PRESURGICAL ORTHODONTIC MANAGEMENT AND SECONDARY BONE GRAFT IN THE CLEFT PATIENTS
|
|
- Bruce Cunningham
- 5 years ago
- Views:
Transcription
1 PRESURGICAL ORTHODONTIC MANAGEMENT AND SECONDARY BONE GRAFT IN THE CLEFT PATIENTS *ABIDA IJAZ, BDS, D.Orth, MCPS, MS **SAEED ASHRAF CHEEMA, MBBS, FCPS (Plastic Surgery) INTRODUCTION The incidence of cleft lip and palate in multi ethnic Hawaii population was reported as 12.5 per 10,000 live births 1 and that of Australian children from Victoria as 7.8 per 10,000 pregnancies. 2 According to Wikipedia, the highest prevalence rates for cleft lip and palate are reported for Native Americans (3.74/1000 ) and Asians (Japanese: 0.82/1000 to 3.36/1000, Chinese: 1.45/1000 to 4.04/1000 ). African-Americans (0.18/1000 to 1.67/ 1000 ) have been reported to have the lowest prevalence rates and in Caucasians as 1.43/1000 to 1.86/ In the mixed dentition stage, the initial orthodontic treatment comprises cross bite correction whether transverse, sagittal or both. In cleft children, restricted maxilla may present both transverse and sagittal cross bite. Expansion of the maxillary dental arch can be attained by various means such as ordinary removable screw plates or fixed expanders in the form of Trihelix, Quad Helix 4, soldered Hyrax 5 or Hyrax with acrylic splint 6 and Haas screw appliance 7. Bonded acrylic expanders incorporating midline screw or fan shaped screw is the recommended treatment for transverse deficiency 8. The modified expansion device (MED) 4-9, a bonded expander addresses the problem of transverse along with minor correction of sagittal cross bite by providing occlusal clearance. On correction of cross bites and incisal rotations, bone grafting is performed. Secondary bone grafting is the most accepted procedure and is performed preferably before eruption of the permanent canine 10. The grafted bone provides adequate periodontal support 11 for eruption and preservation of teeth adjacent to cleft 12. Secondary graft is placed during mixed dentition stage 13. The anterior iliac crest is the most common donor site, providing an adequate amount of bone with high particulate cancellous bone content. This article reports on combined orthodontic and surgical management on three patients presenting with cleft of the lip and palate in mixed dentition stage. A male patient with repaired unilateral cleft of the lip and palate on the right side, the other one with bilateral cleft lip and palate and a female patient with repaired left side cleft of lip and palate are described. CASE 1 A male child age 6 ½ years was referred to the cleft centre of The Children s Hospital (Fig 1-10). The presenting complaint was an unpleasant facial appearance and deranged dentition. He was born with right unilateral cleft of the lip and anterior palate. Initial lip repair was reported at 3 months and palatoplasty at one year of age. Intra oral examination (Fig 3, 4) revealed an apparent cleft in the right alveolus. The teeth were in early mixed dentition stage. Lower permanent central incisors were partially erupted and the rest of teeth in both of dental arches were deciduous. The primary teeth lying in line of the cleft i.e. the right upper central and lateral incisors were in gross palatal rotation with localized open bite because of the defect. The right upper quadrant was in crossbite up to first deciduous molar. The OPG revealed an inverted pear shaped radiolucent area which was 2.8 x 2cm in dimensions. On the occlusogram, the cleft extended backward to first deciduous molar region. Cephalometrically, the child was analyzed to have skeletal 1 pattern. Treatment Plan The treatment plan for this patient was unilateral expansion of the collapsed segment after eruption of * Assistant Professor / Head of Orthodontic Department, The Children s Hospital & Institute of Child Health, Lahore, Pakistan abida_ijaz@yahoo.com, abida_ijaz@hotmail.com, ** Assistant Professor Plastic Surgery, Services Institute of Medical Sciences and Services Hospital Lahore. sacheema2002@yahoo.com Pakistan Oral & Dental Journal Vol 27, No. 1 9
2 permanent first molar. When the upper first permanent molars were adequately erupted, the modified expansion device with unilateral screw was bonded to upper arch (Fig 5). The soft acrylic was applied on top surface of the expander to fill the defect part. The screw was opened at the rate of two turns every alternate day. On correction of the right cross bite, the screw was ligated, post expansion records were obtained. (Fig. 6) and the patient was sent for six weeks stabilization along with oral hygiene instructions. After wards, the fixed retention appliance, Nance with extended arm (Fig 7) was cemented and the patient was referred for secondary graft surgery at 9 years of age. One and a half month after surgery the patient was examined and the intraoral examination revealed a successfully healing graft (Fig 8). The extra oral views reflected an improved contour of the face and better upper lip support (Fig 9, 10). Fig. 3: Intra-oral Front View Fig. 4: Upper Occlusal View Fig. 1: Pre-treatment Front View Fig. 5: Modified Expansion Device with Unilateral Screw Fig. 2: Pre-treatment Profile Fig. 6: Post-expansion View 10 Pakistan Oral & Dental Journal Vol 27, No. 1
3 CASE 2 Fig. 7: Post-Expansion Retention (Nance with Extended Arm) Fig. 8: Occlusal View at 1 1/2 months after Secondary Graft Fig. 9: Post Graft Front View An 8 years old boy with repaired bilateral cleft of the lip and palate was referred to the cleft centre of the CH&ICH (Fig 1-10). Cleft lip was repaired at 3 months and palatoplasty was performed at 1 year of age. Bilateral scars of the upper lip and nasal base deformity and deranged occlusion were the major concerns of the parents. On intra oral examination, the premaxilla was displaced laterally and inferiorly and the midline of the premaxilla was deviated 6mm to the left of the facial midline (Fig 3). Occlusion was acceptable in the molar region, whereas it was in cross bite in the canine and deciduous molar region on both sides. The dentition was in early mixed dentition stage. Right upper central and lateral permanent incisors were erupted and rotated while left deciduous central had recently been shed and the deciduous lateral incisor was present. Supernumerary teeth were present bilaterally in the line of cleft, one on either side (Fig 4). Treatment Plan The custom made modified expansion device with midline screw and fan shaped spring (Fig 5) was planned for this patient as the cross bite was gross in the anterior buccal segment necessitating more expansion anteriorly. The cleft part was filled with soft acrylic. Expansion was done at the rate of two turns every alternate day. On completion of expansion and correction of cross bite, routine management was undertaken as mentioned earlier (Fig 6) and the patient was referred for secondary graft surgery. Six weeks after secondary graft post-surgical records were attained that revealed a pleasant change in the transverse dimension, facial contour on both sides, better lip support and a successfully healing graft (Fig 8, 9, 10). Fig. 10: Post Graft Profile Pakistan Oral & Dental Journal Vol 27, No. 1 Fig. 1: Pre-treatment Front View 11
