Preadjusted Edgewise Fixed Orthodontic Appliances: Principles and Practice

Preface xxi

Acknowledgements xxiii

Contributorsxxv

Introduction:: What is the Preadjusted Edgewise Appliance? xxix
Farhad B. Naini and Daljit S. Gill

What Does ‘Edgewise’ Mean xxix

What Does ‘Preadjusted’ Mean xxxiv

Preadjusted Edgewise Appliance Components xxxix

Bracket Design Features xl

Bracket Positioning xliii

Stages of Treatment xliv

Conclusion xliv

References xliv

Part I Principles 1

1 Principles of Treatment Planning 3
Farhad B. Naini and Daljit S. Gill

Introduction 3

Patient Concerns 4

Patient Motivation and Compliance 4

Handling Patient Expectations 4

Medical History 6

General Dental Health 6

Previous Orthodontic Treatment 7

Treatment Timing:: When Should Treatment be Undertaken? 7

Problem List 9

Treatment Aims 11

Presenting the Treatment Options 14

How do we decide whether or not to Extract Teeth? 15

Space Analysis and Space Planning 17

Informed Consent 21

What Should be Included in a Treatment Plan 23

Treatment Mechanics 23

References 26

2 Principles of Orthodontic Biomechanics 29
Farhad B. Naini and Daljit S. Gill

Introduction 29

Basic Concepts and Principles 30

Newton’s Laws of Motion and Static Equilibrium 38

Displacement of Rigid Bodies 39

Control of Tooth Movement 41

Types of Tooth Movement 44

Clinical Applications and Relevance 47

Conclusion 54

References 55

3 Anchorage 57
Zaid B. Al-Bitar

Introduction 57

Anchorage Value 59

Assessment of Anchorage Need 61

Classifications of Anchorage 61

Anchorage Control with Fixed Appliances 62

Anchorage Creation 73

Anchorage Loss 74

References 75

4 Consent 79
Gavin J. Mack

Introduction 79

Types of Consent 80

Valid Consent 80

Withdrawal of Consent 81

Treatment Options 81

Key Factors to be Communicated with Patients 82

Treatment Benefits 83

Treatment Risks 84

Effective Communication 88

Conclusions 89

References 90

5 Dentolegal Aspects of Orthodontic Treatment 93
Alison Williams

Introduction 93

Advertising 94

The Initial Consultation 94

Pretreatment Records 97

Dentolegal and Ethical Issues that may Arise During Treatment Planning 99

Obtaining Consent 100

Dentolegal Issues Arising During Active Orthodontic Treatment 102

Retention 106

Relapse 107

Duty of Candour 107

Responding to a Complaint 108

References 109

Part II The Preadjusted Edgewise Appliance 111

6 BracketDesign 113
Chris D. Donaldson

The Origins of Fixed Appliance Bracket Design 113

Preadjusted Edgewise Straight-wire Appliance 117

Straight-wire Appliance:: Bracket Prescriptions 121

Straight-wire Appliance:: Bracket Modifications 129

Acknowledgements 135

References 135

7 Bracket Placement 137
Hemendranath V. Shah, Daljit S. Gill, and Farhad B. Naini

Introduction 137

Design Features of Preadjusted Edgewise Appliance Brackets 137

Direct versus Indirect Bonding 140

Direct Bonding Technique 141

Indirect Bonding Technique 142

Banding Molars and Premolars 143

Tips for Bracket Selection in Certain Situations 145

References 146

8 Bonding in Orthodontics 147
Declan Millett

History 147

Bonding Procedure 148

Bonding to Artificial Substrates 151

Indirect Bonding 151

Bonding Adhesives 152

Health Risks Associated with Bonding 154

Effectiveness of Adhesives 154

Debonding 156

Bonded Retainers 157

Additional Uses of Bonding in Orthodontics 158

Future Possibilities of Orthodontic Bonding 158

Summary 158

Acknowledgements 159

Further Reading 159

References 159

9 Debonding 165
Lucy Davenport-Jones

Introduction 165

Preparation 166

Stainless Steel Brackets 166

Ceramic Brackets 166

Self-ligating Brackets 168

Lingual Appliances and Bite Turbos 168

Solvent Use 168

Electrothermal Debonding 168

Laser Debonding 168

Band Removal 169

Composite Resin Removal 169

Finishing Techniques 169

Iatrogenic Damage 171

Particulates 171

Conclusions 172

References 172

10 Archwires 175
Leila Khamashta-Ledezma

Introduction 175

Properties of Archwires 176

Archwire Shape and Arch Form 179

Archwire Materials 180

Aesthetic Archwires 185

Fatigue 187

Corrosion of Metal Alloys 188

Which is the Best Aligning Archwire or Archwire Sequence? 191

Pain from Initial Archwires 192

Root Resorption from Different Archwires 194

Allergy to Nickel 195

