modular appliance /certified fixed orthodontic courses by indian dental academy

Tackling an iatrogenic problem!!

INDIAN DENTAL ACADEMY

Leader in continuing dental education

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Introduction• All modern mechanics have a double scale of

ladder ascendant & descendant , ascending from

experiment to the invention of causes &

descending from causes to the invention of new

experiments

• Anchorage plays a very vital role in

orthodontics. Loss of anchorage can take place

during

• Aligning, leveling and retraction stages.

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Reasons for anchor loss

during aligning

•Lower molars normally drift mesially to

occupy the lee-way space after shedding of

lower primary second molars which can be

restricted by timely placement of lingual

arch.

•Anchorage requirement in upper arch is

greater compared to lower arch

•Improper positioning of brackets.

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Reasons for anchor loss

during retraction

iatrogenic

factors

incorrect

alpha &

beta bendsexcessive forces

used during

retraction.

posterior segments

are not consolidated

during retraction.

Improper

positioning

of loop

Improper bracket

positioning

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When in doubt use

a wire applying

lighter forces

Anchorage

reinforcementUse light

Continuous

force

During

aligning….

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How to control anchorage

during leveling ?

•Using light continuous forces

•Maintain the direction of force

•Rein force anchorage

•Proper bracket positioning.

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Anchorage control during

retraction

retraction

individual

enmasse

Walking of

canine

Rein force

anchorage

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Anchorage

reinforcement

EO

high

cervi

calstraight

com

bi

IO

TPA

Nance button

Class –II elastics

Lingual archwww.indiandentalacademy.

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how to correct anchor loss ?

Anchor loss

occurs by mesial

tipping of molars

Hence distalize

molars

Extra oral

Intra oralwww.indiandentalacademy.

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Extra oral

High pull

Cervical pull

Combi pull

distalizing effect

on molars and

premolars

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Intra oral

Inter maxillary

Intra maxillary

Absolute

anchorage

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IO non compliance

appliances

Intermaxillary

Elastics

Modular appliance

Intra maxillary

Modified nance arch with NiTi coils

distalising bow Absolute

anchorage

Palatal

implantswww.indiandentalacademy.

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APPLIANCE DESIGN:

• Modular appliance is made up of 0.016x0.0 22 rectangular SS / TMA wire

• Modular appliance consists of an omega

loop touching the mesial aspect of buccal

tube and there is an upward curve in the

mesial part of the canine bracket, which

ends in a hook on the upper or gingival

part.

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•The gingival part of the hook is

helicoidally recurred with the end inward

to avoid erosion of the vestibular mucosa.

•Tip back bend of 45 degrees is given distal to omega loop .

•The wire should be cinched distal to the molar buccal tube

•The buccal segment should be contoured to prevent tissue impingement.

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APPLIANCE DESIGN

omega

loop

hook to

engage

elastics

tip back bend of 45

degreeswww.indiandentalacademy.

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•Class II elastics ( preferably blue

or green ) applying 100 – 150 gm

force are used from the hook mesial

to canine and to the lower molar

hook.

•The modular sectional arch blocks

the segment between the canine and

the upper first molar in one unit ,

which it moves in distal direction.

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BIOMECHANICS

•Based on cantilever mechanism

Mechanics

of spring

elastics

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•These mechanics can

effectively tip back an upper

molar and rotate the molar

mesial out.

•Distal end of omega loop acts

as a stop and applies the

tipping force on upper molar.www.indiandentalacademy.

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•A light class II elastic is

placed from lower arch

•Class –II elastic is effective ,

not only because of its distal

force but because a very large

moment is produced tipping

the molar distally.

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• Class – II elastics can flare the lower arch, increase the vertical and steepen the occlusal plane.

• Hence elastics are used for a short period of time.

• Because the molars tip back rapidly, only a short period of class – II elastic wear is required leading to negligible side effects

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Pre - treatment

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Pre - treatment

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Upper 5’s

lower 4’s

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Pre - surgical

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Post surgical

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Post - surgical

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Case - 3

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Case - 3

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Modular

appliance

Less time

consuming

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advantages

fixed into the

auxiliary tube

•Distalisation is brought

about in short duration

of time……..

versatile

Unilateral or bilateral

Class II

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Conclusion

If anchor loss is noticed early and timely

intervention of modular appliance is made, it saves

a lot of drudgery.

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AcknowledgementDr. E. MUNIRATNAM NAIDU,

Principal,

Dr. P. JAYA KUMAR,Vice principal,

PROF&HEAD OF DEPARTMENT,ORTHODONTICS.

STAFF MEMBERS & P.G. STUDENTSDepartment Of orthodontics

MEENAKSHI AMMAL DENTAL

COLLEGE.www.indiandentalacademy.

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