 LDOM®
Appliance
This fixed
orthodontic
appliance may
consists off:
-
Brackets
-
Molar Tubes
with hooks
-
Arch Wire
-
Elastic
Ligature
-
Intermaxillary
Elastics
-
Auxiliaries
There are
variations
based on case,
stage of
treatment and
individual
preference.
Most common
combinations
are described
below.
Molar tube selection
|
Stage
III
preference |
Maxillary
1st
Molar |
Mandibular
1st
Molar |
|
Round Wire
Finish |
Round Tube
close to
occlusal
table
bonded or
welded on
a molar
band. |
Round Tube
close to
gingiva
bonded or
welded on
a molar
band. |
|
Rectangular
Wire
Finish |
Combination
of round
and
rectangular
tubes
bonded or
welded on
a molar
band.
Rectangular
tube will
be close
to
occlusal
table and
round tube
will be
gingival
to the
rectangular
tube. |
Combination
of round
and
rectangular
tubes
bonded or
welded on
a molar
band.
Round
tube will
be close
to gingiva
and
rectangular
tube will
be
occlusal
to the
round
tube. |
Type of interproximal elastics
|
Case |
Intermaxillary
Elastic |
|
Non
Extraction |
2 Oz. |
|
Extraction |
3.5 Oz. |
|
Class I
and II |
Class II
Elastics |
|
Class III |
Class III
Elastics |
Bracket
selection
based on type
of case
|
Non
Extraction
Case |
Choose a
kit with
20
brackets,
all
permitting
distal
tipping
and distal
root
uprighting. |
|
1st
Bicuspid
Extraction
Case
|
Choose a
kit with
16
brackets.
Anterior
brackets
permitting
distal
tipping
and distal
root
uprighting
while 2nd
Bicuspid
bracket
permits
mesial
tipping
and mesial
root
uprighting. |
|
2nd
Bicuspid
Extraction
Case |
Choose a
kit with
16
brackets.
All
brackets
permitting
distal
tipping
and distal
root
uprighting. |
Archwire
selection
based on stage
|
Stage |
Archwire |
Size |
Form |
Brackets |
|
Stage I
Passive
Start |
NiTi |
0.014” |
Standard
arch |
Cuspid to
Cuspid |
|
Stage I
Active
Start |
Round
Steel |
0.014” or
0.016” |
Looped
with
expanded
arch form
for a
crowded
case.
Anchor
Bend. |
Cuspid to
Cuspid |
|
Stage I
Active
Start |
Round
Steel |
0.016” |
Straight
with
expanded
arch form.
Anchor
Bend. |
Cuspid to
Cuspid |
|
Pre Stage
II
If so,
there will
not be a
Pre Stage
III |
Round
Steel |
0.018”,
0.020” or
0.022” |
Straight
with toe
in for
maxillary
arch wire
and toe
out for
mandibular
arch wire.
Bite
Sweep. |
Add
Bicuspid |
|
Stage II |
Round
Steel |
0.022” |
Straight
with toe
in for
maxillary
arch wire
and toe
out for
mandibular
arch wire.
Bite
Sweep. |
If no Pre
Stage II
then add
Bicuspid
only
towards
end of
Stage II
to those
Bicuspid
that
require
rotational
correction |
|
Pre Stage
III |
Round
Steel |
0.018”’,
0.020” or
0.022”.
Goal is to
be able to
fit 0.022”
passively |
Straight
with toe
in for
maxillary
arch wire
and toe
out for
mandibular
arch wire.
Gable
Bend. |
Add
Bicuspid |
|
Round
Stage III |
Round
Steel |
0.022” |
Straight
with toe
in for
maxillary
arch wire
and toe
out for
mandibular
arch wire.
Gable
Bend. |
|
|
Rectangular
Stage III |
Rectangular |
0.022” x
0.025” |
Standard
arch form
with or
without
pre-torque |
|
Auxiliary
selection
based on stage
|
Stage |
Auxiliary |
Action |
|
Stage I
Passive
Start |
NiTi Arch
Wire |
Some
cellular
movement |
|
Stage I
Active
Start |
Rotating
Springs |
To rotate
mal
aligned
anterior
teeth |
|
Stage I
Active
Start |
2nd
order
bends |
Over
correction |
|
Pre Stage
II |
Rotating
Springs |
To rotate
mal
aligned
bicuspids |
|
Stage II |
Rotating
Springs |
To rotate
mal
aligned
bicuspids |
|
Stage II |
Uprighting
Springs |
To break
anterior
segment to
allow
posteriors
to move
mesially |
|
Pre Stage
III |
None |
|
|
Round
Stage III |
Torqueing
Spring |
To torque
maxillary
anterior
teeth as a
segment or
individually |
|
Round
Stage III |
Uprighting
Springs |
To restore
axial
inclination
of all
teeth
mesial to
the anchor
molar |
|
Rectangular
Stage III |
Deep
Groove
Brackets |
To allow
use of
NiTi
torque bar |
|
Rectangular
Stage III |
NiTi
Torque Bar |
Torque
maxillary
anterior
teeth |
|
Rectangular
Stage III |
Uprighting
Springs |
To restore
axial
inclination
of all
teeth
mesial to
the anchor
molar |
| 
