Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 42

Let's Talk About That

greater control much sooner than with any rectangular system using the same amount of force. I
now reduce the number of appointments, finishing many fixed cases in 6 to 12 appointments. My
arch wire progression is as follows:
1.
2.
3.
4.

0.014″ thermal NiTi
0.018″ × 0.018″ ultra-soft thermal NiTi
0.020″ × 0.020″ thermal NiTi
0.019″ × 0.019″ SS or 0.020″ × 0.020″ Beta Ti
(upper 0.020″ × 0.020″ SS is also used)

As you can see, I have 3-D control early and
throughout treatment.
This is a simple way of accelerating treatment,
gently, so it's easier to get the esthetic smile and
still speed up treatment.
PT: Creating an esthetic smile arc and full incisal
display are major goals of your treatment. Is it
possible to do this and speed up treatment?
TP: This happens very early in treatment using a
combination of Pitts 21 control and Pitts esthetic

bracket placement. I can usually set up the awesome esthetic smile in three to five appointments
(Figure 2). It's part of the Pitts protocol using an
appropriate bracket position, immediate light
elastics, proper disarticulation, wire progression,
early repositioning of brackets as needed, and
various muscle exercises.
My biomechanical focus that adds to the WOW
factors of the "Pitts 21 smile" and hastens treatment includes:

▫▫ How I shape the teeth, including proportion▫▫
▫▫
▫▫
▫▫
▫▫
▫▫
▫▫
▫▫
▫▫

ality, prior to appliance placement (adding
composite, removing enamel)
Reshaping of canine tip prior to appliance
placement
Bracket positioning for smile and occlusion
Pitts 21 bracket slot torque (upright or flipped
upside down)
Mandibular bracket position
Disarticulation buttons in the proper position
and shape
Light elastic size and position from first appointment
Archwire size, width, and shape
Focusing on A-P/vertical position of maxillary
incisors
Repositioning brackets early as needed for
vertical positioning of the maxillary incisors
and smile arc

This allows me to set up the smile and the occlusion quite rapidly.
PT: "Bite buttons" are an integral part of your
protocols. Can you be more specific about the
size, shape, and location of these buttons? Are
they different for Class I, Class II, Class III cases?
For example, in a moderate Class II malocclusion
with a deep overbite and deficient upper incisor
display, where would you place the button and
where would you attach the inter-arch elastics?

Figure	2. Before (a) and after (b) treatment

42	

TP: It's the combination of bite buttons, elastics,
bracket used, and bracket position that sets up
the smile design quickly.

PCSO	Bulletin	 	 Fall	2019



Pacific Coast Society of Orthodontists Bulletin Fall 2019

Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Fall 2019

No label
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - No label
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 2
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 3
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 4
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 5
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 6
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 7
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 8
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 9
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 10
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 11
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 12
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 13
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 14
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 15
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 16
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 17
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 18
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 19
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 20
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 21
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 22
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 23
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 24
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 25
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 26
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 27
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 28
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 29
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 30
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 31
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 32
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 33
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 34
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 35
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 36
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 37
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 38
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 39
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 40
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 41
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 42
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 43
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 44
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 45
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 46
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 47
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 48
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 49
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 50
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 51
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 52
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 53
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 54
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 55
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 56
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 57
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 58
Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 59
http://www.brightcopy.net/allen/pcso/92-2
http://www.brightcopy.net/allen/pcso/92-1
http://www.brightcopy.net/allen/pcso/91-4
http://www.brightcopy.net/allen/pcso/91-3
http://www.brightcopy.net/allen/pcso/91-2
http://www.brightcopy.net/allen/pcso/91-1
http://www.brightcopy.net/allen/pcso/90-04
http://www.brightcopy.net/allen/pcso/90-3
http://www.brightcopy.net/allen/pcso/90-2
http://www.brightcopy.net/allen/pcso/90-1
http://www.brightcopy.net/allen/pcso/83-4
http://www.brightcopy.net/allen/pcso/89-3
http://www.brightcopy.net/allen/pcso/89-2
http://www.brightcopy.net/allen/pcso/89-1
http://www.brightcopy.net/allen/pcso/88-4
http://www.brightcopy.net/allen/pcso/88-3
http://www.brightcopy.net/allen/pcso/88-2
http://www.brightcopy.net/allen/pcso/88-1
http://www.brightcopy.net/allen/pcso/87-4
https://www.nxtbook.com/allen/pcso/87-03
https://www.nxtbook.com/allen/pcso/87-2
https://www.nxtbook.com/allen/pcso/87-1
https://www.nxtbook.com/allen/pcso/86-4
https://www.nxtbook.com/allen/pcso/86-3
https://www.nxtbook.com/allen/pcso/86-2
https://www.nxtbook.com/allen/pcso/86-1
https://www.nxtbook.com/allen/pcso/85-4
https://www.nxtbook.com/allen/pcso/85-3
https://www.nxtbook.com/allen/pcso/85-2
https://www.nxtbook.com/allen/pcso/85-1
https://www.nxtbook.com/allen/pcso/preview-program-2013
https://www.nxtbook.com/allen/pcso/84-4
https://www.nxtbook.com/allen/pcso/84-2
https://www.nxtbookmedia.com