4 Fig. 2: Pre-treatment Profile Fig. 6: Post-expansion Occlusal View Fig. 3: Intra-oral Front View Fig. 7: Post-Graft Front View Fig. 8: Post-Graft Occlusal View Fig. 4: Upper Occlusal View Fig. 5: MED with Midline Screw and Fan spring Fig. 9: Post Graft Front View 12 Pakistan Oral & Dental Journal Vol 27, No. 1
5 Fig. 10: Post Graft Profile Fig. 1: Pre-treatment Front View CASE 3 An 8 years female presented with repaired unilateral cleft of the lip and palate on the left side (Fig 1-10). Cheiloplasty was reported at 3 months and palatoplasty at one year of age. History of consanguineous marriage was recorded. This patient was the second out of four kids (two females and two males).the youngest brother was also reported as born with unilateral cleft of the lip and palate (Fig 1, 2). On intraoral examination the patient showed mixed dentition with deranged occlusion and localized open bite at the cleft site (Fig 3). On the occlusal surface, the cleft was in the form of a fissure (Fig 5) but on the labial side it appeared like a slit (Fig 4). The occlusal view showed a pear shaped radiolucent area (1x1 ½ cm) in the left lateral region. On the OPG, the cleft appeared as a slit like radiolucent area. A supernumerary tooth was also seen in the cleft line. Cephalometrically, the patient was found to have skeletal II pattern (SNA 84, SNB 76). Fig. 2: Pre-treatment Profile Treatment plan Her treatment plan was presurgical orthodontic alignment of rotated teeth without involving left upper lateral incisor, being placed in the line of cleft. The upper anteriors were bonded and included in the straight wire system till alignment of the rotated centrals (Fig 6, 7, 8). On correction of rotation of the left central incisor, the cleft on the labial surface became more prominent. The aligned incisors were then stabilized with rectangular arch followed by routine records. The patient was then referred for secondary graft surgery. Three months after graft procedure, successful results with improved contour of the face and better lip support were seen (Fig 9, 10). Fig. 3: Intra-oral Front View Fig. 4: Pre-treatment Left Side View Pakistan Oral & Dental Journal Vol 27, No. 1 13
6 Fig. 5: Pre-treatment Occlusal View Fig. 9: Post Graft Smile View Fig. 6: Post Alignment Occlusal View Fig. 10: Post Graft Profile DISCUSSION Fig. 7: Post Alignment Front View Fig. 8: Post Alignment Left Side View Rapid palatal expansion produces larger forces at the sutural site over a short period of time 14. These heavy forces maximize skeletal expansion of midpalatal suture before any dental movement or physiological sutural adjustment can occur. As seen in a number of studies, skeletal and dental effects are easy to achieve and relapse is rare when RME is performed in the prepubertal period or during puberty 15, 16. In cleft palate cases, as buttressing effect from zygoma is not present, slow expansion of the constricted palate can be achieved. The custom made MED 4-9 (modified expansion device) was given in two male patients. In one patient, MED with unilateral screw was bonded to expand the collapsed minor segment of the right unilateral cleft. Expansion was followed by retention and further graft procedure 13. Fan shaped MED 17 was given in other patient in early mixed dentition with repaired bilateral cleft lip and palate. Custom made fan shaped MED 14 Pakistan Oral & Dental Journal Vol 27, No. 1
7 was applied to get desired expansion which was followed by retention and further secondary alveolar bone graft. 18 Toygar 19 in his case report, used rigid acrylic bonded RME appliance, very similar to MED, in a 13 year old girl and concluded that the rigid acrylic bonded RME prevented upper molar extrusion and provided more parallel expansion, with less tipping of the posterior teeth, than could have been achieved with conventional banded expanders. During expansion, little change was reported in vertical dimension with only a slight posterior rotation of the mandible. He used the same appliance for retention purpose. Neol Reed 6 compared treatment outcome with banded and bonded rapid palatal expansion appliances and found that the banded rapid palatal expansion group had more vertical change than the bonded one. The stability of maxillary expansion has been widely examined with significant relapse reported by Stockfish 20, Linder-Aronson and Lindgren 21. However, numerous other studies strongly contradicted these findings. Moussa 22 found goal stability in 55 of Hass patients 8 to 10 years after retention, Mew 23 found no significant relapse after 2 ½ years after retention in 25 consecutive treated patients. In our experience, the bonded expander was used for vertical control as well as to stabilize the expanded dentoalveolar segments till fabrication of the retention appliance. In the female patient, the upper and lower dental arches were well coordinated and therefore expansion was not indicated. The left upper central incisor which was grossly rotated was included in the bracket system 13, 18 as it moved away from the cleft during presurgical alignment. Tooth movement towards the cleft does not bring the bone along, unless and until the graft is accepted. The lateral incisor was planned to be left as such till second phase of orthodontic treatment after graft acceptance. Presurgical alignment was done to facilitate graft placement and post surgical closure. In all of three cases iliac bone was used to harvest the bone graft. Donor site wound was closed in layers with a suction drain inside, which was removed on third postoperative day. This donor site is easily reachable, provides sufficient graft with a good cancellous bone ratio and leaves a good scar that is parallel to the skin tension lines and thus gives good cosmetic results. Pakistan Oral & Dental Journal Vol 27, No. 1 Moreover the scar is concealed in the belt area. Bone graft at the recipient site needs a good soft tissue cover and it was provided with local mucosal flap from the adjacent buccal sulcus. The flap donor site was closed primarily. Absorbable sutures were used both at recipient and donor site. In