SlideShare une entreprise Scribd logo
1  sur  21
En Masse Retraction and Two-
Step Retraction of Maxillary
Anterior Teeth
in Adult Class I Women
A Comparison of Anchorage Loss
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
www.indiandentalacademy.com
INTRODUCTION
 Lip protrusion is one of the major chief complaint in
adults.
 Extracting the first four premolars and retracting the
anterior segments with maximum anchorage is the
most common way to reduce lip protrusion and to
straighten the patient’s profile.
 Accurate prediction of anchorage loss is very critical.
www.indiandentalacademy.com
 Tweed
 Storey and Smith
 Begg
 Controversies
 Proffit and Fields
 Roth
 Kuhlberg
www.indiandentalacademy.com
 Staggers and Germane
 Burstone
 Despite controversies of anchorage preservation,
there have been a few studies about comparing the
two paradigms.
 The purpose of this study was to compare the
degree of anchorage loss of the posterior teeth and
the amount of retraction of the anterior teeth
between en masse retraction and two-step retraction
of the maxillary anterior teeth in Class I malocclusion
patients with lip protrusion.
www.indiandentalacademy.com
MATERIALS AND METHODS
 Initial sample
 Final samples selection criteria:
1) Women older than 17 years to eliminate potential
influence of sex and growth;
2) Class I malocclusion (0< ANB<5) with
normodivergent
pattern (22<FMA<31), lip protrusion (Ricketts’ lower
lip to esthetic line >2 mm), labioversed upper incisor
(U1 to palatal plane >105), and less than 4 mm
crowding in each arch;
3) Four first premolars extraction cases;
4) Use of a 0.022-inch straight wire appliance with
Roth setup (fully bonded to second molars).
www.indiandentalacademy.com
 Thirty patients fulfilled the criteria and were allocated
into group 1 (n=15, mean age=21.4 years, en masse
retraction, using sliding mechanics, as described by
Bennett and McLaughlin).
 Group 2 (n=15, mean age=24.6 years, two-step
retraction, with sliding mechanics for canine
retraction and loop mechanics for the upper incisor
retraction).
 After matching gender, age, skeletal, dental, and soft
tissue relationships and treatment appliance
www.indiandentalacademy.com
 Lateral cephalometric radiographs were taken before
(T1) and after treatment (T2).
 All lateral cephalograms were traced by one
investigator.
 All traces were digitized by means of a graphic tablet
using a program developed for this study with an
IBM-compatible computer.
www.indiandentalacademy.com
Figure 1. Landmarks and reference
planes used for this study. 1, nasion
(N); 2, sella (S); 3, orbitale (Or);
4, porion (Po); 5, articulare (Ar);
6, gonion (Go); 7, menton (Me);
8, gnathion (Gn); 9, pognion (Pog);
10, anterior nasal spine (ANS);
11, posterior nasal spine(PNS);
12, pterygoid point (Pt point);
13, subspinale (point A);
14, supramentale (point B); 15, upper
incisor edge (U1E); 16, upper incisor
root apex (U1A); 17, center of
maxillary first molar crown on occlusal
surface (U6C); 18, most mesial point
of mesial surface of maxillary first
molar crown (U6M);
19, mesiobuccal root apex of
maxillary first molar (U6A);
20, furcation of maxillary first molar
(U6F);21, vertical reference planewww.indiandentalacademy.com
Figure 2. (a–c) Skeletal
variables. Skeletal horizontal
variables: 1, SNA; 2, SNB; 3,
ANB; 4, facial angle (N-Pog to F
H plane); 5, anteroposterior
dysplasia indicator (APDI); 6,
Wits appraisal.
Skeletal vertical variables: 7,
Bjork sum; 8, facial height ratio
(posterior facial height/anterior
facial height X100); 9, Frankfort
mandibular plane angle (FMA).
www.indiandentalacademy.com
Figure 3. (a–c) Anchorage variables. (a) 1,
U1 to PP ; 2, U6 to PP, (b) 3, U1E-Hor: the
horizontal distance from U1E to PTV (mm);
4, U1A-Hor: the horizontal distance from
U1A to PTV (mm); 5, U6M-Hor: the
horizontal distance from U6M to PTV (mm);
6, U6AHor: the distance from U6A to PTV
(mm), (c); 7, U1E-Ver: the vertical distance
from U1E to palatal plane (mm); 8, U1A-Ver:
the vertical distance from U1A to palatal
plane (mm); 9, U6C-Ver: the vertical
distance from U6C to palatal plane (mm);
10, U6F-Ver: the vertical distance from U6F
to palatal plane (mm).www.indiandentalacademy.com
 Dahlberg’s formula for error determination
 Comparison of skeletal variables between groups 1
and 2 at T1,
 The time of retraction between groups 1 and 2,
 Anchorage variables between groups 1 and 2 at T1
and T2, and
 Changes of anchorage variables during T2 and T1
were evaluated by independent t-tests.
www.indiandentalacademy.com
RESULTS
 skeletal vertical variables in group 2 showed a
relatively more hypodivergent pattern than in group 1
www.indiandentalacademy.com
 Although the mean time of retraction in group 2 was
longer than in group 1, there was no significant
difference in the time of retraction between groups 1
and 2
www.indiandentalacademy.com
 The anchorage variables at T1 showed no significant
differences between group 1 and group 2. At T2, there
were also no significant differences between the two
groups except U1A-Hor. U1A-Hor showed that the upper
incisor root apex in group 2 was farther from the PTV
than in group 1
www.indiandentalacademy.com
 Although there was no significant difference in the
amount of change in the horizontal position of the
upper incisal edge (U1E-Hor) between the two
groups, the amount of change in the vertical position
of the upper incisal edge (U1E-Ver) showed a
significant difference.
 The reason could be due to downward movement of
the upper incisal edge of group 2, which was
originally positioned more superiorly.
 However, the vertical position of the upper incisal
edge of group 1 was well maintained.
www.indiandentalacademy.com
 There were no significant differences in the amount
of changes in the upper molar
 Bodily and mesial movements of the upper molars
were found in both groups
 Approximately 4 mm of the retraction of the upper
incisal edges resulted from 1 mm of anchorage loss
in the upper molars in both groups
www.indiandentalacademy.com
DISCUSSION
 Since it is known that patients with a hypodivergent
facial type have stronger natural anchorage than
those with a hyperdivergent one, group 2 might have
a better tendency of natural anchorage preservation
than group 1.
 However, the fact that there was no difference in
anchorage loss of the upper molar suggests that
two-step retraction takes only more time to close the
extraction space without advantage of anchorage
preservation.
www.indiandentalacademy.com
 Maximum anchorage
 The upper incisors were retracted in group 1 with a
combination of tipping and bodily movement.
 However, the upper incisor in group 2 moved in a
relatively uncontrolled tipping manner and showed a
resultant downward movement of the upper incisal
edge
www.indiandentalacademy.com
 The fact that approximately 4 mm of the retraction of
upper incisal edges resulted from 1 mm of
anchorage loss of the upper molars in both groups
may be helpful when diagnosing lip protrusion
patients and estimating soft tissue change for them.
 If, in lip protrusion cases, more retraction of the
anterior teeth is needed than the predicted amounts,
additional anchorage reinforcement with headgear or
orthodontic miniscrews would be necessary.
www.indiandentalacademy.com
CONCLUSIONS
 No significant differences existed in the degree of
anchorage loss of the upper posterior teeth and the
amount of retraction of the upper anterior teeth
associated with en masse retraction and two-step
retraction of the anterior teeth.
 When choosing retraction mechanics, it is necessary
to consider additional aspects such as the inclination
and vertical position of the anterior teeth rather than
anchorage loss.
www.indiandentalacademy.com
THANK
YOU !!!!
www.indiandentalacademy.com

