The words you are searching are inside this book. To get more targeted content, please make full-text search by clicking here.
Discover the best professional documents and content resources in AnyFlip Document Base.
Search
Published by mohari72, 2021-04-04 12:04:10

MEAW Vol.1

MEAW Vol.1

MEAW

Multi-loop Edgewise Archwire

Kim Jeong-Il



D Kim Young-Ho

This book is dedicated to the late Professor Kim Young-Ho.
He introduced me to the MEAW concept and inspired me
to do research and practice with passion as an orthodontist.

5

It has been over 30 years since I started practicing as an orthodontist. Although it took a little
while for me to absorb and understand the concept of orthodontics, I still believe I am
insufficiently trained and have a long way to go. Since I started practicing, I have encountered a
number of orthodontic methods and applied such methods in clinic. However, I have been always
concerned about what the best solution and analysis would be. About 25 years ago I met the
deceased Professor Kim Young-Ho, which was a turning point in my career. He enabled me to
apply the MEAW technique to my orthodontic approaches and raised the awareness of the some of
the most important aspects of daily orthodontic clinical practice which were used to be ignored up
to that time. This has further modified my personal views of patients.

MEAW, first designed by the deceased Dr. Kim, was initially used to treat the open bite cases
only, but is now regularly applied to all kinds of malocclusion cases. In other words, MEAW had
once been regarded as a tool that could only be applied to the open bite patients or, only as a
finishing wire that could be used at the finishing stage of treatment. Nevertheless, in contemporary
orthodontics, many orthodontists as well as the general practitioners now frequently use MEAW on
a daily basis to treat all sorts of malocclusion cases. Despite this popularity, the textbook that
formally teaches the MEAW technique has never been published in Korea. Also, the books that
were published in Japan were restricted to the non-extraction treatment method only and they did
not faithfully reflect the original concepts by Dr. Kim. As you can figure out from the book title,
this book is distinguished from the books published so far about MEAW. In this book, non-
extraction and premolar extraction cases are explained step by step according to the original
orthodontic philosophy and treatment methods founded by the late Dr. Kim.

The most important issue in orthodontic treatment is the exact understanding of malocclusion
and the diagnosis and treatment plan. Malocclusion itself cannot be treated without understanding
its specific problems and treatment strategy. Most orthodontists are aware of the usefulness of
MEAW technique, but it is notable that the MEAW technique brings about a meaningful result
only when accurate diagnosis and proper treatment are all accomplished.

6 FOREWORD

This book consists of three parts: Part I Orthodontic Diagnosis, Part II Orthodontic
Treatment, and Part III Clinical Cases.

Part I is based on the late Professor Kim’s diagnosis method, which provided us with the
guidance about what the orthodontists should consider before the treatment. This part focuses on
causes and problems of each malocclusion. Instead of making a diagnosis just based on the visible
problems, I believe that the identification of hidden factors is crucial, as they can further provide
the orthodontists with a wide range of diagnosis and treatment methods. Therefore, in this book,
the importance of cephalometric radiographic analysis, model analysis and facial aesthetic analysis
is emphasized. Additionally, it proposes the orthodontic differential diagnosis methods, which can
further be used both for the extraction and for the non-extraction treatments. In particular, in the
extraction treatment chapter, it explores the indications of the extraction of maxillary second
molars, the extraction of maxillary and mandibular first premolars, the extraction of maxillary first
premolars and mandibular second premolars, the extraction of incisors and the extraction of first
molars.

In part II, the basic principles of MEAW are explained, and the use of MEAW in various
malocclusion cases is demonstrated with abundant photographs and diagrams. The details of each
procedure -brackets, bracket positioning, leveling and alignment, space closure, finishing, and
retention- are carefully explained with the answers to common concerns that frequently arise in
practicing orthodontics. However, it should be acknowledged that the methods introduced in this
book are not the eventual solution, and the further variables may arise in each different real clinical
case.

In part III, five different cases are explained. Case 1 deals with the extraction of four first
premolars, Case 2 deals with the extraction of maxillary first premolars and mandibular second
premolars, Case 3 explains a non-extraction treatment in Class II malocclusion and Case 4 explains
a non-extraction treatment in Class III malocclusion. Case 5 deals with the midline deviation
treatment.

