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DEMOGRAPHICS DIAGNOSIS TREATMENT TIME MECHANICS CASE STUDY FEMALE 14 YEARS OLD CLASS I CROWDING IMPACTED UL3 ANTERIOR CROSSBITE MILD FACIAL PROTRUSION PROJECTED TREATMENT TIME: 22 MONTHS ACTUAL TREATMENT TIME WITH ACCELEDENT: 15 MONTHS Courtesy of Dr. Straty Righellis HYBRID PASSIVE & ACTIVE SELF LIGATING APPLIANCE EXTRATION ON DEMAND CE PROGRAM Accelerating Orthodontics – Faster Tooth Movement with Pulsatile Forces Presenter: Dr. Straty Righellis ADDITIONAL RESOURCES

DEMOGRAPHICS DIAGNOSIS MECHANICS TREATMENTTIME filedemographics diagnosis mechanics treatmenttime case study female 14 years old class i crowding impacted ul3 anterior crossbite mild

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DEMOGRAPHICS DIAGNOSIS TREATMENTTIMEMECHANICS

CASESTUDY

FEMALE14YEARSOLD

CLASSICROWDINGIMPACTEDUL3ANTERIORCROSSBITEMILDFACIALPROTRUSION

PROJECTEDTREATMENTTIME:22MONTHS

ACTUALTREATMENTTIMEWITHACCELEDENT:15MONTHS

Courtesyof Dr.StratyRighellis

HYBRIDPASSIVE&ACTIVESELFLIGATINGAPPLIANCEEXTRATION

ONDEMANDCEPROGRAMAcceleratingOrthodontics– FasterToothMovementwithPulsatileForcesPresenter:Dr.StratyRighellis

