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ePaper created 2017-03-17, 13:11:17 | version 1.38.0
Fig. 6a rapid overbite correction industry report | Fig. 6a: The mechanism of how BT2s work. Application of buccal rhomboid elastics with active SL is shown. Fig. 6b: As the bite is opened with the application of BT2s, elastics in a rhomboid pattern are used posteriorly to erupt the buccal segments by lifting the curved archwires occlusally, and to intrude the incisors mildly with low resistance in the brackets. Fig. 6b in the lower arch and the smaller dimension .016 x .022 stainless steel lower arch is placed in the upper arch for upper downward and forward Differential Eruption using Class III rhomboid pattern elastics from the lower canine hook to second premolar and upper canine hook to upper first molar hook. For Class II patients with severe overjet (in conjunc- tion with deep overbite), bonding resin may be temporarily added to the BT2s and into the vertical groove to extend them horizontally. The BT2 is rough- ened with a high-speed diamond bur, etched, primed with metal primer, and bonded with bonding resin. The overall objective is to overcorrect the deep over- bite to within a 20 % overbite for long-term retention (it is equally important not to overly open the bite be- cause the tongue may position anteriorly long-term). It is additionally recommended that upper and lower brackets from lateral-to-lateral be bonded 1 mm toward the incisal than the customary, average centre of the long-axis crown positions to facilitate RBC. Conclusions: Advantages of BT2s applications A system was developed and tested for rapid bite correction. This included the use of new BiTurbos, lateral box elastics with active self-ligating brackets to provide freedom of movement of the system with recommended i-Arch wires for improved torquing moments. The BT2 system for rapid bite correction includes: 1. Two BT2s at the palatal of the upper central incisors bonded more incisally 2. Active self-ligating appliance with NiTi clips, bonded more incisally lateral-to-lateral incisor 3. i-Arch wires with compensating curve on the upper arch and reverse curve of Spee on the lower arch to further facilitate incisor intrusion 4. Two elastics (1/4, 4.5 oz) in rhomboid-shaped pat- terns at the buccal segments. BT2s are ideally applied in new super-low profile, active self-ligating brackets, with NiTi clips for light, continuous forces, completely coated for aesthetics, and with progressively lower forces from molars to found with the use of this biocompatible force system as it gradually reduces the vertical mandibular overclosure and muscle activity. How do BT2s work? The BT2 mechanism of action is that it increases the vertical dimension and reduces the muscle hyperac- tivity related to CNS tension through the hypothala- mus-adrenal pathway (Fig. 6a). As the bite is opened with the application of BT2s, elastics in a rhomboid pattern (1/4, 4.5 oz) are used posteriorly to erupt the buccal segments by lifting the curved archwires occlusally, and to intrude the incisors mildly with low resistance in the brackets (Fig. 6b). In Class II correc- tion Differential Eruption is used by placing a full dimension upper arch wire .018 x .025 stainless steel to act more as an anchorage unit and a lower dimen- sion mandibular archwire in .016 x .022 stainless steel. This permits the lower molars and premolars to be differentially erupted upward and forward to correct the Class II malocclusion (Figs. 5f–h). In addi- tion, this also allows the BT2s to work effectively by simultaneously increasing the anterior vertical dimension to correct the Class II malocclusion in conjunction with the rhomboid elastics bilaterally for Rapid Bite Opening (RBC). Special procedures with BT2s and over-correction of deep overbites In Class III malocclusions with lower incisor over- closure over the upper incisors anteriorly, BT2s are bonded to the lingual of the lower incisors to disartic- ulate the dentition and permit placement of the upper brackets (Figs. 7a–e). In Class III malocclusions the higher .018 x .025 stainless steel archwire is placed ortho 1 2017 35