MBT Philosophy: Dr. R. Saikiran 1 Year PG Department of Orthodontics

MBT PHILOSOPHY
Dr. R. Saikiran
1ST YEAR PG
DEPARTMENT OF ORTHODONTICS
1
CONTENTS
• Introduction
• Transition from Standard edgewise to PEA System
• Overview of the philosophy
• Appliance specifications
• Bracket positioning and case set up
• Anchorage control during leveling and aligning
2
• Arch leveling and overbite control
• Space closure and sliding mechanics
• Finishing the case
• Appliance removal and retention protocols
• Conclusion
• References
3
INTRODUCTION
• The MBT bracket system is based on a more

balanced mix of science, tradition and
experience.
• It is a bracket system for use with light

continuous forces, lacebacks and bendbacks.
4
TRANSITION FROM STANDARD EDGEWISE
TO
PEA SYSTEM
5
The work of Andrews
“ Father of the preadjusted bracket system”
First generation of PEA leaned heavily on science and tradit

Andrews published his landmark article in 1972, and
subsequently designed an appliance based on his
findings.
Wide range of Various

brackets Archforms
Bracket positioned at Heavy force levels

centre of clinical crown
6
Transition from Standard edgewise to
PEA System
The work of Roth

Second generation of PEA brackets
This was based essentially on early clinical experiences by Roth while

experimenting with the original SWA of Andrews.
Standard wide
Roth brackets archform
Bracket positioned at Emphasis on

centre of clinical crown articulators
7
PEA System
The work of McLaughlin and Bennett

1975- 1993
Third generation of PEA brackets
Treatment mechanics recommendations included accurate bracket positioning,

and lacebacks and bendbacks for early anchorage control, with light archwire
forces. Sliding mechanics were recommended on .019/.025 steel rectangular
wires, with light .014 finishing wires.
Standard SWA Ovoid archwire

bracket selection selection
Bracket positioned at Light forces and

centre of clinical crown sliding mechanics
8
PEA System
The work of McLaughlin ,Bennett and Trevisi

1993- 1997
They re-examined Andrews original findings, and took into account additional
TM
research input from Japanese sources when designing the MBT bracket
system.
Ovoid archwire
TM
MBT brackets selection
Bracket positioned with Light forces and

the help of gauges sliding mechanics
9
PEA System
The work of McLaughlin ,Bennett and Trevisi

1997- 2001
In order to complete a modern systemised method of treatment mechanics,

it became necessary to address the subjects of archwires selection and
force levels.
TM Ovoid / tapered /square

MBT brackets
archwire selection
Bracket positioned with Updated Light forces

the help of gauges and sliding mechanics
10
Overview of the philosophy
11
Overview of philosophy
• Bracket selection
• Versatility of the bracket system
• Accuracy of bracket positioning
• Light continous forces
• The .022 vs .018 slot
• Anchorage control early in treatment
• Group movement
12
Overview of philosophy
• The use of three arch forms

• One size of rectangular steel wire
• Archwire hooks
• Method of archwire ligation
• Awareness of tooth size discrepancies
• Persistence in finishing
13
Appliance Specifications :
Variations & Versatility
14
Appliance specifications
Design features
Range of brackets
Victory Series™ Bracket

The most common choice of many orthodontists. This mid-size
bracket delivers a superb combination of comfort, control and
aesthetics. It is ideal in cases with smaller teeth and minimal to
moderate degrees of difficulty.
Unitek™ Full-Sized Twin Bracket

This provides the greatest degree of control; it holds a key
advantage when treating patients with larger teeth, difficult
malocclusions and in cases which are prone to breakage.
15
Design features
Range of brackets
Clarity™ Bracket
For those patient who desire the greatest degree of aesthetics,
Clarity ceramic brackets blend nicely against the tooth surface for a
more refined look. The metal slot allows for better sliding mechanics.
APC™ Light Cure Adhesive System

For added convenience, all of the brackets in the MBT
system are available with APC™ Adhesive Light Cure
adhesive already pre-applied.
16
Design features
Range of brackets
Victory Series™ Low Profile Brackets

The bracket’s remarkable low profile greatly reduces
occlusal interference. The bracket also features a contoured
microetched base. Ample under tie-wing area means that
bracket size is not sacrificed for easy ligation. In fact, the tie-
wing undercuts are deep enough to accommodate double
ligation.
Smartclip™ Self-Ligating Appliance System