all of three cases the flaps and donor sites healed uneventfully. The outcome of this combined presurgical orthodontic management and secondary graft surgery in these patients was a pleasant change in the facial appearance. In the male patients horizontal dimension of the face particularly the mid face was improved by expanding the collapsed alveolar segments, with unilateral bonded expander in the first patient with fan shaped expander for bilaterally collapsed buccal segments. The upper lip and nasal alar base support was improved by restoring contour of the grafted alveolus and partly due to improved axial inclinations of the upper incisors in case of the female patient. SUMMARY Three cases of cleft lip and palate are presented which were dealt with presurgical orthodontics followed by secondary bone grafting of the alveolar defects. This combined approach improved the deranged occlusion, arch malalignment, problems of cross bite and localized open bite at cleft site along with the midface cosmesis. REFERENCES 1. Forrester MB, Merz RD. Descriptive Epidemiology of oral clefts in a multi ethnic population, Hawaii Cleft Palate Craniofacial J 2004;41: Vallino-Napoli LD, Riley MM, Holiday J. An epidemiologic study of isolated cleft lip, Palate, or both in Victoria Australia from1983 to Cleft Palate Craniofacial J 2004; 41: Cleft lip and Palate: Prevalence among racial groups [online] 2007 [cited 2007 April 07]. Available from: URL: # Prevalence_among_racial_groups. 4. Hagberg C, Larson O, Milerad J. Incidence of cleft lip and palate and risks of additional malformations. Cleft Palate Craniofacial J. 1998;35: Amin F, Ijaz A. Rapid palatal expansion in mixed dentition stage with custom made modified expansion device. Pakistan Oral & Dent. J. 2004;24: Erverdi N, Sabri A and Kucukkeles N. Cephalometric evaluation of Haas and hyrax rapid maxillary appliances in the treatment of the skeletal maxillary transverse deficiency. J Marmara University Dent Faculty.1993; 1:
8 7. Reed N. Ghosh J and Nanda RS. Comparison of treatment outcomes with banded and bonded RPE appliances. Am J Orthod Dentofacial Orthop.1990; 116: Haas AJ. Long term post treatment evaluation of rapid palatal expansion. Angle Orthod 1980;50: Doruk C, Bicakci AA, Basciftci FA, Agar U, Babacan H. A comparison of the effects of rapid maxillary expansion and fan-type rapid maxillary expansion on dentofacial structures. Angle Orthod 2004; 74: Ijaz A. Maxillary expansion in the mixed dentition stage with modified expansion device. A report of two cases. Pakistan Oral & Dent. J. 2001; 21: De Silva Filho OG, Okada HY, Capelozza Filho L, Suguimoto RM. Orthodontic traction of a permanent canine through a secondary bone graft in a unilateral cleft lip and palate patients. J Clin Orthod 1998; 32: Hinrich JE, Deed ME, Waite DE, Bevis RR, Bandt CL. Periodontal evaluation of canines erupted through grafted alveolar cleft defects. J Oral Maxillofac Surg 1984; 42: Bergland O, Semb G, Abyholm FE. Elimination of the residual alveolar cleft by secondary bone grafting and subsequent orthodontic treatment. Cleft palate J 1986; 23: Batra P, Sharma J, Duggal R, Parkash H. Secondary bone grafting in cleft lip and palate with eruption of tooth into the graft: A case report. J Indian Soc Pedod Prev Dent 2004;22(1): Proffit W, Henry W. Orthodontic treatment planning: Limitation, Controversies and special problems. Contemporary orthodontics. 2000; 3: Haas AJ. The treatment of maxillary deficiency by opening the mid-palatal suture. Angle orhtod 1965 ; 35: Timms DJ. A study of basal movements with rapid maxillary expansion. Am J Orthod 1980; 77: Doruk C, Bicakci AA, Basciftci FA, Agar U, Babacan H. A comparison of the effects of rapid maxillary expansion and fan-type rapid maxillary expansion on dentofacial structures. Angle Orthod 2004; 74: Kamakura S, Yamaguchi T, Kochi S, Sato A, Motegi K. Preliminary report of two-stage secondary alveolar bone grafting for patients with bilateral cleft and palate. C l e f t Palate Craniofacial Journal 2003;40: Toygar T, Iseri H. Non extraction treatment with a rigid acrylic, bonded rapid maxillary expander (case report). J Clin Orthod. 1997; 31: Stockfish H. Rapid expansion of the maxilla; success and relapse. Trans Eur Orthod Soc 1969;45: Linder-Aronson A, Lindgren J. The skeletal and dental effects of rapid palatal expansion. Br J Orthod 1979; 6: Moussa R, O Reilly MT, Close JM. Long term stability of rapid palatal expander treatment and edgewise mechanotherapy. Am J orthod 1995; 108: Mew J. Relapse following maxillary expansion: a study of 25 consecutive cases. Am J Orthod 1983; 33: Pakistan Oral & Dental Journal Vol 27, No. 1
RAPID PALATAL EXPANSION IN MIXED DENTITION STAGE WITH CUSTOM MADE MODIFIED EXPANSION DEVICE
Pakistan Oral & Dent. Jr. 24 (2) Dec 2004 ABSTRACT RAPID PALATAL EXPANSION IN MIXED DENTITION STAGE WITH CUSTOM MADE MODIFIED EXPANSION DEVICE *FARHAT AMIN, MCPS (Oral Surg). FCPS-II. (Orth), Trainee **ABIDA
More informationMixed Dentition Treatment and Habits Therapy
Interception Mixed Dentition Treatment and Habits Therapy Anterior Crossbites Posterior Crossbites Interference s with Normal Eruption Habit Therapy Tsung-Ju Hsieh, DDS, MSD 1 2 Anterior Crossbites Anterior
More informationCase Report: Long-Term Outcome of Class II Division 1 Malocclusion Treated with Rapid Palatal Expansion and Cervical Traction
Case Report Case Report: Long-Term Outcome of Class II Division 1 Malocclusion Treated with Rapid Palatal Expansion and Cervical Traction Roberto M. A. Lima, DDS a ; Anna Leticia Lima, DDS b Abstract:
More informationMaxillary Expansion and Protraction in Correction of Midface Retrusion in a Complete Unilateral Cleft Lip and Palate Patient
Case Report Maxillary Expansion and Protraction in Correction of Midface Retrusion in a Complete Unilateral Cleft Lip and Palate Patient Masayoshi Kawakami, DDS, PhD a ; Takakazu Yagi, DDS, PhD b ; Kenji
More informationOrthodontic treatment for jaw defor. Sakamoto, T; Sakamoto, S; Harazaki, Author(s) Yamaguchi, H. Journal Bulletin of Tokyo Dental College, 4
Orthodontic treatment for jaw defor Titlelip and palate patients with the co external-expansion arch and a facia Sakamoto, T; Sakamoto, S; Harazaki, uthor(s) Yamaguchi, H Journal ulletin of Tokyo Dental
More informationHyrax, quadhelix, headgear,pendulum, Delaire facemask
Hyrax, quadhelix, headgear,pendulum, Delaire facemask Hyrax Indication: -serious narrowing of the upper arch -bilateral or unilateral cross bite -treatment of cleft palate ( scar-tissue enlargement) hyrax
More informationClass II. Bilateral Cleft Lip and Palate. Clinician: Dr. Mike Mayhew, Boone, NC Patient: R.S. Cleft Lip and Palate.
