Finishing and detailing /certified fixed orthodontic courses by Indian dental academy

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INDIAN DENTAL ACADEMY
Leader in continuing dental education

Introduction
Finishing and detailing is the last stage of
treatment .
The finishing procedures are considered ,from
the beginning stages of treatment , as a part of
total scheme of treatment
The objective of any orthodontic treatment depends
on the end goal
In the finishing and detailing stage we continue to
focus on these goals, the foundation established by
the background in the fundamentals of occlusion

Goals of Orthodontic Treatment
Healthy and functionally stable occlusion
Incorporate andrews six keys
Stable jaw relationships
Correlation between Cr and Co
Facial esthetics
Depends on the patient and the community in
which he leaves
Stability of results
Natural occlusion before trmnt was stable and
any change in www.indiandentalacademy.com be another
position must

Finishing is the last step, before active treatment is
discontinued, of ensuring that the teeth and related
structures are positioned in such a way as will lead
to a better stability of results, enhancement of
esthetics ,optimized functions of the stomato-gnathic
system and an improvement of the health of the
periodontium.
Detailing is the achievement of the ideal positions of
every tooth in the vtl and hzl planes with particular
reference to the individual in out, rotation , tip and
torque adjustments

Concept
Earlier relied on nature to achieve final finishing in individual
case.
“The best the orthodontist can do is to secure normal relations
of the teeth and correct the general form of the arch , leaving
the finer adjustments to individual type and form to be
worked out by the nature, which must, in any event finally
triump ( Angle )
LI upright over basal bone and artistic or 2nd order bends in
arch wire (Tweed)
Arch form and placement of LI in reln to the A-Pog line.
( Ricketts)
Overcorrecting major problems so that the changes during
denture recovery would move towards ideal occlusion
(Merryfield)

The natural forces of eruption and occlusion combine with
those of physiology and growth to settle teeth functionally
into the best position for each individual characteristics
. (Bench-et al)
Many felt that a mere reliance on mother nature to achieve
final positioning of teeth in treated case was inadequate.
1972- Andrews 6 keys- nl values of in out,tip and torque
for individual teeth- built in to the SWA- gave necessary
impetus for precise orthodontic treatment
Roth added the goals of gnathologic finishing as part of
orthodontic treatment ,found Andrews brackets well suited to
achieve these goals and built over treatment in his appliance to
neutralize the relapse tendency.

Roth adds his functional req to the Six
Keys to normal occlusion
1. Lower incisors at the +1 to A-Po; for facial
esthetics, for planning anchorage control, and
for selection of mechanotherapy.
2. Tips of the upper incisors 2-2.5mm below the
lip embrasure of the upper and lower lips,
when the lips are closed with no lip strain.
3. No more than 1 mm of attached gingiva
showing upon a full smile.

4. App. 2.5mm overjet-overbite relationship
(.0005" clearance with the lingual surface of
the upper incisor.)
5. A flat occlusal plane, at the end of therapy that
would return to a 1 to 1.5mm curve, at its
deepest point, after appliance removal and
settling of the occlusion
6. A curve of Wilson that would allow seating of
centric cusps, but clearance upon excursions.

7. Lower incisors aligned contact point-tocontact point with the roots in the same plane,
when observed from the occlusal, and a
mesioaxial inclination of 2 degrees.
8. L- 3 crowns angulated mesially 5 degrees,
with the incisal tip 1mm higher than the incisal
edge of, the lateral incisors. The lower cuspids
should have a slightly exaggerated mesial
rotation in extraction cases.

9. The lower bicuspids should be uprighted 1
degree from their normal mesial inclination and
should have a slight distal rotation (more so on an
extraction case). The contact point should be
adjacent to the contact point on the lower cuspid
distal surface.
10. The lower molars should be uprighted 1 degree
from their normal 2-degree mesial inclination,
and should have a slight distal rotation.

