Multiloop Edgewise Archwire Research Articles

ISW Treatment for the Skeletal Class III with Anterior Crossbite and Minor Facial Asymmetry

ABSTRACT Skeletal class III with anterior crossbite is a very common orthodontic problem in Taiwan. Early diagnosis and treatment are very important to achieve effective correction. This article reports the treatment outcomes using improved superelastic TiNi alloy wire (ISW; developed by Tokyo Medical and Dental University) for a case of skeletal class III malocclusion with anterior crossbite and lower anterior crowding combined minor facial asymmetry. ISW allowed relief of crowding to facilitate correction for this case. In comparison with the traditional treatment with SSW multiple L loops of class III patient, ISW multiloop edgewise archwire (MEAW) can provide a more efficient and easier way for the patient. After 16 months of treatment, a desirable outcome was achieved and patient was satisfied with the treatment procedure and result. How to cite this article Tseng CH, Jian-Hong YU. ISW Treatment for the Skeletal Class III with Anterior Crossbite and Minor Facial Asymmetry. Int J Experiment Dent Sci 2013;2(1):53-59.

Orthodontic management of a patient with missing upper posterior teeth, severe curve of Spee and periodontal problems

This article describes the complex dental treatment of an adult patient with missing upper posterior teeth, malocclusion with a severe curve of Spee and generalized moderate chronic periodontitis. A skeletal Class II due to a retruded mandible with high overjet and overbite and labial inclination of the maxillary incisors were also present. Based on the loss of supporting periodontal tissue, missing upper posterior teeth and extrusion of the antagonist teeth, with consequent loss of space for rehabilitation, the orthodontic treatment consisted of a mini-screw anchorage on the posterior maxilla. A multiloop edgewise arch wire was applied in the lower arch in order to correct the severity of the curve of Spee, intruding posterior teeth and incisors. When the occlusal plane was established and a normal interocclusal space was obtained at the posterior teeth a prosthodontic treatment with implants was done to replace the missing teeth. In spite of the high skeletal Class II at the end of the treatment, the overall treatment improved periodontal attachments and a Class I dental relationship was achieved with a slight mandibular anterior repositioning. Furthermore, improved aesthetics of the patient was obtained by upper incisor retraction without increasing vertical dimensions.

Class II division 2 adult orthodontic treatment

Background This article presents a case of non-extraction orthodontic treatment of an adult patient with class II division 2 malocclusion following the multiloop edgewise archwire (MEAW) philosophy.

Posterior scissor bite and lateral open bite with missing lower first molar and second premolar

This article presents an adult patient with scissor bite in the posterior region, lateral open bite with a missing first molar and a second premolar on the lower left side. The scissor bite was difficult to correct due to severe occlusal difficulties in the lower left arch with a highly titled and extruded third molar. After third molar extractions (except left mandibular molar), the first step was to upright the lower second molar with a helical loop, replaced in a second step by a multiloop edgewise archwire including the third molar in order to correct the occlusal plane, uprighting and intruding the posterior teeth (second and third molar) and extruding the lateral teeth (canine and first premolar). In a third step, after the occlusal space was obtained on the teeth with previous scissor bite, the upper second molar buccal inclination was also improved with a helical loop followed by a multiloop edgewise archwire technique.

Association between root resorption incident to orthodontic treatment and treatment factors

The purpose of this study was to clarify the prevalence and degree of root resorption induced by orthodontic treatment in association with treatment factors. The files of 243 patients (72 males and 171 females) aged 9-51 years were randomly selected from subjects treated with multi-bracket appliances. The severity of root resorption was classified into five categories on radiographs taken before and after treatment. The subjects were divided into extraction (n = 113 patients, 2805 teeth) and non-extraction (n = 130 patients, 3616 teeth) groups and surgical (n = 56 patients, 1503 teeth) and non-surgical treatment (n = 187 patients, 4918 teeth) groups. These subjects were also divided into two or three groups based on the duration of multiloop edgewise archwire (MEAW) treatment, elastic use, and total treatment time: 0 month (T1; n = 184 patients, 4831 teeth), range 1-6 months (T2; n = 37 patients, 994 teeth), more than 6 months (T3; n = 22 patients, 596 teeth); range 0-6 months (n = 114 patients, 3016 teeth) more than 6 months (n = 129 patients, 3405 teeth); range 1-30 months (n = 148 patients, 3913 teeth) and more than 30 months (n = 95 patients, 2508 teeth). The prevalence of overall and severe root resorption evaluated by the number of subjects and teeth was compared with a chi-square test. A Student's t-test for unpaired data was used to determine any statistically significant differences. The prevalence of severe root resorption based on the number of teeth was significantly higher in the group with extractions (P < 0.01). Longer use of a MEAW appliance and elastics also produced a significantly higher prevalence of root resorption (P < 0.05). On the other hand, the prevalence of severe root resorption was not significantly different between the subjects treated with or without surgery, but there was a significant increase when treatment time was prolonged (P < 0.05). A significant difference was found in the amount of root movement of the upper central incisors and the distance from their root apices to the cortical bone surface (P < 0.05). These are regarded as essential factors in the onset of root resorption. These results indicate that orthodontic treatment with extractions, long-term use of a MEAW appliance and elastics, treatment time, and distance of tooth movement are risk factors for severe root resorption.