Bilateral Cleft Lip and Palate Clinician: Dr. Mike Mayhew, Boone, NC Patient: R.S. Class II Cleft Lip and Palate Pretreatment Diagnosis Class II dolichofacial female, age 22 years 11 months, presented
More informationChanges of the Transverse Dental Arch Dimension, Overjet and Overbite after Rapid Maxillary Expansion (RME)
Dental Journal Changes of the Transverse Dental Arch Dimension, Overjet and Overbite after Rapid Maxillary Expansion (RME) Department of Advanced General Dentistry Faculty of Dentistry, Mahidol University.
More informationTWO PHASE FOR A BETTER FACE!! TWIN BLOCK AND HEADGEAR FOLLOWED BY FIXED THERAPY FOR CLASS II CORRECTION
Case Report NUJHS Vol. 5, No.2, June 2015, ISSN 2249-7110 TWO PHASE FOR A BETTER FACE!! TWIN BLOCK AND HEADGEAR FOLLOWED BY FIXED THERAPY FOR CLASS II CORRECTION 1 2 3 4 U S Krishna Nayak, Ashutosh Shetty,
More informationCorrection of Crowding using Conservative Treatment Approach
Case Report Correction of Crowding using Conservative Treatment Approach Dr Tapan Shah, 1 Dr Tarulatha Shyagali, 2 Dr Kalyani Trivedi 3 1 Senior Lecturer, 2 Professor, Department of Orthodontics, Darshan
More informationEctopic upper canine associated to ectopic lower second bicuspid. Case report
Original Article Published on 15-06-2001 In Italiano, per favore En Español, por favor Ectopic upper canine associated to ectopic lower second bicuspid. Case report A.R. Mazzocchi* * MD DDS. Corresponding
More informationTreatment planning of nonskeletal problems. in preadolescent children
In the name of GOD Treatment planning of nonskeletal problems in preadolescent children Presented by: Dr Somayeh Heidari Orthodontist Reference: Contemporary Orthodontics Chapter 7 William R. Proffit,
More informationORTHODONTICS Treatment of malocclusion Assist.Lec.Kasem A.Abeas University of Babylon Faculty of Dentistry 5 th stage
Lec: Treatment of class I malocclusion Class I occlusion can be defined by Angles, classification as the mesiobuccal cusp of the upper 1 st permanent molar occlude with the developmental groove of the
More informationMOLAR DISTALIZATION WITH CUSTOM MADE BILATERAL PALATAL DISTALIZER
Pakistan Oral & Dent. Jr. 24 (1) June 2004 ORTHODONTICS ABSTRACT MOLAR DISTALIZATION WITH CUSTOM MADE BILATERAL PALATAL DISTALIZER ABIDA IJAZ, BDS, D. Orth, MCPS.Orth, MS. Orth (Turkey) Class II malocclusion
More informationUNILATERAL UPPER MOLAR DISTALIZATION IN A SEVERE CASE OF CLASS II MALOCCLUSION. CASE PRESENTATION. 1*
UNILATERAL UPPER MOLAR DISTALIZATION IN A SEVERE CASE OF CLASS II MALOCCLUSION. CASE PRESENTATION. 1* Department of Orthodontics and Pedodontics 1 Faculty of Dental Medicine, University of Medicine and
More informationChanges in Lip, Cheek, and Tongue Pressures After Rapid Maxillary Expansion Using a Diaphragm Pressure Transducer
Original Article Changes in Lip, Cheek, and Tongue Pressures After Rapid Maxillary Expansion Using a Diaphragm Pressure Transducer Nazan Küçükkeleş, DDS, PhD a ; Cenk Ceylanoğlu, DDS b Abstract: The purpose
More informationThe Modified Twin Block Appliance in the Treatment of Class II Division 2 Malocclusions
Journal of Orthodontics/Vol. 28/2001/271 280 The Modified Twin Block Appliance in the Treatment of Class II Division 2 Malocclusions F. M. V. DYER H. F. MCKEOWN P. J. SANDLER Department of Orthodontics,
More informationRETENTION AND RELAPSE
RETENTION AND RELAPSE DEFINITION Maintaining newly moved teeth long enough to aid in stabilizing their correction MOYERS loss of any correction achieved by any orthodontic treatment RELAPSE CAUSES OF RELAPSE
More informationDifferent Non Surgical Treatment Modalities for Class III Malocclusion
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861. Volume 9, Issue 6 (Sep.- Oct. 2013), PP 48-52 Different Non Surgical Treatment Modalities for Class III Malocclusion
More informationCase Report Unilateral Molar Distalization: A Nonextraction Therapy
Case Reports in Dentistry Volume 2012, Article ID 846319, 4 pages doi:10.1155/2012/846319 Case Report Unilateral Molar Distalization: A Nonextraction Therapy M. Bhanu Prasad and S. Sreevalli Department
More informationOrtho-surgical Management of Severe Vertical Dysplasia: A Case Report
Case Report Ortho-surgical Management of Severe Vertical Dysplasia: A Case Report 1 Vinni Arora, 2 Rekha Sharma, 3 Sachin Parashar 1 Senior Resident, 2 Professor and Head of Department, 3 Former Resident
More informationDr Robert Drummond. BChD, DipOdont Ortho, MChD(Ortho), FDC(SA) Ortho. Canad Inn Polo Park Winnipeg 2015
Dr Robert Drummond BChD, DipOdont Ortho, MChD(Ortho), FDC(SA) Ortho Canad Inn Polo Park Winnipeg 2015 Severely compromised FPM with poor prognosis Children often present with a developing dentition affected
More informationMesial Step Class I or Class III Dependent upon extent of step seen clinically and patient s growth pattern Refer for early evaluation (by 8 years)
Orthodontics and Dentofacial Development Overview Development of Dentition Treatment Retention and Relapse Growth of Naso-Maxillary Complex Develops postnatally entirely by intramenbranous ossification
More informationExpansion/Arch Development
Expansion/Arch Development 9 Expansion and Arch Development is a broad term used to describe appliances designed to treat crowding, the most common type of malocclusion in mixed-dentition patients. These
More informationMemRx Orthodontic Appliances
MemRx Orthodontic Appliances Uses and Instructions The MemRx Fundamentals As the need for faster, more efficient treatment of non-compliant patients increases, orthodontic!technology and materials has
More informationORTHOdontics SLIDING MECHANICS
ORTHOdontics PGI/II SLIDING MECHANICS FOCUS ON TARGETED SPACE GAINING AND ITS APPLICATIONS, INCLUDING WITH RAPID PALATAL EXPANDIONS. ALSO INCLUDES RETENTION AND CLINICAL PEARLS FACULTY: Joseph Ghafari,
More informationSurgically assisted rapid palatal expansion (SARPE) prior to combined Le Fort I and sagittal osteotomies: A case report
200 Carlos Alberto E. Tavares, DDS, MS, DOrth Professor Department of Orthodontics Associação Brasileira de Odontologia - RS Porto Alegre, Brazil Miguel Scheffer, DDS, MS Chairman Department of Oral and
More informationLocalised vertical relapse following orthodontic correction in young growing patients with cleft lip/ palate:
266 > http://dx.doi.org/10.17159/2519-0105/2017/v72no6a4 Localised vertical relapse following orthodontic correction in young growing patients with cleft lip/ palate: Case studies potentially leading to
More informationOrthodontic treatment of midline diastema related to abnormal frenum attachment - A case series.