11. The lower buccal segment should have

progressive torque close to Andrews'
measurements for establishing the curve of Wilson,
and there should be no rotations or spaces.
12. The upper 1st molars should have sufficient
distal rotation, mesioaxial inclination, and buccal
root torque, so as to fit with the lower 1st molars,.
The same would follow for the upper 2 nd molars.
(14 degrees torque and 0 degrees tip).

13. The upper bicuspids should be uprighted to 0
degrees from their normal 2-degree mesial
inclination, with no rotation.

14. The U-3 must have its contact points adjacent to
the contact points of the upper bicuspid and lateral
incisor, to establish proper length for cuspid
guidance. ( +11 to +13 degrees of mesial crown
tip)


15. The U-2 & U-1 should be almost equal in incisal
edge length, with no more than 0.5mm height
differential.
16. There should be no rotations or spaces in the
upper arch, and the buccal segments from the
cuspids distally should have 14 degrees non
progressive buccal root torque.

17. The arch form should be a modified catenary
curve consisting of five separate radii —
one for the front of the arch form, one for each
cuspid-bicuspid area and one for each buccal
segment from the first bicuspid distally.
The widest point of the lower arch would be at the
mesiobuccal cusp of the mandibular first molars
and at the first bicuspids.
The widest point of the maxillary arch would be at
the mesiobuccal cusps of the first molars.

Roth's sequence of finishing
To finish lower arch before the upper arch
L anteriors at or slightly lingual to the cephalometric goal
LI should have divergent roots
L canines positioned in mesio-axial inclination with distal
root positioning
4. Canine tip 1 mm higher than incisal edge of LI
5. Canine crowns lingually inclined , long axes labio-axially
inclined
6. L posteriors uprighted 30 distal from nl mesio-axial position
of 20
7. L posteriors rotated slightly distally
8. Levelled curve of spee
Sequentially from antr to postr. Sets lower arch to receive the
upper teeth.
1.
2.
3.


Upper arch
1. Max 6 to have distal rotation with suff: buccal root
torque to lift the palatal cusp (supporting)
2. Positioning of 6 determines that of 7 from a
rotational standpoint since both are trapezoidal in
shape
3. This facilitates the PM to seat in a class I reln
4. U canines should have sufficient mesio-axial
inclination so that their tips ride on the disto-incisal
inclines of L canine- canine guided occlusion
5. UI positioned to close the space and occupy sufficient
space within their reach
Finishing the upper arch prior to lower makes it
impossible to finish case properly ,for when the lower
arch is corrected one has to move all upper teeth to
get proper relationship of upper arch to lower arch.

Dougherty – 1976. outlined 17 factors to be
considered in finishing and detailing.
Correction and Overcorrection of the A-P Jaw
Relationship
The tip and torque of anterior brackets place
demand for anchorage, - upper arch,
Total anchorage for anteroposterior correction
is about the same for all appliances.
Overcorrection of the Class II case is the greatest
challenge in this area.
Some class II show relapse with the OJ returning
and DB deepening– overcorrection to end to end
position and maintain it with class II elastics for 6-8
wks followed by settling into ideal class II relnp.

Establishing Correct Tip of the Upper and

Lower Anterior Teeth
Tip in face- eliminates the need for 2nd-order
bends - treatment more efficient.
Wire bending reqiured when:
improper bracket placement relative to the vertical
reference lines of the anterior teeth
irregularly shaped anterior teeth -peg-shape LI present.