An integral nickel-titanium clip permits easy and simple
archwire insertion and removal, yet holds the archwire
with a pre-programmed force that avoids unintentional
disengagement.
17
Design features
Identification system
The original system of dots and dashes has been superseeded by laser
numbering of standard size metal brackets.
1 2 1 1
This feature can not be carried through into mid size brackets, owing to their
smaller size, and it is technically not possible with clear brackets. So for these
group of brackets, a more conventional system of colored dots continued to be
used.
18
Design features
Torque in the base
Torque in the base was an important issue with the first and second generation
PEA brackets, because level slot line up was not possible with brackets designed
with torque in face.
Modern bracket systems, including the MBT system, have been developed using
computer aided design and computer aided machining- the CAD-CAM system.
This allows more flexibility of design, not only to place the slots in the correct
position in the brackets, but also to enhance the bracket strength and features
such as depth of tie wings and labio-lingual profile.
All torque in the base : Full size and clear

Combination of torque in base and torque in face : Mid size
19
Design features
Rhomboidal shape
The original rectangular shape of the standard metal SWA has been
superseeded by the rhomboidal form.
Reduces the bulk of each bracket.
Allows reference lines in both the horizontal and the vertical planes,
thereby assisting in accuracy of bracket placement.
20
Rectangular shape Rhomboidal shape
Design features
Design of bracket base

Tapered bracket bases on lower incisors can help in plaque control
in the lower incisor area which is otherwise quite difficult to clean.
Lower premolar brackets may be

offset on specially designed bases, to
increase bond strength and reduce
the risk of bond failure. (Swartz, 1994 Conventional bonded Gingivally offset bracket
JCO) bicuspid bracket Enlarged base
A stress concentrator in the base of

the Clarity ceramic bracket facilitates
easy removal at the conclusion of
treatment. Stress concentrator for
metal like debonding 21
In-out specification
100% fully expressed.
Approximately 20% of cases have upper 2nd bicuspids with

small clinical crowns.
For this reason an upper second bicuspid bracket has been provided
with an additional 0.5 mm of in-out compensation.
22
U/L 2nd 2nd premolar

premolars bracket without in
out compensation
Lingual Buccal
2nd premolar
bracket thicker
Good by 0.5mm
alignm
e nt of m
argina
l ridges
23
Tip specification
Tip is almost fully expressed.
Upper anterior tip Lower Anterior tip

canine Latera Central Canine Lateral Central
0
l incisor incisor incisor
incisor <1 play of 19 x 25
Andrews
wire in 0.022 slot in
8.4 8.0 3.6 2.5 0.4 0.5
Norms upper canine bracket
Original SWA 11 9 5 5 2 2
TM 8 8 4 3 0 0
MBT
0 0 0 0 0 0
11 9 5 0
8 8 4
U: 10 less distal root tip
SWA tip MBT tip
24
0
0 0 0 0 0 0
5 2 2 L: 12 less distal root tip 3 0 0
Tip Specification
TM
Reasons for reduced tip in MBT
Tip compensation is not needed with the light force mechanics. This
change has dramatically reduced the anchorage needs. By using
additional tip in the anterior brackets, anywhere from 2 to 3 mm of
molar anchorage can be lost in bringing the roots of the anterior
teeth to this over-angulated position.
This normally translates into a reduced need for patient cooperation..
Reduced tendency of bite deepening during early stages of treatment.
25
Tip Specification
TM
Advantages of reduced tip in MBT
This X-ray shows a case treated with a bracket with excessive

cuspid tip. This is what the MBT Versatile+ bracket was designed
against.
Since the MBT Versatile+ measurements are identical to Andrew‘s
original research figures, there is no compromise in ideal static
occlusion. If the condyles are in centric relation, there is no
compromise in ideal functional occlusion as described by Roth.
26
Tip Specification
Upper premolar tip Lower premolar tip
2nd premolar 1st premolar 2nd premolar 1st premolar
Andrews 2.8 2.7 1.5 1.3

norms
Original SWA 2 2 2 2
0 0 2 2
TM
MBT
SWA tip
MBT tip
27
Tip Specification
Upper molar tip Lower molar tip
2nd molar 1st molar 2nd molar 1st molar
Andrews 0.4 5.7 2.9 2.0

norms
Original SWA 5 5 2 2
0 0 0 0
TM
MBT
28
Tip Specification
50
Tube:
?
Tube: 0
0 0 tip
5 tip
Effective 50 mesial tip Effective 50 mesial tip

