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VOL 1 #33

FALL 2010/WINTER 2011a Periodical Designed to Inform

Orthodontic Professionals &Dealers

R/W

A.T.I.

LEONEAMERICA’S

ORTHONEWSORTHONEWSOur D.B. Self-Ligating Bracket

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Rapid Open Bite Treatmentin Combination with theLogic Bracket System

By Dr. Mcdadeseepages

10-11

By Dr. Orsiseepages

6-9

FEATURED ARTICLEFEATURED ARTICLE

Experimental Data &Clinical Confirmations OnLow-Friction Biomechanics

SEE PAGES 2-4

Diameter SilverContent

MeltingPoint

1/32”(.79mm)

1145oF618oC 56%

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New Products

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NEWPRODUCTSFOR2010

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INTRODUCTION“…there’s a lot of talk about low-friction techniques and in an effort to obtain them ourcompetitors have created self-ligating orthodontic brackets that are engineeringmasterpieces but not very easy to use. Here at Leone instead, with the clear objective oflow friction of the wire in the bracket slot and the combination of it with logic, capacity,creativity and simplicity, our research and planning department has realized a ligature thatis able to reach the pre-defined objective by itself. That is how the idea of Slide, our newligature, was born. Pursuing efficiency we have realized a ligature that includes new theo-ries of modern orthodontics designed to rediscover the importance of low-friction forthe treatments.A simple tool that will allow you to obtain the best results in the shortestamount of time”. This is what doctor Elena Pozzi stated on Leone’s Information Bulletinthree years ago when the innovative ligature Slide was presented: in times where the ma-jority of the companies was focusing on the production of the umpteenth self-ligatingbracket, Leone was working to reduce the friction on any type of orthodontic bracket bymeans of a simple elastic module.Without any doubt we can state that the courage andfantasy of those who worked on this project have been recognized as the efficiency of Slidehas been widely proved both in vitro, through several researches, and in vivo, with the ev-idence of thousand of cases treated with the STEP & Slide system with a very high per-centage of success and great therapeutic results. As far as in vitro experimentation isconcerned…

AIM OFTHE STUDYThe aim of this in vitro study was to compare the frictional forces produced by a passiveself-ligating bracket (SmartClip 3M) (figg.1,2) and two types of elastomeric ligatures, low-friction ligatures (Slide) (fig. 3,4), and conventional elastomeric ligatures (fig. 5,6), on a con-ventional bracket (STEP) used with two types of wires (.014” super elastic nickel titaniumwire and .019”X.025” stainless steel wire), in a wet dry state.

EXPERIMENTAL MODELAND DATAANALYSISResistance to sliding produced by the different bracket/wire/ligature combinations weremeasured using a frictional testing device that was set on the crosshead of an Instron 4301testing machine with a load cell of 10 N. Frictional forces produced by thefollowing samples were recorded:

1.self-ligating bracket along .014” super elastic nickel titanium wire;2.conventional bracket with Slide ligature along .014” super elastic nickel titanium wire;3.conventional bracket with conventional elastomeric ligature along .014” super elasticnickel titanium wire;4.self-ligating bracket along .019”X.025” stainless steel wire;5.conventional bracket with Slide ligature along .019”X.025” stainless steel wire;6.conventional bracket with conventional elastomeric ligature along .019”X.025”stainless steel wire;

Slide Article

Experimental Data And Clinical ConfirmationsOn Low-Friction BiomechanicsBy Dr. ssa Linda Orsi,Dr. Fabio Giuntoli,Prof.ssa Paola Gandini

Bruno PozziEditor-in-Chief

Kory CarmanAssistant Editor

Kathleen NortonDistribution

Honeyleth AbdonDistribution

Emilio PozziPresident - LeoneAmerica

A Div. of American Tooth

Phil ZubiateArt Director

Dan BurkeGraphics

Katy SkelleyContributor

Judy FischerDistribution

Tiffany BushContributor

IMPORTANT DISCLOSURE: ©2010. All rights reserved. No part of this brochure may be reproduced without written permission from American Tooth Industries. ©2010 Florentine Graphics Division of ATI - www.americantooth.com

OrthoNews Contributors

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Experimental Data And Clinical Confirmations On Low-Friction Biomechanics

Slide Article

The experimental model, consisted of thebracket welded to a little steel bar, the or-thodontic wire, along which the bracketcould slide, and the ligation method, wassecured to a steel support especially de-signed for this study and the lower part ofthe support was locked to the lowerfixed clamp of the testing machine. Allmeasurements were performed underdry (fig.7) and wet (fig.8) conditions atroom temperature of 20±2°C. Duringtraction test in the wet state, a part of the steel support with the bracket/wire/ligation system was immersed in a littleplastic cup full of Ringer’s solution (NaCl: 9,0 g/l; CaCl x 2H2O: 0,17 g/l; KCl: 0,4 g/l; NaHCO3: 2,1 g/l; pH: 7,4).This cupwas placed on the lower arm of the steel bearing itself.