Contenu connexe

Tendances

Molar distalization
Molar distalizationMolar distalization
Molar distalizationMaher Fouda
 
Stability Retention and Relapse in orthodontics
Stability Retention and Relapse in orthodonticsStability Retention and Relapse in orthodontics
Stability Retention and Relapse in orthodonticsAshok Kumar
 
Camouflage in orthodontics
Camouflage in orthodonticsCamouflage in orthodontics
Camouflage in orthodonticsDr.ankur dhuria
 
finishing and detailing in orthodontics
finishing and detailing in orthodonticsfinishing and detailing in orthodontics
finishing and detailing in orthodonticsJasmine Arneja
 
3-D DIAGNOSIS & TREATMENT PLANNING IN ORTHODONTICS / fixed orthodontics cours...
3-D DIAGNOSIS & TREATMENT PLANNING IN ORTHODONTICS / fixed orthodontics cours...3-D DIAGNOSIS & TREATMENT PLANNING IN ORTHODONTICS / fixed orthodontics cours...
3-D DIAGNOSIS & TREATMENT PLANNING IN ORTHODONTICS / fixed orthodontics cours...Indian dental academy
 
Molar distalization /certified fixed orthodontic courses by Indian dental aca...
Molar distalization /certified fixed orthodontic courses by Indian dental aca...Molar distalization /certified fixed orthodontic courses by Indian dental aca...
Molar distalization /certified fixed orthodontic courses by Indian dental aca...Indian dental academy
 
orthodontic bracket prescription 1
orthodontic bracket prescription 1 orthodontic bracket prescription 1
orthodontic bracket prescription 1 Maher Fouda
 
orthodonticTraction of impacted maxillary canine and Piggyback technique
orthodonticTraction of impacted maxillary canine and Piggyback techniqueorthodonticTraction of impacted maxillary canine and Piggyback technique
orthodonticTraction of impacted maxillary canine and Piggyback techniquemohammed alawdi
 
Space closure by frictionless mechanics 2 /certified fixed orthodontic course...
Space closure by frictionless mechanics 2 /certified fixed orthodontic course...Space closure by frictionless mechanics 2 /certified fixed orthodontic course...
Space closure by frictionless mechanics 2 /certified fixed orthodontic course...Indian dental academy
 
Surgery First Orthognathic Approach (SFOA)
Surgery First Orthognathic Approach  (SFOA)Surgery First Orthognathic Approach  (SFOA)
Surgery First Orthognathic Approach (SFOA)Dr. Arun Bosco Jerald
 
Molar distalization
Molar distalization Molar distalization
Molar distalization Monica Ravuri
 
MBT system in orthodontics /certified fixed orthodontic courses by Indian den...
MBT system in orthodontics /certified fixed orthodontic courses by Indian den...MBT system in orthodontics /certified fixed orthodontic courses by Indian den...
MBT system in orthodontics /certified fixed orthodontic courses by Indian den...Indian dental academy
 
Molar distalisation in Orthodontics
Molar distalisation in OrthodonticsMolar distalisation in Orthodontics
Molar distalisation in OrthodonticsMiliya Parveen
 
Anchorage management in orthodontics
Anchorage management in orthodonticsAnchorage management in orthodontics
Anchorage management in orthodonticsAshok Kumar
 

Tendances (20)

Molar distalization
Molar distalizationMolar distalization
Molar distalization
 
Temporary anchorage devices
Temporary anchorage devices Temporary anchorage devices
Temporary anchorage devices
 
Lingual Orthodontics Khush
Lingual Orthodontics KhushLingual Orthodontics Khush
Lingual Orthodontics Khush
 
Intrusion arches
Intrusion archesIntrusion arches
Intrusion arches
 
Stability Retention and Relapse in orthodontics
Stability Retention and Relapse in orthodonticsStability Retention and Relapse in orthodontics
Stability Retention and Relapse in orthodontics
 
non compliance class 2 correcters
non compliance class 2 correctersnon compliance class 2 correcters
non compliance class 2 correcters
 
Camouflage in orthodontics
Camouflage in orthodonticsCamouflage in orthodontics
Camouflage in orthodontics
 
finishing and detailing in orthodontics
finishing and detailing in orthodonticsfinishing and detailing in orthodontics
finishing and detailing in orthodontics
 
3-D DIAGNOSIS & TREATMENT PLANNING IN ORTHODONTICS / fixed orthodontics cours...
3-D DIAGNOSIS & TREATMENT PLANNING IN ORTHODONTICS / fixed orthodontics cours...3-D DIAGNOSIS & TREATMENT PLANNING IN ORTHODONTICS / fixed orthodontics cours...
3-D DIAGNOSIS & TREATMENT PLANNING IN ORTHODONTICS / fixed orthodontics cours...
 