Orthodontic treatment of midline diastema related to abnormal frenum attachment - A case series. Running title: Orthodontic treatment of midline diastema. Dr. Amit Dahiya 1, Dr. Minakshi Rana 2, Dr. Arun
More informationBONE GRAFTING IN TREATMENT OF CLEFT LIP AND PALATE 337
PRIMARY BONE GRAFTING IN THE TREATMENT OF CLEFT LIP AND PALATE WITH SPECIAL REFERENCE TO ALVEOLAR COLLAPSE By FRANK ROBINSON, F.R.C.S., and BARRIE WOOD, L.D.S. Burns and Plastic Surgery Unit, Booth Hall
More informationSURGICAL - ORTHODONTIC TREATMENT OF CLASS II DIVISION 1 MALOCCLUSION IN AN ADULT PATIENT: A CASE REPORT
Case Report International Journal of Dental and Health Sciences Volume 02, Issue 02 SURGICAL - ORTHODONTIC TREATMENT OF CLASS II DIVISION 1 MALOCCLUSION IN AN ADULT PATIENT: A CASE REPORT Amit Dahiya 1,Minakshi
More informationCrowded Class II Division 2 Malocclusion
Class II Division 2 Malocclusion Crowded Class II Division 2 Malocclusion Clinicians: Drs. Chris Chang, Hsin-Yin Yeh, Sophia Pei-Wen Shu, W. Eugene Roberts Patient: Miss Jhan Pre-treatment Diagnosis An
More informationTreatment of severe unilateral open bite and crossbite in cleft lip and palate patients
European Journal of Orthodontics 6 (1984) 294-3(12 1984 European Orthodontic Society Treatment of severe unilateral open bite and crossbite in cleft lip and palate patients Hans Enemark Aarhus, Denmark
More informationAngle Class II, division 2 malocclusion with severe overbite and pronounced discrepancy*
O C a s e R e p o r t ngle Class II, division 2 malocclusion with severe overbite and pronounced discrepancy* Daniela Kimaid Schroeder** bstract This article reports the treatment of a young patient at
More informationClass II Correction using Combined Twin Block and Fixed Orthodontic Appliances: A Case Report
Case Report Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2017/506 Class II Correction using Combined Twin Block and Fixed Orthodontic Appliances: A Case Report Ahmed Alassiry Assistant
More informationPrinciples of Cross-bite Treatment
Principles of Cross-bite Treatment Columbia University School of Dental and Oral Surgery Ülkü Z. Ersoy DDS, DMSc; Dr. Gliedman June 8 th, 2004 Overview Definition Prevalence Etiology Rationale for Early
More informationThe conservative treatment of Class I malocclusion with maxillary transverse deficiency and anterior teeth crowding
B B O C a s e R e p o r t The conservative treatment of Class I malocclusion with maxillary transverse deficiency and anterior teeth crowding Lincoln I. Nojima* Abstract This report describes the treatment
More informationEXPANSION. Effective Management of Transverse Problems in the Growing Patient: Evidence-based Approach
Effective Management of Transverse Problems in the Growing Patient: Evidence-based Approach Lorenzo Franchi, DDS, PhD The transverse deficiency of the maxillary arch is the most common occlusal problem
More informationMaxillary Growth Control with High Pull Headgear- A Case Report
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 17, Issue 01 Ver. X January. (2018), PP 09-13 www.iosrjournals.org Maxillary Growth Control with High
More information#39 Ortho-Tain, Inc
1 #39 Ortho-Tain, Inc. 1-800-541-6612 OPTIMUM ORTHODONTICS FOR THE 5 TO 12 YEAR-OLD BY COMBINING REMOVABLE AND FIXED APPLIANCES WITH THE USE OF THE NITE-GUIDE AND OCCLUS-O-GUIDE APPLIANCES INTRODUCTION:
More informationAPPENDIX A. MEDICAID ORTHODONTIC INITIAL ASSESSMENT FORM (IAF) You will need this scoresheet and a disposable ruler (or a Boley Gauge)
APPENDIX A MEDICAID ORTHODONTIC INITIAL ASSESSMENT FORM (IAF) You will need this scoresheet and a disposable ruler (or a Boley Gauge) Name: _ I. D. Number: Conditions: 1. Cleft palate deformities 2. Deep
More informationORTHODONTIC INTERVENTION IN MIXED DENTITION: A BOON FOR PEDIATRIC PATIENTS
Bhola M and Gera T. Orthodontics for the mixed dentition. Doi:10.21276/ledent.2018.02.02.03 Case Report ORTHODONTIC INTERVENTION IN MIXED DENTITION: A BOON FOR PEDIATRIC PATIENTS Meenu Bhola, 1Taruna Gera
More informationManagement of Ectopically Erupting Maxillary Incisors: A Case Series
case report Management of Ectopically Erupting 10.5005/jp-journals-10005-1319 Maxillary Incisors: A Case Series Management of Ectopically Erupting Maxillary Incisors: A Case Series 1 Kotumachagi Sangappa
More informationGentle-Jumper- Non-compliance Class II corrector
15 CASE REPORT Gentle-Jumper- Non-compliance Class II corrector Amit Prakash 1,O.P.Mehta 2, Kshitij Gupta 3 Swapnil Pandey 4 Deep Kumar Suryawanshi 4 1 Senior lecturer Bhopal - INDIA 2 Professor Bhopal
More informationEarly Mixed Dentition Period
REVIEW ARTIC CLE AODMR The Effects of a Prefabricated Functional Appliance in Early Mixed Dentition Period Toshio Iwata 1, Takashi Usui 2, Nobukazu Shirakawa 2, Toshitsugu Kawata 3 1 Doctor of Philosophy
More informationEUROPEAN SOCIETY OF LINGUAL ORTHODONTISTS
EUROPEAN SOCIETY OF LINGUAL ORTHODONTISTS CANDIDATE NUMBER:44 CASE NUMBER: 2 Year: 2010 ESLO 01 RÉSUMÉ OF CASE 5 CASE CATEGORY: CLASS II DIVISION 1 MALOCCLUSION A MALOCCLUSION WITH SIGNIFICANT MANDIBULAR
More informationEarly treatment. Interceptive orthodontics
Early treatment Interceptive orthodontics Early treatment Some malocclusion can be prevented or intercepted. Diphasic treatment is sometimes considered more logical and sensible. During the phase one,
More informationA Modified Three-piece Base Arch for en masse Retraction and Intrusion in a Class II Division 1 Subdivision Case
