Pacific Coast Society of Orthodontists Bulletin Spring 2020 - 32

Let's Talk About That

Figure 5. Optimal incisor root positions
anterior one-third of the alveolar process, and
the mandibular incisor root apices are centered
(Figure 5).

Figure 4. (a) Bracket slots are virtually superimposed over the WALA ridge when posterior teeth
are optimally positioned. (b) Archwires can therefore be customized to match the WALA ridge.
desired positions. When mandibular posterior
teeth are tipped to their optimal inclinations,
the resulting spatial location of the bracket slots
closely approximates the width and shape of the
WALA ridge, making it a convenient template for
forming customized archwires (Figure 4a, b).
PT: What about the incisors?
WA: We are currently working on a study of
incisor root positions in a sample of untreated
individuals with naturally occurring optimal
occlusions. We have learned that, almost without
exception, maxillary incisor roots occupy the

32	

As with posterior teeth, achieving proper crown
inclinations while keeping the roots in these
preferred areas requires only faciolingual tipping
for most patients; torque is seldom needed. It is
a pervasive misconception that the straight-wire
appliance is designed to work by gradually filling
the bracket slots, ultimately with large rectangular archwires, to fully express built-in prescription values. Actually, the prescription values for
angulation, rotation, and crown prominence (in/
out) can all be expressed with round wire. Only
the prescription for inclination (torque) requires
rectangular wire, but as we have discussed, optimal tooth inclinations are generally achieved by
faciolingual or buccolingual tipping with round
wire.
Using rectangular wire to actively express the inclination prescription in a bracket is only needed
rarely for individual teeth that erupt ectopically,
when the width or length of an arch is intentionally compromised to compensate for uncorrectable AP or transverse jaw discrepancies, or
when archwire shapes are not coordinated with

PCSO Bulletin    Spring 2020



Pacific Coast Society of Orthodontists Bulletin Spring 2020

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