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●damon system(戴蒙系统)  

2009-11-02 10:45:43|  分类: 默认分类 |  标签: |举报 |字号 订阅

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●damon system(戴蒙系统) - lytornado - ly.tornado 的博客

Wikipedia字典对damon system的觧释

请奌入連结 

Damon smiles are more than straight teeth

 damon photo gallery       damon system photo album

damon system for doctor's              damon TV spots  

damon system braces                           damon research

damon cases show

 

DAMON3 矫正动画

DAMON system日本人症例动画(请点入后点个案例的movie檔)

デーモンシステム3 (damon 3)KAZ矯正齒科

DAMON SYSTEM日文版            DAMON SYSTEM英文版

DAMON SYSTEM的影片(左下)

damon system orthodontic photo album

DAMON SYSTEM较大银幕的影片(7分钟)

damon 3 mx slides show

upper damon 3 +lower damon 3 mx slides show

damon 3 slides show 

damon system所有网络影片

gazotube里的damon影片           在youtube里的damon 影片

在facebook里的damon影片         lytornado在yahoo里的影片  

DR. DWIGHT DAMON的网站          damon system首席讲师dr. alan bagden网站

Dr. terry dischinger的网站                   口腔正畸网里的damon system文章

 A comparative study: the Damon System vs. conventional appliances

my damon braces story(blog)          clinical impression of DAMON system 

damon system的发展沿革

INTRODUCTION:The Full Face Philosophy: a 2-Year Orthodontic Program (by dr.derek mahony)

HOW WE GOT FROM THERE TO HERE AND BACK (里面是对于binding的解释,ribbon arch的形状 &damon system治疗病人的arch改变图例)

  

damon3影片

damon system官方网站(患者的影片介绍共4个)

new damon 3 mx网站

DR. JOHN LIN(林锦荣医师)的creative orthodontics

11 damon cases from creative orthodontics

damon 3 MX金属矫正器病人心得

damon 3 MX金属矫正器病人心得~1

CW's Teeth-record (DAMON SYSTEM BRACKET)

Are Damon braces really better than regular braces? 

damon 3 mx extraordinary brackets 

damon 3的bracket内建的角度与使用的弓丝 

Fast Track News You Can Use to Boost Your Performance with the Damon Self-Ligating Bracket System

1. Begin nearly all cases with .014 Damon Copper Ni-Ti    in both arches. Keep this wire in place for a  minimum of 10 weeks.(刚开始要使用轻持续力,且超过10周以上,其目的就是要让牙齿好好感受弓丝的力量,一来不overpower,二来可以轻易的进入下一条方线,,)  

2. Place archwire stops anterior to the crowding.(也就是说把stop放在不拥挤的牙位处,对rotation或crowding的牙齿可以得到改正的机会与适切的力量) 

3. Simplify your wire progression by using the following four-wire sequence in both arches:(damon system的四个阶段):

.014 Damon Copper Ni-Ti (Part No. 205-1902) – Light Wire Phase

.014 x .025 Damon Copper Ni-Ti (Part No. 210-1905) – High Tech Edgewise Phase

.018 x .025 Damon Copper Ni-Ti (Part No. 210-1907) – High Tech Edgewise Phase

.019 x .025 Damon Posted Stainless Steel – Major Mechanics and Finishing Phases

Note: In young patients with well-aligned teeth, use a three-wire sequence:(青年人用3个弓丝系列)

.014 Damon Copper Ni-Ti (Part No. 205-1902)

.016 x .025 Damon Copper Ni-Ti (Part No. 210-1906) ?

.019 x .025 Damon Stainless Steel

4. Rigid or semi-rigid wires should be inserted nearly passive after leveling, aligning and the elimination of  rotations with Copper Ni-Ti. 

5. Copy the final arch form from the lower arch following completion of the edgewise high-tech phase of the  archwire progression. 

