Uroš Mezeg dr. dent. med 1

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Transcription:

Uroš Mezeg dr. dent. med 1

UROŠ MEZEG DR. DENT. MED. Uroš Mezeg dr. dent. med 2

Uroš Mezeg dr. dent. med 3

Uroš Mezeg dr. dent. med 4

MBT FILOZOFIJA V ORTODONTSKI TERAPIJI DIAGNOSTIKA IN NAČRT OBRAVNAVE IZBIRA ORTODONTSKEGA APARATA NAMEŠČANJE NOSILCEV IZBIRA LOKOV PRAKTIČNI DEL Uroš Mezeg dr. dent. med 5

DIAGNOSTIKA IN NAČRT OBRAVNAVE

Dr. Uros Mezeg Zg. Otok 8 4240 Radovljica +38645309090 OZBE MEZEG 15.11.2010, Progress, YR. 14 MO. 9 Produced on the Dolphin DIGITAL Imaging System Uroš Mezeg dr. dent. med 7

STAROST: 14 let in 9 mesecev Dr. Uros Mezeg Zg. Otok 8 4240 Radovljica Phone: +38645309090 OZBE MEZEG Uroš Mezeg dr. dent. med 8 15.11.2010, Progress, YR. 14 MO. 9

70 118 108 30 146 109 36 132 59 73 2 76 78

Uroš Mezeg dr. dent. med 10

Črna je CO Povprečje: Distalno (x): 0.1 Rdeča je CR Navpično (y):-0,1 Uroš Mezeg dr. dent. med 11

71 118 108 31 148 108 38 128 56 72 3 78 79 Uroš Mezeg dr. dent. med 12

70 118 114 30 146 115 36 132 59 73 2 76 86 Uroš Mezeg dr. dent. med 13

Proclination of incisors Intrusion of anterior teeth Uroš Mezeg dr. dent. med 14

Nekontroliran tipping Kontroliran tipping Uroš Mezeg dr. dent. med 15

Uroš Mezeg dr. dent. med 16

Uroš Mezeg dr. dent. med 17

IZBIRA ORTODONTSKEGA APARATA

+7º 0º -7º 10º(-10º) 17º -14º -14º -7º -7º Molars Premolars Canines Lateral incisors Central incisors -10º -20º -6º -6º -17º -12º +6º 0º -6º Uroš Mezeg dr. dent. med 19

Uroš Mezeg dr. dent. med 20

A rectangular.019/.025 steel wire in.022 slot will have approximately 10º of slop. The exact amount depends on the precision of manufacture of the wire and bracket slot and the amount of wire edge rounding or radiusing Uroš Mezeg dr. dent. med 21

Arch form is an important factor in selection of canine brackets in upper and lower arches. Uroš Mezeg dr. dent. med 22

Uroš Mezeg dr. dent. med 23

Bimaxillary protrusion Uroš Mezeg dr. dent. med 24

Without lacebacks, on average the lower incisor moved forwards 1.4 mm. Uroš Mezeg dr. dent. med 25

If the upper palatal bar is placed 2 mm away from the palate, tongue forces can assist in vertical control of the molars. Uroš Mezeg dr. dent. med 26

NAMEŠČANJE NOSILCEV NAJPOGOSTEJŠE NAPAKE PRI NAMEŠČANJU NOSILCEV REŠITVE,KI JIH PONUJA SISTEM MBT PRI NANEŠČANJU NOSILCEV Uroš Mezeg dr. dent. med 27

NAJPOGOSTEJŠE NAPAKE PRI NAMEŠČANJU NOSILCEV Uroš Mezeg dr. dent. med 28

When placing brackets, it is important to view the teeth from the correct perspective. Uroš Mezeg dr. dent. med 29

Teeth with roots that are lingually displaced can reveal shorter clinical crowns. Teeth with roots that are facially displaced can reveal longer clinical crowns Uroš Mezeg dr. dent. med 30

Horizontal bracket placement errors can result in unwanted rotation, but are avoided with attention to technique Axial bracket placement errors can result in unwanted tip, but are avoided with attention to technique Excessive adhesive under the bracket base can result in rotation errors, but are avoided with attention to technique. Figure 1 Figure 2 Figure 3 3 Bracket Placement Uroš Mezeg dr. dent. med 31

vertical errors The center of the clinical crown is more difficult to visualize in partially erupted teeth in young patients Uroš Mezeg dr. dent. med 32

