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simultaneous torquing & intrusion /certified fixed orthodontic courses /certified fixed orthodontic courses by Indian dental academy
1. Simultaneous Torquing and
Intrusion Auxillary
INDIAN DENTAL ACADEMY
Leader in continuing dental education
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2. Simultaneous Torquing and Intrusion Auxiliary
RAPHAEL L. GREENFIELD, DDS, MSD
Intrusion is required throughout retraction to maintain occlusal
plane angle and keep roots within cancellous bone for future
torquing
Patient before and two years after
intrusion of incisors to eliminate
"gummy" smile.
Sectional archwire with auxiliary. B. Intrusion
Torquing and intrusion auxiliary, with sectional archwire
arch (.018") should be broad enough to avoid
completely filling bracket slots
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impingement of soft tissue. C. Intrusion arch
engaged to activate auxiliary.
3. Use of Class I elastic to prevent labial crown tipping of incisors in
Class II, division 1 case.
Simultaneous Torquing and Intrusion Auxiliary - . Activation needed to
intrude central and lateral incisors (half this amount is needed if only
•
Helix used instead of tipback bend in Class II,
central incisors are engaged). B,C. With activation for intruding all four
division 1 case.
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incisors, arch lies in vestibule. D,E. "V"-bend keeps bite-opening bend of
intrusion arch from entering buccal tube as incisors are retracted.
4. •
By using this auxillary, simultaneous torquing and incisor intrusion is
achieved during retraction.
•
By using light, continuous forces and maintaining the roots within the
cancellous bone, root resorption and patient discomfort are minimized.
•
Treatment time is significantly reduced because the incisors do not
require torquing at the completion of retraction.
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5. If canines are not engaged and intrusion arch is tied into incisor roots tend to converge toward midline and spaces
open at incisal edges, due to bowing of wire. B. With canines engaged, there is initial undesirable extrusive
component on incisors (assuming canines and incisors are initially at same level).
•
•
The torquing spring is especially effective in Class
II, division 2 cases where the central incisors are
When torquing incisors lingually on a continuous
lingually inclined By simultaneously torquing the
rectangular archwire, there is 1° of mesial
roots as the incisors are intruded, the roots are
convergence of the gingival portions of the central
kept safely away from the labial cortical plate and
and lateral incisor crowns for every 4° of lingual
well within cancellous bone.
crown torque.1, The same convergence would
•
In a Class II, division 1 malocclusion, the .018"
occur if the intrusion arch were engaged directly
intrusion arch and torquing spring maintain
into the four incisor brackets). However, this
proper root angulation as the anterior segment is
effect is eliminated with the torquing and
retracted with light Class I forces This produces
intrusion auxiliary, because the intrusion arch is
bodily distal movement with intrusion instead of
connected to the anterior segment by a one-point
the usual extrusive component seen with
contact.
retraction.
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6. Clinical cases
A. 12-year-old male Class 11, division 2 patient
before treatment. B. Torquing and intrusion
auxiliary used for six months. C. After 26 months of
treatment.
12-year-old male Class II, division 2 patient before treatment. B.
Torquing and intrusion auxiliary used for five months. C. After 26
months of treatment.
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7. Clinical cases of clII DivI
A. 11-year-old female Class II, division 1 patient before
treatment. B. Torquing and intrusion auxiliary used for
eight months. C. After 22 months of treatment.
A. 11-year-old female Class II, division 1 patient before
treatment. B. Torquing and intrusion auxiliary used for
seven months. C. After 28 months of treatment.
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8. Cuspid intrusion after incisor intrusion
•
A. 12-years-old male Class II,
division 1 patient before treatment.
B. Torquing and intrusion auxiliary
used for five months. C. Cuspid
intrusion with .012" nickel titanium
overlay wire (three months). D. After
23 months of treatment.But the
auxillary should be in place to
intrude canines.
•
True incisor intrusion produces
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plateau,
behind incisors
9. Torquing individual teeth with intrusion
•
11-year-old female patient before treatment. B.
•
A. 11-year-old female patient with flared upper
Torquing auxiliary engaged through vertical
incisors before treatment. B. Placement of
bracket slot for torquing central incisors
auxiliary to intrude incisors without lingual root
individually (six months). C. After 18 months of
torque. C. After 26 months of treatment.
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treatment.
10. Point of force application
•
Transpalatal arch used to stabilize molars
during intrusion
•
.
when the upper incisors are flared labially and no
lingual root torque is desired This is achieved by
A. Point of force application perpendicular
moving the point of force application
to center of resistance of incisors produces
perpendicular to the center of resistance of the
no moment and no torque. B. Point located
incisors, thus producing no moment and no torque
he point can be located by drawing an imaginary
on line bisecting cemento-enamel junctions
line that bisects the cemento-enamel junctions on
on lingual surfaces of central incisors. C.
the lingual surfaces of the central incisors. I
Placement of auxiliary and intrusion arch.
strongly recommend that a lingual molar
stabilizer such as a Nance button or transpalatal
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arch be used to minimize undesirable side-effects
11. SELECTIVE INTRUSION
•
Indiscriminant levelling with a
continuous arch or with a sectional
wire can produce undesirable side
effects. Many times the overbite is
corrected not because intrusion
has accomplished, but because
extrusion and altering the cant of
the
occulusal
plane
have
occurred.If this occurs it is
impossible to achieve through
intraoral mechanics.
•
In classII D 2 cases, the central
incisors should be intruded using
intrasegment intrusion i,e centrals
should be intruded more than the
laterals.If continuous wire placed
in 4 incisors will level,but erupt
laterals & also produce moments
which will cause roots to converge
mesially .So centrals should be
intuded,then all 4’s sould be
intruded.
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12. Thank you
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