Bioprogressive therapy as an answer to orthodontic needs. Part II.

From the foregoing discussions, it may be recognized that a new, lighter, and sequential order of force applications is recommended. Accordingly, in order for the clinician to apply the new technique with the intelligence, he must realize that many biologic factors form the fundamental criteria of its application. We have attempted to examine these factors and place them in their appropriate hierarchy of significance. While edgewise was the background, sufficient departure from traditional edgewise therapy has been made to warrant a new label, ""bioprogressive therapy.'' It was so named because of the practice of progressive banding and a planned progression of events in sequential order. Eight steps usually form the frame of reference. Ironically, it can be applied in the very young and in the very old. It is difficult to appreciate these views and practices in the beginning because the method may be difficult to envision on the typodont or as simply a laboratory mechanical exercise due to the fact that cortical bone, growth, and muscle are not present in an artificial medium. In order to fully apply the recommendations of the proponents of this method, mechanical forecasting, physiologic forecasting, and growth forecasting principles are all employed. Even as a simple mechanical regime, however, it rates with or better than any other current multibanded method as a practical and efficient clinical procedure. Size 0.016 by 0.016 inch blue Elgiloy wire is commonly but not exclusively used. Loops or forms are bent in the wire for lighter and more continuous pressures on teeth to be moved. Soldering of auxiliaries has been eliminated, as well as the heat treating of wires. The 0.016 by 0.016 inch to 0.016 by 0.022 inch yellow Elgiloy is used for detailing near the end of treatment. The 0.018 by 0.022 inch is the largest wire employed, and it is used for spanning distances between teeth in the progressive debanding phases. Anchor teeth are stabilized against cortical bone; hence, cortical anchorage. In order to position and control the teeth behind or away from cortical bone or against or away from muscle or to intrude into or extrude away from the bony alveolus, three-plane control is utilized. A limited use of round wire is employed with this technique except for specific isolated conditions in which there is a place for tipping or simple alignment and rotation of teeth. We try to avoid leveling with round wires, for reasons that have been explained. Used as a triple-control technique, the bioprogressive method excels in proper overtreatment and for delivery of anchorage. A continuous arch is broken up into segments so that movements in desired planes of space are not complicated and anchorage can be shifted in favor of the desired move. The technique usually involves orthopedic correction, particularly in the maxilla, when such corrections are needed...