Standard Operating Protocol

Phase I

Usual sequence of wires for most cases unless specified (note term for future reference).
ကကေ့စ်အမ ျားစက
ု ု ပမ
ု ှန ် archwire sequence အတုငျား် အသုျားပပြုနင
ု ပ
် ါတယ်။ ကန င်တစ်ခ န်မှ ပပန်ပပျားသုျားသပ်ကုျားက ျားနင
ု ဖ
် ု ေ့

အသုျားပပြုတaေ့ rchwireနအခ
ေ့ န်က လကတွေကု မှတ်ထ ျားပါ။

Bonding of all teeth. Band on 1st molars and bond the 2nd molars (except in openbite case).
သွေ ျားကတွေမှ bracket ကတွေ၊ buccal tube ကတွေကပ်ပါ။ 1st molar မှ band စွေပ်ဖလ
ု ေ့ အ
ု ပ်ရင် စွေပ်ပါ။ openbite case ကတွေမှ

လုအပ်သလု ပပြုပပင်ကပပ င်ျားလကုသမှုကပျားရနင

ု ပ
် ါတယ်။

Laceback from Molar tube to canine with 0.10 ss ligature wire (not given when canine is buccaly
or palatally placed) – Tighten laceback in extraction cases to create 1 mm space mesial to canine
if incisor crowding is present. ဒကနရ မှ မုလ buccal tubeကကန canine အထ 0.10 SS ligature wire န ေ့

ခ ည်တ ကု laceback လုပ်တယ်လု ေ့ကပပ ပါတယ်။ Canine က buccaly / palatally ကရ က်လွေနျား် ကနရင်ကတ ေ့ မခ ည်ဘ

ခ န်ထ ျားရပါလမမ
ေ့် ယ်။ က ှ ှေ့သွေ ျား incisor crowding ပဖစ်ကနရင် canine ရ ေ့mesial ဘက်မှ 1 mm space ရလ ကအ င်

laceback ကု တင်ျားတင်ျားခ ည်ထ ျားနင

ု ပ
် ါတယ်။

Bendback on each wire (burn NiTi) 1-2 mm distal to the buccal tube. Bendback is not placed in
Class II div 2 cases where proclination of incisors is needed. Use Ovoid archwires for all cases.
Buccal tube ရ ေ့ကန က်ဘက်မှ အစွေနျား် ထက
ွေ က
် နမယေ့် archwire ကု 1-2 mm ကလ က်အကွေ ကကန ကကွေျားလုကတ
် ကု

bendback လုပ်တယ်လု ေ့ကခေါ်ပါတယ်။ Niti wire ဆုရင် အပူကပျားပပျားမှ ကကွေျားရပါတယ်။ Class II div 2 case ဆုရင်ကတ ေ့

လုအပ်တေ့ incisor proclination ရကအ င် bendback န ေ့ခ ြုပ်မထ ျားသငပ

ေ့် ါဘူျား။

0.012 NiTi one month – Start derotation with lingual rotation tie / rotation wedges from beginning
itself. Apply light force with Echain / Elastic thread / ligature wire to buccaly / palatally placed
teeth (especially the canine). Place crossbite elastics using lingual button. ဒ 0.012 archwire အဆငမ
ေ့် ှ

lingual rotation tie / rotation wedge ကလျားကတွေ သုျားတ န ေ့ လုခ င်တေ့ derotation effect ကု ရနင
ု ပ
် ါတယ်။ Buccaly /
palatally ဘက် ကရ က်လွေနျား် ကနတေ့ canine ကတွေကု Elastomeric chain / elastic thread / ligature wire ကတွေ အသုျားပပြုပျား

light force န ေ့ဆွေကကညေ့်နင

ု ပ
် ါတယ်။ Lingual buttons ကတွေကု အသုျားပပြုပပျား crossbite elastics ကတွေကု တပ်နင
ု ပ
် ါတယ်။

0.014 NiTi one month – Continue as above till satisfactory result. အထက်က 0.012 wire မှ လပ
ု

လုခ င်တရ
ေ့ လဒ် ရလ တအ
ေ့ ထ တပ်ကကညေ့န
် င ု ပ
် ါတယ်။

0.18 NiTi one month – Continue as above till satisfactory result. အထက်က 0.012 wire မှ လပ
ု

လုခ င်တရ
ေ့ လဒ် ရလ တအ
ေ့ ထ တပ်ကကညေ့န
် င ု ပ
် ါတယ်။

0.018 SS intermediate wires အဆငမ

့် ှာ

A. Anterior spacing ရှိနေရင့်

Do not remove laceback. Size the wire leaving 3 mm distal to the distal of buccal tube. Place in
slot and then use E Chain (Power chain). Start with long power chain (mild force); if spacing is
more, replace after 3 weeks with short power chain (medium force), and then again after 3 weeks
replace with continuous power chain (heavy force). Go on replacing with new sections of
continuous power chain every 3 weeks till space closure occurs. The power chain can be stretched
a few times before placement to reduce the forces further. No bendback is placed at this time since
the teeth are being retracted.

