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BURSTONE & Friends Un Pozzo per L'Etiopia Firenze 28-29 Settembre 2012 Gabriele floria

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L'espansione delle arcate dentali mediante apparecchi linguali individualizzati con sistema Incognito 3M Unitek.

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BURSTONE & Friends Un Pozzo per L'Etiopia

Firenze 28-29 Settembre 2012

Gabriele floria

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Il cambiamento e’ automatico, il progresso no.

Anthony Robbins

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Se dedicarsi all’ortodonzia linguale richiede studio, sacrificio, rischio di fallimenti, e delusioni...... perche

lo facciamo ?

1) per il paziente ?2) per guadagnare di piu ?

3) per crescere ed evolversi ?

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“Chiunque smetta di imparare e’ vecchio, che abbia venti o ottant’anni.

Chiunque continua ad imparare resta giovane,

la piu grande cosa nella vita e’ mantenere la propria mente giovane.”

Henry Ford

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Dottore, .....perche’ non l’ortodonzia linguale?

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Incontriamoci con un sorriso e una volta che avremo cominciato l'un l'altro ad amarci

diverrà naturale fare qualcosa per gli altri.

(Madre Teresa di Calcutta) 

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DIFFUSIONE MONDIALE ORTODONZIA LINGUALE

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Starting lingual cases

Europe 2004 => 6000 lingual cases2% of total ortho cases

Fastidio nel parlareIrritazioni linguali

Problemi nella masticazione

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FonazioneMasticazione

Contatto linguale

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Tutti sanno che una cosa e’ impossibile da realizzare, finche’ non arriva uno sprovveduto

che non lo sa, e la inventa.

Albert Einstein

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A New Bracket System for Lingual OrthodonticTreatmentPart 1: Theoretical Background and Development

Journal of Orofacial OrthopedicsFortschritte der Kieferorthopädie

AbstractBackground and Method: This paper presents a new lingualbracket system differing fundamentally both in design and inmanufacturing methods from existing appliances. Using state-ofthe-art CAD/CAM technology, the two normally separate processesof bracket production and bracket positioning are fused intoone unit. In this process, the demand for maximum individualitywith simultaneously minimized space requirements is put consistentlyinto practice.Results and Conclusion: Improved patient comfort, simplifiedrebonding in the event of bracket loss, and enhanced finishingprecision are the improvements resulting for the course of treatment.In addition, bracket manufacture by a Rapid Prototypingtechnique permits direct transfer to clinically purposeful furtherdevelopments.Key Words: Lingual orthodontics · Lingual bracketsystem · Bracket manufacture · Individualized bracketbase · Vertical slot · Patient comfort

Department of Orthodontics, University of Munster, Germany;Private practice, Bad Essen, Germany.Received: January 3, 2002; accepted: March 4, 2002

2002 inizio

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Nell’articolo illustrava tutto il

sistema

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L’utilizzo del ROBOT per la individualizzazione dei archi

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I primi casi trattati con i nuovi brackets

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Archwire

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Archwire

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Customized brackets and archwires for lingualorthodontic treatmentDirk Wiechmann, DDS,a1 Volker Rummel, DDS,b Andrea Thalheim, DDS,c Jean-Stefane Simon, DDS,d andLital Wiechmann, DDSe

Bad Essen and Essen, Germany, and Marseille, FranceAfter 20 months of clinical testing and more than 600 bonded arches, brief interim conclusions can be drawnon treatment with a new lingual bracket system, one that differs fundamentally from conventional appliancesin both design and manufacture. The demand for maximum individuality is met by using state-of-the-artcomputer-aided design/computer-aided manufacturing technology to fuse the 2 normally separate processesof bracket fabrication and bracket positioning. Both the brackets and the pertinent archwires arecustomized. Additional advantages of the system include direct and thus simplified rebonding in the eventof bracket loss, more precise finishing, and enhanced patient comfort. (Am J Orthod Dentofacial Orthop2003;124:593-9)

Am. J. Orthod. Dentofacial Orthop2003;124:593-9D.Wiechmann...

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miglioramenti nella costruzione dei bracket

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nuova tecnologia per la fabricazione dei brackets

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Advantages of Incognito Technique

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Advantages of Incognito Technique

• No Bracket stock

• Bracket Design

• Bracket slot precision

• Patient comfort

• Brackets re-bonding procedure

• Archwire

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Advantages of Incognito Technique

• No Bracket stock

• Bracket Design

• Bracket slot precision

• Patient comfort

• Brackets re-bonding procedure

• Archwire

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Bracket Design

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Bracket Design

7th Generation Incognito

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Bracket Design

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Bracket Design

Easy RebondingCrown or Bridge

Occlusal guide for individual bondingMirroring

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Advantages of Incognito Technique

• No Bracket stock

• Bracket Design

• Bracket slot precision

• Patient comfort

• Brackets re-bonding procedure

• Archwire

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Slot Real Size

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Slot Real Size

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Slot Real Size

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Archwire

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Archwire

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Archwire

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Archwire Selection

Efficienza e Velocità

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Archwire Selection

Diverse leghe:

- CuNiTi per allineamento e livellamento

- Stainless Steel per torque e scorrimento

- TMA (beta titanio) per la finitura

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Archwire SelectionMa la sequenza crescente nella sezione degli archi è una regola sempre valida ?

Si può partire con un arco rettangolare prima di un arco tondo ?

La modificazione della forma d’arcata deve avvenire alla fine o all’inizio del trattamento ?

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Modificare la forma di arcata

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Paziente 1965 Marco

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Paziente 1773 LauraPrima classe sch.Deviazione linea interincisiva inf.

doppio scissor bitedurata trattamento mesi

17

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Paziente MS1864 Floriana

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24 aprile 30 agosto

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Advantages of Lingual Customized Orthodontics

• Patient acceptance

• Less risk of caries

• Easier treatment protocols

• Accuracy and predictability

• Patient comfort

• Expansion capability

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Conclusioni:

Se le arcate dentarie fossero modificabili come la cera

morbida di un typodont, per allargarle con le mani, le

spingereste dall’interno o le tirereste dall’esterno ?

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L’ortodonzia linguale è sempre stata un potente mezzo ortodontico

anche per creare espansione, ma ciò che fino ad oggi è mancato sono

stati dei mezzi in grado di controllare con esattezza che le

forze applicate portassero a risultati precisi e predicibili, senza infastidire

il paziente ne fare impazzire l’operatore.

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“La potenza è nulla senza il controllo”

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anche il postulato che vede la terapia fissa partire con archi superelastici tondi e leggeri per poi salire negli spessori, deve essere rivisto in tecnica

linguale laddove si voglia ottenere una rimodellazione della forma d’arcata prima

ancora di un allineamento e di un livellamento dentale.

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dal 2006

120 casi di ortodonzia linguale individualizzata

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Grazie per l’attenzione

[email protected] - www.floria.it