14 Use of a Tip-Edge Stage-

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Published on March 21, 2014

Author: indiandentalacademy

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Tip Edge Technique: Tip Edge Technique Leader in continuing dental education www.indiandentalacademy.com INDIAN DENTAL ACADEMY www.indiandentalacademy.com Use of a Tip-Edge Stage-1 Wire to Enhance Vertical Control During Straight Wire Treatment :  Use of a Tip-Edge Stage-1 Wire to Enhance Vertical Control During Straight Wire Treatment The straight wire appliance gives supreme control and finishing potential, but there can be difficulties during the overbite reduction phase because of the continuous arch mechanics. The Begg appliance is renowned for its superb ability regarding overbite and overjet reduction because it is able to provide the consistent low forces required for intrusion. Several appliances have been developed with the aim of enhancing vertical control without losing the finishing capabilities of the Edgewise mechanism. Two of the better known appliances are the Beddtiot appliance and the Tip-Edge appliance. This 17.2-year-old patient presented with a Class II, division2 incisor relationship, a significant anteroposterior skeletal discrepancy, a mandibular deficiency, and a low angle between the maxillary and mandibular planes www.indiandentalacademy.com PowerPoint Presentation: Only the upper arch was bonded with 0.018-inch Roth prescription brackets with vertical slots and molar bands with twin rectangular tubes. A 0.012-inch super elastic arch wire was placed, and a 0.016-inch Tip-Edge stage-1 type arch was used as an auxiliary wire and tied only to the central incisors using steel ligatures through the vertical slots in the central incisor brackets . Tip-back bends were placed to provide 40 g of intrusion. The ends of the auxiliary wire were cinched and no intra-arch traction was applied at this stage. A Nance arch was fitted to enhance anchorage control.Three months into treatment, the overbite was reducing,and a 0.016-inch super elastic main arch wire was placed . The mechanics at this stage were aimed at overbite reduction and at encouraging the apex of the upper incisors to move lingually. Use of a Tip-Edge Stage-1 Wire to Enhance Vertical Control During Straight Wire Treatment: Two Case Reports, Helen Taylor, BDS, MScD, DOrth, MOrth, FDSRCS(Eng) ( Angle Orthod 2003;73:93–99.) www.indiandentalacademy.com PowerPoint Presentation: Overbite control: A super elastic 0.016 x 0.022-inch main upper arch wire was placed to maintain torque. The auxiliary wire was retained to hold the overbite correction and the space closure achieved thus far. In lower 0.016x 0.022 –inch main wire with 0.16 auxillary wire is used for controlling the overbite. Space closure using Tip- edge stage I arch wire loops with super elastic arch wires: At 11.5 months, a 100-g intra-arch traction was applied to the upper left-quadrant where spontaneous space closure was slower than that seen in the right quadrant. This was done using a lightweight elastomeric chain from the hook on the molar tube to the traction loop on the auxiliary wire. Later full sized arch wire to express the tip & torque of the straight wire is used. www.indiandentalacademy.com PowerPoint Presentation: SUMMARY: 0.16 STAGE I TIP EDGE arch wire can be used over the super elastic arch wire in straight wire appliance for fast bite opening and controlled space closure.They also help in maintaining the corrected overbite during the sequencing of wires in the straight wire appliance. By using a superelastic wire as the main wire throughout the majority of treatment, forces are kept light and canine teeth are able to translate bodily distally with minimum anchorage loss. www.indiandentalacademy.com Employing Tip-Edge brackets on canines & premolars to simplify straight-wire mechanics R. Thomas Rocke, DDS, MS, Westville, Ind. : Employing Tip-Edge brackets on canines & premolars to simplify straight-wire mechanics R. Thomas Rocke, DDS, MS, Westville, Ind. Taken from the AJO-DO 1994 Oct (341-350): CLINICIANS' CORNER - Rocke The straight-wire appliance was developed in part to reduce wire bending and therefore make treatment results more predictable. Because tip prescription is built into the bracket slots, teeth are held at their final crown angulations