ADDITIONALRESOURCES

CASESTUDY

CourtesyofDr.StratyRighellis

BASELINE

DEMOGRAPHICSFEMALE14YEARSOLD

DIAGNOSISCLASSIWITHVERTICALGROWTHPATTERNCROWDINGIMPACTEDUL3ANTERIORCROSSBITEMILDFACIALPROTRUSION

MECHANICSHYBRIDPASSIVE&ACTIVESELFLIGATINGAPPLIANCEEXTRACTION

TREATMENTTIMEPROJECTEDTREATMENTTIME:22MONTHS

ACTUALTREATMENTTIMEWITHACCELEDENT:15MONTHS

CASESTUDY

CourtesyofDr.StratyRighellis

Seated Condylar Position Compared to Maximum Intercuspation

DEMOGRAPHICSFEMALE14YEARSOLD

DIAGNOSISCLASSIWITHVERTICALGROWTHPATTERNCROWDINGIMPACTEDUL3ANTERIORCROSSBITEMILDFACIALPROTRUSION

MECHANICSHYBRIDPASSIVE&ACTIVESELFLIGATINGAPPLIANCEEXTRACTION

TREATMENTTIMEPROJECTEDTREATMENTTIME:22MONTHS

ACTUALTREATMENTTIMEWITHACCELEDENT:15MONTHS

CASESTUDY

CourtesyofDr.StratyRighellis

DEMOGRAPHICSFEMALE14YEARSOLD

DIAGNOSISCLASSIWITHVERTICALGROWTHPATTERNCROWDINGIMPACTEDUL3ANTERIORCROSSBITEMILDFACIALPROTRUSION

MECHANICSHYBRIDPASSIVE&ACTIVESELFLIGATINGAPPLIANCEEXTRACTION

TREATMENTTIMEPROJECTEDTREATMENTTIME:22MONTHS

ACTUALTREATMENTTIMEWITHACCELEDENT:15MONTHS

CASESTUDY

CourtesyofDr.StratyRighellis

NoTreatment VTO

VerticalGrowthPatternCounterClockwiseRotator

DEMOGRAPHICSFEMALE14YEARSOLD

DIAGNOSISCLASSIWITHVERTICALGROWTHPATTERNCROWDINGIMPACTEDUL3ANTERIORCROSSBITEMILDFACIALPROTRUSION

MECHANICSHYBRIDPASSIVE&ACTIVESELFLIGATINGAPPLIANCEEXTRACTION

TREATMENTTIMEPROJECTEDTREATMENTTIME:22MONTHS

ACTUALTREATMENTTIMEWITHACCELEDENT:15MONTHS

CASESTUDY

CourtesyofDr.StratyRighellis

NoTreatment VTOwithExtractionsDEMOGRAPHICS

FEMALE14YEARSOLD

DIAGNOSISCLASSIWITHVERTICALGROWTHPATTERNCROWDINGIMPACTEDUL3ANTERIORCROSSBITEMILDFACIALPROTRUSION

MECHANICSHYBRIDPASSIVE&ACTIVESELFLIGATINGAPPLIANCEEXTRACTION

TREATMENTTIMEPROJECTEDTREATMENTTIME:22MONTHS

ACTUALTREATMENTTIMEWITHACCELEDENT:15MONTHS

CASESTUDY

CourtesyofDr.StratyRighellis

StrategiesforWireChangesStage1:Leveling/Aligning

Mechanics&Intervals1. BeginwithlargestNiTi wirepossible,closingclipseasily

.014or.018NiTi2. 4weekintervalschangingNiTi wires

.020square>.0195x.025NiTi3. Resetbracketsandbandsecondmolarspriortostage2

Variability:Amountofcrowding

Goal:<4months.0195x.025ss

DEMOGRAPHICSFEMALE14YEARSOLD

DIAGNOSISCLASSIWITHVERTICALGROWTHPATTERNCROWDINGIMPACTEDUL3ANTERIORCROSSBITEMILDFACIALPROTRUSION

MECHANICSHYBRIDPASSIVE&ACTIVESELFLIGATINGAPPLIANCEEXTRACTION

TREATMENTTIMEPROJECTEDTREATMENTTIME:22MONTHS

ACTUALTREATMENTTIMEWITHACCELEDENT:15MONTHS

CASESTUDY

CourtesyofDr.StratyRighellis

.022HybridApplianceAnteriorTeeth:ProdigyActiveSLBBicuspidTeeth:PassiveSLB

Wires:Upper:.014NiTiLower:.014NiTi

INITIALPLACEMENT

Stage1:Leveling/Aligning

DEMOGRAPHICSFEMALE14YEARSOLD

DIAGNOSISCLASSIWITHVERTICALGROWTHPATTERNCROWDINGIMPACTEDUL3ANTERIORCROSSBITEMILDFACIALPROTRUSION

MECHANICSHYBRIDPASSIVE&ACTIVESELFLIGATINGAPPLIANCEEXTRACTION

TREATMENTTIMEPROJECTEDTREATMENTTIME:22MONTHS

ACTUALTREATMENTTIMEWITHACCELEDENT:15MONTHS

CASESTUDY

Stage1:Leveling/Aligning

U/L.014NiTiInitialPlacement

U.020 sq L.018 sqNiTi4WeeksLater 8WeeksLater

U/L.0195x.025NiTi

12 Weeks Later

U/L.0195x.025NiTiBand7’s

4OfficeVisitsforLeveling/Aligning

CASESTUDY

4WeeksLaterU:.020squareNiTiL:.018squareNiTi

8 WeeksLaterU: .0195x.025NiTiL: .0195 x.025 NiTi

InitialPlacementU/L.014NiTi

12WeeksLaterBand7’sU: .0195x.025NiTiL: .0195 x.025 NiTi

Stage1:Leveling/Aligning

CASESTUDY

CourtesyofDr.StratyRighellis

StrategiesforWireChangesStage2:Working

Mechanics&Intervals1. ClosespaceswithNiTi springsforcontinuousforcelevels

.0195x.025ss2. 6 weekintervals

Variability:Overbite&overjetTransversetoothpositionsVerticalcontrolsPatientcooperation

SpaceClosureExpectations:MaximumAnchorage8to10monthsReciprocalAnchorage4to6months

DEMOGRAPHICSFEMALE14YEARSOLD

DIAGNOSISCLASSIWITHVERTICALGROWTHPATTERNCROWDINGIMPACTEDUL3ANTERIORCROSSBITEMILDFACIALPROTRUSION

MECHANICSHYBRIDPASSIVE&ACTIVESELFLIGATINGAPPLIANCEEXTRACTION

TREATMENTTIMEPROJECTEDTREATMENTTIME:22MONTHS

ACTUALTREATMENTTIMEWITHACCELEDENT:15MONTHS

CASESTUDY

WorkingStageStart

2.5MonthsintoWorkingStage

4MonthsintoWorkingStage

6MonthsintoWorkingStage

4OfficeVisitsforWorkingPhase

Stage2:Working TotalTreatment:10Months

4OfficeVisitsforWorkingPhase

TotalTreatment:4MonthsWorkingStageStart U:.0195x.025DKHL:.0195x.025SS

TotalTreatment:10Months6MonthsLater

CASESTUDY

Stage2:Working

CASESTUDY

CourtesyofDr.StratyRighellis

StrategiesforWireChangesStage3:Detailing

Mechanics&Intervals1. ReSetbrackets2. PlacelargestNiTi wireswithclipsclosed3. Progressto.0195x.025ss wires