Establishing Correct Torque of the Upper and

Lower Anterior Teeth
The anterior torquing needs of patients vary - no
single set of bracket torque values can meet the
needs of all the cases .
Adjust the torque in the upper and lower anterior
segments at various stages of treatment .
Eg: over jet correction of the moderate-to-severe
Class II case – T frequently lost in U antrs and the
LI angulated forward, so lingual root T in U arch
wire and labial root T in L arch wire .
Ideally these compensations to be done in early
stages of OJ correction and space closure

Start MO

End of OJ redn
T lost in U antrs
LI angulated forward


T needed to be
added to recover
correct I angulation

Coordinating Arch Widths and Arch form
Coordination of archwires - from beginning
through the rectangular wire phase -prevent
crossbites from developing.
 In asymmetry cases -distorted anterior arch
forms, (cuspid regions).
To correct - during the finishing stage,
• cross-elastics in cuspid areas,
• archwires canted in the direction opposite to
the asymmetry.

Cross-elastics in cuspid
areas used to compensate
for asymmetrical upper
archform (symmetrical
arch indicated by dashed
line).

Modified upper archform
(dotted line): archwire
canted in direction
opposite to asymmetry.

Establishing Correct Posterior Crown Torque
Built in torque- preadjusted posterior brackets
-eliminates wire bending.
a tendency for upper palatal cusps to be situated
below the occlusal planeposterior buccal root torque - rectangular
finishing wires.
In the lower arch, 1st & 2nd molars- undesirable
lingual tipping, buccal crown torque to the rectangular
archwires.

Establishing Marginal Ridge Relationships and

Contact Points
Proper marginal ridge relationships - finishing
stage - function of bracket height.
Incorrect bracket height - apparent early .
effective to reposition brackets as early as possible.
An .014" round wire can be used to step any
improperly positioned brackets.

Upper central incisor
with incorrect bracket
height and
compensating step in .
014" archwire.

Bracket repositioned at
next appointment,
with .016" archwire.


Correction of Midline Discrepancies
minor discrepancies -3mm or less 5 methods of elastic wear
A single Class II elastic on one side and a double
Class II elastic on the other, for cases with a
bilateral Class II component
A single Class II elastic on one side only, when the
overjet results in a slight Class II relationship on
that side and the opposite side is in a Class I
position.

Class III elastics on one side and Class II elastics on
the other, for cases with the corresponding dental
relationships.

A single Class III elastic on one side only, when that
side is in a Class III position and the opposite side has
a Class I dental relationship .

An anterior cross-elastic, when the discrepancy
occurs primarily www.indiandentalacademy.com segments.
in the anterior



Establishing the Interdigitation of Teeth
rectangular wires - the teeth unable to settle .
Settling before debonding - L/.014" & U/ .014"
round sectional wire from Li to Li & vertical
triangular elastics .
Adv. - establish an individual archform within
certain limits


Checking Cephalometric Objectives
Progress headfilms - halfway through treatment reassessment of anchorage & changes in the division
of treatment time.
final cephalometric headfilms- 3 or 4 months before
debonding.
Evaluate the success or failure of trmnt ,no adv for
pat if after debonding

Important factors to evaluate with progress and

final cephalometric x-rays include
 AP posn. of the incisors

incisor angulations,
changes in the occlusal plane,
 the degree to which vertical dev. - occurred
or restricted, &
the success of the correction of horizontal
and skeletal components of the case.

Checking the Parallelism of Roots
The tip built into preadjusted brackets - proper
root paralleling.
A panoramic x-ray - before debanding to evaluate
root parallelism.
If crown-root angulation is beyond normal
standards, bracket repositioning or archwire
bending may be required to modify the root
positions.

Maintaining the Closure of All Spaces
space closure be maintained - extraction cases passive tiebacks , lacebaks ,in the finishing stage to
prevent relapse


 Evaluating Facial and Profile Esthetics
Esthetic evaluation - ongoing process during all stages
of orthodontic treatment.
A projection of esthetic goals - made as part of the
treatment plan and is monitored clinically and
cephalometrically
Determining if All Habits Have Been Corrected
Habits such as tongue thrusting - been corrected
before the finishing stage .
because as the patient grows, airway size increases
and the tongue can assume a more postr position.
Orthodontically improved oral env:- normal fn.