Dhaval Ranjitbhai Lekhadia, Gautham Hegde RESEARCH ARTICLE 10.5005/jp-journals-10029-1149 A Modified Three-piece Base Arch for en masse Retraction and Intrusion in a Class II Division 1 Subdivision Case
More informationORTHODONTIC INITIAL ASSESSMENT FORM (OIAF) w/ INSTRUCTIONS
Use the accompanying Tip Sheet and How to Score the Orthodontic Initial Assessment Form for guidance in completion of the assessment form. You will need this score sheet and a disposable ruler (or a Boley
More informationProsthetic Options in Implant Dentistry. Hakimeh Siadat, DDS, MSc Associate Professor
Prosthetic Options in Dentistry Hakimeh Siadat, DDS, MSc Associate Professor Dental Research Center, Department of Prosthodontics & Dental s Faculty of Dentistry, Tehran University of Medical Sciences
More informationTreatment of a Horizontally Impacted Permanent Incisor in a 9-Year-Old Girl: A Case Report
Journal of Dental School 2017; 35(1): 65-70 Treatment of a Horizontally Impacted Permanent Incisor in a 9-Year-Old Girl: A Case Report Shiva Shekarian 1 Mohammad Behnaz* 2 1 Dental Student, School of Dentistry,
More informationUse of a Tip-Edge Stage-1 Wire to Enhance Vertical Control During Straight Wire Treatment: Two Case Reports
Case Report Use of a Tip-Edge Stage-1 Wire to Enhance Vertical Control During Straight Wire Treatment: Two Case Reports Helen Taylor, BDS, MScD, DOrth, MOrth, FDSRCS(Eng) a Abstract: Vertical control is
More informationFixed appliances II. Dr. Káldy Adrienn, Semmeweis University
Fixed appliances II. Dr. Káldy Adrienn, Semmeweis University Head gear/facebow Delair mask/ face mask Fixed Class II. correctors Lip bumper Eva plate Nance appliance Pearl appliance Habbit crib Applied
More informationOF LINGUAL ORTHODONTICS
EUROPEAN SOCIETY OF LINGUAL ORTHODONTICS CANDIDATE NUMBER: KDr. KP. kanarelis CASE NUMBER: 1 Year: 2010 WBLO 01 RESUME OF CASE 1 CASE CATEGORY: ADULT MALOCCLUSION NAME : IOANNIS.G BORN: 03.01.1989 SEX:
More informationTransForce 2. Arch Developer Appliances Clinical Cases. New Horizons In Orthodontics
TransForce 2 Arch Developer Appliances Clinical Cases New Horizons In Orthodontics New Horizons In Orthodontics Transverse and Sagittal Arch Development Dr. William Clark has 50 years experience in orthodontic
More informationNonsurgical Treatment of Adult Open Bite Using Edgewise Appliance Combined with High-Pull Headgear and Class III Elastics
Case Report Nonsurgical Treatment of Adult Open Bite Using Edgewise Appliance Combined with High-Pull Headgear and Class III Elastics Isao Saito, DDS, PhD a ; Masaki Yamaki, DDS, PhD b ; Kooji Hanada,
More informationKJLO. A Sequential Approach for an Asymmetric Extraction Case in. Lingual Orthodontics. Case Report INTRODUCTION DIAGNOSIS
KJLO Korean Journal of Lingual Orthodontics Case Report A Sequential Approach for an Asymmetric Extraction Case in Lingual Orthodontics Ji-Sung Jang 1, Kee-Joon Lee 2 1 Dream Orthodontic Clinic, Gimhae,
More informationAttachment G. Orthodontic Criteria Index Form Comprehensive D8080. ABBREVIATIONS CRITERIA for Permanent Dentition YES NO
First Review IL HFS Dental Program Models Second Review Ortho cad Attachment G Orthodontic Criteria Index Form Comprehensive D8080 Ceph Film X-Rays Photos Narrative Patient Name: DOB: ABBREVIATIONS CRITERIA
More informationA SIMPLE METHOD FOR CORRECTION OF BUCCAL CROSSBITE OF MAXILLARY SECOND MOLAR
Short Communication International Journal of Dental and Health Sciences Volume 01,Issue 03 A SIMPLE METHOD FOR CORRECTION OF BUCCAL CROSSBITE OF MAXILLARY SECOND MOLAR Sumit Yadav 1,Davender Kumar 2,Achla
More informationSignificant improvement with limited orthodontics anterior crossbite in an adult patient
VARIA Significant improvement with limited orthodontics anterior crossbite in an adult patient Arzu Ari-Demirkaya Istanbul, Turkey Summary Objectives. Orthodontic treatment is known to last as long as
More informationInterdisciplinary management of Impacted teeth in an adult with Orthodontics & Free Gingival graft : A Case Report
Original article: Interdisciplinary management of Impacted teeth in an adult with Orthodontics & Free Gingival graft : A Case Report Dr Renuka Patel, Dr Falguni Mehta, Dr. Ashish Pandey Assistant Professor,
More informationSegmental Orthodontics for the Correction of Cross Bites
10.5005/jp-journals-10005-1080 CASE REPORT IJCPD Segmental Orthodontics for the Correction of Cross Bites 1 Anirudh Agarwal, 2 Rinku Mathur 1 Professor and Head, Department of Orthodontics, Rajasthan Dental
More informationThe ASE Example Case Report 2010
The ASE Example Case Report 2010 The Requirements for Case Presentation in The Angle Society of Europe are specified in the Appendix I to the Bylaws. This example case report exemplifies how these requirements
More informationModified Intraoral Repositioning Appliance in Complete Bilateral Cleft Lip and Palate
10.5005/jp-journals-10005-1096 CASE REPORT IJCPD Modified Intraoral Repositioning Appliance in Complete Bilateral Cleft Lip and Palate 1 Pradeep Raghav, 2 NK Ahuja, 3 Subhash Gahlawat 1 Professor, Department
More informationCorrection of a maxillary canine-first premolar transposition using mini-implant anchorage
CASE REPORT Correction of a maxillary canine-first premolar transposition using mini-implant anchorage Mehmet Oguz Oztoprak, DDS, MSc, a Cigdem Demircan, DDS, b Tulin Arun, PhD, DDS, MSc c Transposition
More informationTreatment of Long face / Open bite
In the name of GOD Treatment of Long face / Open bite in preadolescent children Presented by: Dr Somayeh Heidari Orthodontist Reference: Contemporary Orthodontics Chapter 13 William R. Proffit, Henry W.
