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2. IMPORTANCE OF STAFF
4. ARCH FORM
5. NON-EXTRACTION CASES
8. SURGICAL CONSIDERATIONS
9. FINISHING
10.RETENTION
1
1
This can include:
2
2
The initial exam and
consultation are times to
educate the patient
• Airway
• Habits
• Dentition
77
__
74
3
40
31
31
121
0
10
-4
102 9
96 -7
3
3
CONVENTIONAL CRANIAL BASED CEPHALOMETRICS
SN-GoGn° 32 82 SNA°
80 SNB°
2 ANB°
F-Mand° 26
U1-Palatal plane°
Pal-Mand° 28
110 -1 A-Na Perp mm
U1 APO°
5
0 Wits mm
2
Occlusal Plane Angle L1 APO°
TMJs Skeletal,
And Dental &
Muscles Soft Tissue
Position of
Anterior
Airway Segments
N.D. 77
INITIAL __
74
12.8 yrs 3
40
31
“ I DON’T USE CEPHALOMETRICS
ANY MORE”
31
121
0
10
-4
102 9
96 -7
4
4
2014 JCO Study of Orthodontic Diagnosis
and Treatment Procedures-Part 1
Table 3
Cephalometric Diagnostic Records
1986 - 90%
1996 - 90%
2008 - 74%
2014 - 64%
Michigan Growth
Studies
90°
A point
Nasion
Perpendicular
Pogonion
5
5
The “Wits” appraisal of
jaw disharmony
Alex Jacobson, MDS, MS, PhD
AJO-DO
November 2003 - Volume 124 Issue 5
Pages 470-479
or www.ajodo.org
84
__
79
30 5 ANB
27
27
112
‐1
6
1 3 WITS
94
84
__
79
30 5 ANB
27
27
112
‐1
6
101 1 3 WITS
94 ‐12
OCCLUSAL PLANE ANGLE = 101
6
6
G.B.
BEGINNING 87
__
86
52.8 yrs 1 ANB
20
14
111
23 6
5
5 WITS
86 4
94 +8
OCCLUSAL PLANE ANGLE = 86
N.S.
BEGINNING
73
17.0 yrs __
66
7
50
42
104
49 -3
POSITIONALLY SENSITIVE
13
3
DENTALLY8 SENSITIVE
Po can vary 1.5 to 2 cm
94
-22
7
7
N.B.
BEGINNING 86
20.8 yrs 28
95
__
-9
29
25
122
-2
-1
122
-15
-4 62 8
-15
29 85 88
66
66 16
A.H.
BEGINNING 85
__
81
12.6 yrs 4
37
29
35 107
7
1
107 -4
1
59 105
13 -4
22 78
80
80 9
Orthodontic Case
Surgical Case
8
8
Orthodontists need to
dentally compensate incisors
in many cases
Mx 1
Md 1
CLASS I
Mx1-PP
115
POP
Mx1-OP
8 57 0 Wits
20 65
Md1-OP
OMP
95
Md1-MP
9
9
J.C.
75
75
__
0
43
35
38 113
High Angle -4
113 8
11 56 -3 -3
27 80 3
72
-8
72
81
__
78
3
27
21
21
117 0
Low Angle 6
117 3
3
5 58
3
16 65
100 -6
100
79
75
__
4
24
20
104
Class II 6
-2
21
104
4
8 69 3
4
13 66
101
101 -11
10
10
78
82
__
26 -4
24
23
120
-6
Class III 3
-8
2
120
6 54
-8
17 81
82 -1
82
N.D. 77
INITIAL __
74
12.8 yrs 3
40
31
31
121
0
10
-4
121 102 9
12 47
-4
19 66
96 96 -7
90°
Subnasale
11
11
ARNETT
SOFT TISSUE
CEPHALOMETRIC ANALYSIS
SUBNASALE
N.D.