Developing skeletal Class III malocclusion treated nonsurgically with a combination of a protraction facemask and a multiloop edgewise archwire

For a girl, aged 12 years 3 months, with a skeletal Class III malocclusion, negative overjet, severe maxillary crowding, and hyperdivergent pattern, orthognathic surgery combined with orthodontic treatment is often the treatment of choice, because it can greatly improve the patient's facial profile and ensure the long-term stability of the results. However, because of high risks and treatment expenses, patients sometimes refuse to have surgery. We report a nonsurgical combination therapy including facemask and multiloop edgewise archwires and the outcome for a patient with a developing skeletal Class III malocclusion and a long anterior facial height. Treatment included advancement of the maxilla by orthopedic means and counterclockwise rotation of the mandibular occlusal plane by the orthodontic dentoalveolar compensation of distal en-masse movement of the mandibular dentition.

Multiloop edgewise archwire in the treatment of a patient with an anterior open bite and a long face

An adolescent girl with an Angle Class III malocclusion, excessive lower facial height, and anterior open bite sought nonsurgical treatment. She was treated with a multiloop edgewise archwire (MEAW). In association with a chincup, MEAW mechanics allowed the successful correction of the anterior open bite and the molar relationship, without major alterations of the patient's profile. Combined orthodontic and surgical treatment should be considered for patients with skeletal anterior open-bite malocclusion. For patients who do not want surgery, however, MEAW treatment is an alternative that can have excellent results.

Orthodontic treatment of severe crowding malocclusion with temporomandibular joint closed-lock by means of multi-loop edgewise archwire: a case report

In this case report, crowding malocclusion with TMJ (temporomandibular joint) closed lock was treated with modified offset archwire (MOAW) and multi-loop edgewise archwire (MEAW). Owing to the TMD (temporomandibular disorder) problems, we decided to extract the lower third and upper second molars. Crowding in the upper and lower arches was successfully treated with the improvement of TMD. Condylar movement was improved by orthodontic treatment with ΔY shift noted on condylographic evaluation. Two years after the treatment, the occlusion was fairly stable.

Successful Treatment of Postpeak Stage Patients with Class II Division 1 Malocclusion Using Non‐extraction and Multiloop Edgewise Archwire Therapy: A Report on 16 Cases

AimTo determine cephalometrically the mechanism of the treatment effects of non-extraction and multiloop edgewise archwire (MEAW) technique on postpeak Class II Division 1 patients.MethodologyIn this retrospective study, 16 postpeak Class II Division 1 patients successfully corrected using a non-extraction and MEAW technique were cephalometrically evaluated and compared with 16 matched control subjects treated using an extraction technique. Using CorelDRAW® software, standardized digital cephalograms pre- and post-active treatments were traced and a reference grid was set up. The superimpositions were based on the cranial base, the mandibular and the maxilla regions,and skeletal and dental changes were measured. Changes following treatment were evaluated using the paired-sample t-test. Student's t-test for unpaired samples was used to assess the differences in changes between the MEAW and the extraction control groups.ResultsThe correction of the molar relationships comprised 54% skeletal change (mainly the advancement of the mandible) and 46% dental change. Correction of the anterior teeth relationships comprised 30% skeletal change and 70% dental change.ConclusionThe MEAW technique can produce the desired vertical and sagittal movement of the tooth segment and then effectively stimulate mandibular advancement by utilizing the residual growth potential of the condyle.