6. Posterior arch width is gained without the use of rapid palatal expanders.(不使用扩大装置) 

7. Do not bind the molars with TPAs, lingual bars, headgear, Nance buttons, or other similar appliances, because they will prevent posterior lateral development.(会阻碍后方齿群的排列) 

8. Move teeth in groups.(组牙移动) 

9. To open space, use medium-light Ni-Ti springs. To close space, use 9 mm medium Ni-Ti springs. On adult  cases or challenging extraction cases, use pletcher springs. Do not activate more than two brackets in  length 

10. To prevent spaces from opening after leveling and aligning, tie the interiors together under the archwire  with chain or ligature wire. 

11. Use tieback modules or chain to consolidate the posteriors.(这是damon system的特色) 

12. Retain all cases with bondable lingual retainers. Retain the following types of cases with a Damon splint:Class II, Herbst retention, severe posterior crossbites, lateral tongue thrusters, severe Class II corrected  with elastics or Herbst with springs, any patient with transverse dysfunction (buckle-lingual coordination challenges), patients in need of tongue training, and TMJ patient retention. Damon splints are used in approximately 1/3rd  of all patients treated with the Damon System.

* These tips are a composite list of several suggested recommendations developed by Dr. Damon and others.

These tips should not be considered a treatment plan or be used in place of your clinical judgment.

 

damon bracket的矫正器黏着高度数据(bracket placement)

maxillary (上颚)

 U-1   4.75mm  U-2  4.50mm   U-3  5.00mm  U-4 4.50mm  U-5  4.25mm

mandibular(下颚)

L-1 4.75mm      L-2 4.50mm     L-3  5.00mm   L-4 4.50mm    L-5 4.25mm

(它所有的测量是由牙齿的incisal edge到center of the archwire slot(弓丝槽沟的中心)

 

placement tips(黏着小贴士):

1)upper brackets open incisally & lower  brackets open gingivally(上颚的矫正器开关在切端,下颚的矫正器开关在龈端~~你就记得开关都朝下就对了)

2)focus on the mesiodistal ends of the pad & the mesiodistal edges of the tooth. the reduced size of the bracket and slide assembly allows you to visualize more of the pad(把焦点摆在矫正器的底座的近远心端与牙齿的近远心端,矫正器滑盖与配件的组合这种减少大小的设计,可以让你很清楚的看到底座)~~务必正确配合boone gauge来黏着矫正器

3)check the panorex for proper root position prior to bracket placement,place the damon application at the same height position as a traditional bracket system,or refer to the recommended measurements above(在黏着矫正器前要检查一下全景x光片,这可以看牙根的正确位置,把矫正器黏在正确的位置,可以参照传统矫正系统或是上面所列的高度数据)~~这一点非常重要,不管术前,术中,或是术后,若有必要这项检查工作是必要的

4)place appliance  using the crown-long axis and bracket scribe line(在黏矫正器时可以参照牙冠的长轴,或是矫正器上面的标志线)

5)ensure that the internal slot and horizontal components of the bracket are parrallel with the desired occlusal plane, this is  especially important while placing the lower anteriors(要确认矫正器的槽沟内部与其水平的部份和咬合平面取得良好的平行度,这在下颚前牙区尤其重要)

6)use a mouth mirror to aid placement,the damon brackets can be bonded directly & indirectly(使用口镜来辅助黏着,戴蒙矫正器可以直接黏也可以间接黏)

(from: damon  workbook第p.129)

底下是个人的操作心得补充:

7)配合使用blugloo,或是en-light这两种黏着剂(都是光固化型的),不仅操作便利,且不受时间的限制,可以将多余溢出bracket外的黏剂清除后再光照之,如此可以保持整体矫正器的美观,不会看起来一沱一沱的,而且残渣堆在上面会感觉脏脏的

8)canine eminence(犬齿的转折凸出),这是很重要的,有必要都要注意弯制canine offset,这样在dental arc(牙弓弧线)是重要的,因为常常你会看到犬齿因为过度被往远心拉扯,产生转过头的现象,所以近远心端不在弧线上,所以牙与牙的contact point不连贯,弧线不协调,自然对咬合有干扰

