Whenever the desired objective of your treatment plan requires bodily tooth movements, significant tooth rotations, root torquing or leveling, aligning, and rotating of entire arches, it is necessary to utilize full-arch fixed mechanics. When observing a well-aligned dental arch, it is apparent that the ideal position of each tooth is defined by three parameters: the “in-out” position; the crown angulation or “tip;” and the crown inclination or “torque.”
For many years, orthodontic brackets were the same for all teeth, making it necessary for the clinician to incorporate three bends for each tooth into the main arch wire — in order to locate the tooth in its ideal position. A rather complicated and arduous task, this required a great deal of skill, effort, and multiple readjustments of the arch wires throughout the treatment.
As a result of extensive studies conducted in the early 1960s, Dr. Lawrence F. Andrews introduced pre-adjusted “Straight Wire” type brackets. These brackets are specific for each tooth. They have the necessary torque, tip, and in-out position built into the individual brackets. Provided that the bracket is positioned ideally on each tooth in the middle of the clinical crown, parallel to the incisal edge, and along the long axis, the Straight Wire appliance has the capability of finishing treatment with little or no bends in the arch wire. Typically, the only wire bending necessary involves small compensating bends in the arch at the end of treatment for final detailing.
Every year, new wires and bracket systems are introduced in an attempt to make treatment easier and faster. Most of these products are excellent. As with all orthodontic therapy, however, there is usually a learning curve involved. We highly recommend that you take a class in the use of any new product before you use these new tools.
SML can provide you with stainless steel or esthetic ceramic brackets, molar bands with buccal tubes, the series of arch wires of your choice and any Wilson 3D®components necessary for you to completely treat your patient with pre-adjusted appliances. Technical assistance in choosing the right system for your patient is only a phone call away. In addition to supplying a complete kit containing all the necessary straight-wire brackets, arch wires, and accessories on a per patient basis, SML can perform the actual set-up, as well. Each bracket is placed in the correct position on the patient’s model (as per your instructions) and a plastic matrix material is vacuum-formed over the brackets. This creates a tray that holds the brackets for transfer to the patient.
Featured Appliances
Indirect Bonding Trays
In addition to supplying a complete kit of all of the necessary straight-wire brackets, arch wires, and accessories (on a per patient basis), SML can do the actual set-up as well.
Each bracket is placed in the correct position on the patient’s model in accordance with your instructions. A plastic matrix material is then vacuum formed over the brackets. This creates a tray that holds the brackets for transfer to the patient.
To make the bonding procedure cleaner and more predictable, the trays are typically cut into sections — each tray flexible enough to fit easily over the patient’s teeth. Transparant tray material ensures that light-cured cements can be used if desired.
Some clinicians prefer a dual-tray system. With this system, a second hard tray is designed to fit over the flexible tray that holds the brackets. Immediately after placing the soft tray, the hard tray is placed directly over it. A cotton roll is then placed over the top of the hard tray and the patient is instructed to close carefully ( but firmly). This pressure holds the brackets snugly in place until the bonding process is complete. Note: When using a transfer tray technique, please specify type of brackets, where they are to be placed, and which tray system you prefer.
Positioner
The Positioner is used primarily to help “settle-in” the occlusion at the end of a full-fixed bracket and band case.
Fabricated from flexible plastic (silicone or rubber), this retaining appliance is typically used to create a slightly over-treated Class I relationship. The appliance is fabricated after the individual teeth are cut from a current set of models and reset into the ideal relationship. Impressions for this appliance can be taken with brackets still in place. This will allow you to deliver the appliance immediately on the same day that you plan to remove your bands and brackets. Upon delivery, the patient is instructed to clench into the Positioner on a scheduled basis. This action not only allows for a gentle settling-in of the individual teeth (into their correct positions), but also establishes a correct interarch relationship. Various colors (as well as the standard clear material) are available for this appliance. Note: A specific “Set-up and Positioner Prescription” form is available upon request.
Fixed Therapy Removable Bite Plane
This removable anterior bite plane appliance can be used in conjunction with full arch fixed mechanics when an increase in vertical dimension is needed.
Using ball clasps for retention, the doctor can remove and replace the appliance without disturbing the fixed components. This design is easy to adjust during treatment and more hygienic than most fixed approaches. Note: If loss of vertical dimension is over-closed — to the point that the lower anteriors cannot be properly bracketed — this removable approach is contraindicated. Instead, consider using a fixed bite plane.
Inman Aligner™
Ideal for mild-to-moderate anterior crowding (upper and lower arch) and orthodontic relapse, The Inman Aligner™ embraces the concept of proximal recontouring, but also brings to the mix a new overall design and new Niti coil-spring technology.
Nickel Titanium coil springs power two aligner bows that gently oppose each other, guiding the teeth into their new position. These gentle forces are active over a very large range of movement, which is why the Inman Aligner works so quickly.
The inner bow pushes forwards, while the outer bow pulls back on the front teeth. These forces allow for predictable rotation, protrusion and retroclination movements. Most cases are completed within 6 – 18 weeks (depending on the complexity of the case).
The Inman Aligner:
- Aligns the front teeth (crowding, protrusion, rotations, crossbites)
- Works great as a stand-alone treatment or in combination with simple whitening and bonding
- Is perfect for pre-alignment in cosmetic cases — teeth don’t need much preparation and veneers can be super-thin
“Invisible” Retainer U/L
A popular retainer design for the extremely appearance-conscious patient, the Invisible Retainer is fabricated from a thin sheet of clear thermo-plastic material that is vacuum-formed to the occlusal and incisal surfaces of the entire arch.
The completed appliance typically extends over the buccal and labial surfaces and is typically finished just short of the gingival margins on the labial and buccal surfaces. On the upper appliance, the palate is horseshoe shaped for patient comfort.
Note: Invisible Retainers are quite thin and are contraindicated for anyone who bruxes their teeth. In addition, the patient should be instructed in the gentle care required for this appliance.
Open Palate Retainer U
This appliance is designed primarily as a final retainer to be used at the completion of any orthodontic therapy.
The area over the hard palate is left free of acrylic. The tongue never loses its natural contact with the hard palate and the result is that speech remains virtually unaffected — and there is no danger of the patient developing a deviate swallowing pattern. To reduce the possibility of fracture, the ribbon of acrylic that contacts the lingual of the anteriors is reinforced with Kevlar. Adams Clasps are used because they remain retentive over time. To prevent any unwanted tooth movement, both the clasps and the labial bow must be designed to stay out of occlusion. Note: Always send the lab both upper and lower casts along with a bite relationship for fabrication of this appliance.