INITIAL 77
74
__
12.8 yrs 3
40
31
121
31
10 -0
121
12 47 9
-4 -5
19 66
96
96 -7
12
12
NATURAL HEAD POSTURE
LITERATURE
• Sella-Nasion 5.3 sd
• Basion-Nasion 4.7 sd
• Porion-Orbitale 5.0 sd
ARNETT
SOFT TISSUE -8
CEPHALOMETRIC ANALYSIS
170
7
5
-19
-22
17 -15
15 15
-13
3 100
4 -1
26 8 21
115 3
96 57 -9 12 3
8 57 2 3 5 2
0
20 65 65 3 13 1
8
95
4 -5
2 51 47
59 -3
12
7 73 125
13
13
Conventional Ceph
82 SNA°
SN-GoGn° 32 80 SNB°
2 ANB°
14
14
ARNETT NORMS AND STANDARD DEVIATIONS
UPPER ANTERIOR SEGMENT-HORIZONTAL
Male STCA research values and (means)
Incisor torque to occl. plane 54.8° to 60.8° (57°)
K
Incisor tip to TVL -13.9 mm to -10.3 mm (-12)
K
Lip thickness 13.4 to 16.2 mm (14)
K
Lip to TVL 1.6 mm to 5.0 mm (3)
K
UPPER ANTERIOR SEGMENT-VERTICAL
Male STCA research values and (means)
Max. anterior height 25.2 mm to 31.6 mm (28)
KLip length 21.9 mm to 26.9 mm (24)
KIncisor exposure 2.7 to 5.1 mm mean (4)
Inter-labial gap 1.3 mm to 3.5 mm (2)
LOWER ANTERIOR SEGMENT
Male STCA research values and (means)
Occlusal plane to TVL 93.6° to 96.4° (95°)
Incisor torque to occl. plane 60.0° to 68.0° (64)
L
Lip thickness 13.4 to 16.2 mm (15)
L
Lip to TVL -1.6 mm to 3.2 mm (1)
L
Soft tissue ‘B’ point -8.7 mm to -5.5 mm (-7)
Soft tissue pogonion -5.3 mm to -1.7 mm (-3)
15
15
Upper Anterior Segment – Horizontal Numbers
Upper Incisor Tip Projection
Mx 1 ‐ TVL
Upper Incisor Inclination
Mx1 – Mx OP
16
Upper Lip Thickness
Mx1 Labial ‐ ULA
12 3
57 ‐9
‐ Upper Lip Anterior
ULA ‐ TVL
16
Upper Anterior Segment – Vertical Numbers
Mx Anterior Height
Sn’ – Mx1 Tip
Upper Lip Length
Sn’ – ULI
17
26 21
Upper Incisor Exposure
UL1 – Mx 1 Tip
‐
5 2
Inner Labial Gap
UL1 – LLS
17
Lower Anterior Segment Numbers
18
Lower Lip Thickness
LL Inside – LLOutside
96 Lower Lip Anterior
Mx Occlusal Plane 65 13 1 LLA
Mx OP ‐ TVL
‐5 Soft Tissue B Point
Lower Incisor Inclination
B’
Md1 – Md OP
Soft Tissue Pogonion
‐3 Pog’ ‐ TVL
18
ARNETT SOFT TISSUE CEPHALOMETRIC ANALYSIS
Anterior Segment – Numbers
Mx Anterior Height
Upper Incisor Inclination Upper Lip Length
Upper Incisor Tip Projection
19
21
Upper Lip Thickness
Upper Lip Anterior
26
12 Upper Incisor Exposure
57 ‐9 3
96 Inner Labial Gap
Mx Occlusal Plane
5 2
Lower Lip Anterior
65 13 1
Lower Lip Thickness
Lower Incisor inclination ‐5 Soft Tissue B Point
Soft Tissue Pogonion
‐3
AJO, SEPT. 1999
19
ARNETT SOFT TISSUE CEPHALOMETRIC ANALYSIS
Upper Anterior Segment – Horizontal Numbers
57
-
CLASS I
Mx1-PP
115
POP
Mx1-OP
8 57 0 Wits
20 65
Md1-OP
OMP
95
Md1-MP
57 -9
-
20
20
ARNETT SOFT TISSUE CEPHALOMETRIC ANALYSIS
Upper Anterior Segment – Horizontal Numbers
12
57 -9
-
12
57 -9 3
- Upper Lip Anterior
N.D.
