May’s Tip

Do not memorize, understand – Dr. T. Mulligan

Correction of the canted incisal arc – incisal plane.

The correction of a canted occlusal plane is quite complicated, it requires composite build-up to stabilize the occlusion in the ideal position. Also, it requires the assistance of triangular elastics and in some cases TADs.  This article will discuss correction of the canted incisal plane.

Numerous clinicians correct canted incisal plane by repositioning brackets, more incisal for intrusion and more gingivally for extrusion.  However, this will change the torque on the teeth.  The brackets placed more incisal – will increase the torque and move the incisal edges labially. The brackets placed more gingivally – will decrease the torque and move the incisal edges lingually.

The Overlay Arch is an elegant solution. Tip back for intrusion and tip forward for extrusion. Also, the amount of the activation is easy to titrate with lesser squeeze with the Tweed loop forming pliers.

Examples of the activation of the Overlay Arch for canted incisal plane:

1. Intrusion of #21(9), 22(10), 23(11) – TIP BACK ON BOTH SIDES
2. Extrusion of #21(9), 22(10), 23(11) – TIP FORWARD ON BOTH SIDES
3. Extrusion of #13(6), 12(7), 11(8) and Intrusion of #21(9), 22(10), 23(11) – TIP FORWARD on the right side, TIP BACK on the left side

The images below demonstrate intrusion of #21(9), 22(10), 23(11). The Overlay Arch is ligature tied in two places between the central incisor and the cuspid and the TIP BACK is on both sides.