More informationUnilateral Cleft Palate, a case report.
Original Article Published on 29-09-05 Yaşar Göyenç* Hakan Gürcan Gürel** Author s affiliations: * PhD, Professor ** DDS, Research Assistant Department of Orthodontics, Faculty of Dentistry, Selcuk University,
More informationLittle has been published concerning orthodontic tooth
CASE REPORT Orthodontic tooth movement after extraction of previously autotransplanted maxillary canines and ridge augmentation Anthony R. Collett, BSc(Hons), BDSc, MDSc, PhD, a and Basil Fletcher, BDS,
More informationMANAGEMENT OF VERTICAL EXCESS IN BIMAXILLARY HYPOPLASIA WITH CUSTOM MADE FRONTAL HIGH-PULL HEAD GEAR
ORTHODONTICS IDEAS AND INNOVATION MANAGEMENT OF VERTICAL EXCESS IN BIMAXILLARY HYPOPLASIA WITH CUSTOM MADE FRONTAL HIGH-PULL HEAD GEAR 1 ABIDA IJAZ, BDS, D.Orth, MCPS, MS, FICD, FPFA 2 JUNAID ISRAR, BDS,
More informationMolar distalisation with skeletal anchorage
Molar distalisation with skeletal anchorage Antonio Gracco, Lombardo Luca and Giuseppe Siciliani Department of Orthodontics, University of Ferrara, Ferrara, Italy Background: Distalisation of the upper
More informationIndian Journal of Basic and Applied Medical Research; June 2014: Vol.-3, Issue- 3, P
Case Report: Custom made modified distal jet appliance an effective and economic appliance. Dr.Falguni Mehta 1, Dr.Renuka Patel 2,Dr.Harshik Parekh 3,Dr.Manop Agrawal 4 1Head Of Department, Department
More informationCorrection of Unilateral Scissor Bite using Periodontally Accelerated Osteogenic Orthodontics
JIOS Case report Correction of Unilateral Scissor Bite using Periodontally 10.5005/jp-journals-10021-1272 Accelerated Osteogenic Orthodontics. Correction of Unilateral Scissor Bite using Periodontally
More informationDual Force Cuspid Retractor
CLINICAL INNOVATION 1 Matrishva B Vyas, 2 Neeraj Alladwar ABSTRACT The most time consuming stage of bicuspid extraction-based treatment is cuspid retraction. Cuspid retraction with both types of conventional
More informationTreatment of Angle Class III. Department of Paedodontics and Orthodontics Dr. habil. Melinda Madléna associate professor
Department of Paedodontics and Orthodontics Dr. habil. Melinda Madléna associate professor Disorders in Angle Class III The position of the lower jaw is foreward regarding to the upper jaw Mesialocclusion
More informationHDS PROCEDURE CODE GUIDELINES
D8000 - D8999 Primary Dentition: Teeth developed and erupted first in order of time. Transitional Dentition: The final phase of the transition from primary to adult teeth, in which the deciduous molars
More informationTreatment of a malocclusion characterized
CONTINUING EDUCATION ARTICLE Cephalometric evaluation of open bite treatment with NiTi arch wires and anterior elastics Nazan Küçükkeleș, DDS, PhD, a Ahu Acar, DDS, PhD, b Arzu A. Demirkaya, DDS, c Berna
More informationAn Effectiv Rapid Molar Derotation: Keles K
An Effectiv ective e and Precise Method forf Rapid Molar Derotation: Keles K TPA Ahmet Keles, DDS, DMSc 1 /Sedef Impar, DDS 2 Most of the time, Class II molar relationships occur due to the mesiopalatal
More informationManagement of Crowded Class 1 Malocclusion with Serial Extractions: Report of a Case
Management of Crowded Class 1 Malocclusion with Serial Extractions: Report of a Case Hayder A. Hashim, BDS, MSc Abstract Aim: The purpose of this article is to show the value of serial extractions in a
More informationDeveloping Facial Symmetry Using an Intraoral Device: A Case Report
Developing Facial Symmetry Using an Intraoral Device: A Case Report by Theodore R. Belfor, D.D.S.; and G. Dave Singh, D.D.Sc., Ph.D., B.D.S. Dr. Theodore Belfor graduated from New York University College
More informationOrthodontic Treatment Using The Dental VTO And MBT System
Orthodontic Treatment Using The Dental VTO And MBT System by Dr. Hideyuki Iyano Dr. Hideyuki Iyano, Department of Orthodontics, Ohu University School of Dentistry, Japan. He is also a member of the Japan
More informationPalatal Depth and Arch Parameter in Class I Open Bite, Deep Bite and Normal Occlusion
26 Iraqi Orthod J 1(2) 2005 Palatal Depth and Arch Parameter in Class I Open Bite, Deep Bite and Normal Occlusion Ahmad A. Abdulmawjood, a Mahmood K. Ahmed, a and Ne am R. Al-Saleem a Abstract: This study
More informationCase Report n 2. Patient. Age: ANB 8 OJ 4.5 OB 5.5
Case Report n 2 Patient Age: 12.11 Diagnosis Angle cl.ii div.2 ANB 8 OJ 4.5 OB 5.5 Author: Dr. Case History The patient is a thirteen year old girl who exhibits delayed development, both physically and
More informationRehabilitating a Compromised Site for Restoring Form, Function and Esthetics- A Case Report
Research & Reviews: Journal of Dental Sciences Rehabilitating a Compromised Site for Restoring Form, Function and Esthetics- A Case Report Priyanka Prakash* Division of Periodontology, Department of Dental
More informationThe Tip-Edge Concept: Eliminating Unnecessary Anchorage Strain
