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Basic Correction Procedure For Edgewise Orthodontic
Aug 01, 2018

(1) The first stage: alignment and leveling

Alignment refers to the correction of dislocated teeth in the horizontal direction (including buccal and lingual, near-distal, and twisted dislocations) to form a normal arch form. Flattening refers to the correction of the height of the teeth in the vertical direction and the abnormal occlusion curve of the dental arch. At the same time, alignment and leveling begin, sometimes it takes a long time to level the dental arch. For some serious cases of deep overdose or open occlusion, the leveling process should be carried out throughout the treatment. Only after aligning and leveling can you enter the second stage. The use of orthodontic archwires should follow the principle of “from soft to hard, from round to square”.

1. Aligning the teeth; the movement of the teeth during the alignment is mainly the oblique movement and twisting of the lips and tongues, and the near and far directions. In this period, nickel-titanium wire with small rigidity, good resilience, large range of action, and multi-strand twisted wire are used. The initial archwire is generally selected from nickel-titanium wires having a diameter of 0.35 mm or 0.40 mm. For some teeth with more serious misalignment, the archwire does not need to be completely grooved, just put on or just ligature one wing. After the dental arch was aligned with nickel-titanium wire, the stainless steel wire with the first sequence of curvature of 0.40 mm or 0.45 mm was used.

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The principle of aligning the teeth is to use the restoring force generated by the deformation of the archwire to act on the teeth to move, while using the interaction of the teeth (ie, mutual support) to spread the crowded teeth. When the front teeth are aligned, the front teeth are tilted, and the front teeth are crowded to remove the front teeth. For severely crowded cases, the gaps in the crowded areas should be extended before they are aligned. For torsion teeth should be corrected at an early stage. Mild torsion can be corrected by ligating a highly elastic archwire into the groove. A more severe torsion dislocation can be placed on the lingual side of the tooth and corrected by interactive traction, in which case a thicker stainless steel wire should be applied. Bend the blocking song at the adjacent teeth of the malocclusion.

2. The leveling curve; the leveling curve should be based on different misalignment mechanisms and patient growth and development. Here we mainly discuss the leveling of the dental arch of patients with deep overbite. For patients with deep occlusion of the anterior segment with low or low mandibular plane angle, the posterior teeth are predominantly elevated. The method of flattening the dental arch can be used:

  (1) Rocking chair type lip arch: Spees curved lip arch with enlarged maxillary and lip arch, and anti-Spees for lower jaw. Curve the lip arch to flatten the curve of the arch by lowering the anterior teeth and raising the posterior teeth. This method is suitable for general patients, but it is not suitable for patients whose mandibular plane angle is large and growth and development have basically stopped.

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(2) Multi-purpose lip arch: use the lip arch to open the canine and the double canine, only interact with the first molar and the four incisors, apply pressure to the anterior teeth, as long as used properly, the anterior teeth are lowered and the posterior teeth are raised. The ratio is greater than the rocker-shaped lip. Applicable to cases with large mandibular plane angle.

(3) Planar guide plate: mainly through the elevation of the posterior teeth to cooperate with the square wire arch aligner to level the occlusion curve. Suitable for cases with lower mandibular plane glue.

(4) Shaped hook: The J-shaped hook is used for high-level traction in the proximal part of the canine, thereby using an external force to lower the upper front teeth. Applicable to patients with a high front sulcus and a smiling face.

   In addition, if the patient's arch is narrow, it needs to be corrected before the leveling. Commonly used methods of expanding the arches include opening the middle sulcus and simply extending the dental arch. If there is an ambush resistive tooth, it should also be orthodontic traction through the surgical window during this period. If the posterior teeth are locked, the dental arch and the upper and lower back teeth can be enlarged. Interactive traction to lift.