Orthotown May 2017 - 25
orthothai
Nice case! This profile and skeletal configuration is very common in Asia. For profile concern
those cases are better treated by extraction. I saw several cases like this treated nonextraction in
Singapore (Invisalign but also self-ligating) and protrusion always becomes an issue in the future.
The Asian face and Caucasian face do not age the same way relative to soft tissue. With
Caucasians, protrusion of the teeth decreases with time. Soft-tissue aging, with the Asian face,
is the reverse. ■
Member Since: 10/14/13
Post: 17 of 19
3/10/2017
tom525
Hi, Fen-in this case you have placed the brackets very close to the gingival tissue. Tom Pitts
is a proponent of this, but it bothers me hygiene-wise. Is it something that you do in extraction
cases for torque control? I am sure the patient is thrilled with this result. I often do composite
buildups before and during treatment myself. It gives me control during treatment. ■
Member Since: 06/18/08
Post: 18 of 19
3/10/2017
The hygiene part bothers me too (a lot!), so I've modified the placement a bit more incisally.
(See example below.)
Fenrisúlfr
Member Since: 02/25/09
Post: 19 of 19
1. I usually band the 6s and 7s, so that influences the
anterior bracket positions.
2. Torque expression seems to be consistently better with
this position in both extraction and non-extraction
cases. Although torque (twist/Mc) is a free vector,
tooth curvature can affect the inclination, especially
in the molar/premolar region. On those teeth, it
is important to get the tube/band at the height of
contour.
3. With more incisal placement (relative to the posteriors), I'd be running into situations with insufficient
overbite and posterior centric and balancing
interferences.
4. Leveling the COS is never an issue even with deepbite extraction cases, since I always band/bond the
7s and add a slight RCOS during space closure. For
targeted leveling, I'll switch to segmented arches.
5. At the end of treatment, the lower brackets serve as a
good reference guide for the depth of overbite.
Hope that answers your question! ■
3/10/2017
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