Long-term stability of an adult Class III open-bite malocclusion treated with multiloop edgewise archwire

This case report describes the treatment of a 17-year-old girl with an anterior open- bite and Class III malocclusion, who had a history of thumb-sucking habit in childhood. The multiloop edgewise archwire technique was used on the mandibular arch to facilitate uprighting of the mandibular posterior teeth, change the cant of occlusal plane, close the anterior open-bite, and correct the Class III malocclusion. At the end of treatment, Class I occlusion and correction of the anterior open-bite had been achieved. An examination 8 years 8 months after treatment revealed long-term stability of the treatment results.

Morphological characterization of as-received and in vivo orthodontic stainless steel archwires

This study was undertaken to evaluate the material degradation of clinical bracket-archwire-contacting surfaces after in vivo orthodontic use. Twenty-four stainless steel multiloop edgewise archwires with two different cross sections (0.016 x 0.016 and 0.016 x 0.022 inches) were used for at least 6 months in the mouths of 14 patients. The surfaces of both as-received (cross-section of 0.016 x 0.016, 0.016 x 0.022, and 0.017 x 0.025 inches) and the in vivo wires were examined using scanning electron microscopy. The as-received wires exhibited an inhomogeneous surface with different surface irregularities resulting from the manufacturing process. For the in vivo archwires, an increase in the variety, type, and number of surface irregularities were observed. Crevice corrosion occurred not only at surface irregularities formed during manufacturing and orthodontic handling but also at the bracket-archwire-contacting surfaces and at the archwire surfaces coated with plaque and food remnants. This corrosion may be linked to the formation of a micro-environment at these locations. In addition, a limited number of signs of degradation induced during in vivo testing due to wear and friction were observed.

Effects of maxillary second molar extraction on dentofacial morphology before and after anterior open-bite treatment: a cephalometric study

The purpose of the present study was to probe into the effects of maxillary second molar extraction on dentofacial morphology by the use of cephalometric radiographs taken before and after anterior open-bite treatment. The subjects were 30 Japanese patients who had received multiloop edgewise archwire therapy without premolar extraction. They were divided into two groups. Group 1 consisted of 15 patients who had their maxillary second molars removed. Group 2 comprised 15 patients who had been treated without extraction of maxillary second molars. Lateral cephalograms were taken before and after treatment. Seventeen angular and 31 linear measurements were obtained from the lateral cephalograms. Paired and unpaired t tests were used to determine the significance of differences in measurements. The retrusion and extrusion of the maxillary incisors, the distal movement of the maxillary first molars, and the uprighting of the maxillary first premolars and the mandibular first molars were greater in group 1 than in group 2. Moreover, the maxillary first molars intruded significantly in group 1 but extruded insignificantly in group 2. Extraction of maxillary second molars, as well as nonextraction, can be an effective operating procedure for open-bite correction of the permanent dentition.

CORRECTION OF ANTERIOR OPEN BITE BY MULTILOOP EDGEWISE ARCHWIRE (A CASE REPORT)

This case report was a treatment of anterior open bite with multiloop edgewise archwire (MEAW). The patient was a class II skeletal pattern nineteen year old girl. The possible etiology of this case was sucking habit and skeletal dysplasia. In 14 months the ideal class I molar and canine relationship was achieved.

Initial effect of multiloop edgewise archwire on the mandibular dentition in Class III malocclusion subjects. A three-dimensional finite element study

The purpose of this study was to compare the effect of a multiloop edgewise archwire (MEAW) with a plain ideal archwire (IA) on distal en masse movement of the mandibular dentition. A three-dimensional finite element model (3D FEM) of the mandibular dentition, without third permanent molars, was constructed to include the periodontal membrane (PDM), alveolar bone, standard edgewise bracket (0.018 x 0.025 inch), stainless steel IA (0.016 x 0.022 inch), and MEAW (0.016 x 0.022 inch). Stress distribution and displacement of the mandibular dentition were analyzed when Class III intermaxillary elastics (300 g/side) and 5 degree tip-back bends from the first premolar to the second molar were applied to the IA and the MEAW for distal en masse movement of the mandibular dentition. Compared with the IA, the discrepancy in the amount of tooth displacement was less and individual tooth movement with the MEAW was more uniform and balanced. There was minimal vertical displacement or rotation of the teeth with the MEAW when compared with the IA. The MEAW seems to have advantages for distal en masse movement of the mandibular dentition.

