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ePaper created 2017-03-17, 13:11:17 | version 1.38.0
| industry report rapid overbite correction BiTurbo2 (BT2) system for rapid deep overbite correction Authors: Dr John Constantine Voudouris, Canada; Dr Vittorio Gaveglia, Italy & James John Poulos, USA Abstract The aim is to introduce a new, miniaturised BiTurbo2 device (BT2) as part of an overall, four-component system to treat severe, skeletal deep overbite maloc- clusion. Methods: Clinical applications of the first generation of BiTurbo (BT1) devices initially manufac- tured as one-piece were evaluated over a 2-year period in the private orthodontic clinic of Dr J. Vou- douris. Improvements were implemented to develop a second generation BT2. The BT2 was manufactured by SIA Orthodontic Manufacturer, in Italy as a four- piece unit including a body brazed to the bonding pad for greater flexibility, braze, for the separate curved bonding pad, and 80-gauge mesh for higher bond strength against lingual shearing forces. Two BT2s were positioned and bonded on the palatal aspects of Fig. 1: Anatomy of BiTurbo2: The eight main characteristic features of the second generation BT2 are shown. Fig. 1 30 ortho 1 2017 the upper central incisors located at the incisal-third of the crowns. BT2s were the central device of a 4-component system to treat severe skeletal mandib- ular overclosure with deep overbite. The second com- ponent of the system included BT2s bonded simulta- neously with a full Siamese twin, active self-ligating brackets to use the lower resistance in the appliance, shown in systematic review in vitro. The third compo- nent included new initial i-Arch wires with light forces that had a higher vertical dimension than hori- zontal dimension (for example .018 x .014). This was used to improve moments of torque closer to the cen- tre of resistance at the upper and lower incisors with compensating curve in the upper archwires, while the lower arches incorporated reverse curve of Spee and where both facilitated mild incisor intrusion. The fourth component of the system included 2 vertical elastics at the buccal segments, in rhomboid-patterns from the upper canines and first molars to the lower first premolars and lower second molars. These were medium 1/4, 4.5 oz elastics for moderate buccal seg- ment extrusion in conjunction with the BT2s. Clinical Results: The ready-made metal BT2s were found to be highly efficient chairside and effective for Rapid Bite Correction (RBC). No clinically significant root re- sorption was not found that was possibly associated with the biocompatible forces applied. Conclusion: BiTurbos are recommended for rapid opening of over- bites for a minimum of 6 months since they raise the vertical dimension automatically and reduce muscle hyperactivity to permit extrusion of the buccal seg- ments into the excessive freeway space. Introduction Experienced orthodontic clinicians often report that severe, deep overbites ranging from 75–120 % are one of the most challenging orthodontic treat-