INITIAL
12.8 yrs
9
47 -4 13
21
21
ARNETT SOFT TISSUE CEPHALOMETRIC ANALYSIS
Upper Anterior Segment – Vertical Numbers
Mx Anterior Height
26
Mx Anterior Height
21
26
Mx Anterior Height
21
26 Upper Incisor Exposure
22
22
ARNETT SOFT TISSUE CEPHALOMETRIC ANALYSIS
Upper Anterior Segment – Vertical Numbers
Mx Anterior Height
21
26 Upper Incisor Exposure
5 2
Inner Labial Gap
N.D.
INITIAL
12.8 yrs
29 25
3 5
96
Mx Occlusal Plane
23
23
ARNETT SOFT TISSUE CEPHALOMETRIC ANALYSIS
Lower Anterior Segment – Numbers
96
Mx Occlusal Plane 65
CLASS I
Mx1‐PP
115
POP
Mx1‐OP
8 57 0
Wits
20 65
Md1‐OP
OMP
95
Md1‐MP
96
Mx Occlusal Plane 65 13
Lower Incisor inclination
24
24
ARNETT SOFT TISSUE CEPHALOMETRIC ANALYSIS
Lower Anterior Segment – Numbers
25
25
N.D.
INITIAL
12.8 yrs
102
66
15 7
-4
-6
N.D.
INITIAL
12.8 yrs
29 25
102 9
47 -4 13
3 5
66
15 7
-4
-6
N.D. BEG/PREDICTION
SN AT S
26
26
The Transverse Dimensions is about
Four Factors:
27
27
N.D.
N.D.
N.D.
28
28
TOP TEN LESSONS I HAVE LEARNED IN ORTHODONTICS
2. IMPORTANCE OF STAFF
4. ARCH FORM
5. NON-EXTRACTION CASES
8. SURGICAL CONSIDERATIONS
9. FINISHING
10.RETENTION
Written
Treatment Plan
ARCHWIRE SEQUENCE
1st BICUSPID
EXT.
.015 multistrand .016 round heat activated
.0175 multistrand
.016 x .022 rectangular
heat activated
.014 round stainless steel
.016 round stainless steel
.019 x .025 rectangular
.018 round stainless steel
heat activated
.020 round ss heat treated
.019 x .025 & .017 x .025 .019 x.025 & .017 x .025
rectangular ss heat treated rectangular ss heat treated
29
29
ARCHWIRE SEQUENCE
1ST BICUSPID
EXT.
.015 multistrand .016 round heat activated
.0175 multistrand
.016 x .022 rectangular
heat activated
.014 round stainless steel
.016 round stainless steel
.019 x .025 rectangular
.018 round stainless steel
heat activated
.020 round ss heat treated
.019 x .025 & .017 x .025 .019 x.025 & .017 x.025
rectangular ss heat treated rectangular ss heat treated
ARCHWIRE SEQUENCE
2nd BICUSPID
EXT.
.015 multistrand .016 round heat activated
.0175 multistrand
.016 x .022 rectangular
heat activated
.014 round stainless steel
.016 round stainless steel
.019 x .025 rectangular
.018 round stainless steel
heat activated
.020 round ss heat treated
.019 x .025 & .017 x .025 .019 x.025 & .017 x.025
rectangular ss heat treated rectangular ss heat treated
ARCHWIRE SEQUENCE
2nd BICUSPID
EXT.