Molar distalization /certified fixed orthodontic courses by Indian dental aca...
Molar distalization /certified fixed orthodontic courses by Indian dental aca...Molar distalization /certified fixed orthodontic courses by Indian dental aca...
Molar distalization /certified fixed orthodontic courses by Indian dental aca...
 
orthodontic bracket prescription 1
orthodontic bracket prescription 1 orthodontic bracket prescription 1
orthodontic bracket prescription 1
 
orthodonticTraction of impacted maxillary canine and Piggyback technique
orthodonticTraction of impacted maxillary canine and Piggyback techniqueorthodonticTraction of impacted maxillary canine and Piggyback technique
orthodonticTraction of impacted maxillary canine and Piggyback technique
 
Space closure by frictionless mechanics 2 /certified fixed orthodontic course...
Space closure by frictionless mechanics 2 /certified fixed orthodontic course...Space closure by frictionless mechanics 2 /certified fixed orthodontic course...
Space closure by frictionless mechanics 2 /certified fixed orthodontic course...
 
Biomechanics of molar distalization
Biomechanics of molar distalizationBiomechanics of molar distalization
Biomechanics of molar distalization
 
Surgery First Orthognathic Approach (SFOA)
Surgery First Orthognathic Approach  (SFOA)Surgery First Orthognathic Approach  (SFOA)
Surgery First Orthognathic Approach (SFOA)
 
Molar distalization
Molar distalization Molar distalization
Molar distalization
 
Intrusion in orthodontics
Intrusion in orthodonticsIntrusion in orthodontics
Intrusion in orthodontics
 
MBT system in orthodontics /certified fixed orthodontic courses by Indian den...
MBT system in orthodontics /certified fixed orthodontic courses by Indian den...MBT system in orthodontics /certified fixed orthodontic courses by Indian den...
MBT system in orthodontics /certified fixed orthodontic courses by Indian den...
 
Molar distalisation in Orthodontics
Molar distalisation in OrthodonticsMolar distalisation in Orthodontics
Molar distalisation in Orthodontics
 
Anchorage management in orthodontics
Anchorage management in orthodonticsAnchorage management in orthodontics
Anchorage management in orthodontics
 

En vedette

Canine retraction in pre adjusted edgewise technique /certified fixed orthodo...
Canine retraction in pre adjusted edgewise technique /certified fixed orthodo...Canine retraction in pre adjusted edgewise technique /certified fixed orthodo...
Canine retraction in pre adjusted edgewise technique /certified fixed orthodo...Indian dental academy
 
Retraction mechanics
Retraction mechanicsRetraction mechanics
Retraction mechanicsTony Pious
 
Space closure in orthodontics by elastics
Space closure in orthodontics  by elasticsSpace closure in orthodontics  by elastics
Space closure in orthodontics by elasticsHawa Shoaib
 
biomechanics of space closure in orthodonticcs / fixed orthodontics courses
biomechanics of space closure in orthodonticcs / fixed orthodontics coursesbiomechanics of space closure in orthodonticcs / fixed orthodontics courses
biomechanics of space closure in orthodonticcs / fixed orthodontics coursesIndian dental academy
 
Sliding mechanics
Sliding mechanics   Sliding mechanics
Sliding mechanics paul3060
 
Space closure /certified fixed orthodontic courses by Indian dental academy
Space closure  /certified fixed orthodontic courses by Indian dental academy Space closure  /certified fixed orthodontic courses by Indian dental academy
Space closure /certified fixed orthodontic courses by Indian dental academy Indian dental academy
 
Canine retraction /certified fixed orthodontic courses by Indian dental academy
Canine retraction /certified fixed orthodontic courses by Indian dental academy Canine retraction /certified fixed orthodontic courses by Indian dental academy
Canine retraction /certified fixed orthodontic courses by Indian dental academy Indian dental academy
 
Rapid canine retraction and orthodontic treatment with dentoalveolar distract...
Rapid canine retraction and orthodontic treatment with dentoalveolar distract...Rapid canine retraction and orthodontic treatment with dentoalveolar distract...
Rapid canine retraction and orthodontic treatment with dentoalveolar distract...Dr Mujtaba Ashraf
 
Friction mechanics /certified fixed orthodontic courses by Indian dental aca...
Friction mechanics  /certified fixed orthodontic courses by Indian dental aca...Friction mechanics  /certified fixed orthodontic courses by Indian dental aca...
Friction mechanics /certified fixed orthodontic courses by Indian dental aca...Indian dental academy
 
Friction less mechanics in orthodontics /certified fixed orthodontic course...
Friction less mechanics in orthodontics   /certified fixed orthodontic course...Friction less mechanics in orthodontics   /certified fixed orthodontic course...
Friction less mechanics in orthodontics /certified fixed orthodontic course...Indian dental academy
 
Space closure 2 /certified fixed orthodontic courses by Indian dental academy
Space closure 2 /certified fixed orthodontic courses by Indian dental academy Space closure 2 /certified fixed orthodontic courses by Indian dental academy
Space closure 2 /certified fixed orthodontic courses by Indian dental academy Indian dental academy
 