3Points:1. Class12. OJ/OBwithin2mmofoptimal

3. Nointra-archspacesandlateralopenbites<2mm

Goal:MutuallyProtectedOcclusionBalancedprofilewithSmileEstheticsKeys

DEMOGRAPHICSFEMALE14YEARSOLD

DIAGNOSISCLASSIWITHVERTICALGROWTHPATTERNCROWDINGIMPACTEDUL3ANTERIORCROSSBITEMILDFACIALPROTRUSION

MECHANICSHYBRIDPASSIVE&ACTIVESELFLIGATINGAPPLIANCEEXTRACTION

TREATMENTTIMEPROJECTEDTREATMENTTIME:22MONTHS

ACTUALTREATMENTTIMEWITHACCELEDENT:15MONTHS

2 OfficeVisitsforDetailingbeforeDeband Appointment

CASESTUDY

4WeeksLaterTriangleelasticsU: .0195 x.025 SSL: .0195 x.025 SS

DetailingStartResetbracketsU: .0195 x.025 NiTiL: .0195 x.025 NiTi

Stage3:Detailing

3MonthsLaterDeband

TotalTreatment:15Months

CASESTUDY

CourtesyofDr.StratyRighellis

FINISH

DEMOGRAPHICSFEMALE14YEARSOLD

DIAGNOSISCLASSIWITHVERTICALGROWTHPATTERNCROWDINGIMPACTEDUL3ANTERIORCROSSBITEMILDFACIALPROTRUSION

MECHANICSHYBRIDPASSIVE&ACTIVESELFLIGATINGAPPLIANCEEXTRACTION

TREATMENTTIMEPROJECTEDTREATMENTTIME:22MONTHS

ACTUALTREATMENTTIMEWITHACCELEDENT:15MONTHS

CASESTUDY

CourtesyofDr.StratyRighellis LINGUALOCCLUSION

DEMOGRAPHICSFEMALE14YEARSOLD

DIAGNOSISCLASSIWITHVERTICALGROWTHPATTERNCROWDINGIMPACTEDUL3ANTERIORCROSSBITEMILDFACIALPROTRUSION

MECHANICSHYBRIDPASSIVE&ACTIVESELFLIGATINGAPPLIANCEEXTRACTION

TREATMENTTIMEPROJECTEDTREATMENTTIME:22MONTHS

ACTUALTREATMENTTIMEWITHACCELEDENT:15MONTHS

CASESTUDY

FINISH:15MONTHS1WEEK

BASELINE

TreatmentSummary

Stage1:Leveling&Aligning 4Months

Stage2:Working 7.25Months

Stage3:Detailing 4Months

CASESTUDY

CourtesyofDr.StratyRighellis

NoVisibleRootResorption

DEMOGRAPHICSFEMALE14YEARSOLD

DIAGNOSISCLASSIWITHVERTICALGROWTHPATTERNCROWDINGIMPACTEDUL3ANTERIORCROSSBITEMILDFACIALPROTRUSION

MECHANICSHYBRIDPASSIVE&ACTIVESELFLIGATINGAPPLIANCEEXTRACTION

TREATMENTTIMEPROJECTEDTREATMENTTIME:22MONTHS

ACTUALTREATMENTTIMEWITHACCELEDENT:15MONTHS

CASESTUDY

CourtesyofDr.StratyRighellis

PRE VTO ACTUAL

DEMOGRAPHICSFEMALE14YEARSOLD

DIAGNOSISCLASSIWITHVERTICALGROWTHPATTERNCROWDINGIMPACTEDUL3ANTERIORCROSSBITEMILDFACIALPROTRUSION

MECHANICSHYBRIDPASSIVE&ACTIVESELFLIGATINGAPPLIANCEEXTRACTION

TREATMENTTIMEPROJECTEDTREATMENTTIME:22MONTHS

ACTUALTREATMENTTIMEWITHACCELEDENT:15MONTHS