Orthotown September 2016 - 30
clinical orthodontics // feature
insertion of .014 copper nickel titanium
(CuNiTi). The archwire sequence of 14x25
unit, 18x25 CuNiTi, 19x25 stainless steel
was followed with 10-week appointment
intervals. The posterior crossbite relationships
in Case 1 were corrected before advancement
to 18x25 CuNiTi. In Case 1, once both
arches were worked to 19x25 stainless steel,
a Rocky Mountain Orthodontics fi xed/
removable transpalatal arch was inserted
into the vertical lingual sheaths of the
upper molar bands, with 6mm of clearance
relative to the palate (Fig. 12). In Case 2,
molar bands were avoided by placing a
bonded TPA bent from .036 stainless steel.
It was bonded to the occlusal surfaces of
the upper first molars (see Fig. 13, pg. 29).
This prevents lingual rolling of the buccal
segments during intrusion.
Fig. 14a
Fig. 14b
Case-specific treatment
In Case 1, a collimated CBCT view of
the maxilla was captured with a Carestream
Dental CS 9300. A miniscrew placement
simulation was performed, showing excellent
bone density at the midpalatal suture,
allowing for a single miniscrew and dumbbell
(see Fig. 4, pg. 25). In Case 2, a similar
simulation was also performed; both quality
and quantity of bone were assessed. It
was determined that a single midpalatal
miniscrew at the midpoint of the suture
would be less reliable than two paramedian
miniscrews. The density-gradient tools of the
miniscrew placement simulation showed an
acceptable gradient of relative bone density
in two paramedian locations, rather than a
single screw placed in the midpalate.
In Case 1, a 6mm miniscrew was inserted
at the midpalatal raphe at the mesial aspects
of the first molars. A dumbbell attachment
was bent from 19x25 stainless steel and
bonded into the cross-slot of the miniscrew
with filled f lowable composite (Wave,
Patterson Dental), and with composite
carefully flowed into the undercuts of the
head of the miniscrew.
In Case 2, two 6mm miniscrews were
inserted at the paramedian locations shown
30
SEPTEMBER 2016 // orthotown.com
Fig. 14c
http://www.orthotown.com
Table of Contents for the Digital Edition of Orthotown September 2016
Orthotown.com Highlights
Dental Hygiene— in an Orthodontic Practice?
Industry News
New Products
Monthly Poll: Bonding
Non-Sx. Plan for This Case?
A Winning Combination
Townie Talks: Transitions Q&A
Clinical Orthodontics: A Great Future in Plastics
Dolphin Imaging & Management Solutions
GORP 2016
Product Profile: Ormco
Orthotown September 2016 - Cover1
Orthotown September 2016 - Cover2
Orthotown September 2016 - 1
Orthotown September 2016 - 2
Orthotown September 2016 - 3
Orthotown September 2016 - 4
Orthotown September 2016 - 5
Orthotown September 2016 - Orthotown.com Highlights
Orthotown September 2016 - 7
Orthotown September 2016 - Dental Hygiene— in an Orthodontic Practice?
Orthotown September 2016 - 9
Orthotown September 2016 - 10
Orthotown September 2016 - 11
Orthotown September 2016 - Industry News
Orthotown September 2016 - 13
Orthotown September 2016 - New Products
Orthotown September 2016 - 15
Orthotown September 2016 - Monthly Poll: Bonding
Orthotown September 2016 - 17
Orthotown September 2016 - 18
Orthotown September 2016 - 19
Orthotown September 2016 - Non-Sx. Plan for This Case?
Orthotown September 2016 - 21
Orthotown September 2016 - 22
Orthotown September 2016 - 23
Orthotown September 2016 - A Winning Combination
Orthotown September 2016 - 25
Orthotown September 2016 - 26
Orthotown September 2016 - 27
Orthotown September 2016 - 28
Orthotown September 2016 - 29
Orthotown September 2016 - 30
Orthotown September 2016 - 31
Orthotown September 2016 - Townie Talks: Transitions Q&A
Orthotown September 2016 - 33
Orthotown September 2016 - 34
Orthotown September 2016 - 35
Orthotown September 2016 - 36
Orthotown September 2016 - 37
Orthotown September 2016 - Clinical Orthodontics: A Great Future in Plastics
Orthotown September 2016 - 39
Orthotown September 2016 - Dolphin Imaging & Management Solutions
Orthotown September 2016 - 41
Orthotown September 2016 - 42
Orthotown September 2016 - 43
Orthotown September 2016 - GORP 2016
Orthotown September 2016 - 45
Orthotown September 2016 - 46
Orthotown September 2016 - Product Profile: Ormco
Orthotown September 2016 - 48
Orthotown September 2016 - Cover3
Orthotown September 2016 - Cover4
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