The specialty of orthodontics is full of techniques and camps, each offering specific protocols to achieve the best results. The Damon System is different; it's a philosophy that focuses on the why to get to the how, challenging orthodontists to think and reason their way to a successful finish. The philosophy is predicated on the notion that teeth treated with passive self-ligation (PSL) move faster than teeth treated with traditionally ligated brackets; the increased play between the slot and bracket reduces friction and enables greater movement, even with low forces. This low-force, low-friction system is also more biologically sound for the periodontal apparatus, which is good news for the patient and for treatment stability. This book is the how-to guide for PSL in orthodontics, from diagnosis to bracket placement to finishing—and everything in between.
Author(s): Nasib Balut
Edition: 1
Publisher: Quintessence Publishing Company, Incorporated
Year: 2022
Language: English
Tags: Dentistry; Orthodontics; Passive Self-Ligation
Cover
Title Page
Dedication
Library of Congress Cataloging-in-Publication Data
Frontmatter
Contents
Foreword
Preface
Contributors
Chapter 1, Diagnosis Using the BEST Philosophy
What Is BEST?
General Anatomical Assessment Using CBCT
Anatomical Assessment of Paranasal Sinuses and Upper Airways
Static and Dynamic Assessment of the TMJ
Comprehensive history taking
Meticulous clinical examination
Assessment of Teeth and Their Cortical Bone
3D Cephalometric Analysis
Esthetic Assessment
Assessment of Records Before Removing Appliances
Clinical Case
General anatomical assessment using CBCT
Anatomical assessment of paranasal sinuses and upper airways
Static and dynamic assessment of the TMJ
Assessment of teeth and their cortical bone
3D cephalometric analysis
Esthetic assessment
Treatment plan
Assessment of records before removing appliances using BEST
BEST Forms
References
Chapter 2, Damon System Philosophy
Damon System Philosophy
Friction
Lip bumper eff ect
Posterior transverse adaptation
Anchorage
“A second chance”
Neutral Zone
Orbicularis Activation Hypothesis :Differential Forces
Light Forces
Damon Passive Self-Ligating Brackets
Four Treatment Phases
Phase 1: Light round CuNiTi archwires
Phase 2: High-technology rectangular CuNiTi archwires
Phase 3: Major mechanics – “Heavy”rectangular SS or TMA archwires
Phase 4: Finishing and detailing
Extractions in the Damon System
Conclusion
References
Chapter 3, PSL Bracket Placement
Strategies for Bracket Placement with a Smile Esthetics Approach
Smile height
Smile arc
Anterior teeth torque
Suggested Guidelines for Bracket Placement
1. Evaluate the shape and size of each clinical crown
2. Evaluate the initial gingival shape and contour
3. Place brackets on the maxillary arch before the mandibular arch
4. Placement of brackets in the mandibular arch
Clinical case
Ideal Tooth Shape and Size
Tooth width
Tooth height
Clinical cases
Conclusion
References
Chapter 4, Torque Selection Protocol Using Damon System Brackets
What Is Torque?
Factors to Consider for Torque Selection
Periodontal biotype
Biomechanics
Initial inclination of anterior teeth
Desired final inclination of anterior teeth
Class I Nonextraction
Class I with Extractions
Clinical case
Class II, Division 1
Class II, Division 2
Clinical case
Class III
Clinical case
Open Bite
Clinical case
Smile Esthetics
Conclusion
References
Chapter 5, Disocclusion with Bite Turbos
What Is a Bite Turbo?
Why Use Bite Turbos?
Condylar position
Materials and Placement
Materials
Placement
Anterior Bite Turbos
Clinical case
Posterior Bite Turbos
Clinical case
Removal
References
Chapter 6, Intermaxillary Elastics and PSL
Application of Elastics in the DamonSystem
Advantages and Disadvantages of Intermaxillary Elastics
Advantages
Disadvantages
Types of Elastics
Classification of Elastics
Class I Elastics
Occlusal “O” type elastic
Class II Elastics
Indications for Class II elastics
Triangular Class II elastic
Class III Elastics
Indications for Class III elastics
Other Configurations of Intermaxillary Elastics
Rectangular or box elastic
U-shaped elastic
Delta elastic
V-shaped elastic
“M” or “W” elastics
Spaghetti elastic (W with a tail, M with atail)
Elastics for crossbite (lateral occlusion)
Asymmetric elastics
Clinical Cases
Case 1
Case 2
Conclusion
References
Chapter 7, Archwire Sequence with the Damon System
Wires and Metallurgy
Alloys
Stainless steel
CuNiTi
Titanium-molybdenum and B-titanium
Arch Form
Stops
Auxiliary Springs (Coil Springs)
How is the spring activated and how often?
Should trapped teeth be ligated when space is being created to integrate them into the arch?
Class III cases
Four Treatment Phases
Phase 1: Light Round CuNiTi Archwires
Objectives and philosophy
How long should the second archwire be in place during the first phase of round archwires?
Tandem/non-tandem mechanics
Phase 2: High-Technology Rectangular CuNiTi Archwires
Objectives and philosophy
When do we use the 0.016 × 0.025 CuNiTi archwire?
