Sunday, 23 May 2010

Social Six, Simple and Aesthetic - Lingual Approach

There is an article at Orthodontic Products blog that Dr Ron Roncone, is signing, and it deals with cases of minor crowding from 4+4 or 4-4 on the upper and lower anterior.

The use of the self legating lingual brackets from GAC is shown and some clinical tips are given.

For example:

  • Do not bond more gingival than 1mm (2mm is not acceptable), to avoid vertical and torque problems later on.
  • Reshape the cusp of the canines
  • Bond the 1st premolar to avoid the side-effect of the 6 front teeth aligning on a straight rather than curved way (use mushroom shape NiTi wire to level initially)
  • Build up the lingual cusp of the 1st premolar to avoid extrusion while level and aligning. 
Those and some other tips are given, and are essential, when you want to apply lingually braces, without having a set up done priorly and without constructing an indirect bonding tray.

Some of the pictures from the article:
Bracket placement, 1mm from the incisal edge
Side-effect without a mushroom shape NiTi used and without engaging the 1st premolars
Notice the use of crimp-able stops, mesial of the 1st premolars to facilitate expansion and de-crowding

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