throughout treatment. Straight-wire brackets are used in an attempt to produce bodily tooth movement. However, teeth tend to tip when a force is applied. This tipping, especially when canines are retracted, can deflect the arch wire causing super eruption of the incisors with a resultant increase in anterior overbite and an open bite in the canine/premolar area. Placing Tip-Edge brackets (TP Orthodontics, Inc., LaPorte, Ind.) on canines and employing tipping and uprighting mechanics on these teeth can overcome these problems. When canine with standard straight-wire edgewise bracket is uprighted or retracted, it tends to tip and extrude incisors. (Line drawings courtesy, Peter C. Kesling, Westville, Ind.) Overbite is deepening as canines are retracted with elastomeric links from canines to molar hooks. An open bite in the canine/premolar area is also developing. www.indiandentalacademy.com PowerPoint Presentation: Simple tipping of canine with Tip-Edge bracket causes no arch wire deflection and therefore no incisor extrusion. A, Tip-Edge bracket slot opens as crown tips distally allowing for easy placement of larger diameter wires. B, A 0.028-inch wire has been placed in the tipped canine bracket to illustrate this feature. www.indiandentalacademy.com PowerPoint Presentation: USING SIDEWINDER SPRINS LATER TO UPRIGHT AND TORQUE CANINE AND PREMOLAR. Side-Winder springs will upright tooth to tip prescription on 0.022-inch wire, and in addition, B, torque tooth when full-size 0.0215 x 0.027 inch edgewise wire is used. (1 ) A 0.0215 x 0.027-inch rectangular straight wire fits easily into tipped canine bracket, or any other Tip-Edge bracket slot. (2) As the Side-Winder spring uprights the tooth, the bracket slot closes down on the flat surface of the arch wire producing torque. (3) Tooth at final tip and torque prescription. www.indiandentalacademy.com PowerPoint Presentation: Pretreatment records of 14-year-old boy. The patient has a severe Angle Class II, Division 2 malocclusion with an extremely deep overbite. www.indiandentalacademy.com PowerPoint Presentation: A, Appliance placement. Straight wire brackets are placed on maxillary incisors and mandibular central incisors. Tip-Edge brackets are placed on canines where erupted and mandibular lateral incisors. Starting arch wires (0.016-inch E.S.P. Australian) and light (2 oz.) Class ll elastics correct the Class ll. B, The overbite and overjet are corrected and the premolars are bracketed and leveled. Note the 0.016-inch arch wire passing through tipped mandibular canines without deflection. C, Arch wires (0.016 inch) are replaced with 0.022-inch round wires. www.indiandentalacademy.com PowerPoint Presentation: Appliance removal. A good, functional Class l occlusion and pleasing profile was obtained. (Dotted line = Start; solid line = finish.) www.indiandentalacademy.com PowerPoint Presentation: Pretreatment records for 12.5-year-old girl. Four first premolars were removed to eliminate crowding and provide space to permit reduction of the bimaxillary protrusion . www.indiandentalacademy.com PowerPoint Presentation: A, Appliance placement. Straight-wire brackets were placed on all anterior teeth except for a Tip-Edge bracket on the upper left, and later upper right canine The case was started with 0.016-inch E.S.P. Australian arch wires and light (2 oz ) Class II elastics. B. Upper 0.0215 x 0.027-inch rectangular arch wire was used for anterior retraction and posterior space closure. Before space closure, the mandibular canines were rebracketed with Tip-Edge brackets which were also later bonded on the premolars C. Arch wires (0.022 inch) maintain arch from while a Nitinol torquing bar torques maxillary incisors and Side-Winder springs upright canines and premolars. D, Rounded 0.0215 x 0.027-inch edgewise finishing ash wires are placed for final crown and root torque. { Overbite and overjet reduced using tip-edge bracket & wire} www.indiandentalacademy.com PowerPoint Presentation: Final facial and intraoral photographs. A good Class I occlusion was obtained. The patient's profile improved even though forward mandibular growth was weak. (Dotted line = Start; solid line = finish.) www.indiandentalacademy.com PowerPoint Presentation: Thank you Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com

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