Checking for TMJ Dysfunctions such as

Clicking and Locking
Document - TMJ dysfunction prior to treatment,
Monitor - TMJ dysfunction during treatment. Problems
– if managed before the development of true internal
derangement, - joint function - re-established without
permanent damage.
Monitor the patient for symptoms of TMJ dysfunction
during retention.

Checking Functional Movements
Before debonding, - checked for interferences during
protrusive movements and lateral excursions.
lower eight most anterior teeth make contact with the
upper six most anterior teeth during protrusive
movements.
requires - slight widening of archform - bicuspid area, mesial of the lower bicuspids contacts the distal of the
upper cuspids.


 Correction of Rotations and Overcorrection Where

Needed
Most rotations - eliminated before finishing stage.
Any remaining rotations can be corrected during
finishing by one of three methods:
Rubber rotation wedges under the rectangular
archwire.
Steiner rotation wedges— these are useful because
they can be placed after the archwire is in position.
Lingual elastics—the most effective method.

Establishing a Relatively Flat Plane of

Occlusion
Reasons for completing cases to a relatively flat
occlusal plane, according to Andrews, proper fit of the upper dentition against the lower
dentition.
Curve of spee left in lower arch the – L teeth
occupy less room and OJ.
Overcorrected in deep bite cases to prevent
relapse

According to McLaughlin, Bennet & Trevisi,
attention should be given to the following
considerations during the finishing stages of
treatment.
Horizontal
Vertical
Transverse
Dynamic
Cephalometric & esthetic.

Horizontal Considerations
Coordination of tooth fit.
A major consideration in HP is coordination of tooth
fit in ant. and post. areas.
Ant. & post. teeth fit well
Crowns of upper ant. teeth
do not occupy enough space
relative to the lower ant. Teeth

– 20% of cases.

60% of cases.

Excess of upper ant. tooth substance – 20% of cases.

Mandibular excess in 60% cases will be evidenced by
Post. space closure – difficult in upper arch –
maintaining correct overjet.
Overjet is correct, buccal segments – mild to moderate
class II.
Ant. space closure – upper arch – difficult while
maintaining the correct overjet.
Horizontal plane  difficulty relates primarily to
factors of tip in the ant. teeth, incisor torque & tooth
size.

Establishing the correct tip of the anterior &

posterior teeth.
Main factor that influence amount of space occupied by
each tooth.
Andrew’s prescription –
40° tip- upper ant. seg, 6° tip – lower ant. seg.
34° tip differential - size of upper ant. seg. & lower.
improved tooth fit – 60% disc. cases.
Shape of incisor crowns:
• Barrel or  shaped – tipping – little effect

 Providing adequate incisor torque

Torque control – weakness of PAE.
 Approx. 1mm seg. of rect. wire – in a bracket slot – same
dimension to carry out difficult root movement.
 Full size wires – not used, to permit sliding.  effectiveness
relative to torque control.
 U/L torque needs vary greatly.
Additional palatal root torque–
upper incisor br.
Addnl. labial root torque – lower incisor br.

Management of tooth size discrepancies.
Tooth size – ‘seventh key’ – normal Occlusion.
Common – lack of tooth mass – u/ant. seg. Relative
to l/ant. seg.
Corrected by either reducing tooth mass in one
arch or by adding to the opposite one
Excess tooth mass – L/ ant. seg – adv. to carry tooth
redcn. – initial stages of trt.
Minimal amt reduced from upper arch in initial
stages for it may lead to spacing in the arch

Controlling rotations.
In out compensation built into br. + correct br.
positioning is effective in controlling rotns.
Beneficial in class I & Cl. II cases to place Pm br.
0.5 mm to mesial  buccal cusps rotate distally to
class I, palatal cusps – mesially – occlude
Accurately into the fossae of lower arch.
Lower canine br slightly mesially  Labial rotn. of
mesial aspect – better contact with distal aspect of
lower laterals.

