Why use the word “System” when speaking of this new approach
to clinical orthodontics? “System” is the blending of passive
self-ligating brackets and high-technology archwires carefully selected
to keep the applied force in the “Optimal Force Zone” in
each of the four phases of treatment. These four phases of treatment
include:
- In the initial Ni-Ti light
round wire phase, archwires are carefully selected to minimize binding between
the “tube” of the
passive ligating bracket and the archwire. This allows sliding of
the teeth and brackets along the wire as they start to level and
align. Binding and friction in a conventional mechanical system comes
from the ligature pushing on the wire and the seating of archwire
against the base of the slot. There is also the binding created by
the deflection of the archwire against the sides of the bracket slots
in crowded cases. In recent years, many clinicians have started cases
placing large dimension rectangular Ni-Ti archwires with the intent
of controlling torque to minimize the dumping of the incisors as
teeth level and align. With the Damon
System, the intent of the initial light round archwires is to apply
just enough force to stimulate cellular activity without crushing
the vascular supply in the periodontium.
This has been defined as staying in the “Optimal Force Zone” or
Biozone. If the appropriate force is applied, the muscles of the
face and lips give a “lip bumper” effect on the incisors,
minimizing anterior tipping. The intent of the initial archwire is
not to remove all of the rotations but to align teeth and bracket
slots just enough to move to the second phase of archwire progression.
This is best accomplished by taking advantage of using a small dimension
archwire in the large lumen of the bracket. An analogy of this phase
of treatment is a car being driven on both sides of a curving highway
to straighten out the bends in the road. This same principle of archwire
and tube helps minimize the force and binding friction. To summarize:
the initial phase starts tooth movement, rotation control, leveling,
aligning, arch form, and prepares for the second phase of archwire
sequencing.
- The second, or high-tech edgewise phase,
is the “heart
and soul” of the System. This phase starts working on torque,
root angulations, levels, completes rotation control, continues arch
form
development, consolidates space in the anterior segments, and prepares
for the third phase of archwire sequencing. IT
IS CRITICALLY IMPORTANT TO TAKE A PANOREX AND EVALUATE ROOT AND BRACKET
POSITION BEFORE PROCEEDING TO THE MAJOR MECHANICS PHASE OF TREATMENT.
- The third, or major
mechanics phase of archwire sequencing is
the working phase of treatment. This includes posterior space closure,
anteroposterior dental correction, and adjusting buccolingual discrepancies.
Stainless steel archwires are primarily used to maintain vertical
and buccolingual control during this major mechanical phase of treatment.
- The fourth phase is the finishing and detailing phase of archwire
sequencing. If adjustments and torque requirements are minimal, the
working archwire can be used to complete treatment. If moderate bends
and torque are required, it is strongly recommended to use edgewise
TMA. This gentle archwire makes finishing easy for both patient and
clinician.
Before detailing archwire selections,
I would like to emphasize the enormous variable in patient response
to the recommended archwires. I strongly encourage clinicians
to choose archwire sizes very carefully and not just based on “What can I get in?” or “Patient
tolerance.” Choose the correct archwire size and give it
time to work!
ARCHWIRE SEQUENCE FOR .022 BRACKETS
LIGHT ROUND WIRE PHASE
.014 Damon Copper Ni-Ti Initial archwire – Start tooth movement, leveling,
begin arch form development, prepare for next archwire.
.016 Ni-Ti SE Used occasionally as second archwire in severely
crowded adult cases that are not quite ready for the second phase
archwire.
HIGH-TECH EDGEWISE PHASE
.014 x .025 Damon Copper Ni-Ti. The workhorse of the second phase. Placed in upper
and lower well-prepared arches.
018 x .025 Damon Copper Ni-Ti is the wire in the high-tech edgewise phase.
Excellent wire to prepare for insertion of the working stainless
steel transition wire.
.017 x .025 Damon Ni-Ti used with 20° of
anterior torque and reverse curve; superb for division 2 second
wire. If only intrusion needed, use the same size wire without
the torque in the anterior.
.019 x .025 Damon Ni-Ti used with 20° of
anterior torque and reverse curve. Great followup wire on challenging
division II cases. If only intrusion needed, use the same size
wire without the torque in the anterior.
HIGH-TECH EDGEWISE PHASE
.014 x .025 Damon Copper Ni-Ti. The workhorse of the second phase. Placed in upper
and lower well-prepared arches.
018 x .025 Damon Copper Ni-Ti is the wire in the high-tech edgewise phase.
Excellent wire to prepare for insertion of the working stainless
steel transition wire.
.017 x .025 Damon Ni-Ti used with 20° of
anterior torque and reverse curve; superb for division 2 second
wire. If only intrusion needed, use the same size wire without
the torque in the anterior.
.019 x .025 Damon Ni-Ti used with 20° of
anterior torque and reverse curve. Great followup wire on challenging
division II cases. If only intrusion needed, use the same size
wire without the torque in the anterior.
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