Effective 100 mesial tip
29
Torque specification
Torque is not efficiently expressed.
The area of torque expression is small and depends on twist effect of a
relatively small wire.
30
Torque Specification
0
0.019 X 0.025 SS wire has 10 ‘slop’ in 0.022 slot depending on
the precision of manufacture of the wire and bracket slot and
amount of wire edge rounding.
Better performance than expected
X
0
10
Y
X
Y 31
Upper incisor torque Lower incisor torque

Lateral incisor Central incisor Lateral incisor Central incisor
Original
SWA 3 7 -1 -1
TM
MBT
10 17 -6 -6
Greater palatal root torque in upper incisors

Greater labial root torque in the lower incisors
32
The most common torque need for the upper incisors during
orthodontic treatment is increased palatal root torque. This
torque tends to be lost during the stages of overjet reduction
and space closure.
SWA MBT SWA MBT
U: Lateral incisor U: Central incisor
The most common torque need for the lower incisors is labial root
torque to bring them into a more upright position. This is because
they tend to be inclined labially due to elimination of crowding,
leveling of the curve of Spee, and the use of Class II mechanics
elastics.
SWA
MBT
L: incisors 33
Upper canine Lower canine

torque torque
Original SWA
-7 -11
-7 -6
TM
MBT
Upper canine torque appeared to be satisfactory
0
-11 torque in lower canine (SWA) tends to leave roots in more prominent.
34
Upper premolar Lower premolar

torque torque
2nd premolar 1st premolar 2nd premolar 1st premolar
Original SWA -7 -7 -22 -17
-7 -7 -17 -12
TM
MBT
Upper premolar value proved to be satisfactory.

TM
Lower premolars : lingual crown torque decreased in MBT
35
Upper molar Lower molar

torque torque
2nd molar 1st molar 2nd molar 1st molar
Original SWA -9 --9 -35 -30
-14 -14 -10 -20

TM
MBT
SWA torque MBT torque
Increasing the buccal crown torque in the upper molars

reduces the possibility of palatal cusp interferences.
36
Reasons for reducing the amount of lingual crown torque in the lower cuspid, bicuspid
and molar areas:
SWA torque MBT torque
Lower cuspids and sometimes bicuspids often show gingival

recession and benefit from the roots being moved closer to
the center of the alveolar process
Many orthodontic cases demonstrate narrowing in the maxillary arch
with lower posterior segments that are compensated toward the
lingual. These cases benefit from buccal uprighting of the lower
posterior segment.
It has been consistently observed that lower second molars with -35° of
torque consistently “roll in” lingually. Therefore, the authors have chosen to
reduce the lingual crown torque in the lower cuspids and bicuspids by 5°,
by 10° in the lower first molars, and by 25° in the lower second molars. 37
Versatility of the System
TM
MBT incorporates seven different bracket and buccal tube possibilities,
depending on the needs of the case. This creates the platform for the
archwires and the bracket system to produce the necessary individualisation
and overcorrection of certain types of case..
This reduces the need for first, second and third order bends later in treatment,
and improves efficiency.
38
Versatility
1.Options for palatally displaced upper lateral incisors.
0
0
10 17
1 2 1 1
lateral Central
incisor incisor
bracket on lateral incisor inverted

0 0
-10 17
1 2
1 1
39
Versatility
0 0 0
2. Three torque options for upper canines: (-7 ,0 ,7 )
0 0 0
3. Three torque options for lower canines: (-6 ,0 ,6 )
Arch form: : Upper
-7 degree
torque
7 degree
torque
40
Versatility
Torque options for canines
Canine prominence (U: 0, 7; L: 0,6)
Extraction decision (tip control) (U: 0; L:0)
Overbite (L: 0; 6)
Rapid Palatal Expansion (L: 0; 6)
41
Versatility
Agenesis of upper lateral incisors where space needs to be closed.

(U : 7)
42
Versatility
4. Interchangeable lower incisor brackets
5. Interchangeable upper premolars brackets
43
Versatility
6.Use of upper second molar tubes on first molars in non – headgear cases
44
Versatility
7. Use of lower second molar tubes for upper first and second molars of the
opposite side, when finishing cases in a class II molar relationship.
45
Additional bracket and tube options
Brackets for small upper second premolars.
Lower second premolar tubes
Lower first molar non convertible tubes
Lower first molar double and upper first molar triple tube attachments
Bondable mini second molar tubes
46
Bracket positioning and case set up
47
Bracket positioning
“In the past, the best results were

achieved by the orthodontists who were
the best wire benders. In the future, the
best results will come from those
orthodontists who are the best bracket
positioners.”
-MBT
48
Bracket positioning
Theory of bracket positioning
When direct bonding brackets, it is helpful to avoid viewing teeth

