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Forsus™ Class II correctors

Forsus Class II correctors EZlock-Dr Chamberland orthodontist in Quebec City

3M Unitek Forsus™ Class II correctors

Here is a clinical example of Forsus™ Class II correctors.

 

 

 

 

 

Forsus Class II correctors-Dr Chamberland orthodontist in Quebec City

Forsus™ Class II corrector

A loop in the mandibular arch serves as anchorage for the push rod that composes the male part of the Class II corrector. The spring composes the female part in which the push rod is inserted. This spring is attached to a molar band in the maxillary arch. The attachment in the lower loop allows multidirectional opening, closing and lateral (to the left and to the right) movements.

Questions and comments

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  1. Medhat says:

    Dear Dr.Chamberland,

    1) Do you consider using forsus or any other fixed functional appliance if the lower incisors to the mandibular plane angle 100° or more? Do you respect the 95° angle dogma?

    2) Do you suggest certain contraindications for forsus? eg. crowding, gummy smile?

    3) is the loop in the mand. Arch bent in a .018 stst wire? It seems like round wire from the pictures.

    Thank you in advance,

    College from Belgium

  2. Thank you for your questions,

    1- AP position of the lower incisors

    If the lower incisors are at 100° to mandibular plane (IMPA ≥ 100°), chances are that there is a dentoalveolar protrusion and teeth need to be uprighted during treatment. Therefore, I may include extraction (4s/ 5s, 4s/4s or 5s/5s) in the treatment plan with the use of class II correction device.

    Class II division 1 bimaxillary protrusion-Dr Chamberland orthodontist in Quebec City

    The ceph above show such a case with IMPA at 101° and bimaxillary protrusion and lip incompetency at repose. A fixed functionall appliance will be use to correct the class II relationship, but at the same time, lower teeth need to uprighted and upper teeth need to be retracted.

    Class II division 1-Dr Chamberland orthodontist in Quebec City

    This is the intraoral view of this case. You will notice crwding in the lower arch that will procline even more the incisors if aligment is attempted non extraction.

    Therefore extraction was unavoidable. The ideal extraction plan would have been 4s/5s. However, a significant hypocalcification of tooth #25 made me consider extraction of upper 5s instead of upper 4s. The parents were advise that it will be more difficult to correct the class II relationship.

    So for me, it is not a matter of dogma. It is a matter of treatment plan. Where do you want to place the lower incisors? If the answer is that you will accept their proclination, you may not extract. If the answer is that you want to upright them, then you shall extract.

    This is the visual treamtent plan of the above case. You will note that the lower incisors are more upright and the upper incisors are retracted.

    Visual treatment plan-Dr Chamberland orthodontist in Quebec City

    A similar case is describe on slide 22 and 23 of the keynote Fixed appliance management of Class II correction.

    2- Contraindication to Class II correction device

    Crowding is not a contraindication to class II correction device if you have a solution to resolve crowding. This solution may be extraction of teeth. Class II correction device is not the only way to correct a class II. Maxillary molar distallisation via a pendulum or TADs may be an alternative solution. A class II hyperdivergent with vertical maxillary excess may be a contraindication for class II correction device.

    In the above mentionned keynote, such a case is describe from slide 74 to 84. You will notice that I used TADS to intrude posterior teeth (upper and lower) and it was helpful to created a forward rotation of the mandible and to decrease face height. Once this was achieved, I use SUS2 class II correctors to finish into class I.

    3- Loop in the lower arch

    20x25 SS wire-Dr Chamberland orthodontist in Quebec CityI use SPEED™ .022 bracket slot. Therefore, the wire is .020 x.025 SS wire. It has a rounded edge. This may explain why it looks like a round wire, but is is not.

    A .017 x .022 SS wire does exist for .018 bracket slot user.

    To create this loop, I use an tweed omega loop plier (Dentronix D236).

    .

    Since you mention that you are a collegue from Belgium, please note that I will lecture for the Société Belge d’Orthodontie le 29 janvier 2015 à l’Hôtel Métropole, Place Bouckère.

    Please come and introduce yourself.

  3. Medhat says:

    Thanks for your time and effort answering the questions.
    I will try to attend your lecture in januari, however I guess it will be in French, which is not my strongest language.
    Any plans giving lectures in the Dutch speaking part of Belgium (Flamish) ?

    1. Hi Dr Medhat,

      I understand that you may have difficulty with french language but believe me, french belgium orthodontist might have diffuculty with my “french canadian” accent as welll…HiHiHi!

      I don’t have plans to lecture to the Dutch part of Belgium, because I don’t know that many flamish, except may be Dr Luc Dermaut that i met in Lebanon in 2005 during a scientific meeting.

      However, i would certainly accept an invitation to lecture in english to the Dutch speaking orthodontist. Therefore, if you attend to the lecture in january, it will be easier to promote an invitation.

      Please note that I lecture in english most of the time.

      Here is the list of topic that will be presented:

      1- Hemimandibular hyperplasia and facial asymmetry (75 minutes)

      2- Idiopatic condylar resorption and arthrosis of the joint (75 minutes)

      3- Functional genioplasty growing patients (45 minutes)

      4- Fixed appliance management of class II malocclusion. SUS2 Corrector

      5- Multidisciplinary treatment (Prostho, perio, orthognatic surgery, sleep apnea)

       

      Best regards

    2. I would like to show you another class II div 1 case that have IMPA at 104°.

      Because of the proclined lower incisors, I distalized upper molars with a pendulum appliance and leveled the mandibular arch with intrusive arch mechanics “à la Burstone”.

      The case name is Roxane form slide 12 to 22.

      Best regards
      Dr Sylvain Chamberland

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