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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a  

2008-12-10 21:41:05|  分类: 医学研讨会 |  标签: |举报 |字号 订阅

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

FACIAL standard have changed(1930年演变到1990),不管从lip projection或是lip curl来看,

Sarver's classification of appearance &esthetics

 Macroesthetics  

              

         profile

         vertical properties

        lip fullness & vermillion arch

        chin-nasal projection

        facial widths

Miniesthetis

              

        incisor display

       transverse smile

      smile symmetry

      crowding

     smile arc

Microesthetics

           

gingival shape & contour emergence profiles

tooth shade

tooth shape  contacts ,connectors & embrassures

*MY BRACKET positioning depends on smile arc

*increasing vertical lower face ,high torque,proper torque,arch width,arch form

*it's not just the damon bracket,it is how you use it!!!!!!

incisal plane ,incisal cant,smile presentation

*it is not just about strengthening teeth,arch development is a major factor to  more impressive  mid-facial beauty and non-extraction treatment

*torque seems to come to a higher posture with the very light forces

*force level  is extremely important to arch development

*natural expansion with light force

*mastery of damon finishing  ,developing with 4 steps

1)learning how to use the appliance to fit the teeth together beautifully

2)learing how to create results with enhanced (highest &best) facial & smile esthetics

3)adding efficency to the process without diminishing the quality

-appliance placement/custom torque

-letting the system work

-early light elastics

-finishing elastics  /cuspal continuing

4)learing how to retain the results

esthetic functional occlusion---esthetic facial balance

vertical is important to esthetics

vertical dimension

intrusion & extrusion of the posterior teeth without have to smile line

bracket positioning= 1st key to finishing

-very little flash of composites

-great adhesion

-great slot position

@ideal placement criteria

~smile arc

~matually protected occlusion

~marginal ridge & contacts point

~symmetry

~transition from the anteriors to the buccal segments/occlusion of buccal cusps

~torque control

DR. TOM PITTS在黏67的见解~~他的6会黏在CONTACT LINE的位置,7会更靠OCCLUSIVE一点来黏,

look at the contact points

~more gingival on molars

 1.out of occlusion

 2.more torque control

 ~then find my best

@The key to my bracket positioning

upper cuspid to cuspid esthetics

smile arc & line

arch other tooth is set up for idealizing the occlusion

DR. TOM PITTS提到他在黏DEEP BITE(深咬)CASE之前牙,会将bracket黏靠切端一点(more incisally),open bite(开咬)case会黏靠龈端一点(more gingivally)

lower cuspids会黏在mesial to crown-long axis(height of contours)

DR. TOM PITTSbracket似乎黏的位置较不同,他说是occlusal of wings about level with the height of contact points

@DR. TOM PITTSMOLARS(6/7) & BI'S(4/5)的转矩度与旋转度

      6       -18度的TORQUE/12度的ROTATION

      7      -27度的TORQUE/10度的ROTATION

   4/5       -7度的TORQUE

@COMMON ERRORS(常见的错误)

~bracket too mesial on upper 1st bicuspids/not mesial enough on the cuspids

@deep bite case, 挂橡皮筋时采用上46的短皮圈牵引,使用3/16"(<2 oz) quail~~慢慢的变成kangerloo(4 oz)

@gummy smile或是deep bitecase,bracket放较incisally的地方,可以产生intrusion的作用

@must achieve a great smile arc,#8(指的是右上1=中门牙)  root is completely through the labial plate

@liabilities of non extraction treatment

~lack of papillae-pepper spots

~labial-gingival recession

~causing her to be too prortrusive

~procling the anterior teeth

~possibility of extracting

@ my case illustrated

~torque control

~arch will preformed

~patience

~peri-response to low forces

~finishing elastics

~slendering for tooth size

~bite adjusting retention

@ I   left  plenty of wire behind last engaged tooth~~如用013" cu niti wire,DR. TOM PITTS是把WIREmolar tooth前回折不入线到moalr tube,这样可以产生proclination & anterior open bite,解决它的办法是配戴lift up & down elastics 或是rebond anterior 3-3brackets

@DR. TOM PITTS使用的方线有两种wire size &sequence

019x025   SSW    016X025     SSW

019X025 TMA    016X025  TMA

always have posters or loops distal to lateral incisors on steel of TMA wire

1) never lose your way

2)tie backs +clearing(?) +stops

3)always know which side of the arch wire is up

4)easy to coordinate & gain symmetry

@ DR. TOM  PITTS采用arch symmetry chart & DAMON  SL universal arch form

@ don't overtorque  the upper anteriors  ,use steel on any CL II or space closing mechanics

if use TMA , I nose to incisal plane is important

(http://tw.myblog.yahoo.com/orthodontist-yang/article?mid=5425&prev=5442&next=5424&l=a&fid=10原稿)

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