from the side or above or below. To properly view the teeth during
bonding procedures it will be necessary for the patient to turn the
head, and the orthodontist to change the seating position from
time to time.
49
Bracket positioning
Horizontal errors. Placing the bracket to the mesial or distal of the vertical long
axis leads to undesirable tooth rotation.
Such errors can be avoided by visualizing the vertical long axis—directly from the
facial surface, or with a mouth mirror from the incisal or occlusal aspect. Some
orthodontists even draw a line on the tooth to indicate the correct vertical long axis.
C
B
A
50
Bracket positioning
51
Bracket positioning
Reasons for inadequate rotational corrections

until next visit.
• Accidental escape of the adhesive into the
interproximal contact while removing the flash
during bonding, and that subsequently gets
cured.
• Accidental deformation of wire in an attempt to
engage the wire fully into the slot.
• Improper method of ligation.
52
Bracket positioning
Axial or paralleling errors. If the bracket wings are not parallel to the long axis,
the result will be unwanted crown tipping.
These errors can be avoided in the same way as horizontal errors.
53
Bracket positioning
Thickness errors. Leaving excess adhesive under a portion of the bracket base or
failing to conform the base accurately to the contour of the tooth can cause
improper torque or rotation.
This problem is overcome by expressing all excess adhesive from beneath the
bracket during placement and by more accurate contouring of the bracket base.
54
Bracket positioning
Vertical errors. Improper vertical placement can lead to extrusion or intrusion

of teeth, as well as to torque and in-out errors
55
Bracket positioning
Gingival Concerns
1. Partially erupted teeth.. 2. Gingival inflammation.
3. Teeth with palatally or lingually displaced 4. Teeth with facially displaced roots.
roots.
56
Bracket positioning
Incisal / Occlusal Concerns
1.Incisal or occlusal crown fractures or tooth wear.
2.Crowns with long, tapered buccal cusps.
57
Bracket positioning
Crown Length Concerns
1. Disproportionately long clinical crowns..
2. Disproportionately short clinical crowns..
58
Bracket positioning
Vertical bracket positioning
In an attempt to reduce the errors inherent in using only

a direct visualization method of bracket placement, a
study was carried out to provide a method that could
serve as a supplement to the direct visualization
technique. The result of this study was the development
of a bracket placement chart which allowed for more
accurate vertical bracket placement.
- McLaughlin JCO
1995
59
Bracket positioning
Use of charts
Step one
Dividers and a millimeter ruler are used to
measure the clinical crown heights on as many
fully erupted teeth as possible on the patient’s
study models.
Step two
These figures are recorded, divided in half and rounded to
the nearest .5 mm to obtain measurements for the distance
from the incisal or occlusal surfaces to the center of the
clinical crowns.
Step three
The row on the bracket placement chart that contains the
greatest number of recorded figures is selected for bracket
placement.
60
Bracket positioning
Use of charts
Step four
At the time of banding and bonding, brackets are placed by
visualizing the vertical long axis of clinical crowns (buccal groove on
the molars) as a vertical reference and the estimated center of the
clinical crown as a horizontal reference.
Step five
A bracket placement gauge is then used to confirm that the
brackets are at a height that represents the appropriate figures in
the selected column of the bracket placement chart.
61
Bracket positioning
In the incisor region, the guage is placed

at 90 degrees to the labial surface.
In canine premolar area, the guage is

placed parallel with the occlusal plane.
In the molar regions, the guage is

placed parallel with the occlusal
surface of each individual molar.
62
Bracket positioning
Individualised bracket positioning charts

Upper canines & lower premolars
5.0 5.0
2.0 2.5 3.5 4.0 4.5 4.0 4.5 4.5 4.0 4.5 4.0 3.5 2.5 2.0
2.0 2.0 3.0 3.5 4.0 3.5 3.5 3.5 3.5 4.0 3.5 3.0 2.0 2.0
Abnormal incisal edges
Deep bite & open bite cases
63
Bracket positioning
Pre treatment
U/L .016 X .022 SS with consolidation 64

Bracket positioning
Individualised bracket positioning
charts
First premolar extraction case

3.0 4.0 4.0 3.0
2.0 2.5 3.5 4.0 4.5 4.0 4.5 4.5 4.0 4.5 4.0 3.5 2.5 2.0
2.0 2.0 3.0 3.5 4.0 3.5 3.5 3.5 3.5 4.0 3.5 3.0 2.0 2.0
2.5 3.5 3.5 2.5
Second premolar extraction case

3.0 3.0
2.0 2.5 3.5 4.0 4.5 4.0 4.5 4.5 4.0 4.5 4.0 3.5 2.5 2.0
2.0 2.0 3.0 3.5 4.0 3.5 3.5 3.5 3.5 4.0 3.5 3.0 2.0 2.0
2.5 2.5
65
Bracket positioning
Partial set up or full set – up?