Again, the author would like to acknowledge that these are not the eventual solutions. I
believe that there is no absolute solution in orthodontics and the role of an orthodontist is to seek to
find a better solution for each different case. I believe that the orthodontists should never stop
learning and researching, driven by professionalism as well as by the sympathy toward his or her
patients. I would like to remind you to regard the cases presented in this book, as an indication
only, and try to develop their own treatment method. I hope this book encourages you to think
differently when treating the common problems that you may encounter in your daily orthodontic
practices.

FOREWORD 7

About the Author

Kim Jeong-Il DDS, PhD

E mail: [email protected]

Dr. Kim Jeong-Il, DDS, PhD, currently serves as Chair in the Department of Orthodontics at
Kooalldam dental hospital in Incheon, South Korea. He is also appointed as Clinical Professor in the
Department of Orthodontics at Graduate School of Clinical Dentistry, Korea University, in Seoul, South
Korea. He is also Visiting Professor in the Department of Orthodontics at Dalian Medical University in
Dalian, China.

After graduating from Dental School at Seoul National University in 1987, he completed the
orthodontic residency at Seoul National University Dental Hospital in 1990. He acquired his PhD in the
Department of Orthodontic and Dentofacial Orthopedics at the Kanagawa Dental College in Yokosuka,
Japan, in 2006.

Dr. Kim was instructed to the MEAW concept in orthodontics by the late Professor Kim Young-
Ho, who first invented MEAW, when he took the 2-year long MEAW course from 1993 to 1994 in
Seoul. Since then, Dr. Kim has been a clinical instructor of MEAW society and adjunct Professor at
Seoul National University. He had completed the TMJ and Occlusion related courses taught by
Professor Rudolf Slavicek and Professor Sadao Sato from 2000 to 2001 in Austria, Japan and Boston.
His specialty lies in the malocclusion treatment in consideration of TMJ function, and the main
treatment approach he advocates for this purpose is the control of occlusal plane.

8

Dr. Kim Young-Ho and Dr. Kim Jeong-Il, 2004

<Philosophy of Orthodontic Treatment>

The most important aspect in orthodontic treatment is accurate diagnosis and treatment planning. By
correcting the causes of malocclusion based on a comprehensive understanding of the skeletal and dental
patterns of each patient, an individualized orthodontic treatment planning should be made thoroughly.
Skeletal and denture patterns should be analyzed for accurate diagnosis. Based on accurate diagnosis,
simple but effective treatment method can be applied with the minimum need of wire bending, causing
the least discomfort to the patients. An orthodontist should be able to practice without any stress, but with
less need of orthodontic surgery or tooth extraction, as best as he or she can.

Professional Memberships:

In addition to serving as an educational instructor for the Korean Academy of Orthodontics, Dr. Kim is
a board member of the Korean Academy of Orthodontics, a regular member of Korean Academy of
Stomatognathic Function and Occlusion, and an honorary president of Korea Institute for Malocclusion
Study (KIMS).

Publications

Kim, J.I. (2015). Practical Clinical Orthodontics: Early Orthodontic Treatment. Vol.3. Seoul, Korea: Well Publishing.
Kim, J.I. (2013). Practical Clinical Orthodontics: Orthodontic Diagnosis. Vol.2. Seoul, Korea: Well Publishing
Kim, J.I. (2012). Practical Clinical Orthodontics: Orthodontic Treatment with MEAW. Vol.1. Seoul, Korea: Well Publishing

9

ACKNOWLEDGEMENT

First of all, I would like to express my special gratitude to my permanent teacher and mentor, the
late Professor, Kim Young-Ho, for introducing me to the MEAW concept in orthodontics. I was deeply
influenced by his passion as an orthodontist as well as by his professional expertise.

I also would like to express my special thanks to Professor Sadao Sato, who has inspired me to do
research and practice with passion in orthodontics.

I have realized how difficult it is to write a book on orthodontics in English as a non-native English
speaker. I would like to express a tremendous degree of appreciation to all those who have made this
English publication possible. Without the help from these people, this book could not have been
published. I would like to first thank Lee Chang-Bong, my close friend, Professor of English and
Linguistics at the Catholic University of Korea, and three training dentists in Kooalldam Hospital, Dr.
Yoo So-Young, Dr. Park Sang-Eun, and Dr. Seo Won-Chae, who worked as a team to finalize the
English translation based on the first English draft. I must express my deep gratitude to Kim Sung-Kue,
my second son, and Dr. Kim Ye-Jin, who produced the first draft version of English text. My special
thanks should go to Dr. Son Eun-Jeong and Kim Jung-Hoon for their help in collecting and organizing
the data and to DT Kim Jeong-Min, the chief executive officer of Credent Laboratory, as well, for
providing the necessary equipment. Last but not least, I would like to thank Mr. Bong Gi-Chul,
President of Well Publishing for kindly agreeing to publish and to edit my book.