Management of low angle case in orthodontics
Management of low angle case in orthodonticsManagement of low angle case in orthodontics
Management of low angle case in orthodonticsRavikanth lakkakula
 
Orthodontic Treatment Modalities
Orthodontic Treatment ModalitiesOrthodontic Treatment Modalities
Orthodontic Treatment ModalitiesDr.Mohamad Ghazi
 
orthodontic Wire bending principles / orthodontic courses /certified fixed or...
orthodontic Wire bending principles / orthodontic courses /certified fixed or...orthodontic Wire bending principles / orthodontic courses /certified fixed or...
orthodontic Wire bending principles / orthodontic courses /certified fixed or...Indian dental academy
 
Finishing and detailing /certified fixed orthodontic courses by Indian dental...
Finishing and detailing /certified fixed orthodontic courses by Indian dental...Finishing and detailing /certified fixed orthodontic courses by Indian dental...
Finishing and detailing /certified fixed orthodontic courses by Indian dental...Indian dental academy
 
Analisis mecanico del anclaje
Analisis mecanico del anclajeAnalisis mecanico del anclaje
Analisis mecanico del anclajeLeonardo Gualán
 
elastics orthodontics / fixed orthodontics courses
elastics orthodontics / fixed orthodontics courseselastics orthodontics / fixed orthodontics courses
elastics orthodontics / fixed orthodontics coursesIndian dental academy
 
Elastics & elastomerics /certified fixed orthodontic courses by Indian dental...
Elastics & elastomerics /certified fixed orthodontic courses by Indian dental...Elastics & elastomerics /certified fixed orthodontic courses by Indian dental...
Elastics & elastomerics /certified fixed orthodontic courses by Indian dental...Indian dental academy
 

En vedette (20)

En masse retraction jc
En masse retraction  jcEn masse retraction  jc
En masse retraction jc
 
Canine retraction in pre adjusted edgewise technique /certified fixed orthodo...
Canine retraction in pre adjusted edgewise technique /certified fixed orthodo...Canine retraction in pre adjusted edgewise technique /certified fixed orthodo...
Canine retraction in pre adjusted edgewise technique /certified fixed orthodo...
 
Retraction mechanics
Retraction mechanicsRetraction mechanics
Retraction mechanics
 
Space closure in orthodontics by elastics
Space closure in orthodontics  by elasticsSpace closure in orthodontics  by elastics
Space closure in orthodontics by elastics
 
biomechanics of space closure in orthodonticcs / fixed orthodontics courses
biomechanics of space closure in orthodonticcs / fixed orthodontics coursesbiomechanics of space closure in orthodonticcs / fixed orthodontics courses
biomechanics of space closure in orthodonticcs / fixed orthodontics courses
 
Sliding mechanics
Sliding mechanics   Sliding mechanics
Sliding mechanics
 
Space closure /certified fixed orthodontic courses by Indian dental academy
Space closure  /certified fixed orthodontic courses by Indian dental academy Space closure  /certified fixed orthodontic courses by Indian dental academy
Space closure /certified fixed orthodontic courses by Indian dental academy
 
Canine retraction /certified fixed orthodontic courses by Indian dental academy
Canine retraction /certified fixed orthodontic courses by Indian dental academy Canine retraction /certified fixed orthodontic courses by Indian dental academy
Canine retraction /certified fixed orthodontic courses by Indian dental academy
 
Bioprogressive therapy
Bioprogressive therapyBioprogressive therapy
Bioprogressive therapy
 
Rapid canine retraction and orthodontic treatment with dentoalveolar distract...
Rapid canine retraction and orthodontic treatment with dentoalveolar distract...Rapid canine retraction and orthodontic treatment with dentoalveolar distract...
Rapid canine retraction and orthodontic treatment with dentoalveolar distract...
 
Friction mechanics /certified fixed orthodontic courses by Indian dental aca...
Friction mechanics  /certified fixed orthodontic courses by Indian dental aca...Friction mechanics  /certified fixed orthodontic courses by Indian dental aca...
Friction mechanics /certified fixed orthodontic courses by Indian dental aca...
 
Friction less mechanics in orthodontics /certified fixed orthodontic course...
Friction less mechanics in orthodontics   /certified fixed orthodontic course...Friction less mechanics in orthodontics   /certified fixed orthodontic course...
Friction less mechanics in orthodontics /certified fixed orthodontic course...
 
Space closure 2 /certified fixed orthodontic courses by Indian dental academy
Space closure 2 /certified fixed orthodontic courses by Indian dental academy Space closure 2 /certified fixed orthodontic courses by Indian dental academy
Space closure 2 /certified fixed orthodontic courses by Indian dental academy
 
Management of low angle case in orthodontics
Management of low angle case in orthodonticsManagement of low angle case in orthodontics
Management of low angle case in orthodontics
 
Orthodontic Treatment Modalities
Orthodontic Treatment ModalitiesOrthodontic Treatment Modalities
Orthodontic Treatment Modalities
 
orthodontic Wire bending principles / orthodontic courses /certified fixed or...
orthodontic Wire bending principles / orthodontic courses /certified fixed or...orthodontic Wire bending principles / orthodontic courses /certified fixed or...
orthodontic Wire bending principles / orthodontic courses /certified fixed or...
 
Finishing and detailing /certified fixed orthodontic courses by Indian dental...
Finishing and detailing /certified fixed orthodontic courses by Indian dental...Finishing and detailing /certified fixed orthodontic courses by Indian dental...
Finishing and detailing /certified fixed orthodontic courses by Indian dental...
 
Analisis mecanico del anclaje
Analisis mecanico del anclajeAnalisis mecanico del anclaje
Analisis mecanico del anclaje
 
elastics orthodontics / fixed orthodontics courses
elastics orthodontics / fixed orthodontics courseselastics orthodontics / fixed orthodontics courses
elastics orthodontics / fixed orthodontics courses
 
Elastics & elastomerics /certified fixed orthodontic courses by Indian dental...
Elastics & elastomerics /certified fixed orthodontic courses by Indian dental...Elastics & elastomerics /certified fixed orthodontic courses by Indian dental...
Elastics & elastomerics /certified fixed orthodontic courses by Indian dental...
 