9)canine的矫正器经常记住往牙齿中轴在往近心1mm黏,这对转折的处理有帮助

10)注意正确使用转矩(high torque?low torque?standard torque?)依案例的需求去做搭配

11)为了不让上下颚一开始就全黏上矫正器产生病人的不舒服,可以先黏单颚,让病人习惯后再黏另一颚,这样会减少牙列一开始就互相打架的窘境,因为矫正的案例一开始绝对不是正的,所以矫正器黏上以后,再加上弓线的震荡,很容易让牙列形成联合国战争的,这样对咬合的进度不仅不会帮助,反而会越做越辛苦

12)装矫正器前,可以针对个别牙齿的外型做修型(shaping),这是必要的,因为不经过shaping,很可能你看到的牙齿外形与中轴是不对的,有的有缺角,也要事先修形,这在damon cases里也经常可以看到与提到

13)有干扰的,或是未萌出的牙齿,或是拥挤严重的案例,可以等整平排齐的动作进行一段时间后,择适当时日黏上,这样较不会因为咬合干扰被咬掉脱落必须重黏

14)每次回诊,严格检视矫正器的位置,必要时重黏,这一点很重要

15)在拔牙的case(extractional cases),在上下颚的犬齿建议选用+7度的矫正器,如此在关闭拔牙间隙后,可以避免临床牙冠产生舌倾现象(lingual tipping)

 

  

●7 essential DAMON principles(戴蒙系统矫正器的7项必要的原则)  

1)treatment planning must be facially based

2)do not allow the orthodontic forces to overpower the biological system during any treatment phase

3)the aim of the NI-TI phases of treatment is not only to level and align but also to reshape the arch form specific to each individual patient through functional adaptation

4)complete leveling ,alignment and rotational control require full-depth rectangular archwires

5)the working/final phase of treatment requires rigid wires

6)sagittal relationship corrections are  best carried out by functional adaptation achieved via intermaxillary forces applied en masse

7)retention requires careful consideration  

 

●DAMON"S 3 essentials in maximizing your orthodontic results ~tips from DR. TOM PITTS

essential #1~begin with the end in mind:match torque selection to case goals

依照每个个别案例的需求来选用适当的前牙转矩(torque),矫正线一进入方线时,牙根便会渐依bracket上的转矩设定来开始移动,所以选用variable torque bracket的优点乃在让牙齿提早适应,增加定位后牙根在骨头的时间(duration),因此在debond后牙齿角度也会相对稳定, 有助之后长期的保定

很多医师普遍有一个错误的想法,~~总认为弓丝(archwire)必须完全的吃进去bracket的slot中(fully engaged),才可以表现bracket的torque

,但事实是,torque expression在表现上是因为方线的两个边缘接触到bracket相对的内缘(opposing wall of the lumen)时就开始产生,而整体的表现量必需扣除主线在lumen里面的play(运动),以及所使用的major mechanics(如拉橡皮筋)所造成的偏差量

ex.用.019x.025的ssw在.022x.027的槽沟中约有+-10.5度的play,因此在上颚的门牙区为了弥补wire play或是major mechanics所造成的torque loss,在.019x.025的ssw上的上颚门牙区至少需再加+10度甚至+20 度来弥补

这也就是damon system 设计torque selection与正确的使用wire sequence来表现牙体的torque,因此善用damon system中的variable torque bracket加上pre-torque wire(通常是20度的torque)如.017x.025pre-torqued Ni-Ti(20度的torque),.019x.025pre-torqued Ni-Ti wire,可以让您更轻松的进入finishing stage

essential #2~unlock the malocclusion:disarticulate the arches with Bite Turbos

所谓bite turbo简单的讲就是打开malocclusion让牙齿移动更方便的凸块,都可以称之,以下将bite turbo的用途提列如下

1)防止珐琅质磨损,同时避免bracket脱落

2)提高light wire对arch development的效果,促进early light elastics对前后,垂直和横向修正的效率

3)帮助改善high or low angle脸型(facial profile)

high mandibular plane angle的case~~bite turbo放在后牙区(后牙intrusion/前牙extrusion,改变occlusal plane,降低MPA)

low mandibular plane angle的case~~bite turbo放于前牙区(合并使用EARLY LIGHT POSTERIOR VERTICAL ELASTICS借助后牙extrusion修正low MPA常伴随的深咬问题