I would like to point out that some of the content in this book could be controversial and there can
even be objections from some readers. I take this as a natural and healthy situation in the field of
orthodontics. I strongly believe that without disagreement and ongoing dialogue, we cannot continue
our path to excellence in orthodontics. All the shortcomings and errors in this book are mine.

10

PART I ORTHODONTIC DIAGNOSIS............................................ 17

Chapter 1 _ CAUSES OF ORTHODONTIC TREATMENT FAILURE................................. 18

1. Patients .......................................................................................................................... 20
2. Relationship between Orthodontist and Patient............................................................ 20
3. Orthodontists.................................................................................................................. 22

Chapter 2 _ CAUSES OF MALOCCLUSION ...................................................................... 38

1. Skeletal Factors ............................................................................................................. 40
2. Dental Factors................................................................................................................ 42
3. Environmental Factors................................................................................................... 78

Chapter 3 _ SKELETAL PATTERN ANALYSIS................................................................... 92

1. Vertical Analysis............................................................................................................. 96
2. Horizontal Analysis ...................................................................................................... 100
3. Combination Factor (CF) ............................................................................................. 105
4. Extraction Index (EI) .................................................................................................... 113
5. Classification of Skeletal Pattern................................................................................. 114

Chapter 4 _ DENTURE PATTERN ANALYSIS .................................................................. 122

1. Denture Pattern Analysis............................................................................................. 124
2. Occlusal Plane ............................................................................................................. 126
3. Changes of Occlusal Plane ......................................................................................... 135

CONTENTS 11

Chapter 5 _ ORTHODONTIC DIAGNOSIS........................................................................ 158

1. Orthodontic Differential Diagnosis............................................................................... 160
2. Non-Extraction Treatment Method.............................................................................. 170

1) Methods of non-extraction treatment ..................................................................................... 170
2) Reproximation......................................................................................................................... 188
3. Extraction Treatment ................................................................................................... 193
1) Third molar extraction ............................................................................................................. 194
2) Maxillary second molar extraction .......................................................................................... 196
3) Premolar extraction................................................................................................................. 202
4) Anterior teeth extraction.......................................................................................................... 237
5) First molar extraction .............................................................................................................. 249

PART II ORTHODONTIC TREATMENT........................................ 259

Chapter 6 _ BRACKET SYSTEM AND BRACKET POSITIONING ................................. 260

1. Bracket System............................................................................................................ 262
1) Bracket system ....................................................................................................................... 262
2) Important considerations for bracket selection ...................................................................... 271
3) Bracket selection for non-extraction cases ............................................................................ 288
4) Bracket selection for premolar extraction cases .................................................................... 288

2. Positioning.................................................................................................................... 290
1) Accurate bracket positioning .................................................................................................. 290
2) Bracket positioning for individual teeth................................................................................... 316
3) Bracket positioning in various cases ...................................................................................... 336

Chapter 7 _ LEVELING AND ALIGNMENT....................................................................... 346

1. Basic Orthodontic Terms ............................................................................................. 348
1) Leveling and alignment........................................................................................................... 348
2) Simple leveling and strategic leveling .................................................................................... 350
3) Cinch back bends ....................................................................................................................352
4) Tight cinch back & loose cinch back ...................................................................................... 353

12 CONTENTS

2. Strategic Bonding......................................................................................................... 355
1) Definition ................................................................................................................................. 355
2) Purposes ................................................................................................................................. 355
3) Methods of application............................................................................................................ 355
4) Considerations ........................................................................................................................ 358

3. Archwires for Leveling and Alignment......................................................................... 381
1) Initial archwires ....................................................................................................................... 381
2) Leveling archwire.................................................................................................................... 384

4. Strategic Leveling and Alignment................................................................................ 385
1) Strategies for non-extraction treatment.................................................................................. 385
2) Strategies for premolar extraction treatment.......................................................................... 396

Chapter 8 _ SPACE CLOSURE.......................................................................................... 402

1. Space Closing Method ................................................................................................ 404
1) Sliding method vs loop method .............................................................................................. 404
2) Space closing method ............................................................................................................ 407

