Orthotown May 2013 - (Page 36)

clinical // feature by Neal D. Kravitz, DMD The Forsus Fatigue Resistant Device (3M Unitek, Monrovia, California) is a telescoping Class II appliance connected chairside from the maxillary first molar headgear tube to the mandibular labial archwire, resulting in maxillary skeletal restriction and rapid dental compensation.1,2 With standard labial braces, it is commonly applied during the middle of treatment following persistent patient non-compliance with Class II directional elastics. However, when using the Incognito Appliance System featuring fully individualized computer-manufactured lingual brackets,3 Fig. 1a the orthodontist should ideally plan to incorporate the Forsus Fatigue Resistant Device at the beginning. What options are available if an Incognito patient has not been treatment planned for a Forsus Fatigue Resistant Device and he is non-compliant with elastic wear? This article will review the steps for incorporating the Forsus Fatigue Resistant Device with the Incognito Appliance System, and provide the clinical protocol for two techniques on placing an unplanned Forsus Fatigue Resistant Device. Planned Incorporation of the Forsus Fatigue Resistant Device When preparing for a Forsus Fatigue Resistant Device at the start of treatment, I select custom lingual bands with buccal headgear tubes for the maxillary first molars in the Unitek Treatment Management Portal or TMP (Fig. 1a-c). TMP is an interactive treatment planning program and digital prescription Fig. 1a: Ordering a custom lingual band with a buccal headgear tube on the Unitek Treatment Management Portal. The maxillary ﬁrst molar band has been highlighted to customize the bracket-type. Fig. 1b: A close-up view of the Unitek Treatment Management Portal. Customizing a band with a headgear tube on the buccal. I have also selected for a lingual tube with a hook to reduce the likelihood of molar derotation during distalization. Alternatively, a clinician may choose for a lingual bracket on the ﬁrst molar. Fig. 1b Fig. 1c Fig.1c: A close-up view of the Unitek Treatment Management Portal. I have written special instructions to the technician to extend the band to the gingival margin for added retention. This is only needed for bands on the maxillary ﬁrst molars receiving the Forsus Fatigue Resistant Device. continued on page 38 36 MAY 2013 // orthotown.com http://www.orthotown.com

Table of Contents for the Digital Edition of Orthotown May 2013

Orthotown.com Highlights
Wired for Success: Googlize Your Business
Class III
Waste of Time/Money Marketing Ideas
Do You “Write Up” a Treatment Plan Report?
Orthotown.com Research: Lasers
Orthodontic Acceleration: Propel Alveolar Micro-Osteoperforation
Focus Ortho
New Products
Big Steps Forward for SureSmile Software
A New Era in Digital Orthodontics
Placing an Unplanned Forsus Fatigue Resistant Device with the Incognito Appliance System
From Mom’s Point of View
Orthodontists, Patients and AcceleDent
Ad Index

Orthotown May 2013