Tie-On Rotation Wedge (TORW) for perfect orthodontic finishing: part 2

Dr. Lloyd Taylor illustrates the steps to using Tie-On Rotation Wedges for improving finishing techniques.

Dr. Lloyd Taylor presents additional techniques using Tie-On Rotation Wedges

Part 1 in the March/April 2020 issue of Orthodontic Practice US detailed the placement of Tie-On Rotation Wedges (TORW) with stainless steel finishing arches to achieve perfect proximal contacts. Part 2 below shows some of the additional uses for TORW as well as combinations with other orthodontic accessories.

The following examples are just a few of the many combinations you may employ in your practice using TORW in your finishing technique.

Figure 1 (left): Multiple wedges can be placed to achieve simultaneous rotations. Offset bends should be a maximum of 1
mm high since reciprocal adjacent tooth movement may occur with larger offsets. Figure 2A (right): Off-center bracket identified at the final end of finishing can be replaced to correct the tooth rotation of UR3. However, to be more efficient, TORW can be used to provide the required tooth rotation to align proximal contacts. A 1 mm offset will correct the off-center bracket.
Figure 2B (left): Off-center bracket has been corrected in a single visit using TORW. This eliminated the placement of a new bracket and the sequential wire changes required to return to a final finishing full slot archwire. Figure 3 (center): Round stainless steel finishing arches may be used when only rotations are required for final alignments. Offsets can be as large as 2 mm and tied into the bracket in a single visit. There is little risk of debonding as compared to rectangular finishing wires, which are best tied in 1 mm offset increments. Figure 4 (right): Retentive elastic chain over TORW is rotating UL2 into ideal alignment. Elastic chain and TORW can be used at the same time. The elastic chain can be easily placed over the TORW to maintain the required space closure of the four anterior maxillary teeth.
Figure 5 (left): Bonded eyelet with elastic thread and TORW doubles the rotational forces. The archwire has only been tied one-half way into the ceramic slot to avoid debonding. With the addition of elastic thread, the tooth will completely rotate in just one visit. Figure 6 (center): TORW used with NiTi closing springs to rotate both maxillary laterals. Although NiTi closing springs can rapidly close posterior spaces, by using TORW, rotations of both maxillary laterals are instantly corrected before posterior spaces even start to close. Figure 7A (right): TORW used with fractured ceramic tie wing may be just as effective as with a non-fractured wing if the finishing archwire can be totally seated in the bracket slot and tied down. Here only the three remaining wings can be tied.
Figure 7B: TORW used with fractured ceramic tie wing has
completely rotated UL2 into perfect proximal alignment. There
was no need to rebond the tooth or to change archwires

Besides Tie-On Rotation Wedges, OrthoSource recently announced Crystal Clear Dental Face Shields that completely cover eyes, nose and mouth. Read about it here.

Lloyd R. Taylor, DDS, received his DDS degree from Fairleigh Dickinson Dental School. He first completed a 3-year residency in Oral and Maxillofacial Surgery and Anesthesiology and was Chief Resident at the Albert Einstein College of Medicine/Jacobi Hospital in New York City. Dr. Taylor then completed a 3-year Fellowship in Orthodontics at the Harvard School of Dental Medicine. He also completed an additional 3-year Fellowship in Orthodontic Teaching and Research at the Forsyth (Harvard) Dental Center. Dr. Taylor has practiced both Oral Surgery and Orthodontics in North Hollywood, California, for more than 50 years.


Disclosure:  Dr. Taylor is both the founder and president of OrthoSource since 1985.

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