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Uno, Dos, Tres/ All the Screws in the Same Place Jay Bowman. AAO June 2021. Episode 114

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Farooq Ahmed

Uno, Dos, Tres/ All the Screws in the Same Place Jay Bowman

 

Jay’s preferred location

·      Palate: 2nd premolar – 1st molar

o   Largest inter-radicular site

o   U5 root labial in position

o   Direct insertion, no contra-angle

o   Lowest failure rate

o   ‘T’ shape of palate for insertion  Ludwig & Bowman 2011

 

Distalisation

·      Modified distal jet Moyer’s symposium 2008

o   TAD – u5-u6 position

o   Horseshoe shaped metal wire – ligate to TADs

o   Activation – opencoil located between anterior horseshow and molar

§  Distal vector on 6 only

§  Transeptal fibres will retract the premolars

o   After distalisation convert to anchorage

§   Locking screws maintains position of 6s whilst retract anterior teeth

 

Protraction of posterior teeth

·      TPA modifications

o   TPA+

§  TADs in the U5-U6 region

§  TPA bar positioned behind the TADs

§  Powerchain to protract the 6s anteriorly

 

Class 3 AOB – TPA +

·      Hybrid hyrax – TADs and RME

·      TADs – U5-U6

·      TPA 3mm from the palate

·      Powerchain from TPA to TADs

Protraction of molars and intrusion of molars

 

Class 2 AOB – TPA –

·      TADs – U5-U6

·      Ligate anterior TPA to TADs (TADs distal to TPA)

o   Distalisation and intrusion

 

Absolute anchorage – extraction case TPA –

·      Extraction of 4s

·      TADs U6-U5

·      TPA ligated to TADs, TADs distal to TPA with powerchain

 

 

 

 

 

Class 3 – protraction and intrusion – TPA+

·      TPA_+ with mesial hook on molar

o   TPA + for protraction, TADs anterior to TPA

o   Hooks on molars with powerchain = intrusion

§  ‘L shape chain’ protraction and vertical powerchain

§  \

 

 

References

Seminar in orthodontics Moskowitz 2018

 

 

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