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Finishing and detailing with the pre-adjusted edgewise labial fixed appliance: the why, the what and the how Joey Donovan Siobhan McMorrow Erfan Salloum Declan T Millett Grant T McIntyre Dental Update 2024 17:3, 707-709.
Authors
JoeyDonovan
BDS, DClinDent (Orth), MOrth, Specialist in Orthodontics
BDSc, DDS, FDSRCPSGlasg, FDSRCSEng, DOrthRCSEng, MOrthRCSEng, FHEA, BDSc, DDS, FDS, DOrth, MOrth, Professor of Orthodontics/Consultant Orthodontist
Professor of Orthodontics/Consultant, Orthodontic Unit, Cork University Dental School and Hospital, University College Cork, Wilton, Cork, Republic of Ireland
Finishing and detailing is typically undertaken towards the end of orthodontic treatment. It should, however, be considered at the start of treatment and then evaluated at the end of each treatment stage. An appraisal of the disharmony between the planned and observed facial, skeletal and occlusal objectives is required with ongoing refinement to achieve the treatment goals. With the pre-adjusted edgewise labial fixed appliance, finishing and detailing may involve bracket repositioning, archform adjustment, localized wire bending, elastic traction, partial debonding, occlusal adjustment as well as restorative and periodontal input. It should also take into consideration the retention plan.
CPD/Clinical Relevance: This article summarizes what is involved in finishing and detailing with the pre-adjusted edgewise labial fixed appliance in regard to aesthetics, function and stability, and critiques the evidence available in relation to these aspects.
Article
From an orthodontic perspective, finishing is described as the art of addressing individual perceptions and minute details during the final stages of fixed appliance therapy.1 In the same context, detailing encompasses locating each tooth in its optimal position in all three planes.1
Pre-adjusted labial fixed appliances incorporate first, second and third order tooth movements in the appliance prescriptions to produce the respective ‘in-out’, tip and labio-lingual torque. These movements occur gradually throughout treatment, with archwire progression leading to greater engagement of the bracket slot. Accurate placement of brackets and other attachments is fundamental to finishing and detailing and, although it may seem counterintuitive, finishing and detailing therefore has its origins at the start of treatment.2
The intention of accurate attachment placement is to locate the teeth in their optimal positions and thereby achieve Andrews' six keys of static occlusion, as well as functional occlusal goals (Table 1).3, 4 Several variants of the pre-adjusted edgewise appliance exist with different prescriptions.
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