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Technique Edgewise

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la technique EDGEWISE est l'une des techniques de base utilisée en ODF.

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Technique Edgewise

  1. 1. La technique EDGEWISE <ul><li>www.medespace.net </li></ul><ul><li>Share what you know,learn what you don’t </li></ul><ul><li>présenté par :Dr A.HAMMAR </li></ul>
  2. 2. INTRODUCTION L’Edgewise est une technique fixe multi attache qui a pour objectif de déplacer les dents sur l’arcade ou les arcades en totalité par rapport à la base osseuse correspondant. ce n’est pas une méthode de traitement mais un système mécanique qui permet des déplacement dentaires contrôlés dan s les trois plan de l’espace. EDGWISE  EDG = le côté le plus étroit WISE = le fil
  3. 3. HISTORIQUE <ul><li>Angle a publié ses travaux à partir de 1886 et il a fondu une école destinée à l’enseignement de l’orthodontie qui la considère comme une spécialité à part entière à partir de 1900. </li></ul><ul><li>L’Edgewise est une technique qui fut </li></ul><ul><li>présenté en 1925 par EDWARD ANGLE au cours d’une conférence à « New London ». </li></ul><ul><li>Le premier article sur cette technique parut en 1928 ans «LE DENTAL COSMOS » </li></ul><ul><li>En 1965 sa diffusion commence par un enseignement rationnel. </li></ul>
  4. 4. Les éléments de l’appareillage Edgewise
  5. 5. LES ELEMENTS D’APPAREILLAGE D’EDGWISE <ul><li>L’Edgwise: </li></ul><ul><li>est un appareillage amovo-inamovible comporte des éléments fixes et des éléments interchangeables. </li></ul><ul><ul><li>A. Eléments fixes : </li></ul></ul><ul><ul><li>Attachements principaux : </li></ul></ul><ul><ul><li>Bracket : </li></ul></ul>
  6. 7. Méthode de collage: a- préparation de la surface dentaire : • Nettoyage de la surface dentaire • Mordançage • lavage b- collage proprement dit : • Méthode directe • Méthode indirecte <ul><ul><li>Les tubes d’EDGWISE : </li></ul></ul><ul><li>Ce sont des tubes soudés à mi-hauteur de la face vestibulaire des bagues molaires. </li></ul>
  7. 8. <ul><li>Les attachements accessoires : • Les tubes de FEB • Les crochets d’ouverture distale • Les boutons et les crochets linguaux (cleats lugs) </li></ul><ul><li>Les éléments amovibles : </li></ul><ul><li>Ce sont les arcs qui sont fabriqués à partir de fil d’acier de dimension différente : </li></ul><ul><ul><li>Twist flex </li></ul></ul><ul><ul><li>Fil rond </li></ul></ul><ul><ul><li>Fil rectangulaire </li></ul></ul><ul><li>Les forces auxilliaires : </li></ul><ul><li>- Les FEB </li></ul><ul><ul><li>Les forces intramaxillaire </li></ul></ul><ul><ul><li>Les forces intermaxilllaire </li></ul></ul>
  8. 9. <ul><li>Les forces intermaxilllaire : </li></ul><ul><li>Antéro-postérieurs </li></ul><ul><li>De Cl II ou de Cl III </li></ul><ul><li>Transversal </li></ul><ul><li>° Criss-cross </li></ul><ul><li>° Transverse </li></ul><ul><li>Vertical (dans le cas de béance) </li></ul>
  9. 10. Description de l’appareillage EDGEWISE Éléments fixes Éléments amovibles Forces auxiliaires -les arcs *rectangulaire *rond -Tubes -Brackets -Accessoires F. intra maxillaire F.intermaxiilaires FEB
  10. 11. LES PRINCIPES SPECIFIQUE DE L’EDGEWISE <ul><li>Le contrôle tridimensionnel des mouvements dentaires : </li></ul><ul><li>Arc rond : ces arcs sont utilisés au début de traitement ou ils sont régénérateurs de forces légère. </li></ul><ul><li>Arc rectangulaire : ils sont spécifique de l’EDGWISE selon leur dimensions, on aura : les arcs travaillants de faible diamètre et les arcs de stabilisation ou de finition de grand diamètre. </li></ul>
  11. 12. <ul><li>Courbure de premier ordre : Ce sont les premières courbures introduites sur un blank, ces courbures n’affectent pas la planéité de l’arc. </li></ul>
  12. 13. Courbure de deuxième ordre : Ces courbures affectent la planéité de l’arc et elles sont réalisés dans le sens vertical. - Tip beck bend - Tip forward bend - Gable bend = c’est l’association d’un tip beck et tip forward - Artistic bend