Two little holes were present in the upper and lower part of the steel support.These holes allowed the wire to crossthrough and, once entered, it was held in place by a simple system of screws.The base of the bracket was welded to asteel bar that was secured to the upper moveable clamp attached to the load cell.This device allowed the bracket tomove along the wire as an axial tensile force was applied by the Instron’s load cell with a crosshead speed of 6 mm/min.In the meantime, a calculator connected to the testing machine displayed a peak force variation graph. Each of the 6bracket/wire/ligation combinations was tested 10 times, with new elastomeric ligatures on each trial, in order to mini-mize the influence of elastic deformation. For every traction test over a distance of 12 mm at speed of 6 mm/min thefollowing frictional forces were recorded: the maximum force needed to move the bracket along the wire, the frictionalforce registered at 5 mm, at 7 mm and at 9 mm, the mean of these three values and the mean frictional force recordedfrom 5 mm to 9 mm. Differences between frictional forces produced by the 12 analysed combinations were comparedby means of Kruskal-Wallis one-way ANOVA on ranks followed byTukey’s post hoc test (p<0.05).

RESULTSDescriptive statistics and statistical comparisons of the frictional forces recorded in the different bracket/wire ligation com-binations in the wet state are reported inTables 1 and 2.

No statistically significant difference was found between the frictional forces produced both by self-ligating bracket andby Slide ligature on conventional bracket independently of the wire used and the environmental conditions: all these val-ues were close to 0 N. Conventional elastomeric ligature on conventional bracket coupled with both types of wiresgenerated significantly greater frictional forces, both in wet and dry conditions.

Experimental Data And Clinical Confirmations On Low-Friction Biomechanics

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November

January

March

July

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Experimental Data And Clinical Confirmations On Low-Friction Biomechanics

CONCLUSIONAll studies made over the last years on friction have lead usto the conclusion that the friction caused by ligatures repre-sents without any doubt a breakdown for the orthodonticmovement, especially during leveling and aligning phases.That’s why to date even the most skeptical ones have rec-ognized the advantages deriving from the use of low-frictionsystems: in fact, every day a new type of self-legating bracketis published in orthodontic catalogues. It is not a surprise thatKeim, JCO Editor, declared on June 2005 issue that self-liga-tion would have been the major topics for years to come.The wide range of favorable effects characterizing self-legat-ing brackets has been deeply analyzed and described in de-tail, from arches expansion to the recovery of space with noextraction needed in borderline cases, from the reducedlength of initial phases of arches leveling and aligning to thequick closure of post extraction spaces…but shall at thispoint friction still be considered as an enemy and so that factthat it is missing considered the solution to all problems?Thecompanies producing sophisticated self-legating bracketswould probably respond affirmatively to the question abovebut an attentive clinician knows that the ability and aware-ness of deciding whether to use them or not is crucial tomaximize the advantages of low-friction. So, yes to low fric-tion but only when and where it is necessary…in otherwords a responsible and logical usage of friction.The sole op-tion available to those who use self-ligating brackets to obtainhigh levels of friction during the phase of occlusion refining toallow the entire expression of the braket informations, is the usage of conventional ligatures with different types of self-ligating brackets: and here, not only does this cause a contradiction in terms (isn’t it the bracket that is self-ligating?!),but also the relation costs/benefits needs to be taken into consideration given the fact that treating a case with self-lig-ating systems requires a bigger economic effort compared to conventional biomechanics.An alternative to self-ligating brackets could be the usage of non-conventional ligatures on conventional brackets: to datethe most rational attempt is, three years after its introduction on the market, Slide ligature, a simple, economic, efficientand versatile tool that leaves it up to the clinician when, for how long, and where to address the wire forces in orderto stimulate teeth without the ties of friction.Yes to low-friction biomechanics...but in an intelligent and logical way!

Slide Article

Slide™ ligatures, when usedwith the new Logic brackets,are safely kept in place and integrated into the bracketprofile due to Logic’s unique housing for the Slide™located at the top of the arch wire slot.

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Dr. McDade Article

Fabrication consisted of thearms soldered to two molarbands for the first molars withsoldered extension armsplaced down the lingual ofboth quadrants to expedite

expansion. The expansion was completed in just fourshort weeks. I like to use a light cure acrylic on thethreads after this time in order to create stabilizationof the expansion of the palatal suture. I left this in placefor an additional four months. Five months into thetreatment the Torko expander was removed and thepatient was ready for brackets.

