 L 8 – 10 8 – 10 Pretorqued wires counter
.017 x .025 Ni Ti® with effects of CL II elastics to
20° anterior torque U.3 keep upper incisors from
See Notes. Follow retroclining.
pretorqued wire with
same wire in .019 x .025
for 6 to 8 weeks if more
torque required.

1In patients with very thin attached tissue, severe crowding or periodontal issues, waiting to start elastics until the second appointment may help prevent labial gingival recession. 2Preserving a satisfactory smile arc in a deep-
bite case usually precludes using a reverse curve archwire on the upper arch that would flatten it – even in cases with excessive gingival display. 90% of the correction should come from extruding the buccal segments and
bringing the molars up and forward. It may also be advisable to intrude lower incisors and extrude upper incisors to enhance the smile arc. 3Allowing staff to engage pretorqued wires is not recommended; wire orientation
is critical and it is easy to reverse it inadvertently. 4 If consolidating space behind canines, keep power chain one tooth forward of end of wire to help prevent rotation.
Class I Deep Bite (continued)
Suggested Treatment Protocol

Duration Interval Early Light Elastics Guideposts


Phase Archwires Objectives Notes
in Weeks in Weeks Begun at Initial Bonding for Next Phase

III. Posted Stainless Steel • Take wax bite; coordinate 20 – 30 8 When engaging elastics, Kangaroo 3/16", 4.5 oz – Full CL II When the case is CL I
Major .016 x .025 U/L patient-specific arch form To preclude use the wire posts to L6 to U Post – Full time until and has been in an over-
Mechanics • Consolidate any too much distribute forces over the overcorrected (edge to edge) corrected position for
The diligent use of early remaining minor spacing over- archwire. 8 weeks.
PRN, after 3 weeks, have patient
light elastics may shorten • Express majority of
correction,
advance to Impala 3/16", 6 oz – Full
or even eliminate this remaining torque
do not Once all spaces close,
CL II – L6 to U Post – Full time until
phase, but if additional allow transition from power
• Overcorrect A/P overcorrected (edge to edge)
posterior transverse width intervals to chain to .008 or .010 wire
is required, undertake this and vertical extend to lace anteriors together; Once overcorrected, have patient
phase with elastics and beyond 8 tie back to 6s to avoid switch back to: Quail or Kangaroo
expand wires slightly in weeks. reopening space. – Shorty CL II -- L5 to U Post – Wear
the posterior. often enough to keep edge to edge
and hold for about 8 weeks

To prevent relapse, it is advisable


not to stop CL II elastics too soon.
Just shorten and lighten them.

IV. TMA® • Make final A/P, 15 – 20 4–6 To engage elastics, crimp Quail 3/16", 2 oz or Kangaroo 3/16,
Finishing .019 x .025 U buccolingual, torque and until surgical posts onto TMA 4.5 oz – Shorty CL II
.017 x .025 L occlusal adjustments. sectioning wires to distribute forces L5 to U Post – Full time for 8 weeks
wire, then 2 over the archwire. to hold idealized anterior bite,
preventing relapse into centric slide

Overlay Zebra 5/16", 4.5 oz


Posterior V – U6 to L5 to U Post –
Full time until socked in, then 12
hours daily (after school & nights)

PRN to perfect occlusion, PRN when sectioning wire, maintain


cut upper wire mesial to Shorty CL II but switch from Posterior
the teeth that still require V to Ostrich 3/4", 2 oz – Spaghetti
better articulation. U to L 7 to 3 – Twisted in between.
In the anteriors, end on U Post
Adjust posterior mesial to 3s – Full time
interferences with a
high-speed handpiece
and diamond bur, then
polish, PRN.

These wire/elastics sequence recommendations have been shown to be effective when treating with Damon System mechanics. They are not a replacement for professional expertise.