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Marcotte Mechanics / orthodontic courses by Indian dental academy

Apr 23, 2017

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Page 1: Marcotte Mechanics / orthodontic courses by Indian dental academy

Marcotte Mechanics

INDIAN DENTAL ACADEMY

www.indiandentalacademy.com

Leader in continuing dental education www.indiandentalacademy.com

Page 2: Marcotte Mechanics / orthodontic courses by Indian dental academy

Deep Overbite Correction

Bite opening mechanics for deep bite cases

1. Extrusion of the posterior teeth.

2. Intrusion of the anterior teeth.

3. Combination of the two

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Page 3: Marcotte Mechanics / orthodontic courses by Indian dental academy

1. Extrusion of the posterior teeth.• Correction of deep overbite by this method is often indicated in

patients having a steep occlusal plane.

• The four types of extrusive mechanisms are;a) Tip-back mechanismb) Base-arch mechanismc) 0.016-inch distal extensiond) Parallel eruption of the buccal segment

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Page 4: Marcotte Mechanics / orthodontic courses by Indian dental academy

Tip-back mechanism (extrusion mechanism)

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Page 5: Marcotte Mechanics / orthodontic courses by Indian dental academy

• The tip back mechanism can be used when arch length required is around 1-2mm. Center of rotation is at the distalmost aspect of the lower second molar. Once the buccal segment is upright, space appears between the first premolar and the canine. Activation of the hook over the anterior segment produces a negative moment and an eruptive force to the buccal segment.

The indications for the use of tip back mechanism are ;1. In growing patients with a forward growth rotation.2. For a deep curve of spee in the lower arch.3. For a deep overbite. 4. For slight arch length inadequacy (1-2mm per side)5. For a steepened natural plane of occlusion

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Page 6: Marcotte Mechanics / orthodontic courses by Indian dental academy

• Tip back mechanism consists of:1. 0.036-inch lingual arch2. 0.018 x 0.025 inch anterior segment3. Buccal stabilizing segments of 0.018x0.025

• If the anterior segment has a normal inclination, the hook should be placed between canine & lateral incisor. (Approximate center of resistance of anterior segment)

• If the lower anterior segment is slightly flared with the canines higher than the incisors, the depressive force should be placed distal to the center of resistance of the anterior segment.

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Page 7: Marcotte Mechanics / orthodontic courses by Indian dental academy

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Page 8: Marcotte Mechanics / orthodontic courses by Indian dental academy

Base Arch Mechanism• Some times also called an intrusive arch . this is also used for extruding

teeth in a deep overbite correction.• The main difference between tipback mechanism and base arch is in the

location of the center of rotation.• C-rot for base arch is located close to the mesial root of lower first molar.• The buccal and anterior archwires are similar to that of tip - back

mechanism. The lingual arch wire is also placed.• The base arch mechanism is made from 0.018x0.025inch stainless

steelwith helices.• The force system is identical to that of tip back spring,except there is no

anterior hook free to slide anteroposteriorly.

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Page 9: Marcotte Mechanics / orthodontic courses by Indian dental academy

• If the base arch is preactivated and no lingual arch is present,eruption and rotation of the buccal segments will occur along with lingual crown torque.

• However ,with the lingual arch in place,we can notice 1. Eruption and a negative rotation of the buccal segment (flattening of

the plane of occlusion)2. No increase in arch length.3. That the roots of the buccal segment move forward.4. That second molars appear to be buried.

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Page 10: Marcotte Mechanics / orthodontic courses by Indian dental academy

0.016 – Inch Distal Extension• In order to level a deep curve of Spee, both anterior and posterior segments

need to be erupted and rotated. This eruption can be done with 0.016-inch distal extension.

• In order to use this appliance, there should be:1. Good growth increments remaining, since the appliance is eruptive.2. A significant second- order discrepancy between the canines and the incisors;

Incisors should be higher than the canines.3. Minimal arch length required (2-3mm per side)4. A deep curve of Spee.5. Extraction of teeth, usually the first premolars.

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Page 11: Marcotte Mechanics / orthodontic courses by Indian dental academy

• The appliance consists of:1. 0.018x0.025 inch base arch2. 0.016-inch distal extention. Immediately mesial to the canine bracket a

vertical loop is placed and immediately distal to canine bracket a helix is placed.

3. 0.036-inch lingual arch.

• Higher alpha moments [ anterior ] result in more eruption and rotation of the anterior segment;

• Higher beta moments result in more eruption and rotation of the buccal segment.

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Page 12: Marcotte Mechanics / orthodontic courses by Indian dental academy

Parallel eruption of the buccal segment• It is used in the upper arch only for parallel eruption of buccal segment

• Here cervical head gear with long outer bow bet at about 60° causes negative moment by bringing the outer bow down to the line of action of headgear strap. Once it is engaged the line of action of force, away from center of resistance produce positive moment.

• Both moments tend to cancel each other & pure extrusive forces to the buccal segment is left

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Page 13: Marcotte Mechanics / orthodontic courses by Indian dental academy

Intrusion using base arch

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For intrusion of 4 anteriors, the same base arch used for extrusion is used here. The difference is not involving canine. The force is 100 gms in the midline. The base arch is tied back from the helix to the buccal tube, to prevent flaring of the incisors.To prevent the rotation and eruption of buccal segment , an occipital headgear with short outer which counters the +ve moment from the base arch is used.

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Page 14: Marcotte Mechanics / orthodontic courses by Indian dental academy

•First four incisors are intruded then canine is separately intruded using canine intrusion springs.

•This avoids avoids large moments on the buccal segment .

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Staged Intrusion of Six Anterior Teeth

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Page 15: Marcotte Mechanics / orthodontic courses by Indian dental academy

Thank you

For more details please visit www.indiandentalacademy.com

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