Similaire à En masse retraction and two step retraction of maxillary /certified fixed orthodontic courses by Indian dental academy

Midfacial Changes Through Anterior Maxillary Distraction Osteogenesis in.pptx
Midfacial Changes Through Anterior Maxillary Distraction Osteogenesis in.pptxMidfacial Changes Through Anterior Maxillary Distraction Osteogenesis in.pptx
Midfacial Changes Through Anterior Maxillary Distraction Osteogenesis in.pptxaamirbashir1992
 
Fixed and removable orthodontic appliance application for class III malocclus...
Fixed and removable orthodontic appliance application for class III malocclus...Fixed and removable orthodontic appliance application for class III malocclus...
Fixed and removable orthodontic appliance application for class III malocclus...iosrjce
 
10.1043@0003-321920030730730@ALMR2.0.CO2.pdf
10.1043@0003-321920030730730@ALMR2.0.CO2.pdf10.1043@0003-321920030730730@ALMR2.0.CO2.pdf
10.1043@0003-321920030730730@ALMR2.0.CO2.pdfThendralpraveen
 
2_5442874314619621444.pdf
2_5442874314619621444.pdf2_5442874314619621444.pdf
2_5442874314619621444.pdfssuser786c91
 
Functional genioplasty in growing patients
Functional genioplasty in growing patientsFunctional genioplasty in growing patients
Functional genioplasty in growing patientsDr Sylvain Chamberland
 
Pendulum appliance versus distal jet distalizing appliance.
Pendulum appliance  versus distal jet distalizing appliance.Pendulum appliance  versus distal jet distalizing appliance.
Pendulum appliance versus distal jet distalizing appliance.Sneh Kalgotra
 
Rapid maxillary expansion in growing patients.
Rapid maxillary expansion in growing patients.Rapid maxillary expansion in growing patients.
Rapid maxillary expansion in growing patients.Dr. Carlos Joel Sequeira.
 
Effects on the dental arch form using a /certified fixed orthodontic courses ...
Effects on the dental arch form using a /certified fixed orthodontic courses ...Effects on the dental arch form using a /certified fixed orthodontic courses ...
Effects on the dental arch form using a /certified fixed orthodontic courses ...Indian dental academy
 
transverse dentoskeletal features of anterior open bite in the mixed dentitio...
transverse dentoskeletal features of anterior open bite in the mixed dentitio...transverse dentoskeletal features of anterior open bite in the mixed dentitio...
transverse dentoskeletal features of anterior open bite in the mixed dentitio...Indian dental academy
 
early orthodonatic treatment - serial extraction revisited
early orthodonatic treatment - serial extraction revisited early orthodonatic treatment - serial extraction revisited
early orthodonatic treatment - serial extraction revisited Royal medical services - JOS
 
correction.pptx
correction.pptxcorrection.pptx
correction.pptxSPradhan10
 
Closer look at sarpe chamberland-proffit joms sept08
Closer look at sarpe chamberland-proffit joms sept08Closer look at sarpe chamberland-proffit joms sept08
Closer look at sarpe chamberland-proffit joms sept08Dr Sylvain Chamberland
 
2016 ghassemi-maxillary advancement versus man
2016 ghassemi-maxillary advancement versus man2016 ghassemi-maxillary advancement versus man
2016 ghassemi-maxillary advancement versus manKlinikum Lippe GmbH
 

Similaire à En masse retraction and two step retraction of maxillary /certified fixed orthodontic courses by Indian dental academy (20)

distalización molar
distalización molardistalización molar
distalización molar
 
Midfacial Changes Through Anterior Maxillary Distraction Osteogenesis in.pptx
Midfacial Changes Through Anterior Maxillary Distraction Osteogenesis in.pptxMidfacial Changes Through Anterior Maxillary Distraction Osteogenesis in.pptx
Midfacial Changes Through Anterior Maxillary Distraction Osteogenesis in.pptx
 
Fixed and removable orthodontic appliance application for class III malocclus...
Fixed and removable orthodontic appliance application for class III malocclus...Fixed and removable orthodontic appliance application for class III malocclus...
Fixed and removable orthodontic appliance application for class III malocclus...
 
10.1043@0003-321920030730730@ALMR2.0.CO2.pdf
10.1043@0003-321920030730730@ALMR2.0.CO2.pdf10.1043@0003-321920030730730@ALMR2.0.CO2.pdf
10.1043@0003-321920030730730@ALMR2.0.CO2.pdf
 
Chromosome Arch JC
Chromosome Arch JCChromosome Arch JC
Chromosome Arch JC
 
2_5442874314619621444.pdf
2_5442874314619621444.pdf2_5442874314619621444.pdf
2_5442874314619621444.pdf
 
Functional genioplasty in growing patients
Functional genioplasty in growing patientsFunctional genioplasty in growing patients
Functional genioplasty in growing patients
 
Pendulum appliance versus distal jet distalizing appliance.
Pendulum appliance  versus distal jet distalizing appliance.Pendulum appliance  versus distal jet distalizing appliance.
Pendulum appliance versus distal jet distalizing appliance.
 
7716
77167716
7716
 
Rapid maxillary expansion in growing patients.
Rapid maxillary expansion in growing patients.Rapid maxillary expansion in growing patients.
Rapid maxillary expansion in growing patients.
 