MO characterized by severe antr crowding and rotation –
circumferential supracrestal fiberotomy
carried out 1-4 months before appliance removal
Contraindicated in :-Poor oral hygiene ,Active Pdl
disease,Gingival recession ,Lack of attached gingiva
Imp aspects of long term stability of corrected rotations
 Under corrections -compare with pretreatment plaster cast
 Broken contact points- starting pts for later crowding,
reshaping is necessary
 Placing 2-2 outside 3-3- particularly imp when distal of 2
lingually placed at the start of treatment
 Early correction- derotation just after emergence in the mouth
implies corrections before transeptal fiber arrangement has
been established

Maintaining closure of all spaces.
Passive wire tie backs when rect wires in place,
Lacebacks – molar – cuspids – when light wires
used.
In extn. cases – figure of 8 liagature ties –across
extn. site – to keep it closed.


Horizontal overcorrection.
Cl II & Cl III cases – consider overcorrection.
Fully correct the A/P position of dentition –
using elastics, head gear etc.
After correction – these methods discontinued/
worn part time – 6-8 weeks.
If stable – appl. removed.
Relapse – horizontally overcorrected.

Vertical Considerations
Correct crown lengths, marginal ridge

relationships and contact points.

Correction should be completed during rect. NiTi
stage of trt. If not done early, in finishing stage –
minor archwire bends. Does not ensure stability.
These relns. to be corrected 1-2 yrs, before br.
removal.
Teeth with cusp height which vary from norm or with
abnormal marginal ridges, br.position is modified to
accommodate the difference.

Final management of the Curve of spee.
Low angle cases:
Beneficial to level the entire curve of spee.This include
banding 2nd molars. If not corrected, the LI will be
positioned more gingivally on palatal surface of UI ,
difficult to complete space closure or maintain the
closed space. Upper bite plate retainers given in cases
showing a tendency for bite deepening during retention.
High – angle cases:
High angle cases with open bite tendencies its impt.
to leave some curve of Spee at the back of the

Vertical overcorrection – deep bite and open bite

cases:
Br. On ant. teeth – 0.5 mm more gingival – open bite.
- 0.5 mm more incisally – deep bite.
Bite opening curves used in cases resistant to bite
opening
Overbite cases -Towards end of trt. – 1-2mm over bite,
settle to 3-4mm.
Openbite cases – impt. to evaluate – tongue position
& tongue habits. In some cases it may reassert itself
despite the best efforts of pat and orthodontist

Excessive overbite:- rectified at this stage by
 Auxillary intrusion arch
 Auxillary intrusion spring
 Increased curve of spee in round ss wire

UI moved in vtl direction that improves their
relationship to resting lip position and the tooth to lip
position monitored through out trt:
Other than in gummy smile cases active intrusion of UI
is undesirable. LI are intruded using double tubes on L
molars and continuous or segmented utility arches.

Transverse Considerations.

Arch form.

Single arch form for every patient – efficiency in
arch form management, accuracy or stability is not
achieved.
Key to good arch form management :- balance b/w
efficiency & accuracy
Arch form system consist of

 3 std. Templates( square, tapered & ovoid) – to
establish arch form used from early stages of trt.
 Use of a wax template compressed over br. in lower
arch, before placement of rect. SS wire. Shape of rect
wire based on this template---- IAF
 Allowing to settle with light wire – last trt. procedure.

Archwire Coordination.
U & L archwire coordinated from early stages to
prevent troublesome cross bites in final stage
In all wire sizes – lower arch form established and
Upper coordinated with lower wire, 3mm wider ant.
& post. than the lower wire- 3mm OJ A & Prtly
Post. Torque considerations – beneficial to widen
upper arch – post. Segments – 5mm.
Minor maxillary narowing in finishing stages of trt.
‘Jockey wire’. – 0.045 arch wire coordinated – upper
arch, widened 6mm/side,secured to headgear tubes.

 Establishing posterior torque.

