Journal of general orthodontics最新文献

In orthodontic cases where the regional anatomy provides limited room for eruption, there is etiologically a higher occurrence of tipped/impacted second molars. Although second molar extraction with third molar replacement is a useful option, the "Pivot Arm Appliance" encourages the uprighting of the second molar as a preferred treatment. The most unique and important attribute of the "Pivot Arm Appliance" is the rotating tube. In cases of access limitation, the disto-occlusal surface of the molar presents as one area that is accessible. Other features of the "Pivot Arm Appliance" include: The position of the rotator tube delivers optimal rotational force through the pivoting action of the tube/arm complex. The "Pivot Arm Appliance" takes advantage of the efficiency and simplicity of a Class I lever system. The anatomical fulcrum being the dense cortical bone located anterior to the ascending ramus. The vertical spring system is compact, reliable and delivers gentle controlled force in rotational direction. The lingual location of the "Pivot Arm Appliance" does not hinder the function of the tongue, impinge on the soft tissue or interfere with normal masticatory function. The ease of placement of the rotator tube and subsequent insertion of the spring. It is well to note the uprighting appliance provides a very useful and practical approach to the unique problem of severely tipped second molars with limited buccal access. The "Pivot Arm Appliance" does not function only in these situations but can be used in all cases of second molar uprighting of a moderate to severe nature.

In recent years orthodontic therapy has improved dramatically thanks to perceptive orthodontic practitioners willing to optimize various combination of treatment modalities to effect enhanced results for their patients. Advances in metallurgy, appliance design and mechanics influence the scope of orthodontic practice on almost a daily basis. Incorporating these advancements with a new understanding of facial esthetics creates many opportunities for orthodontic practitioners to refine their treatment philosophy. This article is intended to introduce the tip edge practitioner to a system which blends the uniqueness of Tip Edge "fixed functional" bracket with the principal advantages of straightwire mechanics and treatment philosophy. This complete orthodontic system focuses on arch development, of harmonious, well-supported facial features and maintaining complete case control throughout treatment. The full utilization of Tip Edge bracket prescription is accomplished through the appropriate sequencing of thermal nickel titanium archwires and stainless steel rectangular archwires.

Dentists modify and construct occlusions. This occurs on a daily basis in the disciplines of restorative, fixed and removable prosthetics and orthodontics. These procedures influence the TMJ, the muscles of mastication, the supporting structure of the teeth and the teeth as well. Dentists have an opportunity to not only objectively analyze how they all interrelate, but to create a physiological harmonious relationship. This will reduce a traumatic occlusion to one that is within the histological adaptive range for the tissue to accommodate. This knowledge can be applied to not only help patientsí pain and dysfunction, but to ensure confidence that dentists are not going to be responsible for iatrogenic results. The future of dentistry is not only being able to effectively deal with TMD but to prevent the problems. Management of mandibular whiplash and migraine headaches are also becoming our responsibility. Dentists are the specialists of occlusion. With the technology available to render this quality of care, they must fulfill their obligation to the public, take responsibility and continue to increase their capability. This approach to dentistry provides a new "window of opportunity" as its many applications have yet to be explored.

One important consideration for any dental treatment involves evaluating the relationship of the mandible to the maxilla. Is the habitual bite that the patient possesses the best functional bite? There are a multiplicity of factors that must be considered in this evaluation before the doctor determines whether to treat to the patient's habitual bite position, or should a better bite position be determined.

The "Controlled Arch System", coupled with a proper diagnosis and treatment plan, should produce excellent occlusion and esthetics for your patients from their Mixed Dentition growth period onward. The authors have offered a method of Phase I treatment for children of Mixed Dentition age that can be outlined as follows: 1. Fit maxillary and mandibular Functional Orthopedic appliances to produce whatever transverse expansion of the arches is needed, then distalize the maxillary 6 year molars to a super Class I relation, according the measurements assessed by the Sim Model Analysis. 2. On removal of the Functional Orthopedic appliances, upper and lower Fixed-Removable Lingual Arches are fitted to stabilize teeth and bone. 3. As needed, fit maxillary and mandibular 2 x 4 or 2 x 6 fixed Straightwire appliances with Nickel Titanium wires, utilizing pinched molar hook/stops to establish molar anchorage to level, align and rotate permanent incisors (and lower permanent canines, if erupted). 4. When alignment of the permanent incisors is completed, the FRLAs are left in place as "insurance" appliances to insure that no loss of arch width or arch length occurs. The FRLAs are left in place for up to two years as retainers. 5. Be sure to inform parents and patients that Phase II comprehensive fixed Straightwire treatment is almost certain to be needed during adolescence when the 28 permanent teeth have erupted. 6. Use of this "Controlled Arch System" not only simplifies and shortens the duration of orthodontic treatment, but also can dramatically lower the percentage of extraction cases in an orthodontic practice.