当要修正后牙错咬但前牙BITE TURBOS放置有困难时,DR. stuart frost建议在下第一大臼齿上利用resin flow将咬合面填平,合并使用early light crossbite elastics来修正后牙错咬

essentials #3 ~be creative: use Early Light Short Elastics(ELSE) for early inter-arch correction

短的CLII 橡皮筋有助于早期牙齿基底的移动,elastics的设计可以考虑水平和垂直的向量, 只要有助于修正,几乎任何位置都可以戴橡皮筋

ELSE的橡皮筋戴法与传统的挂下颚第一大臼齿到上犬齿前的hooks上或是挂在犬齿上的差异是非常大的,因为后者的拉法很容易产生下颚前牙外展(flaring out),或是arch form的改变(如挂在canine上)

early light short elastics(ELSE)挂法上 4挂到下6, 2 OZ,一天换4次  +下6/6咬合面放BITE TURBOS,  (.014 Cu Ni-Ti)

当wire换成.014x.025 Cu Ni-Ti时,elastics改成3 oz拉上4到下6,以此,可以改善overjet,

当到位后去除bite turbos,改成前牙上颚的舌侧单放bite turbo(有成品),其目的是给下颚门牙明确的咬合定位,并且继续挂cl ii elastics (4.5 oz),位置改为上3挂下6 

所以总结: 1)variable torque bracket

                    2)bite turbos

                    3)early light short elastics(ELSE)

                  这三项利器可以得到相当不错的治疗成果

 

●the DAMON SYSTEM phases of treatment(戴蒙系统的治疗阶段)

damon system SLB是属于自锁滑盖式的矫正器,操作简便,配合超弹性的弓丝与内建的转矩轴倾度,采用轻力,低摩擦力的特性,可以快速的整平排齐牙列,可以说是自锁式矫正器的一项创新的设计

DAMON SYSTEM的治疗过程大约可以分成3个主要阶段,每个阶段都有它该做的事与工序

1)INITAIL PHASE(初始阶段)~~

它做的是LEVELING& ALIGNMENT(整平排齐的工作),ROTATIONAL CONTROL(牙体旋转的改正),ARCH DEVELOPMENT(牙弓形态的发展与改造)

此阶段所使用的弓丝为小管径(small dimension)的弓丝,它穿入矫正器的large lumen(大槽沟)里,它可以减少阻力(friction)与被绑住(binding),拥挤的牙齿(crowded teeth)可以很舒服与轻松的被改正过来

2)WORKING PHASE(工作阶段)~~

此阶段已完成整平排齐的工作(complete leveling& alignment),改正牙体的旋转(complete rotational control),开始进入转矩控制(torque control),开始间隙的调整(begin space consolidation),与及牙弓形态的继续发展(continue arch development)

此阶段可以获得牙体旋转的控制,它会进入full-depth archwires(也就是方线能吃进去槽沟,进行转矩的表现),矫正器本身的被动自锁式,可以快速的来关闭间隙,利用方丝的特性调整牙弓形态,让low force archwire可以在low -friction的环境下作用

3)FINAL PHASE(最终末阶段)~~

它完成torque control,完成space consolidation,把病人个别特有的牙弓形态表现出来(develop patient-specific arch form),与及最后精细调整的进行(conduct final detailing)

利用弓丝完全吃进槽沟里,与system的被动特性,完成转矩的控制与各项调整,最终的牙弓形态(arch form)是由每一位病人个别特有的牙齿生理排列位置来决定

Damon Archwire Sequence

(参考~~DAMON SYSTEM的4个治疗阶段)

ormco damon system介绍

以下是damon system的案例介绍

·                Crowded Cases (拥挤案例)

·                Class II Extraction Cases (二类错合拔牙案例)Extract for the Face, Not for Space

·                Class II Nonextraction Cases(二类错合不拔牙案例)

·                Herbst®* Cases  (使用herbst装置的案例)

以下是damon system的bonding materials & bonding procedure

Blēgloo? for Damon 3 Brackets

·                Direct Bonding Technique Guide

·                Indirect Bonding Technique Guide

Direct Bonding Technique Guide

·                Indirect Bonding Technique Guide

  

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