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Use of intermaxillary elastics in orthodontic practice, easy, cheap and effective. Kleber Meireles. Episode 75. January 21st 2021

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Hosted by
Farooq Ahmed

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

 

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1 comment
  • 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

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