Vertical changes in orthodontics and their importance. Adith Venugopal. Part 2. Episode 63. November 18th 2020

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Hosted by
Farooq Ahmed

Join me for part 2 of Adith’s lecture looking at the vertical dimension in orthodontics and its management.

Part 2 looks at 6 cases with vertical management of impacted canines, the use of TADs including buccal shelf and infrazygomatic TADs.

4th case impacted canine

  • Avoid continuous archwire as it can cause:
    • Iatrogenic root resorption
    • If stubborn canine = greater occlusal side effects
  • Resolution: TAD opposing arch
    • Traction hook bonded to canine
    • 150g elastic from lower TAD to traction hook on upper canine
    • Providing intermittent forces

5th case scissor bite

  • Buccal shelf TAD – placed vertically buccal to lower 6-7
  • Anterior bite blocks to disocclude
  • Mechanics:
    • Buccal movement of molar with powerchain from BS TAD – molar
    • Intrusion of molar with vertical vector to TAD

6th case cant

  • TAD x 2, between U2-3 and U5-6 – placed high
  • 19*25 NITI continuous
  • Powerchain from TADs to brackets for intrusive force

7th case gummy smile

  • Posterior TADs in conventional mucogingival junction with vertical vector not likely to achieve clinical improvement.
  • Require TAD anterior region, and infrazygomatic TAD for retraction and intrusion

8th case class 3 with AOB

  • Buccal shelf TADs
    • Powerchain BS to hooks distal to lateral incisors on archwire:
      • Distalise lower molars
      • Intrude lower molars
      • Extrude lower anterior teeth – change to occlusal plane
    • Extraction of 3rd molars
    • TADs left in situ in retention in case of relapse.

9th case periodontally compromised patient

  • 014NT, not all teeth ligated, alternate teeth ligated = increase inter-bracket distance = less force

Contributions to this post by Dr AbdAllah Sharafeldin


Venugopal, A., Manzano, P. and Rengalakshmi, S., 2020. A Novel Temporary Anchorage Device Aided Sectional Mechanics for Simultaneous Orthodontic Retraction and Intrusion. Case Reports in Dentistry2020.

Venugopal, A., 2020. Interarch traction for impacted canines. APOS Trends in Orthodontics10(1), pp.60-61.

Venugopal, A., Manzano, P., Arnold, J., Ludwig, B. and Vaid, N.R., 2020. Treating a severe iatrogenic gingival exposure and lip incompetence–a challenge worthwhile. International orthodontics.


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