Join me as I summaries Kleber’s lecture on the use of intermaxillary elastics in orthodontics, topics of force magnitude, side effects and how to counter them, use of a sliding jig and stability are described.
Force magnitude more important than the size of the elastics
- Large variation forces used by orthodontists in Kurol 1996
- Use a gauge on every patient
- Excessive = damage to PDL and RR
- Force required
- Retraction of upper incisors = 250g each side Oesterle 2012 / 350 g Proffit
- Individual
Class 2 elastics effects
- Distalise anterior teeth
- Mesial of lower posterior teeth
- Extrusion of upper anterior teeth
- Extrusion of lower posterior teeth
- Rotate occlusal plane clockwise
- Retrusive upper lip
- Protrusive lower lip
How to avoid side effects
- Case selection: avoid high angle cases
- Avoid upper arch retraction on round wire
- Reduce vertical vector
- Increase horizontal distance mesial of U2s and L7s
- Change the vertical vector by using a sliding jig
- Slidingjig movesvector from above the brackets upper, to below the bracket, lower arch force from below the bracket to above the bracket
- Sliding jig – directs upper arch forces to the molars – more efficient than to archwire only or canine
Class 2 subdivision
- Class 2 one side, class 1 other side.
- Of dental origin, no skeletal
- Usually cant on class 2 side, with arch up on the RHS
- Class 2 elastic on effected side
- Distalisation on URQ with sliding jig
- Retraction of the arch – on rectangular SS – 350g
Torque
- Can be lost upper incisors
- Place torque into the archwire during the retraction – not after retraction
Finishing
- Triangular elastics
Class 2 elastic stability
- Patient may posture: assess displaced mandible / CR
- Tooth movement:
- Bony formation may not be complete
- PDL may not be reorganised
- REQUIRE 3 months of wear for stability, bone growth and PDL
Hello dear Farouk. Thank you very much for this beautiful review of my webinar. You were able to summarize the most important topics in a very short time. Continue with this beautiful work.
Greetings from Brazil