• Blocked out teeth
• Deep – bite cases
• Enamel reduction cases
• Mixed dentition cases
• Severe &/or multiple rotations
66
TM
MBT Arch form and archwire sequencing
67
MBT Arch form
• The arch form has four main components:

1) the anterior curvature,
2) inter-cuspid width,
3) posterior curvature and
4) inter-molar width.
• The literature reveals that inter-

cuspid width is the most critical
aspect of arch form selection.
68
MBT Arch form
The Tapered Arch Form
• For patients with narrow, tapered

arch forms.
• It is particularly important to use this
arch form in patients with narrow arch
forms and gingival recession in the
cuspid and bicuspid regions; a situation
that occurs most frequently in adult
orthodontic cases.
• Also, patients with tapered arch
forms undergoing partial treatment in
one arch only may benefit.
69
MBT Arch form
The Square Arch Form

• For patients with broad arch forms
• In the first portion of treatment in cases
that require buccal uprighting of the lower
posterior segments and expansion of the
upper arch. In such cases, if over-
expansion has been achieved, it may be
beneficial to change to the ovoid arch form
in the latter stages of treatment.
70
MBT Arch form
The Ovoid Arch Form

It has been used most frequently
by the authors over the past
fifteen years. By using this arch
form, along with settling and
retention procedures, post
treatment relapse has been
minimized in the majority of
treated cases.
71
MBT Arch form
Arch form control early in treatment

• It is recommended that all round wires be
stocked in ovoid form only.
• The opening wires will normally be .015 or .0175
multistrand,.016 HANT or sometimes .014 Steel.
• These all may be used in ovoid form, with no
customising.
• As leveling and aligning progress into hevier
round wires there is need to customise some
wires.
72
MBT Arch form
Archform control with rectangular HANT wires

• These wires can not be customised.
• It is therefore necessary to stock them in
tapered, square and ovoid form.
• They do influence archform!
73
MBT Arch form
Archform control with rectangular Steel wires

• To stock ovoid shape only, and modify as
necessary
• To stock ovoid and tapered shape only,
which will reduce the amount of wire
modification needed.
• To stock ovoid, square and tapered
shapes : when stocking all three wires,
there will always be a need to customise
some wires.
74
Anchorage control during tooth leveling
and aligning.
75
Anchorage control during tooth leveling and aligning.
• Anchorage control has traditionally involved limiting

certain unwanted tooth movements while encouraging
others. It must be considered in three planes of space:
• Horizontally, anchorage control usually means limiting

the mesial movement of posterior segments while
encouraging the distal movement of anterior segments.
• Vertically, anchorage control involves the limitation of

vertical skeletal and dental development in the posterior
segments.
• Laterally, it comprises the maintenance of expansion

procedures, primarily in the upper arch, and the
avoidance of tipping or extrusion of the posterior teeth
during expansion.
76
Definition:
The maneuvers used to restrict undesirable changes during
the opening phase of treatment, so that leveling and aligning
are achieved without key features of malocclusion becoming
worse.
Principles of anchorage control:

Reduction of anchorage needs during leveling and aligning:
Reduce the factors which threaten the anchorage
Anchorage support during leveling and aligning:
Use of palatal or lingual bars to help control certain teeth or groups of teeth.
77
Mistakes in tooth leveling & aligning
The tip built into the anterior brackets caused the

crowns of the anterior teeth to incline forward
during initial phase of leveling and aligning.
78
• Early attempts were made to eliminate or

minimise this effect by connecting anterior
segments with elastic forces but this
created greater demand for anchorage
control.
79
• Also if the elastic forces were greater than the leveling

forces of the archwire, their was the tendency for anterior
teeth to tip & rotate distally.
80
• This lead to increasing the curve of spee and deepening

the bite.
• This problem was not as severe in nonextraction cases,

because the amount of tipping was usually restricted by
the limited space in the arch.
• The “roller coaster effect” is seldom seen in today’s

cases:
Reduced tip in MBT bracket system
Lighter archwire forces
Use of lacebacks for canines.
81
Principles of anchorage control
Reduced anchorage needs