Progressive buccal crown torque designed in to
appliance system– lower post. Seg.
Rect SS wire in br: L post– upright position ------Slight
widening tendency in the lower arch. The L postr
root move lingually than crown buccally.
Upper molars are provided with additional buccal
root torque. Due to their anatomy its important to
have adequate width in maxillary bone so that the
buccal roots are not compressed against the cortical
plate.-----impossible to establish correct buccal root
torque

Transverse overcorrection
Cases with narrowing in maxilla overexpanded and held
in that position for an extended period of time. Maxilla
expanded – palatal cusps of upper arch are in contact
with buccal cusps of lower arch.
If carried out in early stages, a palatal bar should be
placed after expansion procedures until rect ss wire is
placed. Torque in post. Br. + torque in arch wire –
allow post. seg. to settle.
Trans palatal or buffalo elastics
Used to constrict the maxillary arch by producing a trans
palatal force in the maxilla. They extend across the
palate and attach to ball hooks on max. PM bands.
Worn in the night- constriction in few months.

Dynamic Considerations
 Establishing centric relation and checking functional

movements.

Evaluate orthodontic cases in CR at beginning of trt.
Re-evaluate mandibular posn. as finishing stage of trt.
commences.
Patients are checked for interference in protrusive &
lateral excursions.
Protrusion – lower eight most ant. teeth make contact
with upper six most ant. teeth.
Lateral excursions – cuspid rise with slight ant. contact,
disclusion of post. teeth on both working & balancing
sides.

Checking for TMJ dysfunction.
Document any evidence of TMJ dysfunction prior to trt.
Muscular imbalance/ pain/ CR not accurately recorded
---- splint therapy / physical therapy prior to trmnt
Monitor during ortho trt. if any symptoms develop.
Normal TMJ fn. reestablished – if managed prior to true
int. derangement.
Seated & reasonably centred condyle position – most
beneficial posn. during ortho trt.

Cephalometric & Esthetic
Considerations
Cephalograms – taken half way through trt.to assess –
anchorage factors- help revisions in trt. planning as
trt. progress. Super imposed to determine changes
occured
Ceph. film – 3-4 months before debonding –evaluateAP position of incisors.
Torque of incisors
Changes in the mandibular plane
Vertical dev.
Success in correcting horizontal, sk. & dental
components of the problem.
Soft tissue profile

Evaluation of esthetic factors involved in Anterior Tooth
Display and Smile
Factors analyzed from the front of the patient
1. Crown length of U/L incisors
2. Incisal edge contours
3. Axial inclinations of U/L incisors
4. Midlines (U,L, labial, facial)
5. Crown torques
6. Smile line (rest and full)
7. R/L symmetry of crown shapes and sizes and gngvl
marginal levels
After studying these any required finishing bends or
esthetic procedures is done.

Max CI – even , equilibrate incisal edges and length of
crown if necessary with restorations
Root angles balanced
Torque should be similar for all Is’ for best stability and
allignment
LI edges above that of CI to clear the lower canine tips in
protrusive movement.
Max Cn slightly longer than Ci for best canine guidance in
lateral excursions
Max Incisal curve II to that of the inner contour of L lip
Achieved by positioning CI .5-1 mm longer than LI

Settling the Case
Rect. Ss wires restrictive for settling of teeth in the
closing stages of trt.
0.014 or 0.016 round wire in lower arch coordinated
to the IAF
0..014 round sectional wire – LI to LI in upper arch.
Vertical  elastics used where settling needs to occur.
Full time wear for first 2 weeks, then night wear for
next 2 weeks, if adequate- debonding.

Variations:
Cuspids labially displ. – extend sectional wire in
upper ant. seg to hold them in postn.

