Clinical consideration on using the elastic "tie backs" during space closure / 대한치과교정학회지

ABSTRACT

Preadjusted appliance, following the original concept of the Andrews Straight-Wire appliance, became increasingly common in the 1980s. In six phases of treatment, anchorage control, leveling and aligning, overbite control, overjet reduction, space closure, and finishing are very effective with using the preadjusted appliances. Space closure is the phase of treatment in which the difference between standard edgewise and preadjusted mechanics is most noticeable. Orthodontists have been able to reduce the use of closing loops and, because of the level slot lineup, enjoy the advantages of sliding mechanics. In 1990, Dr. John C. Bennett and Richard P. McLaughlin introduced the new space closure system, namely, elastic "tiebacks". They found an .019"X.025" working archwire most effective in an .022"-slot system. Hooks of .024" stainless steel or .028" brass wire are soldered to the upper and lower archwires. The force required for space closure is delivered by elastic "tiebacks". An elastic module stretched by 2-3mm(to twice its normal length) usually delivers 0.5-1.5mm of space closure per month. Group movement and sliding mechanics are combined for gentle, controlled space closure, so that about 0.5mm of incisor retraction and 0.5mm of mesial molar movement can be seen each month. The tiebacks are replaced every four to six weeks. By using the elastic "tiebacks", the next two cases were treated during space closure. Even though we found some clinical problems of this mechanics, long treatment time, hard to control of vertical dimension and anchorage, the application method of this system is so simple that orthodontists can manage many patients during short chair time. But we must apply this mechanics after perfect understanding of the biomechanics in tooth movement.