Welcome Ron Not Ron? Click here. My Account The Tip-Edge Concept: Eliminating Unnecessary Anchorage Strain VOLUME 26 : NUMBER 03 : PAGES (165-178) 1992 CHRISTOPHER K. KESLING, DDS, MS Tooth movement in
More informationExtract or expand? Over the last 100 years, the
ORIGINAL ARTICLE A long-term evaluation of the mandibular Schwarz appliance and the acrylic splint expander in early mixed dentition patients Paul W. O Grady, a James A. McNamara, Jr, b Tiziano Baccetti,
More informationCephalometric Analysis
Cephalometric Analysis of Maxillary and Mandibular Growth and Dento-Alveolar Change Part III In two previous articles in the PCSO Bulletin s Faculty Files, we discussed the benefits and limitations of
More informationS.H. Age: 15 Years 3 Months Diagnosis: Class I Nonextraction Severe crowding, very flat profile. Background:
S.H. Age: 15 Years 3 Months Diagnosis: Class I Nonextraction Severe crowding, very flat profile Background: This case was selected to illustrate the long-term impact of treatment planning on the face and
More informationSingle Step Simultaneous Bijaw Surgery and Alveolar Bone Grafting in an Adult with Cleft Lip and Palate: A Case Report
r Cosmetology & O o Facial Surgery Cosmetology & Oro Facial Surgery Agarwal et al., 2016, 2:2 Case Report Open Access Single Step Simultaneous Bijaw Surgery and Alveolar Bone Grafting in an Adult with
More informationAlveolar Bone Remodeling and Development after Immediate Orthodontic Root Movement
Journal of Dental Health, Oral Disorders & Therapy Alveolar Bone Remodeling and Development after Immediate Orthodontic Root Abstract Introduction: Adult orthodontics is rapidly expanding primarily due
More informationClass III malocclusion occurs in less than 5%
CDABO CASE REPORT Orthodontic correction of a Class III malocclusion in an adolescent patient with a bonded RPE and protraction face mask Steven W. Smith, DDS, a and Jeryl D. English, DDS, MS b Dallas,
More informationASSESSMENT OF MAXILLARY FIRST MOLAR ROTATION IN SKELETAL CLASS II, AND THEIR COMPARISON WITH CLASS I AND CLASS III SUBJECTS
ORIGINAL ARTICLE ASSESSMENT OF MAXILLARY FIRST MOLAR ROTATION IN SKELETAL CLASS II, AND THEIR COMPARISON WITH CLASS I AND CLASS III SUBJECTS ABSTRACT FARHAT AMIN, BDS, MCPS, FCPS Mesial rotation of maxillary
More informationThe treatment of a tooth size-arch length discrepancy
ORIGINAL ARTICLE A prospective long-term study on the effects of rapid maxillary expansion in the early mixed dentition Renée G. Geran, a James A. McNamara, Jr, b Tiziano Baccetti, c Lorenzo Franchi, d
More informationINCLUDES: OVERVIEW ON CLINICAL SITUATIONS FREQUENTLY ENCOUNTERED IN ORTHODONTIC TREATMENTS MECHANOTHERAPY USED TO RESOLVE THESE SITUATIONS
ORTHOdontics PGI PROBLEM SOLVING IN ORTHODONTICS INCLUDES: OVERVIEW ON CLINICAL SITUATIONS FREQUENTLY ENCOUNTERED IN ORTHODONTIC TREATMENTS MECHANOTHERAPY USED TO RESOLVE THESE SITUATIONS FACULTY: Fares
More informationNonsurgical Rapid Maxillary Expansion in Adults: Report on 47 Cases Using the Haas Expander
Original Article Nonsurgical Rapid Maxillary Expansion in Adults: Report on 47 Cases Using the Haas Expander Chester S. Handelman, DMD a ; Lin Wang, DDS b ; Ellen A. BeGole, PhD c ; Andrew J. Haas, DDS,
More informationAngle Class II, division 2 malocclusion with deep overbite
BBO Case Report Angle Class II, division 2 malocclusion with deep overbite Arno Locks 1 Angle Class II, division 2, malocclusion is characterized by a Class II molar relation associated with retroclined
More informationCase Report Hexa Helix: Modified Quad Helix Appliance to Correct Anterior and Posterior Crossbites in Mixed Dentition
Case Reports in Dentistry Volume 2012, Article ID 860385, 5 pages doi:10.1155/2012/860385 Case Report Hexa Helix: Modified Quad Helix Appliance to Correct Anterior and Posterior Crossbites in Mixed Dentition
More informationOF LINGUAL ORTHODONTICS
EUROPEAN SOCIETY OF LINGUAL ORTHODONTICS CANDIDATE NUMBER: KDr. KP. kanarelis CASE NUMBER: 2 Year: 2010 WBLO 01 RESUME OF CASE 2 CASE CATEGORY: ADULT MALOCCLUSION NAME : MARIA A. BORN: 18.04.1983 SEX:
More informationEducational Training Document
Educational Training Document Table of Contents Part 1: Resource Document Disclaimer Page: 2 Part 2: Line Item Grade Sheets Page: 3 Release: 11/2016 Page 1 of 6 Part 1: Resource Document Disclaimer The
More informationThe Tip-Edge appliance and
Figure 1: Internal surfaces of the edgewise archwire slot are modified to create the Tip-Edge archwire slot. Tipping surfaces (T) limit crown tipping during retraction. Uprighting surfaces (U) control
More informationCanine Extrusion Technique with SmartClip Self-Ligating Brackets
Canine Extrusion Technique with SmartClip Self-Ligating Brackets Dr. Luis Huanca Ghislanzoni Dr. Luis Huanca received his DDS in 2006 and the MS and Specialist in Orthodontics in 2009 from the University
More information