6. class 3.pdf
6. class 3.pdf6. class 3.pdf
6. class 3.pdf
 
Alveolar Bone Grafting
Alveolar Bone Grafting Alveolar Bone Grafting
Alveolar Bone Grafting
 
Effects on the dental arch form using a /certified fixed orthodontic courses ...
Effects on the dental arch form using a /certified fixed orthodontic courses ...Effects on the dental arch form using a /certified fixed orthodontic courses ...
Effects on the dental arch form using a /certified fixed orthodontic courses ...
 
transverse dentoskeletal features of anterior open bite in the mixed dentitio...
transverse dentoskeletal features of anterior open bite in the mixed dentitio...transverse dentoskeletal features of anterior open bite in the mixed dentitio...
transverse dentoskeletal features of anterior open bite in the mixed dentitio...
 
early orthodonatic treatment - serial extraction revisited
early orthodonatic treatment - serial extraction revisited early orthodonatic treatment - serial extraction revisited
early orthodonatic treatment - serial extraction revisited
 
Part 10 impacted teeth
Part 10 impacted teethPart 10 impacted teeth
Part 10 impacted teeth
 
correction.pptx
correction.pptxcorrection.pptx
correction.pptx
 
Closer look at sarpe chamberland-proffit joms sept08
Closer look at sarpe chamberland-proffit joms sept08Closer look at sarpe chamberland-proffit joms sept08
Closer look at sarpe chamberland-proffit joms sept08
 
ContentServer.pdf
ContentServer.pdfContentServer.pdf
ContentServer.pdf
 
2016 ghassemi-maxillary advancement versus man
2016 ghassemi-maxillary advancement versus man2016 ghassemi-maxillary advancement versus man
2016 ghassemi-maxillary advancement versus man
 

Plus de Indian dental academy

Indian Dentist - relocate to united kingdom
Indian Dentist - relocate to united kingdomIndian Dentist - relocate to united kingdom
Indian Dentist - relocate to united kingdomIndian dental academy
 
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...Indian dental academy
 
Invisalign -invisible aligners course in india
Invisalign -invisible aligners course in india Invisalign -invisible aligners course in india
Invisalign -invisible aligners course in india Indian dental academy
 
Invisible aligners for your orthodontics pratice
Invisible aligners for your orthodontics praticeInvisible aligners for your orthodontics pratice
Invisible aligners for your orthodontics praticeIndian dental academy
 
Development of muscles of mastication / dental implant courses
Development of muscles of mastication / dental implant coursesDevelopment of muscles of mastication / dental implant courses
Development of muscles of mastication / dental implant coursesIndian dental academy
 
Corticosteriods uses in dentistry/ oral surgery courses  
Corticosteriods uses in dentistry/ oral surgery courses  Corticosteriods uses in dentistry/ oral surgery courses  
Corticosteriods uses in dentistry/ oral surgery courses  Indian dental academy
 
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Indian dental academy
 
Diagnosis and treatment planning in completely endntulous arches/dental courses
Diagnosis and treatment planning in completely endntulous arches/dental coursesDiagnosis and treatment planning in completely endntulous arches/dental courses
Diagnosis and treatment planning in completely endntulous arches/dental coursesIndian dental academy
 
Properties of Denture base materials /rotary endodontic courses
Properties of Denture base materials /rotary endodontic coursesProperties of Denture base materials /rotary endodontic courses
Properties of Denture base materials /rotary endodontic coursesIndian dental academy
 
Use of modified tooth forms in complete denture occlusion / dental implant...
Use of modified  tooth forms  in  complete denture occlusion / dental implant...Use of modified  tooth forms  in  complete denture occlusion / dental implant...
Use of modified tooth forms in complete denture occlusion / dental implant...Indian dental academy
 
Dental luting cements / oral surgery courses  
Dental   luting cements / oral surgery courses  Dental   luting cements / oral surgery courses  
Dental luting cements / oral surgery courses  Indian dental academy
 
Dental casting alloys/ oral surgery courses  
Dental casting alloys/ oral surgery courses  Dental casting alloys/ oral surgery courses  
Dental casting alloys/ oral surgery courses  Indian dental academy
 
Dental casting investment materials/endodontic courses
Dental casting investment materials/endodontic coursesDental casting investment materials/endodontic courses
Dental casting investment materials/endodontic coursesIndian dental academy
 
Dental casting waxes/ oral surgery courses  
Dental casting waxes/ oral surgery courses  Dental casting waxes/ oral surgery courses  
Dental casting waxes/ oral surgery courses  Indian dental academy
 
Dental ceramics/prosthodontic courses
Dental ceramics/prosthodontic coursesDental ceramics/prosthodontic courses
Dental ceramics/prosthodontic coursesIndian dental academy
 
Dental implant/ oral surgery courses  
Dental implant/ oral surgery courses  Dental implant/ oral surgery courses  
Dental implant/ oral surgery courses  Indian dental academy
 
Dental perspective/cosmetic dentistry courses
Dental perspective/cosmetic dentistry coursesDental perspective/cosmetic dentistry courses
Dental perspective/cosmetic dentistry coursesIndian dental academy
 
Dental tissues and their replacements/ oral surgery courses  
Dental tissues and their replacements/ oral surgery courses  Dental tissues and their replacements/ oral surgery courses  
Dental tissues and their replacements/ oral surgery courses  Indian dental academy
 

Plus de Indian dental academy (20)

Indian Dentist - relocate to united kingdom
Indian Dentist - relocate to united kingdomIndian Dentist - relocate to united kingdom
Indian Dentist - relocate to united kingdom
 
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
 
Invisalign -invisible aligners course in india
Invisalign -invisible aligners course in india Invisalign -invisible aligners course in india
Invisalign -invisible aligners course in india
 
Invisible aligners for your orthodontics pratice
Invisible aligners for your orthodontics praticeInvisible aligners for your orthodontics pratice
Invisible aligners for your orthodontics pratice
 
online fixed orthodontics course
online fixed orthodontics courseonline fixed orthodontics course
online fixed orthodontics course
 
online orthodontics course
online orthodontics courseonline orthodontics course
online orthodontics course
 
Development of muscles of mastication / dental implant courses
Development of muscles of mastication / dental implant coursesDevelopment of muscles of mastication / dental implant courses
Development of muscles of mastication / dental implant courses
 