Inflamed gingival causes foreshortening, which can effectively reduce the length of the clinical crowns, making the center difficult to ascertain. The bottom image is the same case as the top image, but with gingival inflammation in the upper right quadrant Uroš Mezeg dr. dent. med 33

Uroš Mezeg dr. dent. med 34

Correct vertical bracket positioning will minimize the need for detailing bends at the end of treatment. Uroš Mezeg dr. dent. med 35

REŠITVE, KI JIH PONUJA SISTEM MBT PRI NAMEŠČANJU NOSILCEV Uroš Mezeg dr. dent. med 36

Uroš Mezeg dr. dent. med 37

Uroš Mezeg dr. dent. med 38

Uroš Mezeg dr. dent. med 39

IZBIRA LOKOV Uroš Mezeg dr. dent. med 40

10% Tapered 45% Ovoid 45% Square 10% 45% 45% Recommended ratios Uroš Mezeg dr. dent. med 41

Tapered Square Ovoid Uroš Mezeg dr. dent. med 42

Clear templates may be used at the start of treatment to assess whether the patient s lower arch has a tapered, square or ovoid form. Uroš Mezeg dr. dent. med 43

.015 multistrand.0175 multistrand.014 round stainless steel.016 round stainless steel.018 round stainless steel.020 round stainless steel.016 HANT Stocked in ovoid shape only and modified to templates as necessary.019/.025 HANT Stocked in three shapes: 45% tapered 10% square 45% ovoid.019/.025 stainless steel with soldered hooks Stocked in ovoid only, or in three shapes (ovoid, tapered and square) and modified to the patient s IAF from the wax template Uroš Mezeg dr. dent. med 44

The lower rectangular HANT wire has been removed. Uroš Mezeg dr. dent. med 45

A wax template is softened in warm water and molded over the lower arch to record indentations of the brackets Uroš Mezeg dr. dent. med 46

The wax template viewed from the labial. Uroš Mezeg dr. dent. med 47

The.019/.025 rectangular steel wire is bent to the indentations Uroš Mezeg dr. dent. med 48

The steel rectangular wire is checked for symmetry on a template, and then a Xerox copy can be made and used as the patient s IAF for the lower arch. Uroš Mezeg dr. dent. med 49

After the patient s IAF has been determined for the lower archwire, an upper wire can be created which should superimpose approximately 3 mm outside of the lower wire. Uroš Mezeg dr. dent. med 50

PRAKTIČNI DEL

Uroš Mezeg dr. dent. med 52

In the incisor region, the gauge is placed at 90º to the labial surface. Uroš Mezeg dr. dent. med 54

In the canine and premolar regions, the gauge is placed parallel with the occlusal plane. Uroš Mezeg dr. dent. med 55

In the molar regions, the gauge is placed parallel with the occlusal surface of each individual molar. Uroš Mezeg dr. dent. med 56

Lower first molar non-convertible tubes are often preferable to convertible tubes, because they are less bulky. They are stronger, more comfortable, and cause fewer interferences. Uroš Mezeg dr. dent. med 57

Horizontal and vertical accuracy can be checked from the buccal aspect Uroš Mezeg dr. dent. med 58

Horizontal accuracy in the canine, premolar, and molar regions should be checked with a mouth mirror. Uroš Mezeg dr. dent. med 59

Uroš Mezeg dr. dent. med 60

Povzetek predavanja Natančna ortodontska diagnostika Določitev točnega cilja ortodontske terapije Izbira pravega sistema za ortodontsko zdravljenje Individualizaciji sistema Natančnost pri namestitvi nosilcev Uroš Mezeg dr. dent. med 61

Literatura

Hvala za pozornost! Vprašanja so dobrodošla! Uroš Mezeg dr. dent. med 63

beli.medved@telemach.com www.belimedved.com Uroš Mezeg dr. dent. med 64

17 16 15 14 13 12 11 21 22 23 24 25 26 27 64 70 80 10 0 85 98 98 85 10 1 86 60 62 30 35 40 50 40 50 50 40 50 45 40 30 70 68 88 88 83 84 82 82 10 0 77 71 68 35 35 45 50 40 40 40 40 50 40 35 35 47 46 45 44 43 42 41 31 32 33 34 35 36 37

Individualized bracket-positioning chart for a first premolar extraction case Individualized bracket-positioning chart for a second premolar extraction case. Uroš Mezeg dr. dent. med 67

Tapered (%) Squared (%) Ovoid (%) Andrews' cases 27 20 53 Class I sample 60 3 37 Class II sample 53 7 40 Uroš Mezeg dr. dent. med 68

Uroš Mezeg dr. dent. med 69