It was decided to use the new Leone Logic line as itwas a new design that incorporated the self ligationdesign of brackets that seemed to be much moreprominent in the orthodonticfield, but with the design of astandard twin tie wing bracket.The Logic bracket is made toaccept the Leone Slide ligaturepad which rests on a ledge in the bracket itself; creat-ing a four sided slot which slows for virtually frictionfree movement of the round wire during initialtreatment

The patient, a preadolescent female about eight yearsold, was the subject of my treatment. Upon evaluationI concluded that she had an open mouth posture withopen bite occlusion, a posterior bilateral cross bite, andmultiple articulation errors due to her significanttongue thrust on most sounds.

It was decided thatinstead of a typical fourlegged Leone rapid palatalexpander, that we wouldinstead use the newer Leone "Torko Half Screw" whichis well suited for smaller pallets found typically in mixeddentitions.With the elimination of one set of legs alongwith one of the two stabilization guides, theTorko HalfScrew is only 4mm in height and 7.5mm in width al-lowing for placement in a much more constrictedpalate.

Rapid Open Bite Treatment in Combination withthe Logic Bracket SystemBy: Dr. Mark McDade

Torko appliance in mouth

1 year progress point 1 year progress point

1 year progress point

Initial Photos

Torko appliance

Isabella

TorkoMARKING:

LASER – Leone Brand,Name, Batch number,Direction of Activationand Max. expansionare clearly visible onthe body.

818-X0022 WIDTH 12 MMEXP. 8 MM818-X0023 WIDTH 15 MMEXP. 11 MM

BULK/EXPANSION RATIO:62mm

15mm

62mm

12mm

Grp/Item # 818-X0022

Grp/Item # 818-X0023

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Leone and LeoneAmerica, a division of American Tooth Industries, are ISO certifiedcompanies and deliver the top quality products and service at affordable prices.

Research • Technology • Production Quality ProductControl Customer Service&Order Desk IndividualWelding Service

Dr. McDade Article

Once the initial unraveling stage was completed astandard ligature tie was placed allowing me tocontinue with standard twin tie wing treatment.Whatwas a nice side feature of the Slide was that the bul-bous nature of the ligature pad slightly raised abovethe bracket itself, created a buffer between thebracket and the cheek allowing for a lot less irritationof the check, and no need to use protective wax. I didwant to note that before treatment the second molarwas severely rotated and tipped to the distal.After seven short months the maxillary incisors werealready aligned. The Logic brackets were removedafter twelve months and a Hawley retainer wasfabricated to maintain the maxillary dentition. Finalexamination reveals a patient with normal occlusion,without any tongue thrust, nor open mouthposture. She is now able to make all speechsounds with good occlusion and the eliminationof the tongue thrust altogether.

About the Author

Isabella - 1 year progress point 1 year progress point

End Results

End Results

Isabella 4/22/09 Isabella 9/27/10

Dr. McDade graduated MagnaCum Laude from Tufts Univer-sity School of DentalMedicine inBoston. While in dental school,he received the Charles EvensRestorativeDentistryAward andtheTeledyneBest of BestAwardin Prosthodontics. Dr. McDadecompleted his orthodontic training at theUniversity of Pitts-burgh, receiving his Master of Dental Science degree aftercompleting a three-year residency program.

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LeoneAmericaNational Sales Headquarters&Order Desk inArizona

Virginia LopezKory Carman Judy Fischer Doug OwenJoe Castelli John Maltby

501West Van Buren, Suite S •Avondale, AZ 85323Phone: (623) 925-2094 • Toll Free: (800) 242-9986Fax: (623) 925-2342 • Email: Leoneamerica@americantooth.com

A Periodical Designed to InformOrthodontic Professionals &Dealers

FALL 2010/WINTER 2011

Over 180 Pages Inside!

wirewire abandbands

direcdirectdiagnostic adiagnostic a

i

expansionexpansion

tubes atubeslastics and ligatlastics and ligat pliers andpliers and

Headquarters:1200 Stellar DriveOxnard,CA 93033-2404

Orthodontic DivisionofAmericanTooth Industries

Pozzi®Malibu™Flux

LEONEAMERICA’S

ORTHONEWSORTHONEWSLeone Catalog 2010

Pozzi Malibu Silver Solder

1 oz. per RollGrp/Item# 031-32.50.001 Lot #0000

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Introducingthenew

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SEE PAGES 2-4

Perfect StabilityThroughout TheExpansion:Excellent Control

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1

Self De-ActivationSystem at the Endof the Therapy:Outstanding Safety

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Activationturns formaximumexpansion

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