Orthodontic Treatment with the Ultima Damon System, Four Permanent Contact Points for Precise Control of Rotation, Angulation, and Torque-Case Report

Patient history

Patient: N/A Age: 17 years, 1 month.

Diagnosis

At the diagnosis appointment, the following was determined: Skeletal class III. Bilateral crossbite, narrow upper and lower jaw with crowding in the anterior and canine areas, midline shift to the left.

A competent lip closure with a convex mouth profile.

Ceph analysis:

SNA angle was 74.4° (difference -7.6°, retrognacy OK), SNB angle was 77.4° (difference -2.6°, retrognacy lower), ANB angle was -3.0° (Difference -5.0° Skel. Class III), Wits was -8.5mm ((Difference -7.5mm, Skel. Class III).

The lower incisors showed a strong retrusion to the Me-Go line with -21.7°.

Figures 4a-d are the extraoral images and Figures 5a-e are the intraoral images.

In Figures 6, 7, and 8 are, the cephalometric image with the evaluation and the orthopantomogram.

Course of treatment

The bonding was complete in the upper and lower jaw.

Torque selection: the torque values were selected as follows: 13, 23, 33, 43,44 h.Tq, 12, 22, 31, 32, 41, 42 Low Tq, 11, 21, st.Tq.

Appointment 1: 04.05.2020

A .013” CuNiTi wire was ligated into both jaws at the start of leveling.

Appointment 2: 06/22/2020

Arch change in the upper jaw was a .018” CuNiTi

Appointment 3: 07/23/2020

Arch change in the upper jaw, a .0140 x .0275 CuNiTi (this is the first size of Ultima wire) in lower jaw ligated .018” CuNiTi.

Appointment 4: 09/03/2020

A cephalometry and orthopantomogram were performed at this appointment.

Appointment 5: 12.14.2020

Arch change: up. 0160x.0275 SST, lwr.0140 X.0275 CuNiTi. Fig. 12a-f

Appointment 6: 04.04.2021

Arch change (up. 0.18 x .0275 CuNiTi, lwr. 0.16 x .0275 SST).

Appointment 7: 08/26/2021

Arch Change: (up. 0.18 X .275 TMA, lwr. 0.18 X .0275 CuNiTi). The patient continued to wear the vertical elastics (Figures10a-c).

Figures 10a-c

Recordings were carried out for comparison with the initial findings (Figures11a-c).

The active treatment phase is over, brackets in the upper jaw and lower jaw are removed, and a permanent lingual retainer is inserted in lower jaw 33-43. After one day, the patient wore a retention splint in the upper jaw and lower jaw.

Completed documents: Models, X-rays and photos were made and evaluated. In Figures 12a-i are the results.

In Figure 13a-c are the cephalometric image with the evaluation and the orthopantomogram.

Alignment, leveling, as well as Class I adjustment took about 15 months of active treatment in this case.

The clinical recordings as well as the cephalometric analyzes show a rapid and big difference between the beginning and the end of the treatment.

The cephalometric values are of greater importance, which can be well observed by comparing the three treatment phases (Figures 11a-c).

The presented case report shows examples of the change in size and shape of the maxillary and mandibular alveolar bone observed in adolescents treated with a passive self-ligating continuous multiband and the Damon Ultima low friction/low force treatment protocol. The Damon Ultima demonstrates precise control of rotation, angulation, and torque with shorter treatment time.

None.

No Conflict of interest.