• Bracket design
Bracket tip is the major factor in anchorage demand
early in treatment. The reduced tip reduces the
anchorage needs, lessens the tendency to bite
deepening in early stages.
Low moment generated
• Arch wire forces

The use of light archwire forces early in treatment will be
more comfortable for the patient and will put less demand
on anchorage.
• Avoidance of elastic chain
82
Anchorage support: Anteroposterior direction.
Lacebacks : A/P canine control

Adverse tipping occurred in the early leveling stages if
elastic forces (even very light forces) were applied to the
cuspids. MBT instead placed “lacebacks”.
Lacebacks are 0.010 or 0.009 ligature wires which extend

from the most distally banded molar to the canine bracket.
83
Anchorage support
• The initial purpose of lacebacks was to prevent canines

from tipping forward, but it was found that, where
necessary, these wires were an effective means of
distalizing the canines without the unwanted tipping.
• They are mainly used in extraction cases, but they may

also be required in non extraction case where there is
local threat to anchorage.
84
Anchorage support
Slight tipping of the canines against

the alveolar crest at the gingival
aspect of the canines.
Period of rebound (due to the leveling

effect of the archwire), during which the
roots of the canines are allowed to move
distally. If elastic forces are used, the
rebound does not occur because of the
presence of a continuous tipping force.
This theoretical explanation is supported by the clinical finding

that when a patient returns for routine adjustments, the
lacebacks are consistently loose and need minimal tightening.
85
Anchorage support
• Robinson investigated 57 premolar extraction cases:
86
Anchorage support
Bendbacks : A/P incisor control

• Bendbacks are used in combination with lacebacks.
• Archwire bent back immediately behind the tube on the most
distally banded molar serves to minimise forward tipping of the
incisors.
0.016 HANT / Rectangular HANT
Multistranded round SS wires wires
wires
87
Anchorage support
Lacebacks & bendbacks are normally continued

throughout the leveling and aligning archwire
sequence, up to and including the rectangular
HANT stage.
Thereafter A/P control is continued with passive
tiebacks.
88
Anchorage support
A/P molar control

Posterior anchorage control requirements are normally
greater in the upper arch:
Upper molar moves mesially more easily than the
lower molars.
Upper anterior segment has larger teeth as compared
to lower segment.
Upper anterior brackets have more tip built into them.
Upper incisors require more torque control & bodily
movement.
89
Anchorage support
A/P Upper Molar control: Headgear

Occipital
Combination
Occlusal plane
Cervical
MBT philosophy prefers to use combination HG for most cases.

The force levels used for the combination HG are 150 -250 gms
for occipital pull & 100 – 150 gms for cervical pull .
90
Anchorage support
A/P Upper Molar control: Palatal bar

The palatal bar can be constructed of heavy 0.045/0.051” round
wire extending from molar to molar with a loop placed in the
middle of the palate & the wire about 2mm from the roof of the
palate.
91
Anchorage support
A/P lower molar control:
Lingual arch
Headgear Class
III Ela
s t i cs
Class III elastics & Headgear
It is preferred to delay Class III
elastics until the 0.016 round wire
stage to prevent extrusion of the
incisors.
92
Anchorage support
Anchorage support: vertical direction.
Vertical incisor control
This effect can be avoided by not bracketing the incisors at the

start of the treatment until the canine roots have been uprighted
using lacebacks.
93
Anchorage support
Vertical canine control
High labial canines may be loosely tied to 0.015 multistrand/ 0.016 HANT wire
in early stages of treatment.
If the archwire is fully engaged in the canine bracket slot, it can produce unwanted
tooth movements in the adjacent lateral Incisor & premolar region.
94
Anchorage support
Vertical canine control
Pre treatment U : .016 SS with

open coil spring
.018 Aus sp plus with

95
step bend
Anchorage support
Vertical molar control: high angle cases.
 If the upper 1st molars require expansion, an attempt is

made to achieve bodily movement rather than tipping to
avoid extrusion of the palatal cusps.
 This is best accomplished with fixed expander with high
pull headgear.
 Use of cervical pull HG is avoided.
 TPA is designed with U loop facing forward & such that it
lies 2 mm away from the palate so that the tongue can
exert a vertical intrusive effect.
96
Anchorage support
Anchorage support: transverse direction.