.015 multistrand .016 round heat activated
.0175 multistrand
.016 x .022 rectangular
heat activated
.014 round stainless steel
.016 round stainless steel
.019 x .025 rectangular
.018 round stainless steel
heat activated
.020 round ss heat treated
.019 x .025 & .017 x .025 .019 x.025 & .017 x.025
rectangular ss heat treated rectangular ss heat treated
30
30
TOP TEN LESSONS I HAVE LEARNED IN ORTHODONTICS
2. IMPORTANCE OF STAFF
4. ARCH FORM
5. NON-EXTRACTION CASES
8. SURGICAL CONSIDERATIONS
9. FINISHING
10.RETENTION
THE GOAL
Efficient and User Friendly
Intra-arch Mechanics
and
60%-70%
THE STAFF
31
31
TOP TEN LESSONS I HAVE LEARNED IN ORTHODONTICS
2. IMPORTANCE OF STAFF
4. ARCH FORM
5. NON-EXTRACTION CASES
8. SURGICAL CONSIDERATIONS
9. FINISHING
10.RETENTION
BRACKET PLACEMENT
Procedure in Orthodontics
BRACKET POSITIONING
REFERENCES
• Andrews References
• Incisal Edges
32
32
VERTICAL BRACKET
POSTIONING ERRORS
• Gingival concerns
• Lack of eruption - short clinical crown
• Lingual root positions - short clinical crown
• Gingival inflammation - short clinical crown
• Labial root position - recession - long clinical crown
• Incisal or occlusal concerns
• Tooth wear
• Tooth fracture
33
33
1) Draw the long axis of the clinical crown and the mesial
buccal cusp of the second molars.
34
34
4) Mark the marginal ridge height on the first molars.
35
35
7) Use the same mm difference that was established on the
first molar to locate the bracket height.
36
36
EFFICIENT
BRACKET REPOSITIONING
ARCHWIRE SEQUENCE
.015 multistrand
.0175 multistrand
37
37
ARCHWIRE SEQUENCE
.019 x .025 & .017 x .025 .019 x.025 & .017 x.025
rectangular ss heat treated rectangular ss heat treated
ARCHWIRE SEQUENCE
NON EXT.
.015 multistrand .016 round heat activated
.0175 multistrand
.016 x .022 rectangular
heat activated
.014 round stainless steel
.016 round stainless steel
.019 x .025 rectangular
.018 round stainless steel
heat activated
.020 round ss heat treated
.019 x .025 & .017 x .025 .019 x .025 & .017 x .025
rectangular ss heat treated rectangular ss heat treated
ARCHWIRE SEQUENCE
NON EXT.
.015 multistrand .016 round heat activated
.0175 multistrand
.016 x .022 rectangular
heat activated
.014 round stainless steel
.016 round stainless steel
.019 x .025 rectangular
.018 round stainless steel
heat activated
.020 round ss heat treated
.019 x .025 & .017 x .025 .019 x .025 & .017 x .025
rectangular ss heat treated rectangular ss heat treated
38
38
CLEAN-UP TIME
2. IMPORTANCE OF STAFF
4. ARCH FORM
5. NON-EXTRACTION CASES
8. SURGICAL CONSIDERATIONS
9. FINISHING
10.RETENTION
39
39
Tapered Ovoid Square
40
40
Patient Name
41
41
Lower .019 x .025 Arch Wire
Shaped to Arch Template
2. IMPORTANCE OF STAFF
4. ARCH FORM
5. NON-EXTRACTION CASES
8. SURGICAL CONSIDERATIONS
9. FINISHING
10.RETENTION
42
42
Class I Cases
• Interproximal reduction
• Expansion
A META-ANALYSIS OF MANDIBULAR
INTERCANINE WIDTH IN TREATMENT
AND IN POST-RETENTION
BURKE, S.P., ANGLE ORTH., 68:53-60, 1998
43
43
SHAPIRO, P.A., MANDIBULAR ARCH
FORM AND DIMENSION,
AJO, 66:58-70, 1974
2 millimeters
44
44
1 mm 1 mm 1 mm 1 mm
1.5 mm 1.5 mm 2 mm 2 mm
.5 mm .5 mm 1 mm 1 mm
3 mm 3 mm 4 mm 4 mm
45
45
Predictors of Variation in Mandibular
Incisor Enamel Thickness
Journal of the American Dental Asso., June 2007;
138(6); pg 809-815
N.E. Hall, S.J. Lindauer, E. Tüfekçi , B. Shroff
ARCHWIRE SEQUENCE
NON EXT.
