LEVELING AND ALIGNING:CHALLENGES AND SOLUTIONSBhavna Shroff and Steven J. LindauerSeminars in Orthodontics, Vol 7, No 1 (March), 2001: pp 16-25

OUTLINE OF CONTENTS

Introduction Leveling With Straight Wires Side Effects of Straight Wire Mechanics in the

First Order Side Effects of Straight Wire Mechanics in the

Second Order Conclusion

INTRODUCTION

May involve all of the teeth or may exclude some teeth

Important in sliding mechanics for space closure

W R Proffit, H W Fields, and David Sarver, Contemporary Orthodontics, 4th Edition, Mosby, 2006

INTRODUCTION

Increase the possibility of the undesirable side effects

Analysis of the force systems will show the unanticipated side effects before they occur

LEVELING WITH STRAIGHT WIRES Introduction by L. F. Andrews The six keys to normal occlusion

Key I. Molar relationship Key II. Crown angulation (tip) Key III. Crown inclination Key IV. Rotations Key V. Tight contacts Key VI. Occlusal plane

LEVELING WITH STRAIGHT WIRES Easy to use and a reduction in chairside

time Not suitable for all malocclusions:

Asymmetric buccal occlusions Unilateral vertical discrepancies

LEVELING WITH STRAIGHT WIRES Force systems: Burstone and Koenig (1974)

From Burstone CJ, Koenig HA: Am J Orthod 65:270,1974

LEVELING WITH STRAIGHT WIRES

Step geometry

Asymmetric V geometry

Symmetric V geometry

ANALYSIS OF THE FORCE SYSTEMS Isolate 2 tooth segments Starting at the midline Observe the relationship of each pair of

teeth relative to one another

SYMMETRIC V GEOMETRY

consistent

STEP GEOMETRY

SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE FIRST ORDER

SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE FIRST ORDER

SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE FIRST ORDER

SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE FIRST ORDER

Transpalatal arch 0.030” SS

or 0.032 × 0.032” TMA

SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE FIRST ORDER

SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE FIRST ORDER

Bends or curvature

Transpalatal arch

SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE SECOND ORDER

Stabilized arch

auxiliary wire 0.014” or 0.016” NiTi

SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE SECOND ORDER

SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE SECOND ORDER

CONCLUSION

Straight wire mechanics often be used during orthodontic leveling and aligning

Analysis of the relationships between adjacent teeth will show that the force systems will be desirable or not

Alternative treatment strategies may be indicated when the anticipated side effects are unfavorable

Evaluation of the force systems during orthodontic leveling and aligning can improve treatment efficiency and help avoid unexpected tooth movements