  13. 14. <ul><li>Courbures de 2 er ordre </li></ul>
  14. 15. <ul><li>Courbure de troisième ordre : Ce sont les dernières à être introduites sur l’arc l’Edgwise, elles affectent la planéité de l’arc. </li></ul><ul><li>Torque continu : C’est une torsion uniforme intéressant une ou plusieurs dents donc un secteur de l’arc limité par deux points. </li></ul><ul><li>Réalisation pratique : </li></ul>
  15. 16. <ul><li>Torque progressive : </li></ul>
  16. 17. <ul><li>La maîtrise des zones d’ancrage : 1. La zone d’ancrage : C’est une zone qui résiste au déplacement dentaire sous l’effet des forces orthodontiques. 2. Classification d’ancrage : a- Ancrage maximum : ou la zone d’ancrage ne devra subir aucun déplacement b- Ancrage modéré : ou une perte d’ancrage est permise c- Ancrage nul : perte d’ancrage maximum. 3. Type d’ancrage : a) Ancrage naturel : c’est la résistance naturelle de la dent dans son alvéole b) Ancrage renforcé : c’est un ancrage mécanique induit par des dispositifs pour renforcer l’ancrage naturel. </li></ul>
  17. 18. Les moyens :
  18. 20. <ul><li>Concept de l’arc idéal :  Le but de concept : - Déterminer la forme d’arcade optimal pour le patient - Positionner les dents dans les trois sens de l’espaces - De réaliser une concordance entre l’arcade supérieur et inférieur  La forme de l’arcade idéale pour le patient: - Charte de Bon Will-Hawley - Charte de Brader - Charte de Boone </li></ul>
  19. 22. <ul><li>Courbures des arcs idéaux :  Courbure de premier ordre : Ces courbures permettent l’alignement des dents sur l’arcade en tenant compte la morphologie propre de chaque dent a- Arc mandibulaire b- Arc maxillaire </li></ul>
  20. 24. <ul><li>Courbure de deuxième ordre : Elles sont en fonction des mouvements effectués pendant le traitement. Courbure de troisième ordre : description la mandibule : - Pas de torque au niveau des incisives - Peu ou pas de torque au niveau des canines - Torque progressive radiculo-vestibulaire sur les prémolaires et les molaires. • Au maxillaire : - Torque radiculo-palatin au niveau de secteur antérieur - Torque variable sur les canines - Torque progressive radiculo-vestibulaire sur les prémolaires et les molaires. </li></ul>
  21. 25. <ul><li>Coordination des arcs : C’est la dernière phase de traitement après la phase de de la conception des arcs idéaux, cette opération se fait sur la charte individualisée. </li></ul>
  22. 27. <ul><li>Les points de contrôle en bouche après l’installation de ces arcs idéaux, sont les suivants : </li></ul><ul><li>Concordance des milieux </li></ul><ul><li>Relation de Cl I d’Angle </li></ul><ul><li>Continuité de point de contact </li></ul><ul><li>Concordance entre la position de la mandibule et du maxillaire en relation centrée et en occlusion </li></ul><ul><li>Guide antérieur en propulsion avec désocclusion postérieure </li></ul><ul><li>Guide canin du côté travaillant dans les mouvements de latéralité </li></ul><ul><li>Absence d’interférence du côté non travaillant </li></ul>
  23. 28. <ul><li>Phase de nivellement </li></ul><ul><li>Phase de préparation d’ancrage </li></ul><ul><li>Phase de déplacement dentaire en masse </li></ul><ul><li>Phase de finition par les arcs idéaux </li></ul><ul><li>Contention par plaque de Hawley ou par un arc fixe ou toothpositionner </li></ul><ul><li>Dans les cas avec l’extraction, une phase complémentaire se superpose à la phase de préparation d’ancrage : c’est la phase de la rétraction des canines  Bull-loop. </li></ul>PHASE DE TRAITEMENT EN EDGWISE
  24. 29. BIBLIOGRAPHIE ODF Généralités 23 490 A 10 C.J. Blonder 1986 EDGEWISE 23-490 D10 1985 EMC. Château tome 2 Orthodontie des principes et une technique J. Philipe Le bracket TWA: déplacement & frottement J.J. Aknin L’orthodontie Française 2002

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