ask damon

Upload: rama-rao

Post on 07-Apr-2018

218 views

Category:

Documents


0 download

TRANSCRIPT

  • 8/3/2019 ask damon

    1/5

    Key Issues to Remember:

    The benefit of Copper Ni-Ti is precise transformation temperature, which makes delivery

    of precise and consistent forces possible.

    What determines the force delivered by a thermally activated wire is the difference between

    the transformation temperature of the wire and the mouth temperature. The greater thedifference between transformation temperature and mouth temperature, the greater the force

    the wire delivers. The ability to establish a precise transformation temperature is key to

    producing a wire that delivers consistent and predictable forces.

    With the copper in Copper Ni-Ti, Ormco can establish a transformation temperature range of

    2C during the manufacturing process.

    All other Ni-Ti wires have a transformation temperature range of 5C.

    Lot-to-lot consistency. All clinicians, including Dr. Damon, are familiar with the variability

    of the stiffness and performance of traditional Ni-Ti wires. In the past, Dr. Damon has

    rejected about 30% of his Ni-Ti Align SE wires for lack of sufficient stiffness.

    Q: What is the transformation temperature of .014 Damon Copper Ni-Ti?

    A: The initial wire in the Damon System has to complete two objectives. It must be a small, round

    wire so that it will be passively engaged in the archwire slot and small enough to minimize angles

    as the wire bends when it leaves one bracket and goes into the next. The result is minimum friction

    and binding in the system. Because of the small dimension of this wire, it is also critical that the

    wire deliver sufficient forces for efficient tooth movement. This requires a wire with a relative

    stiffness greater than Ormco's other Copper Ni-Ti wires (27C, 35C and 40C Copper Ni-Ti). To

    assure that optimum forces are delivered, .014 Damon Copper Ni-Ti has a maximum transformation

    temperature of 25C, which is lower than Ormco's other Copper Ni-Ti wires. But this doesn't tell the

    whole story. The wire is also work hardened during the manufacturing process to make it stiffer.

    The combination of a lower transformation temperature and increased work hardening allows

    Ormco to manufacturer a small-dimension archwire with sufficient stiffness to deliver optimal

    forces during the initial phase of treatment.

    Q: What is the difference in force levels between .014 Damon Copper Ni-Ti and .014 Align

    SE?

    A: The design objective of Damon Copper Ni-Ti is not to offer an alternative force level when

    compared to Align SE but rather to produce a wire that would deliver consistent and predictable

    optimal force. Due to fluctuating transformation temperature, Align SE delivers inconsistent force.

    This explains why many doctors have complained that the .014 Align SE initial wire frequently

    takes a permanent set or delivers limited tooth movement force due to insufficient stiffness. Thedesign objective of .014 Copper Ni-Ti is to increase the efficiency, consistency and predictability of

    the initial round wire in the Damon System.

    Q: What is the advantage of .014 Damon Copper Ni-Ti over other Ni-Ti (including .014 Align

    SE)?

    A: The key to consistent force delivery with all Ni-Ti wires is the ability to establish a precise

    transformation temperature; in other words, the temperature at which the wire will transform from

    an inactive state to an active state. Because of the copper in the Copper Ni-Ti alloy, Ormco is able

    to establish a transformation temperature within the limited range of 2C. Due to intrinsic

    limitations, the transformation temperature of other Ni-Ti alloys is 5C. This means .014 DamonCopper Ni-Ti will activate at a precise transformation temperature and deliver more-consistent and

    predicable forces with far greater wire-to-wire consistency than other Ni-Ti alloys and is more

  • 8/3/2019 ask damon

    2/5

    flexible, allowing easier engagement without taking a permanent set.

    Q: Are there any other differences?

    A: The .014 Damon Copper Ni-Ti wires have greater resilience (recovery) relative to other Ni-Ti

    wires and provide greater force to move teeth to their final position. An ideal initial archwire would

    completely level and align the teeth to the shape of the selected arch. This would make full-sizedwire engagement easier since the aligned teeth would minimize or eliminate the need to force the

    wire into bracket slots that are not aligned properly. This is a particularly important difference for

    Damon brackets because clinicians can close the slide rather than ligate the archwire into the slot.