Corticosteriods uses in dentistry/ oral surgery courses  
Corticosteriods uses in dentistry/ oral surgery courses  Corticosteriods uses in dentistry/ oral surgery courses  
Corticosteriods uses in dentistry/ oral surgery courses  
 
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
 
Diagnosis and treatment planning in completely endntulous arches/dental courses
Diagnosis and treatment planning in completely endntulous arches/dental coursesDiagnosis and treatment planning in completely endntulous arches/dental courses
Diagnosis and treatment planning in completely endntulous arches/dental courses
 
Properties of Denture base materials /rotary endodontic courses
Properties of Denture base materials /rotary endodontic coursesProperties of Denture base materials /rotary endodontic courses
Properties of Denture base materials /rotary endodontic courses
 
Use of modified tooth forms in complete denture occlusion / dental implant...
Use of modified  tooth forms  in  complete denture occlusion / dental implant...Use of modified  tooth forms  in  complete denture occlusion / dental implant...
Use of modified tooth forms in complete denture occlusion / dental implant...
 
Dental luting cements / oral surgery courses  
Dental   luting cements / oral surgery courses  Dental   luting cements / oral surgery courses  
Dental luting cements / oral surgery courses  
 
Dental casting alloys/ oral surgery courses  
Dental casting alloys/ oral surgery courses  Dental casting alloys/ oral surgery courses  
Dental casting alloys/ oral surgery courses  
 
Dental casting investment materials/endodontic courses
Dental casting investment materials/endodontic coursesDental casting investment materials/endodontic courses
Dental casting investment materials/endodontic courses
 
Dental casting waxes/ oral surgery courses  
Dental casting waxes/ oral surgery courses  Dental casting waxes/ oral surgery courses  
Dental casting waxes/ oral surgery courses  
 
Dental ceramics/prosthodontic courses
Dental ceramics/prosthodontic coursesDental ceramics/prosthodontic courses
Dental ceramics/prosthodontic courses
 
Dental implant/ oral surgery courses  
Dental implant/ oral surgery courses  Dental implant/ oral surgery courses  
Dental implant/ oral surgery courses  
 
Dental perspective/cosmetic dentistry courses
Dental perspective/cosmetic dentistry coursesDental perspective/cosmetic dentistry courses
Dental perspective/cosmetic dentistry courses
 
Dental tissues and their replacements/ oral surgery courses  
Dental tissues and their replacements/ oral surgery courses  Dental tissues and their replacements/ oral surgery courses  
Dental tissues and their replacements/ oral surgery courses  
 

Dernier

"Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio..."Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio...Sujoy Dasgupta
 
ayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptPradnya Wadekar
 
blood bank management system project report
blood bank management system project reportblood bank management system project report
blood bank management system project reportNARMADAPETROLEUMGAS
 
MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.whalesdesign
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu Medical University
 
Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.kishan singh tomar
 
High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)kishan singh tomar
 
Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Peter Embi
 
How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyZurück zum Ursprung
 
AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectiondrhanifmohdali
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .Mohamed Rizk Khodair
 
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfSGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfHongBiThi1
 
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfSGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfHongBiThi1
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptPradnya Wadekar
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondSujoy Dasgupta
 
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdfSGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdfHongBiThi1
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024EwoutSteyerberg1
 

Dernier (20)

GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...
GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...
GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...
 
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio..."Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
 
ayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologyppt
 
blood bank management system project report
blood bank management system project reportblood bank management system project report
blood bank management system project report
 
MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu
 
Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.
 
High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)
 
Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024
 
How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturally
 
AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissection
 
American College of physicians ACP high value care recommendations in rheumat...
American College of physicians ACP high value care recommendations in rheumat...American College of physicians ACP high value care recommendations in rheumat...
American College of physicians ACP high value care recommendations in rheumat...
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .
 
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfSGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
 
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfSGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.ppt
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and Beyond
 
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdfSGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
 
Rheumatoid arthritis Part 1, case based approach with application of the late...
Rheumatoid arthritis Part 1, case based approach with application of the late...Rheumatoid arthritis Part 1, case based approach with application of the late...
Rheumatoid arthritis Part 1, case based approach with application of the late...
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024
 

En masse retraction and two step retraction of maxillary /certified fixed orthodontic courses by Indian dental academy

