COMMON SENSE
MECHANICS IN EVERYDAY ORTHODONTICS
by Thomas F.
Mulligan, D.D.S., M.S.D.
Phoenix, Arizona
DAY I
INTRODUCTION (Synopsis)
The
practice of orthodontics today requires an ever-increasing
knowledge placing greater demand on the time of the individual
seeking to expand his/her knowledge in total orthodontic care.
Such time limitations make it more critical than ever to
understand orthodontic mechanics at a level that will permit the
operator to compete effectively without changing brackets and
altering techniques every time there is exposure to “something
new.” A genuine grasp of sound orthodontic principles will
allow one to remain with the appliance of choice, while
resolving the tremendous variations of orthodontic tooth-moving
problems through application of knowledge in place of
unnecessary effort. Entirely loop-free appliances applied in a
manner which minimizes patient cooperation will bring untold
satisfaction to both operator and patient. Emphasis is on
simplicity produced by maximum understanding combined with
minimum effort. Desirable and undesirable tooth movements often
result by “accident.” You will clearly understand the cause
and effect factors that produce these movements. As a result,
you will be amazed at your ability to predict response and take
the necessary action to avoid and eliminate the undesirable
responses in an uncomplicated manner.
It has always been a real
challenge to control molar position when all teeth are not
banded/bonded. But, in many cases it is advantageous not
to band/bond all teeth – particularly when the second molars are
normally positioned from the start. You will discover an
approach that not only offers control of molar position, but
eliminates the need for lingual arches, transpalatal arches,
and second molar banding (when no second molar movement is
required). You will not have learned this in the academic
world.
Your exposure to “Force Driven
Archwires” instead of the familiar “Shape Driven Archwires” may
lead you to question the need for prescription brackets. You
will find no need to alter your choice of brackets (single wing
or twin), slot sizes, etc., but you may find it both convenient
and less expensive to avoid use of the many devices used in
combination with bracket therapy.
DAY II (Synopsis)
Treatment of Class II
Malocclusions will be discussed in a manner which will offer the
opportunity for correction without headgear or elastics.
Regardless of whether the Class II is unilateral or bilateral,
the mechanics applied are symmetrical. Forget the use of
complicated asymmetrical mechanics for asymmetrical problems.
This approach is unlike the myriad of complex and expensive
appliances utilized today in non-compliant therapy. You will
learn the significance of molar rotation in creating arch
length, midline correction, and resolution of Class II molar
relationships – whether unilateral or bilateral.
The majority of diastemas
can be treated to stability without the need for retention of
any kind. Have you been taught that fibrotomies and/or
permanent retention is necessary? Likewise, rotations can be
treated in such a manner as to eliminate the associated
balancing forces that so often result in unexpected molar
displacements, while at the same time providing stability for
the corrected rotations.
There should be no doubt
following the conclusion of the first two days that archwire
shape is not the primary determinant of tooth movement, but in
fact is the cause of many undesirable side-effects that so often
lead to the regular use of transpalatal arches, lingual arches,
and crossbite elastics. You will see why the presenter of this
program has never found it necessary to use any of these
approaches.
DAY III (Synopsis)
Archwire shape has been
taught as the best method for obtaining archform as well as
numerous other objectives. You will be exposed to a
“force-driven” concept that produces direct and predictable
movement, but is totally unlike the “shape-driven” concept that
results in so many unpredictable movements and undesirable
side-effects.
These concepts will be applied to
various extraction cases including: asymmetrical extractions,
four first bicuspid extractions, upper first bicuspid
extractions, incisor extractions, etc. Anchorage concepts will
be presented that are altogether different than anything taught
in the world of academics. You will discover the beauty and
simplicity of applying these concepts, as well as their
effectiveness.
No individual will find it
necessary to change bracket prescriptions, wire sizes, etc. in
order to benefit from what is presented. However, you may well
discover that the “neutral slotted” bracket has much more to
offer than previously thought – not to mention that such
brackets are far less expensive. You will also discover that
the multitude of lab appliances in use today can be avoided,
thus further reducing office overhead significantly. In the
final analysis, overhead may be reduced in many ways with an
understanding of Common Sense Mechanics. Examples include staff
size, retirement contributions, medical insurance, sick pay, and
vacation pay, only to mention a few.
DAY IV (Synopsis)
The subject of “Open Bites” will
be discussed and numerous solutions presented that require no
more than an understanding of the mechanics presented thus far.
Understand easily produced force systems in a manner that will
provide the opportunity for open bite corrections in many
different situations.. Likewise, understand why force systems
associated with particular types of tooth movement, often result
in anterior or posterior open bites during orthodontic tooth
movement.
A thorough discussion of Occlusal
Planes will take place, showing their relationship to the Smile
Curve, while also presenting the opportunity to avoid TAD’s in
the correction of canted occlusal planes. The cause/effect
relationships presented will apply to almost any orthodontic
problem we treat – and in any plane of space.
A summary of this course will be
presented which will include Compromise Treatments, An Overview,
and an examination titled, “Fun Learning.” This is not a
written examination, but an open discussion in which we can all
have fun.
An understanding of mechanics,
unlike what you may have learned at other courses, will provide
you with the opportunity to discover individualized solutions to
patient problems without looking to the laboratory for the
various “devices” so heavily advertised in today’s market place.
In summary, it will be discovered
that what has been taught, regarding the use of full appliances,
has placed severe limitations on mechanics applied at the
clinical level. It is time to get rid of the idea that complex
appliances are usually required for complex treatment. What is
required is a thorough understanding of mechanics as it applies
to any appliance in use by the operator.
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The typical schedule for each day
is as follows:
