Stage III checks

CHAPTER 19 Stage III checks

The inspection interval in Stage III is approximately 2 months. As the entire torquing and tip correcting process is essentially built-in, and self-limits automatically, progress and maintenance checks are normally all that is required; it is unusual for an archwire to require removal, except for running repairs or possibly upgrading a deep tunnel auxiliary.

At each check visit, the following should be observed:

Progress of tip and torque. Both proceed concurrently. A Tip-Edge bracket can be seen to have self-limited when its upper and lower surfaces lie parallel to the archwire (Fig. 19.1). Always assess the root angulations as well as the brackets. Lack of progress is almost invariably due to inadequate mesio-distal space in the arch. It may also be due to incorrect bracket angulation, causing the bracket to self-limit before the desired root angle is achieved. An advantage of Plus is that all bracketed teeth are maintained in torque and tip control until the last one is finished. There is therefore no temptation to remove springs from the teeth that look finished, while waiting for the rest. This used to allow some individual root relapse, before Plus.
Available space in the arch. Except towards the end of root uprighting, it is essential to ensure that up to 1 mm of space exists somewhere in each arch (Fig. 19.2). As explained previously, premolar and canine crowns require additional arch length as they upright, and failure to provide this will stifle the action of the uprighting, whether with Plus or Side-Winders. The procedure for introducing extra wire from the back is described presently. Tight or overlapping contacts are sure signs that a limited amount of extra space is needed to make further progress (Fig. 19.3).

Dec 31, 2014 | Posted by in Orthodontics | Comments Off on Stage III checks
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