.015 multistrand .016 round heat activated
.0175 multistrand
.016 x .022 rectangular
heat activated
.014 round stainless steel
.016 round stainless steel
.019 x .025 rectangular
.018 round stainless steel
heat activated
.020 round ss heat treated
.019 x .025 & .017 x .025 .019 x .025 & .017 x .025
rectangular ss heat treated rectangular ss heat treated
2. IMPORTANCE OF STAFF
4. ARCH FORM
5. NON-EXTRACTION CASES
8. SURGICAL CONSIDERATIONS
9. FINISHING
10.RETENTION
46
46
Class II Cases
N.M.
BEGINNING
11.6 yrs
1
3
2
4 19
105 25
58 5
-11 15
65 6 6
13 -1
5
-13
-9
J.H.
BEGINNING
11.4 yrs
1 3
2 4 21 19
95 56 -9 13 4
2 2
60 11 -3
5 -11
-7
47
47
TECHNIQUES FOR
INTER-ARCH CORRECTION
• HG and Class II Elastics
• Bionator
• Teuscher Appliance
• Twin Block
• Herbst
• Jasper Jumper
• Eureka Springs
• Mara
• Forsus
• Esprit
HORIZONTAL SKELETAL
APPLIANCE CHANGES
MAXILLARY MOLAR
DISTALIZATION
• Headgear
• HG, sliding jigs, Cl II elastics
• Cetlin retainer
• Double Nance jig
• Distal jet
• Pendulum
48
48
TOP TEN LESSONS I HAVE LEARNED IN ORTHODONTICS
2. IMPORTANCE OF STAFF
4. ARCH FORM
5. NON-EXTRACTION CASES
8. SURGICAL CONSIDERATIONS
9. FINISHING
10.RETENTION
A.Y.
BEGINNING
6.11 yrs 82
__
84
-2
22
19 116
19 1 -1
1 -6
116
7 58
-6
12 85
2
83
83
49
49
115-120
115-120
80-85
80-85
120
120
80
80
50
50
ORTHOPEDIC TRACTION OF THE
MAXILLA WITH MINIPLATES: A NEW
PERSPECTIVE FOR TREATMENT OF
MIDFACE DEFICIENCY
2. IMPORTANCE OF STAFF
4. ARCH FORM
5. NON-EXTRACTION CASES
8. SURGICAL CONSIDERATIONS
9. FINISHING
10.RETENTION
51
51
DIAGNOSIS AND TREATMENT
PLANNING CHALLENGES
52
52
Critical Appraisal of in Vitro Steady-
State Frictional Resistance Studies
Seminars in Orthodontics
2010: 16
pages 244-248
Elsevier 2010
AJO-DO
October 1998 - Volume 114 Issue 4
Pages 372-382
53
53
Vertical undermining grooves
Conclusion:
54
54
R.O.
R.O.
55
55
R.O.
ARCHWIRE SEQUENCE
.019 x .025 & .017 x .025 .019 x.025 & .017 x.025
rectangular ss heat treated rectangular ss heat treated
ARCHWIRE SEQUENCE
NON EXT.
.015 multistrand .016 round heat activated
.0175 multistrand
.016 x .022 rectangular
heat activated
.014 round stainless steel
.016 round stainless steel
.019 x .025 rectangular
.018 round stainless steel
heat activated
.020 round ss heat treated
.019 x .025 & .017 x .025 .019 x .025 & .017 x .025
rectangular ss heat treated rectangular ss heat treated
56
56
ARCHWIRE SEQUENCE
1st BICUSPID
EXT.
.015 multistrand .016 round heat activated
.0175 multistrand
.016 x .022 rectangular
heat activated
.014 round stainless steel
.016 round stainless steel
.019 x .025 rectangular
.018 round stainless steel
heat activated
.020 round ss heat treated
.019 x .025 & .017 x .025 .019 x.025 & .017 x .025
rectangular ss heat treated rectangular ss heat treated
ARCHWIRE SEQUENCE
1ST BICUSPID
EXT.
