Dear Colleagues,
It has been almost twenty years since the introduction of the Tip-Edge® bracket with its unique archwire slot. You and many other orthodontists have enjoyed the benefits that this revolutionary appliance offers such as supreme control of anchorage and relative ease of bite opening.
A new version of the Tip-Edge bracket was recently introduced — the Tip-Edge PLUS®. This bracket eliminates the need for uprighting springs and torquing auxiliaries during stage three. I have been using Tip-Edge PLUS for close to three years and am writing to relate my experiences regarding the benefits over the original Tip-Edge bracket.
The obvious benefit of Tip-Edge PLUS is the elimination of all springs and auxiliaries during stage three. This is made possible by simply threading a small wire through a tunnel that lies lingual to the archwire slot. The appliance now looks the same as any other straight wire appliance throughout the final stage of treatment. There are several other less obvious advantages to the elimination of uprighting springs that simplify treatment mechanics.
- Modification of archwires during stage three is much faster and easier since the removal and re-insertion of springs is no longer necessary.
- The lack of uprighting springs makes the appliance much more comfortable; and uncooperative patients can no longer remove Side-Winder springs.
- If a ligature tie is lost during stage three, the nickel titanium wire threaded through the bracket’s lingual tunnel keeps the tooth perfectly aligned and engaged on the main wire until the next appointment. We had one patient who somehow left the office with no ligature ties at all; when he returned for his next appointment six weeks later, all teeth were well aligned and remained fully engaged on the main archwire!
- Rotational control is probably one of the biggest unexpected benefits that I have enjoyed with the PLUS bracket. It is far better than I have seen with any other edgewise bracket. Now my stage three patients come in with all teeth perfectly aligned – minor rotations induced by bent springs or missing ligature ties are a thing of the past.
- Bracket debonds and consequent shifting of teeth lingually are much easier to handle. Instead of dropping back to a smaller diameter archwire or backtracking to a rotating spring to realign the displaced tooth, simply thread a nickel titanium wire through the PLUS bracket’s tunnel. Over the next six to seven weeks the tooth is gently brought back to the desired position where it can then be ligated to the main archwire.
- Teaching and delegation of stage three assembly is also much easier. It is simply impossible to place the wrong uprighting spring on the wrong tooth since the system no longer requires springs. At the stage three visit, thread either a .012” or .014” nickel titanium wire through the PLUS bracket´s deep tunnels. The preformed main rectangular wires are then modified and ligated into the archwire slots. The possibility of forgetting to place an uprighting spring on a tooth is eliminated. No more overlooking those lower lateral incisors!
- Last of all, transferring patients to an edgewise practice is much easier. Since there is no need for uprighting springs to finish the patient’s treatment, the appliance can easily be handled by an orthodontist who is familiar with conventional straight wire. This new bracket should also pique the interest of those orthodontists using other straight wire appliances, as the one major turn-off to many of them was the need for all the auxiliaries during stage three. Hopefully this will generate renewed interest in the benefits of differential tooth movement.
I’m positive the benefits are so great that anyone who tries it will never look back. Please feel free to post a message on the Forum if you have any questions regarding Tip-Edge PLUS. For more information on Tip-Edge PLUS visit this newly updated website www.PLUSBrackets.com, we will be placing tips on the clinical use of this new bracket as well as responding to posts on the Forum.
Sincerely,
Christopher K. Kesling, DDS, MS