B. In palatally placed lateral incisors when open coil is used to distalize the canine and bring
the lateral into alignment. လုပ့်မယ့်ဆရ
ု ှိ င့်

Remove laceback. Size the wire leaving 3 mm distal to the distal of buccal tube. If crossbite is
present, then posterior bite-block has to be placed on lower 2nd premolar and molars and tripoded
and balanced to raise the bite. Bond the lateral incisor bracket upside-down (this is continued
till the end of treatment). Use an open coil NiTi spring (medium force 0.010) with archwire passed
through it, the spring length is 3 mm more than the interbracket span. Ligate the adjacent
brackets with Ligature wire for rotation control. Place Bendback. Tie the lateral incisor with
ligature wire / Echain to bring it out simultaneously. Once the lateral incisor comes out, remove
the posterior bite blocks and go on to the next wire.
0.019 x 0.025 NiTi one month အဆငမ
့် ှာ – With laceback and bendback (burn NiTi)

Phase II

Remove laceback

19 x 25 ss – individualized arch form (IAF) for all SS wires from this stage onwards

Overbite correction

If overbite correction has not taken place – Place 0.019 x 0.025 SS for 6 weeks and watch

If overbite correction still not taken place – Place Sweeps on 0.019 x 0.025 SS

19 x 25 SS for space closure

Generalized spacing – Power chain from molar to molar – Start with long power chain for 3 weeks,
then short power chain for 3 weeks and the continuous power chain for 3 weeks (continued) till
space closure obtained

Extraction space closure

Anterior Fig of 8

Posterior Fig of 8

If using a canine bracket with torque (no hook), use a crimpable hook / Gurin screw or use posted
arch-wire (hook soldered to arch-wire – no need to place anterior Fig of 8)

Space closure will involve intra- and inter-arch mechanics. Use Dontrix gauge for determining
force levels.

Intra-arch – Class I Force – From buccal tube hook to canine hook / crimpable hook / hook on
arch-wire.

Inter-arch – Class II Force – From lower buccal tube hook to upper canine hook / crimpable hook
/ hook on arch-wire

Inter-arch – Class III Force – From upper buccal tube hook to lower canine hook / crimpable
hook / hook on arch-wire
Inter-arch Elastics

Class II case – Class II – yellow elastics (2.5 / 3 oz)

Class III case – Class III – yellow elastics (2.5 / 3 oz)

In Class II or Class III open bite cases – Short Class II or Class III Elastics – From premolar hook
to the canine hook / crimpable hook / hook on arch-wire

Intra-arch elastics – First one month you can place yellow intra-arch (Class I) elastics for the wire
to settle before starting serious space closure (Passive Tieback can also be done for the same
purpose).

Class I Elastics – Green (3.5), Blue (4), Red (4.5), Grey (5). Maximum 200 grams of force for
retraction with sliding mechanics.

(Force levels and color change with manufacturers – look at their brochure).

Elastics changed by the patient – Once daily / Twice daily according to force constancy needed.
Ask the patient if there is force on the teeth – you can even place double elastics.

Start with green and go up the force level as needed. Recall every 6 weeks and cut the wire distal
to the buccal tube.

Close Coil Spring (0.10 NiTi Medium force)

Take the smallest one (6mm) tie it to the buccal tube hook and canine hook / crimpable hook /
hook on archwire using a 0.10 Ligature wire. Extend one and a half time its original size (9mm)
or according to manufacturer specification. Recall patient every 6 weeks for check up – Reactivate
as and when needed. Provide the patient with relief wax.

Midline correction during space closure

More force on opposite side to the shift side

Laceback on shift side and force on opposite side

Aysmmetric elastics – Class II on one side and Class III on the opposite side

Anterior cross elastics

Finishing

Individualized arch form (IAF) with 0.14 SS with tight bendback and vertical elastics /Anterior
box elastics with 0.016 NiTi OR section rectangular wire distal to canine