    Damon .014 Copper Ni-Ti

    Q: What are the clinical advantages of Copper Ni-Ti?

    A: Copper Ni-Ti has revolutionized orthodontics by providing the clinician with an archwire that

    delivers constant low forces with unparalleled wire-to-wire consistency. Ormco is now making

    Copper Ni-Ti available in the Damon arch-form. Damon .014 Copper Ni-Ti offers distinct

    advantages over other traditional nickel titanium archwire. Consistent Forces:

    Compared to other nickel titanium alloys, Damon Copper Ni-Ti will generate constant forces over

    longer activation spans. By combining exclusive metallurgical properties with a rigorously

    controlled manufacturing process, Damon Copper Ni-Ti will activate at a precise transformation

    temperature. The result is more- consistent and predictable forces for optimum tooth movement

    than traditional nickel titanium archwires that can provide unpredictable force levels due to

    fluctuating activation temperatures. To provide consistency, each batch is tested at the time it is

    manufactured to ensure that it meets our stringent specifications. Predictable Forces:

    Damon Copper Ni-Ti represents a giant leap in delivering optimum forces compared to all other

    nickel titanium wires. Damon Copper Ni-Ti is more resistant to permanent deformation and

    generates constant forces with only a very small drop in unloading (tooth moving) forces. As

    treatment progresses, the forces in many traditional nickel titanium wires will drop off below

    optimum levels due to inconsistent wire transformation temperatures. Damon Copper Ni-Ti will

    provide optimum and predictable forces throughout treatment. Additionally, Damon Copper Ni-Ti is

    more flexible than traditional nickel titanium wire allowing easier engagement and it will not take a

    permanent set.

    Damon Copper Ni-Ti Traditional Ni-Ti

  • 8/3/2019 ask damon

    3/5

    Damon Copper Ni-Ti will provide optimum force levels throughout treatment while the force levels of traditional Ni-Ti wires tend to drop off to sub-optimum

    levels as treatment progresses.

    Low Friction TMA in the Damon Arch Form

    Q: More and more doctors are using TMA in their Damon cases. Doesn't TMA have too much

    friction to be used in the Damon System? What are the benefits of using TMA in the DamonSystem?

    A: We are now bringing the clinical benefits of Low-Friction Colored TMA to the Damon System.

    Ormco's exclusive ion beam implantation process hardens the surface of regular TMA and thus

    decreases friction by up to 70%. This process also increases the resiliency of Low-Friction Colored

    TMA, which helps maintain any bends put in the archwire. This, combined with the fact that TMA

    has half the stiffness of stainless steel, allows you to use an archwire that will deliver gentler, more

    optimal forces in the working and final phase of the Damon treatment. In the Damon System, Low-

    Friction Colored TMA has a variety of clinical uses that will help facilitate your ability to achieve

    the superior result you demand. Damon Treatment Indications:

    In the final phase, Low-Friction Colored TMA's greater flexibility allows you to more easily

    bend torque in the archwire with moderate forces without hindering your ability to close the

    slide

    Easier to inert and close the slide than stainless steel when small detail bends are desired at

    the end of treatment,

    Low Friction Colored TMA can be used for final realigning after en masse retraction, when

    Class II elastics were used for anchorage.

    Low Friction Colored TMA is easy to insert especially when incorporating second molars.

    Low-Friction Colored TMA is available in Purple and Honeydew. It will be available in .016 x .025,

    .017 x .025 and .019 x .025 cross-sections.

    Debonding Damon2 Brackets

    Q: What is the recommended procedure for debonding Damon2 brackets?

    A: Removing the Damon Appliance is a little different than removing a conventional appliance. As

    you know, the typical method to debond a twin appliance is to grab the mesial-distal tie-wings and

    squeeze until the base deforms and the bracket comes off. This method is unreliable with the

    Damon 2 because the slide reinforces the tie-wings and makes them difficult collapse. We

    recommend using the AEZ 90 Debonding Plier (803-0104). Follow the instructions below to

    successfully debond the Damon 2 appliance.

