Orthotown January/February 2023 - 20

EARNED PLACEMENT
Clinical Efficiency
With 'True Straight Wire'
by Dr. Frank Bogdan
Ever since Larry Andrews published
" The Six Keys to Normal
Occlusion " in the AJO-DO in 19721
(the second year of my residency
at the University of Medicine
and Dentistry of New Jersey, now
Rutgers), it was apparent to me that
straight wire was the way to go in
clinical practice. Upon graduation,
I went with a company that made
Andrews' bracket prescription
built into the base of an edgewise
bracket with a 0.022-by-0.028-inch
slot. The tip and torque required for
each tooth was based on untreated
cases from which Andrews developed
his " six keys of occlusion. "
The Andrews appliance proved
to be a big advantage over the
plain vanilla edgewise brackets
I used in residency. However, I
soon discovered I was never going
to finish a case in a straight wire,
because individual cases would
still require first-, second- and
third-order bends to finish. The
preadjusted appliance did give the
profession a head start to finishing,
but still had shortcomings.
Over the next 20 years, I played
around with various prescriptions in
an attempt to do less wire bending
and increase efficiency with some
success. I settled with a Roth prescription
(modified). The maxillary
canines (-7) did not create the
aesthetic, broad smile I was looking
for in my cases. The canines always
required positive torque in the finishing
stage and therefore required
modifying. In addition, I used a
great deal of functional appliances
(Frankel, Activator, Bionators, Twin
Block and Herbst) to achieve better
results with fewer extractions.
Light force meets
low friction
In the 1990s, my orthodontic career
took a major turn with Ormco
buying the company I mentioned
above. In 1997, I was looking
to change my appliance from a
single-wing edgewise bracket
to an edgewise twin bracket. As
fate would have it, I took a course
in New Orleans with Dr. Dwight
Damon, who had a new passive
JANUARY/FEBRUARY 2023 | 20 | ORTHOTOWN.COM
self-ligating (PSL) bracket system.
Two hours into the lecture, I knew
for the first time in my career that I
was going to make a total system
change to passive self-ligation.
I was impressed with the tooth
movement I was seeing in Damon's
cases when light force (delivered
by superelastic wires) and low friction
(PSL brackets) were combined.
A few years later, as I utilized the
system, I realized that muscles were
affecting my cases like " functional "
appliances because of lower
friction: The tongue muscle was
able to aid expansion of the arches
by uprighting the buccal segments
previously overpowered by a
strong buccinator and orbicularis
muscles. Our office visits were
pushed out to eight to 10 weeks,
and cases were treating out faster,
with fewer office visits and fewer
extractions, because of what I
described at the time as " arch width
development. " It was similar to the
tooth movement I'd previously seen
in Frankel cases2
and described by
Melvin Moss as " teeth uprighting
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Orthotown January/February 2023

Table of Contents for the Digital Edition of Orthotown January/February 2023
