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Managing Complex Cases in Orthodontics. Kleber Meireles and Andre Machado
Manage episode 330359566 series 2830917
Managing Complex Cases in Orthodontics. Kleber Meireles and Andre Machado
Join me for a summary of a dynamic conversation between Kleber and Andre, It was a lecture full of biomechanics and the podcast will focus on specific examples with fixed appliances and aligners.
Fixed appliance mechanics
1. Canine retraction in extraction case with buccal canine: sectional mechanics
o Conventional sliding mechanics retract canine but also distally tip and rotate distal in
o Loop mechanics
§ Mechanics = canine retraction – line of force buccal
§ Side effects = no distal in rotation due to line of the force buccal
§ Mechanics = sectional mechanics allows counter moment to increase as canine retracts = bodily retraction
§ Side effect = no distal tipping of the canine
2. Retraction of upper anterior teeth in extraction cases
o Loss of anterior torque on retraction,
o Torque mechanics:
§ Stop active space closure
§ Apply anterior buccal crown torque
§ When recovered, continue final space closure
Aligner biomechanics
Comment: Physics is physics & there is nothing magical appliance
Distalisation with aligners
· Not effective with aligners
· Mechanics: Distal tip
· Side effects: No root movement
Solution
· Attachments for molar distalisation:
o 6mm: horizontal requires 120g, 10mm from the CoR = 1200gm force required for counter moment, however no aligner material can deliver this force or provide retention to the force, therefore not effective tooth movement
o 4mm attachment requires greater force, 1200/4 = 300g
Issues with aligners
· Rely more on companies to do the treatment planning
o AI does not have knowledge of the roots and its angulation – which is difficult to correct even with conventional braces
· Lack of stiffness in the aligners make it difficult to apply counter moment
o For example incisor retraction in extraction cases
Thank you to our sponsors for supporting this episode
I hope to see you Porto for the Simply Ortho congress on the 9-11 of June
112 jaksoa
Manage episode 330359566 series 2830917
Managing Complex Cases in Orthodontics. Kleber Meireles and Andre Machado
Join me for a summary of a dynamic conversation between Kleber and Andre, It was a lecture full of biomechanics and the podcast will focus on specific examples with fixed appliances and aligners.
Fixed appliance mechanics
1. Canine retraction in extraction case with buccal canine: sectional mechanics
o Conventional sliding mechanics retract canine but also distally tip and rotate distal in
o Loop mechanics
§ Mechanics = canine retraction – line of force buccal
§ Side effects = no distal in rotation due to line of the force buccal
§ Mechanics = sectional mechanics allows counter moment to increase as canine retracts = bodily retraction
§ Side effect = no distal tipping of the canine
2. Retraction of upper anterior teeth in extraction cases
o Loss of anterior torque on retraction,
o Torque mechanics:
§ Stop active space closure
§ Apply anterior buccal crown torque
§ When recovered, continue final space closure
Aligner biomechanics
Comment: Physics is physics & there is nothing magical appliance
Distalisation with aligners
· Not effective with aligners
· Mechanics: Distal tip
· Side effects: No root movement
Solution
· Attachments for molar distalisation:
o 6mm: horizontal requires 120g, 10mm from the CoR = 1200gm force required for counter moment, however no aligner material can deliver this force or provide retention to the force, therefore not effective tooth movement
o 4mm attachment requires greater force, 1200/4 = 300g
Issues with aligners
· Rely more on companies to do the treatment planning
o AI does not have knowledge of the roots and its angulation – which is difficult to correct even with conventional braces
· Lack of stiffness in the aligners make it difficult to apply counter moment
o For example incisor retraction in extraction cases
Thank you to our sponsors for supporting this episode
I hope to see you Porto for the Simply Ortho congress on the 9-11 of June
112 jaksoa
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