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Use of a Tip Edge Stage /certified fixed orthodontic courses by Indian dental academy
1. Tip Edge Technique
INDIAN DENTAL ACADEMY
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2. Use of a Tip-Edge Stage-1 Wire to Enhance
Vertical Control During Straight Wire Treatment
The straight wire appliance gives supreme control and finishing potential, but there can b
difficulties during the overbite reduction phase because of the continuous arch mechanics
Begg appliance is renowned for its superb ability regarding overbite and overjet reduction
because it is able to provide the consistent low forces required for intrusion.
Several appliances have been developed with the aim of enhancing vertical control witho
losing the finishing capabilities of the Edgewise mechanism. Two of the better known ap
are the Beddtiot appliance and the Tip-Edge appliance.
Scan0001.jpg
This 17.2-year-old patient presented with a Class II,
division2 incisor relationship, a significant
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anteroposterior skeletal discrepancy, a mandibular
deficiency, and a low angle between the maxillary and
3. Only the upper arch was bonded with 0.018-inch Roth prescription brackets
with vertical slots and molar bands with twin rectangular tubes. A 0.012-inch
super elastic arch wire was placed, and
a 0.016-inch Tip-Edge
stage-1 type arch was used as an auxiliary wire and tied only to the
central incisors using steel ligatures through the vertical slots in the central
incisor brackets. Tip-back bends were placed to provide 40 g of intrusion. The
ends of the auxiliary wire were cinched and no intra-arch traction was applied
at this stage. A Nance arch was fitted to enhance anchorage control.Three
months into treatment, the overbite was reducing,and a 0.016-inch super elastic
main arch wire was placed .
The mechanics at this stage were aimed at overbite reduction and at
encouraging the apex of the upper incisors to move lingually.
Use of a Tip-Edge Stage-1 Wire to Enhance Vertical Control During Straight Wire Treatment: Two Case
Reports,Helen Taylor, BDS, MScD, DOrth, MOrth, FDSRCS(Eng) (Angle Orthod 2003;73:93–99.)
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4. Overbite control:
A super elastic 0.016 x 0.022-inch main upper arch wire was placed to maintain torque. The auxiliary wire was
retained to hold the overbite correction and the space closure achieved thus far.
In lower 0.016x 0.022 –inch main wire with 0.16 auxillary wire is used for controlling the overbite.
Space closure using Tip- edge stage I arch wire loops with super elastic arch wires:
At 11.5 months, a 100-g intra-arch traction was applied to the upper left-quadrant where spontaneous space closure
was slower than that seen in the right quadrant. This was done using a lightweight elastomeric chain from the hook
on the molar tube to the traction loop on the auxiliary wire.
Later full sized arch wire to express the tip & torque of the straight wire is used.
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5. SUMMARY:
0.16 STAGE I TIP EDGE
arch wire can be used
over the super elastic arch
wire in straight wire
appliance for fast bite
opening and controlled
space closure.They also
help in maintaining the
corrected overbite during
the sequencing of wires in
the straight wire
appliance.
By using a superelastic wire as the
main wire throughout the majority of
treatment, forces are kept light
and canine teeth are able to translate
bodily distally with minimum
anchorage loss.
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6. Employing Tip-Edge brackets on canines & premolars to simplify
straight-wire mechanics R. Thomas Rocke, DDS, MS, Westville, Ind.
Taken from the AJO-DO 1994 Oct (341-350): CLINICIANS' CORNER - Rocke
The straight-wire appliance was developed in part to reduce wire bending and therefore make
treatment results more predictable. Because tip prescription is built into the bracket slots, teeth are
held at their final crown angulations throughout treatment. Straight-wire brackets are used in an
attempt to produce bodily tooth movement. However, teeth tend to tip when a force is applied. This
tipping, especially when canines are retracted, can deflect the arch wire causing super eruption of the
incisors with a resultant increase in anterior overbite and an open bite in the canine/premolar area.
Placing Tip-Edge brackets (TP Orthodontics, Inc., LaPorte, Ind.) on canines and employing tipping
and uprighting mechanics on these teeth can overcome these problems.
Overbite is deepening as canines are retracted
When canine with standard straight-wire edgewise
with elastomeric links from canines to molar
bracket is uprighted or retracted, it tends to tip and
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hooks. An open bite in the canine/premolar area
extrude incisors. (Line drawings courtesy, Peter C.
is also developing.
Kesling, Westville, Ind.)
7. Simple tipping of canine with Tip-Edge bracket causes no arch wire
deflection and therefore no incisor extrusion.
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A, Tip-Edge bracket
slot opens as crown tips
distally allowing for
easy placement of
larger diameter wires.
B, A 0.028-inch wire
has been placed in the
tipped canine bracket to
illustrate this feature.
8. USING SIDEWINDER SPRINS LATER TO UPRIGHT AND TORQUE
CANINE AND PREMOLAR.
Side-Winder springs will upright tooth to tip prescription on
0.022-inch wire, and in addition, B, torque tooth when full-size
0.0215 x 0.027 inch edgewise wire is used. (1 ) A 0.0215 x 0.027inch rectangular straight wire fits easily into tipped canine
bracket, or any other Tip-Edge bracket slot. (2) As the SideWinder spring uprights the tooth, the bracket slot closes down on
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the flat surface of the arch wire producing torque. (3) Tooth at
final tip and torque prescription.
9. Pretreatment records of 14-year-old boy. The patient has a severe Angle Class II, Division 2 malocclusion with
an extremely deep overbite.
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10. A, Appliance placement. Straight wire brackets are placed on maxillary incisors and mandibular central
incisors. Tip-Edge brackets are placed on canines where erupted and mandibular lateral incisors.
Starting arch wires (0.016-inch E.S.P. Australian) and light (2 oz.) Class ll elastics correct the Class ll. B,
The overbite and overjet are corrected and the premolars are bracketed and leveled. Note the 0.016-inch
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arch wire passing through tipped mandibular canines without deflection. C, Arch wires (0.016 inch) are
replaced with 0.022-inch round wires.
11. Appliance removal. A good, functional Class l occlusion and pleasing profile was obtained.
(Dotted line = Start; solid line = finish.)
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12. Pretreatment records for 12.5-year-old girl. Four first
premolars were removed to eliminate crowding and
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provide space to permit reduction of the bimaxillary
protrusion .
13. A, Appliance placement.
Straight-wire brackets were
placed on all anterior teeth
except for a Tip-Edge bracket
on the upper left, and later
upper right canine The case
was started with 0.016-inch
E.S.P. Australian arch wires
and light (2 oz ) Class II
elastics. B. Upper 0.0215 x
0.027-inch rectangular arch
wire was used for anterior
retraction and posterior
space closure. Before space
closure, the mandibular
canines were rebracketed
with Tip-Edge brackets
which were also later bonded
on the premolars C. Arch
wires (0.022 inch) maintain
arch from while a Nitinol
torquing bar torques
maxillary incisors and SideWinder springs upright
canines and premolars. D,
Rounded 0.0215 x 0.027-inch
edgewise finishing ash wires
are placed for final crown
and root torque.
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{Overbite and
overjet reduced
using tip-edge
bracket & wire}
14. Final facial and intraoral photographs. A good Class I occlusion was obtained. The patient's profile
improved even though forward mandibular growth was weak. (Dotted line = Start; solid line = finish.)
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15. Thank you
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