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LEVELING AND ALIGNING: CHALLENGES AND SOLUTIONS

Bhavna Shroff and Steven J. Lindauer Seminars in Orthodontics, Vol 7, No 1 (March), 2001: pp 1625

OUTLINE OF CONTENTS

Introduction Leveling With Straight Wires Side Effects of Straight Wire Mechanics in the First Order Side Effects of Straight Wire Mechanics in the Second Order Conclusion

INTRODUCTION

May involve all of the teeth or may exclude some teeth Important in sliding mechanics for space closure

W R Proffit, H W Fields, and David Sarver, Contemporary Orthodontics, 4th Edition, Mosby, 2006

INTRODUCTION

Increase the possibility of the undesirable side effects Analysis of the force systems will show the unanticipated side effects before they occur

LEVELING WITH STRAIGHT WIRES

Introduction by L. F. Andrews The six keys to normal occlusion


Key I. Molar relationship Key II. Crown angulation (tip) Key III. Crown inclination Key IV. Rotations Key V. Tight contacts Key VI. Occlusal plane

LEVELING WITH STRAIGHT WIRES


Easy to use and a reduction in chairside time Not suitable for all malocclusions:

Asymmetric

buccal occlusions Unilateral vertical discrepancies

LEVELING WITH STRAIGHT WIRES

Force systems: Burstone and Koenig (1974)

From Burstone CJ, Koenig HA: Am J Orthod 65:270,1974

LEVELING WITH STRAIGHT WIRES

Step geometry

Asymmetric V geometry

Symmetric V geometry

ANALYSIS OF THE FORCE SYSTEMS


Isolate 2 tooth segments Starting at the midline Observe the relationship of each pair of teeth relative to one another

SYMMETRIC V GEOMETRY

consistent

STEP GEOMETRY

SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE FIRST ORDER

SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE FIRST ORDER

SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE FIRST ORDER

SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE FIRST ORDER

Transpalatal arch 0.030 SS or 0.032 0.032 TMA

SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE FIRST ORDER

SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE FIRST ORDER

Bends or curvature Transpalatal arch

SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE SECOND ORDER


auxiliary wire 0.014 or 0.016 NiTi

Stabilized arch

SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE SECOND ORDER

SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE SECOND ORDER

CONCLUSION

Straight wire mechanics often be used during orthodontic leveling and aligning Analysis of the relationships between adjacent teeth will show that the force systems will be desirable or not Alternative treatment strategies may be indicated when the anticipated side effects are unfavorable Evaluation of the force systems during orthodontic leveling and aligning can improve treatment efficiency and help avoid unexpected tooth movements