Nonsurgical Mechanism to Correct Class III w/ open bite and crossbite｜【Chris Chang Ortho】CC436
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- čas přidán 16. 07. 2024
- Abstract
The treatment of a full-cusp Class III malocclusion, combined with anterior open bite and posterior cross bite, is very challenging and orthognathic surgery is usually indicated. However, patients often reject surgical correction due to costs, and associated risks and pain. In this case, a 27-year-old male with the said diagnosis came for non-surgical correction to his malocclusion. The Discrepancy Index score of this case was 110. After 33 months of treatment, ideal alignment and a Class I canine and molar relationship were achieved without surgery or TAD application. There were three keys in this treatment. First, correct the open bite by extracting all 1st premolars and closing extraction spaces. Second, fix the posterior cross bite by expanding the upper arch and applying cross elastics. Third, compensate the torque loss due to Class III mechanics through proper torque selections, using standard torque brackets on the upper and super-high torque brackets on the lower anteriors. Also, use 0.016x0.025- inch 34 mm Pre-Torque CuNiTi archwires and apply 3rd order bends on the mandibular 0.016x 0.025- inch stainless steel archwires to increase torque. Additionally, install single torquing springs to correct torque on an individual teeth. With these mechanism non-surgical correction of a complex Class III malocclusion can be achieved effectively.
摘要
Full-cusp第三類咬合不正合併前牙開咬和後牙錯咬非常難以治療，通常需要透過手術矯正。然而患者常因為手術相關費用，疼痛以及風險，所以拒絕此治療方式。此一27歲男性患者即屬於這類案例，因此前來尋求以非手術的方式治療他的咬合不正問題。此案例的術前DI評分為110分。經過了三十三個月的治療，達成了理想的第一類咬合關係，治療過程中也未使用手術以及迷你骨釘。此類案例治療有三個重點，第一：拔掉第一小臼齒，透過關閉空間以解決開咬問題；第二：透過擴張主線，擴大上顎合併佩戴錯咬橡皮筋，以改正後牙錯咬；第三：為補償Class III的力學機制所喪失的扭矩，上顎選擇標準扭矩，下顎選擇高扭矩矯正器；為了矯正前牙錯咬和關閉拔牙空間所需的額外扭矩，可使用0.016x0.025 Pre-torque 34 mm 20° CuNiTi 的主線，以及在0.016x0.025 stainless steel線上進行第三級彎折（ 3rd order bends），提供額外扭矩；3. 使用單顆torquing-spring來微調單顆牙齒的扭矩。藉由上述的力學機制，複雜第三類咬合不正病例也可以透過非手術，簡單而有效的方式治療。
I hope Malaysia Penang will have this knowledge like Dr. Chang.. I have similar bite but most of the ortho dentist only suggest surgery..
i have the same case, consulted with an orthodontic but she refused to get me braces and recommend me to get jaw surgery and meet the proper orthodontic who worked with the surgeon :')
i believe i don't need jaw surgeon bcs my open bite is not that far actually
As usual from Dr Chris, Amazing.
Thank you, my friend!
Great job! 👏👏👏
Awesome, great work
Thank you, my friend!
Dr. the torque compensation Paragraph.. is not understood.. especially the bracket and the torque spring 🤦♀️🤷♀️🤷♀️
Prefect Doc!
Thank you, my friend! Welcome to join us! Please go to orthobonescrew.com to get more information!
You are awesome dr Chris Sir.....I wish to do A residency course under you ....don't know when it will be possible...🥴
Der Beste, einfach so!
Das tolle ohne OP wow 👍
Do you have any offices in the USA?
Woah👍👍👍👍🔥🔥🔥
Can you explain how to instal low torque and high torque on the tooth doc. Im still a bit confused
on the right from above there is no canine
Hi sir,i have a doubt,won't that torque compensating mechanism hinder the retraction process.
no doc, it wont hinder retraction, high torque in lower is to prevent roots coming out labially in lower
@@atutubeatutube
hi Dr. What's up?
1_What is meant by bracket with high and low torque?
2_ the technique that the Dr. used in torque compensation was not understood.
Please, would you mind explaining it🙏 🙏?
Can anyone teach us how to bend the wire in arch expansion?its around 5:00 of the video. Thanks much!
Please go to czcams.com/video/qTYfxTGrrv8/video.html to check.
Imoresionante dr.
Ud tiene algún gmail?