Acknowledgements 197

References 197

11 The Use of Auxiliaries in Orthodontics 203
Andrew T. DiBiase and Jonathan Sandler

Introduction 203

Anchorage and Space Management 203

Class II Correction 208

Tooth Movement 211

Conclusion 217

References 218

12 Optimising Fixed Appliance Treatment with Orthodontic Mini-implants 219
Richard R. J. Cousley

Introduction 219

OMI Advantages 220

OMI Disadvantages 220

Where Does OMI anchorage Come From? 221

Anchorage Options:: Direct Versus Indirect 223

Key Clinical Steps Involved in OMI Usage with Fixed Appliances 226

Three-dimensional Anchorage Applications 228

References 231

13 Care of Fixed Appliances 235
Nazan Adali, Daljit S. Gill, and Farhad B. Naini

Introduction 235

Before Fixed Appliance Treatment 236

During Fixed Appliance Treatment 237

After Fixed Appliance Treatment 245

Conclusions 245

References 245

Part III Stages of Treatment with Preadjusted Edgewise Appliances 247

14 Alignment and Levelling 249
Farhad B. Naini and Daljit S. Gill

Introduction 249

Anchorage Requirements and Preparation 250

Arch Form 255

Tooth Movement with Preadjusted Fixed Appliances 256

Alignment 257

Levelling 293

Conclusion 294

References 294

15 Controlled Space Closure 297
Daljit S. Gill and Farhad B. Naini

Introduction 297

At Completion of Alignment and Levelling 298

Objectives during Space Closure 298

Classification of Anchorage 299

Types of Space Closure 299

Sliding Mechanics with the Preadjusted Edgewise Appliance 300

Frictionless Mechanics with the Preadjusted Edgewise Appliance 306

Monitoring Space Closure 308

Conclusion 309

References 309

16 Finishing 311
Mohammad Owaise Sharif and Stephen M. Chadwick

Introduction 311

Aims and Objectives of Orthodontic Treatment 312

Common Errors Encountered at the Finishing Stages of Treatment 312

Efficient Finishing:: the Importance of Diagnosis and Treatment Planning 317

Conclusion 318

References 318

17 Retention 321
Simon J. Littlewood

Introduction 321

Historical background 322

Aetiology of Post-treatment Changes 323

Reducing Relapse During Treatment 324

Choice of Retainers 324

Fixed Retainers 324

Removable Retainers 327

Responsibilities in Retention 329

Conclusions 329

Acknowledgements 329

References 329

Part IV Management of Malocclusions with Preadjusted Edgewise Appliances 331

18 Management of Class II Malocclusions 333
Martyn T. Cobourne and Mithran S. Goonewardene

Introduction 333

Management Options 334

Growth Modification 336

Orthodontic Camouflage 342

Orthodontics and Orthognathic Surgery 356

References 356

19 Management of Class III Malocclusions 359
Grant T. McIntyre

Introduction 359

Treatment Timing for Class III Malocclusion in Relation to Facial Growth 360

Comprehensive, Camouflage or Compromise Treatment for Class III Cases 362

Managing the Class III Surgical/Orthodontic Patient with Fixed Appliances 366

Class III Malocclusion Occurring with Cleft Lip and/or Palate 370

References 370

20 Management of Deep Incisor Overbite 371
Farhad B. Naini, Daljit S. Gill, and Umberto Garagiola

Introduction 371

Aetiology 372

Indications for Treatment 373

Considerations in Treatment Planning 374

Methods of Overbite Reduction 375

Appliances and Techniques for Overbite Reduction 376

Stability of Overbite Correction 382

Conclusion 384

References 384

21 Management of Anterior Open Bite 385
Chung H. Kau and Tim S. Trulove

Introduction 385

Prevalence and Incidence 385

Aetiology 385

Characteristics 388

Clinical Treatment 389

Retention and Stability 394

Conclusion 394

References 394

22 Management of the Transverse Dimension 397
Lucy Davenport-Jones

Introduction 397

Crossbites 398

Indications for Maxillary Expansion 398

Removable Appliances 399

Functional Appliances 400

Aligners 400

Fixed Appliances 400

Mid-Palatal Suture 404

Surgical Expansion 409

Retention 411

References 411

Part V Appendices 413

Appendix 1 Orthodontic Instruments 415
Farhad B. Naini and Daljit S. Gill

Appendix 2 Orthodontic Elastics and Elastomeric Materials 423
Farhad B. Naini and Daljit S. Gill

Introduction 423

Intraoral Elastic Configurations 423

Points of Application 424

Instructions for Use of Intraoral Elastics 424

Elastomeric Materials 425

Index 427