Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2017-09-06, 09:11:22 | version 1.38.0
open bite closure technique Special procedures with TS2s and overcorrec- tion of open bites As anterior open bites are corrected it is import- ant to observe the gingival protrusions of the TS2s for the possible need of reduction with a high-speed to prevent dental interferences. The objective is to overcorrect the open bite to be greater than 30% overbite for long-term reten- tion. The reason is that open bites are often asso- ciated with patients growing with the mandible in a downward and backward direction. It is addi- tionally recommended that upper and lower brackets from canine-to-canine be bonded 1 mm toward the gingival than the customary average height positions to facilitate open bite closure. This is particularly important at the upper lateral incisors that are the smallest of the incisor teeth and afected most by the unnatural, anterior tongue positioning forces. Conclusions: Advantages of TS2 applications A system of four components was developed and tested to produce rapid open bite closure. This included the use of new tongue stars, ante- rior box elastics with active self-ligating brack- ets with new iArches to provide freedom of movement of the system including the upper and lower archwires with its proven low resis- tance, in vitro. In conclusion: 1) Metal TS2s are highly efective and eficient chairside for ROC. 2) Eficiency is gained by ready-made, bondable TS2s, that do not wear, are miniaturised for patient comfort and facilitate oral hygiene. 3) TS2s are placed on all 12 anterior dental units from the upper canine-to-canine, and lower canine- to-canine since the tongue was ob- served and found to be positioned anteriorly, superiorly and inferiorly. TS2s are applied in conjunction with anterior box elastics (5/16”, 4.5oz) and ideally with new, low profile active self-ligating brackets with NiTi clips for light, continuous forces for the peri- odontal membrane, completely frost-coated for aesthetics, and with progressively lower forces from molars to incisors. Active self-ligating brackets make use of reduced resistance found in vitro and active seating of iArch wires for earlier moments of torque that are closer to the centre of resistance of the incisors to improve control (future publication). references about 1. Ramford SP, Major MA. Occlusion. Philadelphia, US: W.B. Saunders Company; 1971; 42, 89–91. 2. Cooper S. Muscle spindles in the intrinsic muscles of the human tongue. J Physiol (London) 1954;122:193. Dr John Constantine Voudouris maintains teaching positions at the University of Toronto, as an associate in the discipline of Orthodontics, for 31 years, teaching mandibular advancement appliances, and at New York University, as a visiting scholar, in the Division of Biological Sciences for 18 years, teaching active self- ligation. He is a full member of the Eastern Chapter of the Edward H. Angle Society of Orthodontists and the recipient of the prestigious American Association of Ortho dontist’ Milo Hellman Research Award for condylar growth modifications and glenoid fossa remodelling with Herbst appliances, applying electromyo- graphic, cephalometric and histologi- cal investigations. Dr Voudouris maintains a private orthodontic specialty practice in Toronto, Canada. ortho 2/2017 15