  • 1. En Masse Retraction and Two- Step Retraction of Maxillary Anterior Teeth in Adult Class I Women A Comparison of Anchorage Loss INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. INTRODUCTION  Lip protrusion is one of the major chief complaint in adults.  Extracting the first four premolars and retracting the anterior segments with maximum anchorage is the most common way to reduce lip protrusion and to straighten the patient’s profile.  Accurate prediction of anchorage loss is very critical. www.indiandentalacademy.com
  • 3.  Tweed  Storey and Smith  Begg  Controversies  Proffit and Fields  Roth  Kuhlberg www.indiandentalacademy.com
  • 4.  Staggers and Germane  Burstone  Despite controversies of anchorage preservation, there have been a few studies about comparing the two paradigms.  The purpose of this study was to compare the degree of anchorage loss of the posterior teeth and the amount of retraction of the anterior teeth between en masse retraction and two-step retraction of the maxillary anterior teeth in Class I malocclusion patients with lip protrusion. www.indiandentalacademy.com
  • 5. MATERIALS AND METHODS  Initial sample  Final samples selection criteria: 1) Women older than 17 years to eliminate potential influence of sex and growth; 2) Class I malocclusion (0< ANB<5) with normodivergent pattern (22<FMA<31), lip protrusion (Ricketts’ lower lip to esthetic line >2 mm), labioversed upper incisor (U1 to palatal plane >105), and less than 4 mm crowding in each arch; 3) Four first premolars extraction cases; 4) Use of a 0.022-inch straight wire appliance with Roth setup (fully bonded to second molars). www.indiandentalacademy.com
  • 6.  Thirty patients fulfilled the criteria and were allocated into group 1 (n=15, mean age=21.4 years, en masse retraction, using sliding mechanics, as described by Bennett and McLaughlin).  Group 2 (n=15, mean age=24.6 years, two-step retraction, with sliding mechanics for canine retraction and loop mechanics for the upper incisor retraction).  After matching gender, age, skeletal, dental, and soft tissue relationships and treatment appliance www.indiandentalacademy.com
  • 7.  Lateral cephalometric radiographs were taken before (T1) and after treatment (T2).  All lateral cephalograms were traced by one investigator.  All traces were digitized by means of a graphic tablet using a program developed for this study with an IBM-compatible computer. www.indiandentalacademy.com
  • 8. Figure 1. Landmarks and reference planes used for this study. 1, nasion (N); 2, sella (S); 3, orbitale (Or); 4, porion (Po); 5, articulare (Ar); 6, gonion (Go); 7, menton (Me); 8, gnathion (Gn); 9, pognion (Pog); 10, anterior nasal spine (ANS); 11, posterior nasal spine(PNS); 12, pterygoid point (Pt point); 13, subspinale (point A); 14, supramentale (point B); 15, upper incisor edge (U1E); 16, upper incisor root apex (U1A); 17, center of maxillary first molar crown on occlusal surface (U6C); 18, most mesial point of mesial surface of maxillary first molar crown (U6M); 19, mesiobuccal root apex of maxillary first molar (U6A); 20, furcation of maxillary first molar (U6F);21, vertical reference planewww.indiandentalacademy.com
  • 9. Figure 2. (a–c) Skeletal variables. Skeletal horizontal variables: 1, SNA; 2, SNB; 3, ANB; 4, facial angle (N-Pog to F H plane); 5, anteroposterior dysplasia indicator (APDI); 6, Wits appraisal. Skeletal vertical variables: 7, Bjork sum; 8, facial height ratio (posterior facial height/anterior facial height X100); 9, Frankfort mandibular plane angle (FMA). www.indiandentalacademy.com
  • 10. Figure 3. (a–c) Anchorage variables. (a) 1, U1 to PP ; 2, U6 to PP, (b) 3, U1E-Hor: the horizontal distance from U1E to PTV (mm); 4, U1A-Hor: the horizontal distance from U1A to PTV (mm); 5, U6M-Hor: the horizontal distance from U6M to PTV (mm); 6, U6AHor: the distance from U6A to PTV (mm), (c); 7, U1E-Ver: the vertical distance from U1E to palatal plane (mm); 8, U1A-Ver: the vertical distance from U1A to palatal plane (mm); 9, U6C-Ver: the vertical distance from U6C to palatal plane (mm); 10, U6F-Ver: the vertical distance from U6F to palatal plane (mm).www.indiandentalacademy.com
  • 11.  Dahlberg’s formula for error determination  Comparison of skeletal variables between groups 1 and 2 at T1,  The time of retraction between groups 1 and 2,  Anchorage variables between groups 1 and 2 at T1 and T2, and  Changes of anchorage variables during T2 and T1 were evaluated by independent t-tests. www.indiandentalacademy.com
  • 12. RESULTS  skeletal vertical variables in group 2 showed a relatively more hypodivergent pattern than in group 1 www.indiandentalacademy.com
  • 13.  Although the mean time of retraction in group 2 was longer than in group 1, there was no significant difference in the time of retraction between groups 1 and 2 www.indiandentalacademy.com
  • 14.  The anchorage variables at T1 showed no significant differences between group 1 and group 2. At T2, there were also no significant differences between the two groups except U1A-Hor. U1A-Hor showed that the upper incisor root apex in group 2 was farther from the PTV than in group 1 www.indiandentalacademy.com
  • 15.  Although there was no significant difference in the amount of change in the horizontal position of the upper incisal edge (U1E-Hor) between the two groups, the amount of change in the vertical position of the upper incisal edge (U1E-Ver) showed a significant difference.  The reason could be due to downward movement of the upper incisal edge of group 2, which was originally positioned more superiorly.  However, the vertical position of the upper incisal edge of group 1 was well maintained. www.indiandentalacademy.com
  • 16.  There were no significant differences in the amount of changes in the upper molar  Bodily and mesial movements of the upper molars were found in both groups  Approximately 4 mm of the retraction of the upper incisal edges resulted from 1 mm of anchorage loss in the upper molars in both groups www.indiandentalacademy.com
  • 17. DISCUSSION  Since it is known that patients with a hypodivergent facial type have stronger natural anchorage than those with a hyperdivergent one, group 2 might have a better tendency of natural anchorage preservation than group 1.  However, the fact that there was no difference in anchorage loss of the upper molar suggests that two-step retraction takes only more time to close the extraction space without advantage of anchorage preservation. www.indiandentalacademy.com
  • 18.  Maximum anchorage  The upper incisors were retracted in group 1 with a combination of tipping and bodily movement.  However, the upper incisor in group 2 moved in a relatively uncontrolled tipping manner and showed a resultant downward movement of the upper incisal edge www.indiandentalacademy.com
  • 19.  The fact that approximately 4 mm of the retraction of upper incisal edges resulted from 1 mm of anchorage loss of the upper molars in both groups may be helpful when diagnosing lip protrusion patients and estimating soft tissue change for them.  If, in lip protrusion cases, more retraction of the anterior teeth is needed than the predicted amounts, additional anchorage reinforcement with headgear or orthodontic miniscrews would be necessary. www.indiandentalacademy.com
  • 20. CONCLUSIONS  No significant differences existed in the degree of anchorage loss of the upper posterior teeth and the amount of retraction of the upper anterior teeth associated with en masse retraction and two-step retraction of the anterior teeth.  When choosing retraction mechanics, it is necessary to consider additional aspects such as the inclination and vertical position of the anterior teeth rather than anchorage loss. www.indiandentalacademy.com