Damon Optimal-ForceCopper Ni-Ti®

.014 U/L

PRN, .013 U/L if crowdingis severe or periodontalsupport is compromised

.018 U/L

Damon Optimal-ForceCopper Ni-Ti

.014 x .025 U/L10 weeks into this stage: Take Panorex & repositionbrackets. Follow with .018 Cu Ni-Ti if brackets aredrastically repositioned.

.018 x .025 U/L orPRN, .018 x .025 L.017 x .025 Ni Ti® with20° anterior torque U.3

See Notes. Followpretorqued wire withsame wire in .019 x .025for 6 to 8 weeks if moretorque required.

• Begin leveling and alignment

• Initiate arch development without RPEs or W-arches

• Resolve 90% of rotations• Extrude buccal segments• Begin A/P and vertical

correction

• Complete leveling and alignment

• Continue archdevelopment

• Resolve remainingrotations

• Begin torque control• Consolidate minor spacing

10

6 – 8

10

6 – 8

8 – 10

10

6 – 8

10

6 – 8

8 – 10

As bite opens, casesbecome CL II dentally,explaining use of CL IIelastics configurations.

Always place stopsanterior to crowding.

Use Bite Turbos (preferablybehind U1s) to allowbuccal segments toextrude. Disarticulation isalso TMJ favorable.

Reverse curve Ni-Ti is notrecommended on upperarch.2

Typically use power chainunder wire to consolidateminor spaces U/L 3 to 3. Ifconsolidating minorspaces U/L 6 to 6, run wire7 to 7. If 7s are noterupted, consolidate 5 to5. Run wire 6 to 6.4

Pretorqued wires countereffects of CL II elastics tokeep upper incisors fromretroclining.

Quail 3/16", 2 oz – Shorty CL IIL6 to U4 – Full time

Kangaroo 3/16", 4.5 oz – ShortyCL II – L6 to U4 – Full time

When 90% of rotationsare resolved.

Do not rush this Phase. Itmust be possible to insertthe first edgewise wireswith minimal activeengagement. If not, let thecurrent wire work longer.Avoid the use of any wire“icing” product thatwould apply too high aforce when the wirewarms.

When all brackets andteeth are aligned.

It should be possible toinsert the working wireswith minimal activeengagement. If not, thecase is not ready for PhaseIII. Avoid “icing” products.

Class I Deep BiteSuggested Treatment Protocol

Phase Archwires Objectives Duration Interval Notes Early Light Elastics Guidepostsin Weeks in Weeks Begun at Initial Bonding1 for Next Phase

I.Initial

Light-Wire

II.High-TechEdgewise

1In patients with very thin attached tissue, severe crowding or periodontal issues, waiting to start elastics until the second appointment may help prevent labial gingival recession. 2Preserving a satisfactory smile arc in a deep-bite case usually precludes using a reverse curve archwire on the upper arch that would flatten it – even in cases with excessive gingival display. 90% of the correction should come from extruding the buccal segments andbringing the molars up and forward. It may also be advisable to intrude lower incisors and extrude upper incisors to enhance the smile arc. 3Allowing staff to engage pretorqued wires is not recommended; wire orientationis critical and it is easy to reverse it inadvertently. 4If consolidating space behind canines, keep power chain one tooth forward of end of wire to help prevent rotation.

Posted Stainless Steel.016 x .025 U/L

The diligent use of earlylight elastics may shortenor even eliminate thisphase, but if additionalposterior transverse widthis required, undertake thisphase with elastics andexpand wires slightly inthe posterior.

TMA®

.019 x .025 U

.017 x .025 L

• Take wax bite; coordinatepatient-specific arch form

• Consolidate anyremaining minor spacing

• Express majority ofremaining torque

• Overcorrect A/P and vertical

• Make final A/P,buccolingual, torque and occlusal adjustments.

20 – 30

15 – 20

8To precludetoo much

over-correction,

do notallow

intervals toextend

beyond 8weeks.

4 – 6until

sectioningwire, then 2

When engaging elastics,use the wire posts todistribute forces over thearchwire.

Once all spaces close,transition from powerchain to .008 or .010 wireto lace anteriors together;tie back to 6s to avoidreopening space.

To engage elastics, crimpsurgical posts onto TMAwires to distribute forcesover the archwire.

PRN to perfect occlusion,cut upper wire mesial tothe teeth that still requirebetter articulation.

Adjust posteriorinterferences with a high-speed handpiece and diamond bur, thenpolish, PRN.

Kangaroo 3/16", 4.5 oz – Full CL IIL6 to U Post – Full time untilovercorrected (edge to edge)

PRN, after 3 weeks, have patientadvance to Impala 3/16", 6 oz – FullCL II – L6 to U Post – Full time untilovercorrected (edge to edge)

Once overcorrected, have patientswitch back to: Quail or Kangaroo– Shorty CL II -- L5 to U Post – Wearoften enough to keep edge to edgeand hold for about 8 weeks

To prevent relapse, it is advisablenot to stop CL II elastics too soon.Just shorten and lighten them.

Quail 3/16", 2 oz or Kangaroo 3/16,4.5 oz – Shorty CL IIL5 to U Post – Full time for 8 weeksto hold idealized anterior bite,preventing relapse into centric slide

Overlay Zebra 5/16", 4.5 ozPosterior V – U6 to L5 to U Post –Full time until socked in, then 12hours daily (after school & nights)

PRN when sectioning wire, maintainShorty CL II but switch from PosteriorV to Ostrich 3/4", 2 oz – SpaghettiU to L 7 to 3 – Twisted in between.In the anteriors, end on U Postmesial to 3s – Full time

When the case is CL I and has been in an over-corrected position for 8 weeks.

Class I Deep Bite (continued)

Suggested Treatment Protocol

Phase Archwires Objectives Duration Interval Notes Early Light Elastics Guidepostsin Weeks in Weeks Begun at Initial Bonding for Next Phase

III.Major

Mechanics

IV.Finishing

These wire/elastics sequence recommendations have been shown to be effective when treating with Damon System mechanics. They are not a replacement for professional expertise.