Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 43

Clinical Practice
Earl's Pearls
Rapid Bite Opening
Dr. Earl Johnson
Earl had a saying I repeat often - " If you don't know
where you are going, any road will take you there. " It
was great advice for an orthodontic resident: 1. Identify
the problem, 2. Determine goals, 3. Create treatment
plan to get there. It was also a useful adage for my
personal life. How did I want to practice orthodontics?
Where did I see myself raising my family? When do I
want to retire? I think these days we call it " visualization " ,
but Earl always had a way of making it sound
easy and straightforward. His chairside manner, while
blunt, was very effective. He made sure the patient
knew they were in control of treatment and what they
did (and did not do) made a difference. " If you wear
your rubber bands, you get your braces off in 6 months.
If you don't, you will get them off in 2 years. Which
would you prefer? " Through Earl's Pearls, his systematic
and strategic approach to orthodontics lives on in
offices across the country. Thank you for your selfless
service through education, we miss you!
-Dr. Mary Cooke
When planning the timing of your treatment biomechanics,
it is wise to start early on the movements
that will take the longest. Bite opening can take a
long time in many cases. You can start bite opening
on the first appointment! What are your goals?
Anterior intrusion, molar extrusion or mandibular
rotation? Here are some tactics to accomplish your
goals, using a resilient bypass intrusion arch at the
same time you are leveling with your usual wire
succession. This protocol requires a second auxiliary
arch wire tube on the molar.
Basic Mandibular Appliance
Combination Incisor Intrusion and Initial Leveling
The mandibular base arch is your normal initial
leveling arch (.014NiTi, .016NiTi etc.), and you can
proceed with them through your normal arch wire
sequence as the intrusion arch does its work.
Figure 3. Triad light cure composite " turbo bite block "
The auxiliary intrusion arch bypasses the premolars
and canines and will deliver a biologically
optimum intrusion vector to the incisor teeth.
It can be either .014 or .016 stainless. I tend
to use .014 for extraction cases and .016 for
non-extraction cases, in which the lever arm is
a little longer. The intrusion force is adjusted
with a " V bend " just mesial to the first molar. The
anterior portion of the intrusion arch is placed
directly to the labial of the base arch while both
Figure 1. Normal NiTi leveling arch with bypass steel
intrusion arch in a second molar tube basic setup
Figure 2. Posterior triad composite bite block
Spring 2023 PCSO Bulletin
43

Pacific Coast Society of Orthodontists Bulletin Spring 2023

Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Spring 2023

Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 1
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 2
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 3
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 4
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 5
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 6
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 7
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 8
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 9
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 10
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 11
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 12
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 13
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 14
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 15
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 16
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 17
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 18
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 19
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 20
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 21
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 22
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 23
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 24
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 25
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 26
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 27
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 28
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Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 30
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Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 35
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Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 37
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 38
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 39
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 40
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 41
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 42
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 43
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 44
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 45
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Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 47
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 48
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 49
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 50
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Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 53
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Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 55
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 56
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 57
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 58
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Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 60
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 61
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 62
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 63
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 64
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