Cephalometric evaluation of anterior open-bite nonextraction treatment, using multiloop edgewise archwire therapy

There are very few reports of extensive and detailed cephalometric investigations of nonextraction treatment changes for patients with anterior open bite. The purpose of this study was to evaluate changes in dentomaxillofacial morphology by way of lateral and oblique cephalograms of patients who had undergone multiloop edgewise archwire (MEAW) therapy for anterior open-bite correction. The subjects consisted of 21 Japanese female patients who received MEAW therapy without premolar extraction. The mean pre- and posttreatment ages were 16 years 9 months and 19 years, respectively. Lateral and oblique cephalograms were taken before and after treatment. Fifteen angular and 29 linear measurements were obtained from the lateral cephalograms; 17 angular and 20 linear measurements were obtained from the oblique cephalograms. Treatment changes were evaluated by the paired t-test. The upward and forward rotational changes of the mandible consequent to the use of the MEAWs and anterior vertical elastics were larger than the downward and backward rotational changes of the mandible, due to the extrusion of the posterior teeth by leveling and alignment. The uprighting and retrusion of the premolars and molars, and the extrusion, uprighting, and/or retrusion of the incisors and canines played important roles in the anterior open-bite nonextraction treatment by dint of the MEAW technique.

Stability of anterior openbite correction with multiloop edgewise archwire therapy: A cephalometric follow-up study

Successful treatment of anterior openbite malocclusion is considered one of the most challenging areas in orthodontics. This study was designed to evaluate the treatment effects of the multiloop edgewise archwire therapy in openbite correction and to investigate the stability of correction during a 2-year follow-up period. The subjects consisted of 55 white patients who presented with anterior openbite. The subjects were divided into 2 groups: the growing group included 29 patients and the nongrowing group included 26 patients. The lateral cephalograms were analyzed for skeletal, esthetic, and dentoalveolar changes. Analysis of the pretreatment and posttreatment cephalometric radiographs revealed that the overbite increased an average of 4 mm in both the growing and the nongrowing groups. Analysis of the posttreatment and follow-up cephalometric radiographs proved that the treatment results obtained by this therapy were very stable. The changes in overbite during the 2-year follow-up period were not significant. (Am J Orthod Dentofacial Orthop 2000;118:43-54)

Cephalometric evaluation of the anterior open bite treatment

The present study was aimed at evaluating the treatment changes of anterior open bite malocclusion cases treated by means of the Multiloop Edgewise Arch Wire technique, which is considered one of the more effective treatment modalities for anterior open bite malocclusions. The open bite sample was composed of 16 young adults, 4 males and 12 females. The normal occlusion sample, as a controlled sample was composed of 58 young adults who had pleasing facial profiles and normal occlusions with no experience of orthodontic or prosthodontic treatment. The normal sample was subdivided by the cephalometric vertical facial relationships. Forty adults with cephalometric vertical facial relationships within the normal range of Korean standards were classified as Normal Occlusion Group 1. Eighteen adults with an increased vertical facial relationship but with normal occlusion, were classified as Normal Occlusion Group 2. Thirty-nine reference points were digitized on each film, and the computerized cephalometric analysis was obtained with 8 skeletal, 10 dentoalveolar, 17 teeth angulations, and 4 occlusal plane measurements. Treatment changes were determined by the paired t test, and the structural differences between the four groups were tabulated by the Student’s t test. The treatment changes were observed mainly in the dentoalveolar region in the upper and the lower occlusal planes, accompanied by the uprighting of the posterior teeth to the occlusal plane through the distal tipping movement of the entire dentition. After the treatment, there was a tendency for the structural feature of the open bite group to approximate those of the normal occlusion group 2. This ascertains that the treatment changes of open bite malocclusion produced by means of the multiloop edgewise arch wire technique are similar to those found in the natural dentoalveolar compensatory mechanism. (Am J Orthod Dentofacial Orthop 1999;115:29-38)

Correction of open bite malocclusionsusing multiloop edgewise archwires: A cephalometric evaluation: G.A. Nalchajian Rochester, N.Y.: Eastman Dental Center, 1990

Correction of open bite malocclusionsusing multiloop edgewise archwires: A cephalometric evaluation: G.A. Nalchajian Rochester, N.Y.: Eastman Dental Center, 1990