.015 multistrand .016 round heat activated
.0175 multistrand
.016 x .022 rectangular
heat activated
.014 round stainless steel
.016 round stainless steel
.019 x .025 rectangular
.018 round stainless steel
heat activated
.020 round ss heat treated
.019 x .025 & .017 x .025 .019 x.025 & .017 x.025
rectangular ss heat treated rectangular ss heat treated
2. IMPORTANCE OF STAFF
4. ARCH FORM
5. NON-EXTRACTION CASES
8. SURGICAL CONSIDERATIONS
9. FINISHING
10.RETENTION
57
57
N.H.
N.H.
N.H.
58
58
1/2 1/2
59
59
minimal tipping
ARCHWIRE SEQUENCE
2nd BICUSPID
EXT.
.015 multistrand .016 round heat activated
.0175 multistrand
.016 x .022 rectangular
heat activated
.014 round stainless steel
.016 round stainless steel
.019 x .025 rectangular
.018 round stainless steel
heat activated
.020 round ss heat treated
.019 x .025 & .017 x .025 .019 x.025 & .017 x.025
rectangular ss heat treated rectangular ss heat treated
60
60
ARCHWIRE SEQUENCE
2nd BICUSPID
EXT.
.015 multistrand .016 round heat activated
.0175 multistrand
.016 x .022 rectangular
heat activated
.014 round stainless steel
.016 round stainless steel
.019 x .025 rectangular
.018 round stainless steel
heat activated
.020 round ss heat treated
.019 x .025 & .017 x .025 .019 x.025 & .017 x.025
rectangular ss heat treated rectangular ss heat treated
ASYMMETRIES
•Dentoalveolar
•Anterior
•Posterior
•Anterior posterior
•Functional
•CR/CO shifts
•Structural/Skeletal
•Mandible
•Maxilla
ORTHODONTIC PROGRAMS
• Orthodontic Treatment Mechanics and the
Pre-adjusted Orthodontic Appliance
61
61
ASYMMETRIES
•Dentoalveolar
•Anterior
•Posterior
•Anterior posterior
•Functional
•CR/CO shifts
•Structural/Skeletal
•Mandible
•Maxilla
2. IMPORTANCE OF STAFF
4. ARCH FORM
5. NON-EXTRACTION CASES
8. SURGICAL CONSIDERATIONS
9. FINISHING
10.RETENTION
62
62
CLASS II TREATMENT OPTIONS
• Non-extraction
• Upper second molar extraction
• Upper second bicuspid extraction
• Upper first bicuspid extraction
• Upper first or second bicuspid and lower incisor
extraction
• Upper first bicuspid and lower second
bicuspid extraction
• Upper and lower first bicuspid extraction
MAXILLARY MOLAR
DISTALIZATION
• Headgear
• HG, sliding jigs, Cl II elastics
• Cetlin retainer
• Double Nance jig
• Distal jet
• Pendulum
63
63
ORTHODONTIC PROGRAMS
• Orthodontic Treatment Mechanics and the
Pre-adjusted Orthodontic Appliance
• Incisors
• Cuspids
• First bicuspids
• Second bicuspids
• First molars
• Second molars
• Retention
• Incisors
• Cuspids
• First bicuspids
• Second bicuspids
• First molars
• Second molars
• Retention
64
64
Decoronation- a conservative
method to treat ankylosed teeth for
preservation of alveolar ridge prior
to permanent prosthetic
reconstruction
Dental Traumatology
2007
Vol 23
Pages 87-94
CDA Journal
Vol 28, No
11
Pages 846-
854
November,
2000
65
65
THE NUTS AND BOLTS OF
HEMISECTION TREATMENT:
MANAGING CONGENITALLY MISSING
MANDIBULAR SECOND PREMOLARS
INCISOR TORQUE
Incisor Torque
Upper Upper Lower Lower
Central Lateral Central Lateral
66
66
TOP TEN LESSONS I HAVE LEARNED IN ORTHODONTICS
2. IMPORTANCE OF STAFF
4. ARCH FORM
5. NON-EXTRACTION CASES
8. SURGICAL CONSIDERATIONS
9. FINISHING
10.RETENTION
• Airway
• Habits
• Dentition
Perio Status
Transverse
Dimension
Habits
Facial &
