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Quintessence Publishing: Journals: ORTHODONTICS
The Art and Practice of Dentofacial Enhancement

Formerly World Journal of Orthodontics

Edited by
Rafi Romano, DMD, MSc (Editor-in-Chief)

ISSN 2160-2999 (print) / ISSN 2160-3006 (online)

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Winter 2000
Volume 1 , Issue 2

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Ultralight Forces for Simultaneous Orthodontics and Orthopedics: Part III. Dentofacial Orthopedics

Barry Mollenhauer, MDSc, BDSc

Pages: 195-201

Aim: To modify fixed appliances to produce orthopedic effects, at the same time as doing orthodontic treatment. This would obviate the need for a pre-fixed phase of functional appliances, shorten the overall treatment time, and overcome compliance problems with removable appliances. By starting early in treatment with gentle ultralight forces, the orthopedic elements would have time to produce their effects. Methods: By using ultralight forces for vestibular root torque, it is possible to grow the bone ahead of the roots similar to the mucoperiosteal pull from the outside as achieved with some removable functional appliances. Both of these contrast with vestibular root torque using standard orthodontic forces that all too often move the roots through the cortical bone, which manifests as dehiscence posttreatment. Arch development cannot be done laterally with one archwire. Thus, a heavy piggyback archwire (not the usual overlay tied over the first archwire, but attached under the gingival wings of the brackets) controls rotations, is nearer the centroid of the tooth to be more effective, and is less irritating. Interarch orthopedics can be effected at the same time, using the same appliance with appropriate accessories. Results: Less extraction treatment is possible with the result of fuller profiles that reduce pre-aging, broader smiles, and, serendipitously, better stability and less root resorption in the midterm (5 to 10 years) posttreatment. Conclusion: It is possible to do quick orthodontic treatment, develop the arches at the sides and at Points A and B at the same time. Early development of good functional occlusion and the use of ultralight forces overcome the inherent dangers of vestibular root torque. World J Orthod 2000;1:195-201. References

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