Diastemas – areas tied lightly with elastic
thread or ligature wires.
Teeth extd. – figure of 8 ties –across extn. sites.
Palatal expansion cases -a small removable palatal
plate – maintain expansion during settling phase

Moderate to severe Cl II/I, full upper arch wire is
used with wire bend back distally- controls OJ
Settling longer than 6weeks –leave lower rect. wire in
positn –maintain L arch form. eg: difficult postr OB

Serpentine wires:- 1 week before appliance removal
U&L arch wires are removed ,ligated together in a
serpentine fashion from PM to PM with std: ligature
wire--- occlusion to settle without any interdental
spacing– (in minimal discrepancies of tooth position)


Vertical spaghetti elastics:1 week before appliance removal U&L arch wires are
removed . 0.16” ss wire secured in L arch with light
steel ligatures and no arch wire in upper arch.
Series of triangular elastics placed btwn two arches. 3
arms of
elastic include distal br. wing of one max
tooth ,mesial br. wing of the postr tooth and the entire
br. of mand tooth closest to it. In CI region two elastics
placed in midline.
Wear full time – rapid settling of occlusion
Contraindicated in cases originally characterized by
deep bite (Class II div 2) :- serpentine wires used

 Settling elastics with

class II pull:- 2oz elastic
started over L1M
&U2M twisted and
engaged over next 2
teeth and repeated to the
UCi on X side

 Settling elastics with

class III pull:-starts
from U&L 2 M and
extends to the Ci. on X
side

ABO Criteria-1998- evaluating dental casts and
panoramic radiograph
1.

Alignment:- attn paid to incisal edges and lingual
surface of UI and labioincisal surface of LI. Central
groove of U PM &M and buccal cusp of L PM &M
used to assess adequacy of alignment

2.

Marginal ridges:- of adjacent teeth at same level or
within .5 mm of same level. R/G : cej at same
level
Flat bone level btwn adj: teeth.

3.

Buccolingual inclination:-assessed using a flat surface
extended btwn occlsl surface of R&L postrs. Buccal
and lingual cusp of all teeth within 1 mm of the
straight edge

4.

Occlusal relnp:- mb cusp of U 1 M coincide within 1
mm of buccal groove of L1 M and buccal cusp of U
PM,M, Cn align within 1mm of interproximal
embrasure of mandibular postr teeth.

5.

Occlusal cts:-Max: intercuspation btwn buccal cusp
of U postrs and Lingual cusps of L postrs.

6.

Overjet:- LI edges slightly ct lingual surface of UI.

7.

Interproximal cts:- All spaces within the arch should
be closed.

8.

Root angulation:-parallel to each other and
perpendicular to the occlusal plane.

Duration of finishing and detailing affected by
Variation in shape and size of patients teeth

relative to average measurements
Inaccuracies in appliance design
Inaccuracies in appliance placement
Failure to allow sufficient time for the bracket to
express itself
Use of force levels that overpower the appliance
design

Wires Used
0.018” slot

0.02” slot

Finishing - 0.017”x 0.025”ss

0.019”x 0.025”ss

Detailing - 0.016”x 0.022” Bss
0.014”ss

0.017”x 0.025”Bss
0.016”ss

Torque assessment
Eff t = Designated t + T in the arch wire t play
Eff t
by
T play. Done by filling slot
completely with www.indiandentalacademy.com
rect wire of larger dimension

Conclusion
With the built in features of the PEA and the correct bracket
placement, moving teeth to their finished positions begins as
soon as the brs: have been placed and the first archwires
tied in. There is a gradual flow towards the finishing rather
than an abrupt , clearly defined treatment stage.
The real value of PEA becomes apparent in finishing, the
more accurate the appliance, the less time and effort
required in this stage. Even though not required in initial
stages ,in most cases some wire bending is required in
finishing stage to precisely position teeth.
PEA let redefine finishing & detailing as “the correction of
errors made prior to finishing & detailing, over correction
as needed and settling of the case.”

Finishing and detailing /certified fixed orthodontic courses by Indian dental academy

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Finishing and detailing /certified fixed orthodontic courses by Indian dental academy