    1. ImageUsing the Debonding instrument, grasp the

    bracket under the occlusal-gingival tie-wings. Squeeze

    the instrument handles slowly applying gradual force

    until the bracket comes off the teeth. Do not pull, jerk, or

    twist the bracket.

    2. PhotoFor brackets with hooks, grasp under the mesial

    tie-wing to avoid the hook. Do not grasp more than two tie-wings at a time. Squeeze the

    instrument handles slowly applying gradual force until the bracket comes off the teeth. Do

    not pull, jerk, or twist the bracket.

  • 8/3/2019 ask damon

    4/5

    Avoiding Bond Failures with Damon 2

    Q: We are having a problem with brackets debonding shortly after initial bond with the

    Damon Appliance. We are using the same light cure adhesive that we used with our

    conventional appliance and we have not changed our bonding procedure.

    A: This is fairly common problem when starting with the Damon System. There are a couple offactors that you should look at:

    1. The Damon 2 has a slightly different design than most conventional

    appliance. The pad is rhomboid shaped and the bracket is rectangular. If

    you are accustomed to place rhomboid brackets this can be a little

    confusing. Because the configuration on the Damon 2 is slightly different

    there is a tendency to move the bracket more when placing it. Because a

    light cure adhesive will start to cure with the ambient light in office,

    adjusting the bracket placement too much will weaken to bond and make

    the bracket more susceptible to failure. With the Damon 2, the pad is the

    used for placement reference. Try to place the bracket in the correctposition as quickly as possible minimizing the little adjustments as much

    as possible. Notice that with the Damon Appliance, the pad is used as the

    placement reference point.

    2. All self-ligating appliances have a slightly higher profile than conventional appliances. This

    means when curing the adhesive after placing the Damon 2 you need to make sure that you

    position the curing light right as close to the bracket pad as possible and leave it there for the

    recommended time. Because of the higher profile, brackets will enter into occlusion more

    after initial bond and be more susceptible to bond failure.

    3. Check your curing lights to see that they are generating the appropriate output for optimal

    curing.

    Permanent Retention

    Q: Why do you use bond-a-braid in the upper and stainless steel in the lower for permanent

    retention?

    A: When Dr. Damon places the lower lingual retainer, he intends to keep it in place indefinitely.

    Steel is only bonded to the canines and therefore flossing interference is minimized. Conversely, Dr.

    Damon plans to eventually remove the .026 bond-a-braid from the upper. Bond-a-braid is bonded to

    each tooth, lateral to lateral. Since floss can cut through this material, eventual removal is necessary.

    Archwires Sequence for Damon .018

    Q: What is the recommended archwire sequence for Damon .018

    A: There is no one wire sequence in the Damon System. When selecting archwires, the doctor

    should use the archwire that will keep the case in the Optimal Force Zone. As a guideline we can

    recommend the following wires:

    Initial Phase

    .012 Ni-Ti The objective of this wire is to start tooth movement, level, align and begin arch form

    development. Some clinicians use this wire as the initial archwire in the .018 slot. Many other

    doctors feel this wire is too small and does not provide enough force to start tooth movement. Dr.

  • 8/3/2019 ask damon

    5/5

    Damon recommends starting cases with an .014 Ni-Ti.

    .014 Ni-Ti This is the recommended starting archwire. It is used to start tooth movement, level,

    align and begin arch form development.

    .016 Ni-Ti This wire is often used as a second wire in very crowded cases when slightly higher

    forces are needed to continue leveling and aligning. It is very common to use this wire in the lowerarch when there is a lot of crowding.

    Working Phase

    .014 x .025 Ni-Ti This will be the common first rectangular wire used with the .018 slot. It is used

    in well-prepared arches that are almost completely leveled and aligned. It will be used to work out

    rotations and begin torque control.

    .016 x .025 Ni-Ti Can be used when more torque control and arch form development is desired

    before going to the final stainless steel archwire. If it is difficult to engage the .016 x .025 stainless

    steel, this is a good option.

    Final Phase

    .016 x .025 PrePosted Stainless Steel

    Used to maintain integrity of the arches during anteroposterior correction and closure. Used to gain

    complete torque control.

    Finishing Phase

    017 x .025 Low-Friction TMA Used when more torque control is required and/or detail wire bends

    are needed.