Skeletal Pattern Remaining
Dentition-
Canines,
Dental Status
Premolars,
Molars
67
67
CEPHALOMETRIC
TREATMENT PLANNING
DR. G. WILLIAM ARNETT
1.Correct Mx incisor inclination
2.Correct Md incisor inclination
3.Correct overbite
4.Correct overjet and molar overbite
a.Reposture lower lip
5.Set Mx incisor position
6.Set occlusal plane
7.Set ideal chin projection
ORTHODONTIC PROGRAMS
• Orthodontic Treatment Mechanics and the
Pre-adjusted Orthodontic Appliance
68
68
MECHANICAL AND MEDICAL
STABILIZATION OF THE TMJ
• Medications
PATHOPHYSIOLOGY AND
PHARMACOLOGIC CONTROL OF OSSEOUS
MANDIBULAR CONDYLAR RESORPTION
69
69
PATHOPHYSIOLOGY AND PHARMACOLOGIC
CONTROL OF
OSSEOSIS MANDIBULAR CONDYLAR RESORPTION
• Cytokine signaling
• Phospholipid catabolites
• Hormonal imbalances
• Matrix metaloproteases
70
70
Medical Management Protocol
• FREE RADICALS:
71
71
PATHOPHYSIOLOGY AND PHARMACOLOGIC
CONTROL OF
OSSEOSIS MANDIBULAR CONDYLAR RESORPTION
tolerate Feldene
72
72
CYTOKINES (FOR EXAMPLE, TUMOR NECROSIS
NON-RHUEMATOID PATIENTS.
ENBREL, HUMIRA
73
73
2015 joint stabilizing medications
multi-vitamin o antioxidants
omega 3 fatty acid 2-4G o potent antioxidant
feldene 20mg o anti-inflammatory
celebrex 50-100mg o anti-inflammatory
simvastatin 20mg o anti-inflammatory
methotrexate o potent anti-inflammatory
17 beta estradiol o potent anti-inflammatory
amitriptyline 5-10mg o antibruxism?, mm relax
klonopin .5-1mg o antibruxism
botox injection 25-50u o antibruxism
buspirone 5mg tid o counters SSRI bruxism
doxycycline 50-100mg o MMP control
simvastatin o auto immune control
enbrel (etanercept) o binds tumor necrosis factor
humira o binds tumor necrosis factor
Vit D and Ca++ o anabolic bone promoter
17 beta estridiol o anabolic bone promoter
medication publications
Gunson MJ and Arnett GW. Condylar
Resorption, Matrix Metalloproteinases, and think of TMJ
Tetracyclines. RWISO Journal, September medications in the
2010; Vol. 2, No. 1: 37‐44 same fashion as a
Gunson MJ , Arnett GW, Milam SB. rheumatologist
Pathophysiology and Pharmacologic Control stabilizing multiple
of Osseous Mandibular Condylar Resorption. joints involved in
JOMS, August 2012, 70(8):1918‐34. collagen vascular
Arnett GW, Gunson MJ. Risk Factors in the diseases i.e.
Initiation of Progressive Condylar rheumatoid
Resorption. Seminars in Orthodontics, Guest arthritis
Editors: Handelman CS, Green CS. VOL 19,
NO 2, June, 2013.
ORTHODONTIC PROGRAMS
• Orthodontic Treatment Mechanics and the
Pre-adjusted Orthodontic Appliance
74
74
TOP TEN LESSONS I HAVE LEARNED IN ORTHODONTICS
2. IMPORTANCE OF STAFF
4. ARCH FORM
5. NON-EXTRACTION CASES
8. SURGICAL CONSIDERATIONS
9. FINISHING
10.RETENTION
DEFINITION OF FINISHING
• Over-correction
• Settling
SETTLING SUMMARY
Lower Arch
• .016 HA – good alignment
• .019 x .025 SS
75
75
SETTLING SUMMARY
Upper Arch
• .014 SS - 2 x 2 sectional wire
• No elastics needed, or triangle elastics
on canines, and/or posterior teeth
• .014 SS – 3 x 3 sectional wire
• Cuspid to cuspid well aligned
• Keep a 2x2 space closed
• .014 SS full wire
• Chain to keep spaces closed - use molar offsets
76
76
ARCHWIRE SEQUENCE
.019 x .025 & .017 x .025 .019 x.025 & .017 x.025
rectangular ss heat treated rectangular ss heat treated
ARCHWIRE SEQUENCE
NON EXT.