Inter canine width
 Upper & lower canine width should be kept as close

as possible to the starting dimensions for stability.
 Care should be taken to ensure that crowding is not

relieved by uncontrolled expansion of U/L arches.
97
Anchorage support: transverse direction.
Molar crossbites
Care is needed to avoid arbitrary correction of molar
crossbites by tipping movements.
98
Arch leveling & Overbite control
99
Tooth leveling & aligning is normally the first orthodontic objective during
the initial stages of treatment.
Definition:
The tooth movements needed to achieve passive engagement of a steel
rectangular wire of 0.019 X 0.025 dimension & of suitable archform, into
a correctly placed preadjusted 0.022 bracket system.
100
Development of deep overbite
Lower anterior teeth normally erupt

until contact is made with upper
anterior teeth.
The tongue can restrict over-

eruption of lower incisors in some
class II cases.
101
Development of deep overbite
If the molar relationship is class II, the

lower incisors can erupt until they
contact the palate. This can cause a
steep anterior curve of Spee.
Unrestricted eruption of lower 2nd

molars in class II case contributes
to development of posterior part of
curve of Spee.
102
Tooth movements of bite opening:
Eruption & extrusion of posterior teeth
Distal tipping of posterior teeth
Proclination of incisors
Intrusion of incisors
Combination of above
103
Non - Extraction Treatment

Initial archwire placement:
When flat archwires are placed into dental arches with curves
of Spee, the archwires tend to return to their original shape &
this starts the bite opening process. Also, expression of the tip
in the brackets begins the bite opening process.
Bite plate effect:
Introducing bite plate effect in deep bite cases is helpful in following
ways:
It allows early placement of brackets
on lower incisors.
Anterior bite plates can produce an
intrusive force on lower incisors.
Anterior bite plates allow for the
eruption, extrusion & /or uprighting of
posterior teeth.
104
Creating bite plate effect:

• Appliances can be placed on the upper arch only, which allows for
proclination of the upper incisors.
• Acrylic removable bite plates can be placed. This is

particularly helpful in low angle deep bite cases.
• Placement of direct bonding material on the palatal surfaces of

upper incisors.
• In average to high angle cases, the placement of similar coloured

adhesives on the occlusal surfaces of first molars is helpful in
bite opening.
105
The importance of second molars:

In average to low angle deep bite cases, the earliest possible banding or
bonding of the second molars is most beneficial in bite opening.
Inclusion of the second molars provides an excellent lever arm for
eruption & extrusion of premolars & first molars, and assists in incisor
intrusion.
Bite opening curves :

It is preferred not to place bite opening curves in round wires or to
have such curves built in rectangular heat activated wires. These
wires do not complete the leveling of the arches & the bite opening
process.
In the great majority of cases after rectangular SS wires have been in

place for 6 weeks, the arches are normally level & adequate bite
opening has been achieved. If this is not so, bite opening curves can
be placed into the rectangular steel wires. 106
Bite opening curves :

Upper
Lower
107
Anteroposterior issues and elastics :
Intermaxillary elastics can contribute to bite opening effect by assisting

in extrusion of molars as the A/P problem is corrected.
They are beneficial in treatment of most growing patients. If possible they

should be avoided in most non growing patients and adult high angle cases.
108
Extraction Treatment
Most of the mechanical treatment procedures described for deep bite

non extraction cases, also apply to the deep bite extraction cases.
However, there are two other important factors in extraction deep bite
cases:
 With extraction cases lower incisors are normally maintained in their
position or brought to a more retroclined position. This makes the bite
opening more difficult.
 If space closure is attempted before proper arch leveling and overbite
control, it will lead to bite deepening.
109
Overbite control during space closure:

It is important to use light forces during space closure.
Heavy forces causes bite to deepen in two ways:
The canines can tip into the extraction sites causing archwire deflection
and binding. The sliding mechanics then becomes ineffective, and the
overbite deepens.
Excessive forces overpowers the incisor torque control of the rectangular

wire, causing distal tipping and bite deepening.
110
Early management of openbite
Finger and thumb sucking appliances.
Palatal expansion in case with narrow maxilla.
Palatal bars and lingual arches on the molars.
Posterior bite plates on upper and lower posterior teeth.
Removal of deciduous canines and sometimes premolars.
111
Management of openbite during full

orthodontic treatment
If upper and lower arches are crowded and/or show protrusion, upper and
lower bicuspid extractions can be considered.
If the lower arch does not require extraction of lower incisor

retroclination, and the molars are more than 3-4 mm class II,
extractions of upper bicuspids only can be considered.
Appropriate bracket placement.
Second molars should not be banded in early and middle stages.
If class II or class III elastics are required, they should be attached

posteriorly to premolars rather than molars.
112
Space closure & sliding mechanics
113
Need for efficient space closure
• Although space closure is sometimes needed in non

