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ly.tornado 的博客

真正的专业是要放下自己的本位主义与好恶,从顾客的角度去体会他们的需要,,

 
 
 

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●2008.11.15DR. TOM PITTS(汤姆皮兹)来台演讲记~3(演讲笔记) 之b  

2008-12-10 21:37:57|  分类: 医学研讨会 |  标签: |举报 |字号 订阅

  下载LOFTER 我的照片书  |

@若是p't asymmetry的情况,其睡觉时很可能都是用另一侧在睡,因此脸会偏向不对称的那一侧,这在CL III的案例里常见到脸不对称的情形


@ 3/3的口腔内位置是与INCISAL PLANE呈垂直


@DO'nt forget the pharyngeal airway!


@CL III


~reverse upper anterior brackets


~elastics or safe springs


~lower abterior guide plane  (prn)


~after completing ,place in MT splint for retention


@ELE( EARLY LIGHT ELASTICS)的好处


1.controllary  vertical dimension


2.controllary  AP(前后) correction


3.influency higher torque posture


4.enhancing increased arch width


5.increased efficency


6.doesn't hurt the patient


must have full time (24 hrs)


saved  them up to 12 mon of treatment time


3/16" 2 oz (Quails) from L 6(6) TO U 4(4)~~FULL time


@ CL I  OPEN  BITE 案例


~BONDING TEETH


~U & L 014 OR 013 CU NITI


~BITE TURBOS LOWER MOLARS


~SQUEEZE ERERCISES


~3/16" 2 oz (quails) U 3 to L 4 OR L3 (这个叫TENT ELASTICS,像帐蓬一样的挂法)


@ CL II  OPEN BITE 案例


~BONDING TEETH


~U & L 014 OR 013 CU NITI


~BITE TURBOS LOWER MOLARS


~SQUEEZE ERERCISES


~3/16" 2 OZ (QUAILS) U3 TO L5


@ CL III OPEN BITE 案例


~BONDING TEETH


~U & L 014 OR 013 CU NITI


~BITE TURBOS LOWER MOLARS


~SQUEEZE ERERCISES


~3/16" 2 OZ (QUAILS) L3 TO U5


@CROSSBITE : lingual kaplan hooks


posterior bite turbos (disarticulated)


014" CU NITI


5/16" 2 OZ PARROTS( U5-6  lingual  to  L 5-6 buccals)


switch to dolphins (5/16" 3 oz) at 2nd appointment


@ CL III OPEN-severe


posterior crossbite  & anterior down & widen (?)=5/16"(parrots)


@dr. tom pitts不使用reverse curve of spee wire(也就是摇椅弓丝),原因是成型的摇椅弓容易产生形变,牙列的corrdination很容易变掉,对于torque control不利,所以他建议少用


@DEEP BITES


~keep the elastics more distally


except for openbite with good vertical ELE~~treatment works on adults


bite ramps at L 1's( CL III)   U5~~L3/L3~~U5    2 oz 3/16"


@dr, tom pitts在黏前牙的时候提到一个诀窍~~就是将bracketmesial wall与牙体的近心面端的wall平行,这是一个观测法


@No torque rake Or glossectomy


 no special anchorage or TADs


no headgear


LET'S look at extraction mechanics


revealled ~~only extract for the face


~bimaxillary protrusion with lip incompetence


~crowding with protrusion & very wide arches


~remember the more we widen, the arches with the proper torque on the


incisors ,the less we need to consider extraction


space closure on SSW(不锈钢),CONSOLIDATE space 3-3


lace upper or lower 3-3 with doing lifetimes end the SS behind  6's


I always close with 019x025 ssw on a straight wire,use posts or loops distal to laterals


+ 7torque on U & L cuspids


place 019x025 preposted wires with lingual root torque form canine posteriorly with proper  activation , one should expect about 1.2 mm closure per month


space closure with coil springs


I activate every 11 weeks


hice spring


medium NITI open coil spring retraction in children


niti coil  or SS in adults


bend the end to a 90 before hooking(open coil spring的远心端弯一个90,来挂在wire,而不是hookbuccal tube )


I end my SS wires at the 6's activates the spring about 9 mm  or about 4~6 oz approximately 200 gm, tie the ligature on the bracket


closing maxillary space with medium niti coil springs(不放到7/7)


@DR. TOM PITTS不采用76/67连绑当ANCHORAGE


@START WITH FINISHING  IN  MIND!!


@THE enamel plasty makes a big difference


@retainer(保持器的使用):


upper/ortho flex teeth( reliance)


lower/0.027 TMA 3-3


clear slip covers


removable thermoplastic retainer


muscle training splint


dual hardness material


http://tw.myblog.yahoo.com/orthodontist-yang/article?mid=5425&prev=5442&next...(原稿)


 


    

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