2. Space Closing Archwire .............................................................................................. 425
3. Anchorage.................................................................................................................... 429
4. Retrusive Control in Clinical Orthodontics................................................................... 436
5. Archwire Fabrication for Space Closure ..................................................................... 445

Chapter 9 _ FINISHING....................................................................................................... 466

1. Finishing Archwire........................................................................................................ 468
2. Multi-loop Edgewise Archwire (MEAW) ...................................................................... 469

1) Composition and basic form of MEAW .................................................................................. 469
2) Functions and mechanics of MEAW ...................................................................................... 472
3) Instruments and materials for MEAW .................................................................................... 473
4) Fabrication of MEAW.............................................................................................................. 474
5) First-, second- and third-order bends in MEAW .................................................................... 482
6) Completed MEAW .................................................................................................................. 490
7) Heat treatment for the completed MEAW .............................................................................. 491

CONTENTS 13

3. Prescription of MEAW ................................................................................................. 492
4. Basic Adjustment of MEAW ........................................................................................ 500
5. Elastics in MEAW ........................................................................................................ 507
6. Finishing Methods for Special Conditions................................................................... 519

1) MEAW adjustment for midline correction............................................................................... 519
2) Expansion archwires in MEAW .............................................................................................. 521
3) MEAW adjustments in the case of peg lateralis .................................................................... 525
7. Orthodontic Normal Occlusion .................................................................................... 526

Chapter 10 _ RETAINERS .................................................................................................. 542

1. General Types of Retainer .......................................................................................... 544
2. Retainer for a Patient with Maxillary Anterior Crowding ............................................. 545
3. Retainer for a Patient with Mandibular Anterior Crowding ......................................... 546
4. Retainer for a Patient with Class III Malocclusion....................................................... 548
5. Retainer for a Patient with Class II Malocclusion........................................................ 550
6. Retainer for a Patient with Deep Bite .......................................................................... 554
7. Retainer for a Patient with Open Bite.......................................................................... 555
8. Retainer for a Patient with Posterior Cross Bite.......................................................... 557
9. Retainer for a Patient with Space................................................................................ 559

PART III CLINICAL CASES ............................................................ 565

Chapter 11 _ A CASE OF THE MAXILLARY
AND MANDIBULAR FIRST PREMOLAR EXTRACTION .......................... 566

1. Case summary............................................................................................................. 568
2. Pre-treatment records.................................................................................................. 568
3. Diagnosis and treatment planning............................................................................... 571
4. Treatment pocedures .................................................................................................. 572
5. Post-treatment records ................................................................................................ 578

14 CONTENTS

Chapter 12 _ A CASE OF THE MAXILLARY FIRST PREMOLAR
AND MANDIBULAR SECOND PREMOLAR EXTRACTION..................... 584

1. Case summary............................................................................................................. 586
2. Pre-treatment records.................................................................................................. 586
3. Diagnosis and treatment planning............................................................................... 589
4. Treatment pocedures .................................................................................................. 590
5. Post-treatment records ................................................................................................ 594

Chapter 13 _ A NON-EXTRACTION TREATMENT CASE
IN CLASS II MALOCCLUSION.................................................................... 600

1. Case summary............................................................................................................. 602
2. Pre-treatment records.................................................................................................. 602
3. Diagnosis and treatment planning............................................................................... 606
4. Treatment pocedures .................................................................................................. 607
5. Post-treatment records ................................................................................................ 610

Chapter 14 _ A NON-EXTRACTION TREATMENT CASE
IN CLASS III MALOCCLUSION.................................................................... 616

1. Case summary............................................................................................................. 618
2. Pre-treatment records.................................................................................................. 618
3. Diagnosis and treatment planning............................................................................... 622
4. Treatment pocedures .................................................................................................. 622
5. Post-treatment records ................................................................................................ 628

Chapter 15 _ A NON-EXTRACTION TREATMENT CASE OF MIDLINE DEVIATION.... 634

1. Case summary............................................................................................................. 636
2. Pre-treatment records.................................................................................................. 636
3. Diagnosis and treatment planning............................................................................... 639
4. Treatment pocedures .................................................................................................. 640
5. Post-treatment records ................................................................................................ 643

CONTENTS 15


Click to View FlipBook Version
Previous Book
รัฐธรรมนูญกับความเป็นพลเมืองในระบอบประชาธิปไตย
Next Book
demo