LEVELING AND ALIGNING:

CHALLENGES AND SOLUTIONS

Bhavna Shroff and Steven J. Lindauer
Seminars in Orthodontics, Vol 7, No 1 (March), 2001: pp 16-25
OUTLINE OF CONTENTS
 Introduction
 Leveling With Straight Wires
 Side Effects of Straight Wire Mechanics in the First
Order
 Side Effects of Straight Wire Mechanics in the Second
Order
 Conclusion
 INTRODUCTION
 May involve all of the teeth or may exclude some teeth
 Important in sliding mechanics for space closure

W R Proffit, H W Fields, and David Sarver, Contemporary Orthodontics, 4th Edition, Mosby, 2006
INTRODUCTION

 Increase the possibility of the undesirable side effects

 Analysis of the force systems will show the
llunanticipated side effects before they occur
LEVELING WITH STRAIGHT WIRES
 Introduction by L. F. Andrews
 The six keys to normal occlusion
 Key I. Molar relationship
 Key II. Crown angulation (tip)
 Key III. Crown inclination
 Key IV. Rotations
 Key V. Tight contacts
 Key VI. Occlusal plane
LEVELING WITH STRAIGHT WIRES
 Easy to use and a reduction in chairside time
 Not suitable for all malocclusions:
 Asymmetric buccal occlusions
 Unilateral vertical discrepancies
LEVELING WITH STRAIGHT WIRES
 Force systems: Burstone and Koenig (1974)

From Burstone CJ, Koenig HA: Am J Orthod 65:270,1974

LEVELING WITH STRAIGHT WIRES

Step Asymmetric V Symmetric V

geometry geometry geometry
ANALYSIS OF THE FORCE SYSTEMS
 Isolate 2 tooth segments
 Starting at the midline
 Observe the relationship of each pair of teeth
relative to one another
SYMMETRIC V GEOMETRY

consistent
STEP GEOMETRY
SIDE EFFECTS OF STRAIGHT WIRE MECHANICS
IN THE FIRST ORDER
SIDE EFFECTS OF STRAIGHT WIRE MECHANICS
IN THE FIRST ORDER
SIDE EFFECTS OF STRAIGHT WIRE MECHANICS
IN THE FIRST ORDER
SIDE EFFECTS OF STRAIGHT WIRE MECHANICS
IN THE FIRST ORDER

Transpalatal arch
0.030” SS
or 0.032 × 0.032” TMA
SIDE EFFECTS OF STRAIGHT WIRE MECHANICS
IN THE FIRST ORDER
SIDE EFFECTS OF STRAIGHT WIRE MECHANICS
IN THE FIRST ORDER

Bends or curvature
Transpalatal arch
SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE SECOND
ORDER

auxiliary wire 0.014” or 0.016” NiTi

Stabilized arch
SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE SECOND
ORDER
SIDE EFFECTS OF STRAIGHT WIRE MECHANICS IN THE SECOND
ORDER
CONCLUSION
 Straight wire mechanics often be used during orthodontic
leveling and aligning
 Analysis of the relationships between adjacent teeth will show
that the force systems will be desirable or not
 Alternative treatment strategies may be indicated when the
anticipated side effects are unfavorable
 Evaluation of the force systems during orthodontic leveling
and aligning can improve treatment efficiency and help avoid
unexpected tooth movements