Taking a panoramic radiograph of the progress
Anterior space consolidation
Phase 3: Major Mechanics with Heavy Rectangular Archwires (SS or TMA)
Objectives and philosophy: What about the arch form?
0.019 × 0.025 SS archwires
0.016 × 0.025 SS archwires
Low-friction TMA archwires
Auxiliary archwires in the third phase of treatment
Phase 4: Finishing and Detailing
Objectives and philosophy
Clinical Cases
Case 1
Case 2
Conclusion
References
Chapter 8, Early Treatment with PSL
Important Questions RegardingEarly Treatment
Are the benefits significant enough to expose primary teeth to early exfoliation?
What are the true benefits?
Is early treatment effective and stable in the long term?
Fundamental Factors That Ensure Successful Therapy
Attaining the correct diagnosis
Using different diagnostic tools
Recognizing the growth and developmental stages
Maxillary and Mandibular Development
Transverse dimension
Shape of the dental arches
Identifying the Ideal Time to Start Treatment
Intercepting Dentoalveolar, Muscular, and Skeletal Problems
Intercepting Class II malocclusions
Intercepting Class III malocclusions
Assessing Patient Compliance
Early Treatment Protocol with PSL
Phase I: Fixed appliance cementation
Phase II: Observation
Phase III: Fixed appliance recementation
Clinical Cases
Case 1
Case 2
Case 3
Case 4
Conclusions
References
Chapter 9, Damon Space-Gaining Appliance (D-Gainer)
What Is a D-Gainer?
D-Gainer Procedure
Initial appointment
Second (or third) appointment
Third (or fourth) appointment
Extenders
Activation
Clinical case
Interarch Response
Theory of Improved Periodontal Integrity
Timing
Other Considerations
D-Gainer Variations
Variation 1
Variation 2
Detailed Case Examination
Treatment objectives
Treatment sequence
Review and evaluation
Conclusion
References
Chapter 10, Finishing with PSL
The “Why”
The 13 Keys
Key 1: Vision—Seeing the finish from the start
Key 2: Treatment planning the face
Key 3: Variable torque bracket selection
Key 4: Enamel recontouring
Key 5: Bracket position for smile arc and good occlusion
Key 6: Disarticulation and initial elastics
Key 7: Turning anterior crowding into transverse arch width
Key 8: Panoramic repositioning appointment
Key 9: Finishing wires—Finishing in like wires
Key 10: Elastics to help occlusion
Key 11: Occlusal adjustments
Key 12: Enamel contouring/finishing and polishing
Key 13: Soft tissue architecture and contouring
Conclusion
References
Chapter 11, Extractions with the Damon System
To Extract or Not to Extract
Profile
Muscle function
Level of crowding
Incisor inclination
Airway
Smile esthetics
Occlusion
Stability
Biomechanics in Extraction Cases with the Damon System
Torque selection
Type of anchorage
Clinical Cases
Case 1
Case 2
References
Chapter 12, Anchorage in the Damon System
Factors That Determine Anchorage
Tooth size
Number of roots
Alveolar bone
Role of occlusion
Craniofacial biotype
Patient’s age
Periodontal health
Bracket type and design
Type of ligation
Slot dimension
Archwire size
Anchorage Movement Philosophies
PSL Philosophy in Anchorage
Clinical Case
The Role of the Tube in Damon System Anchorage
The Role of Force in Anchorage
Absolute Anchorage
Conclusion
References
Chapter 13, TADs and PSL
What Are TADs?
Components
Advantages
Disadvantages
Contraindications
Risks
Materials
Placement of TADs
Clinical placement considerations
Common sites for placement
Direct or Indirect Anchorage
Biomechanics with TADs
Clinical Cases
Case 1
Case 2
Case 3
References
Chapter 14, Surgery-First Orthognathic Approach and PSL
When to Camouflage and When to Do Surgery
Surgical Treatments
Surgery-First OrthognathicApproach (SFOA)
1. Diagnosis
2. Orthodontic and surgical treatment plan
3. Placement of brackets and tubes
4. Model surgery vs virtual surgery planning
5. Placement of orthodontic archwires before starting surgery
6. Surgery
7. Postsurgical monitoring
8. Orthodontic monitoring
9. Surgeon monitoring
10. Completion of the case and retention
Conclusion
Clinical Cases
Case 1
Case 2
Conclusion
References
Chapter 15, The Impacted and Transposed Canine
Preemptive Approach to Palatal Canine Impaction
Diagnose early
Extract primary canines
Expand the arches with light forces
Labially Impacted Canine Overlapping the Lateral Incisor
Transposed Maxillary Canine and First Premolar
Mandibular Lateral Incisor Transposition
Conclusion
References
Chapter 16, Damon Q2
Damon Q2 Redesign
Clinical trials
Case Report with Damon Q2
References
Chapter 17, Damon Ultima System
Control Challenges with Traditional PSL Appliances
The Damon Ultima Full-Expression PSL Appliance
Ultima wire design
Ultima bracket design
Rotation control
Torque control
Damon Ultima Treatment Protocols
Wire selection and sequence
Bracket selection
Torque teaming to enhance expression
Neutral brackets
Clinical Performance
Conclusion
About the Book
