CASE REPORT ABC Fig. 17 A-C: Final results after 16 months of treatment. Fig. 21: Cephalometric measures based on Ricketts, Jarabak and McNamara Jr. analysis. ABC AB Fig. 18 A-D: AB C D Fig. 22 A-D: At the first appointment anterior teeth were bracketed, both archwires were placed, nickel-titanium and the Original Wire, plus Class II elastics. D Final view: Frontal view (A), upper incisor exposure (B), smiling (C), and lateral view (D). C D ABC Fig. 23 A-C: One month later overjet has decreased but we Fig. 19 A-D: Initial photographs. Frontal view (A), upper incisor exposure (B), smiling (C), and lateral view (D). continue with two archwires. AB ABC Fig. 24 A-C: Medium (Pink) 3/8” elastics placed to replace the (Yellow) 5/16” to complete the overjet correction. CD The profile, upper lip and chin now all had a harmo-nious relationship that differed from the start of treat-ment. (Fig.18). SSW Technique with Self-Ligating Brackets With the advent of self-ligating brackets, terms like low friction, sliding, binding, and light forces returned to the orthodontic world. A lot of orthodontists, using self-ligating brackets started working with Class II elastics, thinner archwires and sliding mechanics. However, many problems started occurring such as losing torque and bite deepening. Also, since the prescription of self-ligating brackets are the same as straight wire all the same canine prescription problems occurred as well with these brackets. Nevertheless, we have realized that when the canine self-ligating archwire slot is in a horizontal position, all those effects don't happen. This is because the self-ligat-ing brackets are nothing but a tube, and the tube permits the tooth to make a bodily movement. For achieving this movement, we must incorporate a single bend in the archwire that will oppose the inclination tendency (moment of force) caused by the Class II elastics. Therefore, when a canine is in an uprighted or distal position, even with self-ligating brackets, the canine bracket must be replaced by a Tip-Edge bracket. www.orthodontics.com Fig. 20 A-D: Intra-oral views show a full Class II malocclusion in both arches with severe overjet. Differential Straight Arch Technique. Also, the straight-wire brackets on incisors do not restrain the distal sliding movement of the upper anterior teeth.Next the wire sequencing involved placing a 0.019” x 0.025” stainless steel archwire with exactly the same shape that the previ-ous 0.020” Premier Plus archwire had, this works to adjust the anterior tooth torque. Note that the upper premolars have achieved excellent occlusion with the lowers without having any brackets bonded to them (Fig. 16). After 16 months, the treatment was finished without bonding any brackets on the upper premolars. Also, in this case the second molars were not bonded. Even though, the SSW Technique protocol recommends bonding all the second molars from the very beginning of treatment, espe-cially in a severe overbite malocclusion (Fig. 17). Fall 2020 23
Journal of the American Orthodontic Society Fall 2020: Page 23