.015 multistrand .016 round heat activated
.0175 multistrand
.016 x .022 rectangular
heat activated
.014 round stainless steel
.016 round stainless steel
.019 x .025 rectangular
.018 round stainless steel
heat activated
.020 round ss heat treated
.019 x .025 & .017 x .025 .019 x .025 & .017 x .025
rectangular ss heat treated rectangular ss heat treated
ARCHWIRE SEQUENCE
1st BICUSPID
EXT.
.015 multistrand .016 round heat activated
.0175 multistrand
.016 x .022 rectangular
heat activated
.014 round stainless steel
.016 round stainless steel
.019 x .025 rectangular
.018 round stainless steel
heat activated
.020 round ss heat treated
.019 x .025 & .017 x .025 .019 x.025 & .017 x .025
rectangular ss heat treated rectangular ss heat treated
77
77
ARCHWIRE SEQUENCE
1ST BICUSPID
EXT.
.015 multistrand .016 round heat activated
.0175 multistrand
.016 x .022 rectangular
heat activated
.014 round stainless steel
.016 round stainless steel
.019 x .025 rectangular
.018 round stainless steel
heat activated
.020 round ss heat treated
.019 x .025 & .017 x .025 .019 x.025 & .017 x.025
rectangular ss heat treated rectangular ss heat treated
ARCHWIRE SEQUENCE
2nd BICUSPID
EXT.
.015 multistrand .016 round heat activated
.0175 multistrand
.016 x .022 rectangular
heat activated
.014 round stainless steel
.016 round stainless steel
.019 x .025 rectangular
.018 round stainless steel
heat activated
.020 round ss heat treated
.019 x .025 & .017 x .025 .019 x.025 & .017 x.025
rectangular ss heat treated rectangular ss heat treated
ARCHWIRE SEQUENCE
2nd BICUSPID
EXT.
.015 multistrand .016 round heat activated
.0175 multistrand
.016 x .022 rectangular
heat activated
.014 round stainless steel
.016 round stainless steel
.019 x .025 rectangular
.018 round stainless steel
heat activated
.020 round ss heat treated
.019 x .025 & .017 x .025 .019 x.025 & .017 x.025
rectangular ss heat treated rectangular ss heat treated
78
78
ORTHODONTIC VTO
Name: _____________________
MIDLINE MOLAR POSITION
Crowding/Spacing-Anteriors
C/S-Molars
Curve of Spee
Midline
Incisor Position
Initial Discrepancy
Stripping
Expansion
Distalizing 6 6
Extraction
Remaining Discrepancy
( ) ( )
79
79
SURGICAL ORTHODONTIC VTO
Name: _____________________
MIDLINE MOLAR POSITION
Crowding/Spacing-Anteriors
C/S-Molars
Curve of Spee
Midline
Incisor Position
Initial Discrepancy
Stripping
Expansion
Distalizing 6 6
Extraction
Remaining Discrepancy
( ) ( )
Right 1st Molar Cuspid Midline Cuspid Left 1st Molar
80
80
SURGICAL ORTHODONTIC VTO
Crowding/Spacing-Anteriors
C/S-Molars
Curve of Spee
Midline
Incisor Position
Initial Discrepancy
Stripping
Expansion
Distalizing 6 6
Extraction
Remaining Discrepancy
81
81
McLaughlin
Brackets and tubes Bennett
with Forestadent
on Large Pad
Maxillary tooth Torque Angulation distal offset Slot
right left
76 67 -14° – 10° 743T0742 742T0742
.022"
on Large Pad
Mandibular tooth Torque Angulation distal offset Slot
right left
82
82
- 12 -
NOTES
NOTES
NOTES
Ciudad de México, México
13 de Abril del 2018