extraction cases, the subject is generally discussed
relative to premolar extraction cases.
The 7mm of extraction space in each quadrant may

be used for one of the following :
Relief of crowding.
Retraction of upper anteriors to correct overjet.
Retraction of U/L incisors in bimaxillary protrusion
cases.
Mesial movement of molars, increasing space for
3rd molar eruption.
114
Anchorage classification
Group A anchorage:
This category describes the critical maintenance
Of the posterior teeth position.75% or more of the
extraction space is needed for anterior retraction.
Group B Anchorage:
This category describes relatively symmetric
Space closure with equal movement of the
posterior and anterior teeth to close the space.
Group C Anchorage:
This category describes non critical anchorage.
75% or more of the space closure is achieved
through mesial movement of the posterior teeth.
115
Two schools of thought of retractions
Single cuspid retraction
Less detrimental to anchorage

Need to alleviate anterior crowding
En-masse retraction
Reduced treatment duration
116
Space closure : A biomechanical prospective
The end result of space closure procedures should be upright, well aligned teeth with
parallel roots. This implies that the tooth movement will almost always require some
degree of bodily tooth movement or even root movement.
Force system for group B space closure:
A M/F ratio approximating 10 :1 is

needed for translation.
117
A biomechanical perspective
Ideal Force system for group A space closure:

For perfect maintenance of the posterior
anchorage no forces should act on the
posterior teeth: only a force system resulting
in anterior translation is desired.
Alternative approaches
Additional force acting on the anterior teeth.
Force from the headgear acting on the

posterior teeth.
118
Group A space closure : Use of differential moments
Increasing the posterior moment while decreasing

the anterior moment would result in the equivalent
change in the M/F ratios.
Additionally, increasing the posterior M/F encourages root movement while

decreasing the anterior M/F causes a tipping type of tooth movement. If the
posterior moment were large enough, the M/F ratio would reach infinity,
consistent with the application of pure couple on the posterior teeth.
Differential moments are not without side effects: Unequal moments must be
“balanced” by a third moment or couple.
119
The difficulty of Group C anchorage mirrors that of group A

anchorage.
The difference is that the anterior teeth become the

effective “ anchor unit”.
Therefore, the anterior moment is of greater magnitude

and the vertical forces side effect is an extrusive force on
the anterior teeth.
120
OTM during space closure can be achieved in following ways:
Frictionless mechanics : this involves the use of closing loops fabricated in a

full or sectional archwire. The teeth move through the activation of the wire loop.
Elastic chain
Friction mechanics: This involves either moving the brackets along an

archwire or sliding the archwire through brackets and tubes.
or
Sliding mechanics
Sliding mechanics with Sliding mechanics with

heavy forces light forces
121
Closing loop archwires
• Closing loop archwires were part of traditional edgewise treatment

mechanics.
• They were individually made for each patient, and had limited range
of action before the omega loop came into contact with the molar
tube.
Other disadvantages were:
• Heavy forces.
• The break in the archwire where the loop is positioned causes a
flexibility in that area which can lead to collapse of the arch form in
that area and bite deepening.
• Lots of chair-side time
122
Elastic chain
Overstretched Understretched
123
Role of friction in Sliding Mechanics
When sliding mechanics are used, friction occurs at the wire bracket interface.
Some of the applied force is dissipated as friction, and the remainder is
transferred to supporting structures of the teeth to mediate tooth movement.
When two surfaces in contact tend to slide against each other, two components
of total force arise.
f: frictional component.
N: Normal force
N
f f
f 124
N N
• The M/F of the retraction assembly is at its lowest point

during the first few days.
• As the teeth are retracted M/F improves.
• A common mistake is to change elastic chain too often.
To optimise the use of sliding mechanics sufficient time
must be allowed for distal root movement to occur.
125
Sliding mechanics with heavy forces
• When traditional edgewise

force levels(500-600gms)
were applied to PEA brackets
for space closure, there was a
need for extra tip, rotational &
torque control.
126
Sliding mechanics with heavy forces
• This was the background to the extraction series

or translation series brackets developed by
Andrews.
• Case treated with such brackets and heavy
forces therefore placed heavier demand on the
anchorage early in the treatment.
127
Sliding mechanics with light forces
In 1990 a method of controlled space closure was described using

sliding mechanics. This has proved effective & reliable for many years.
Archwires
According to MBT: “The .021 x .025 wire, while showing minimal
deflection, does create excessive friction and therefore is not as
effective for sliding through the posterior brackets. The .018 x .
025 wire, on the other hand, has been shown to deflect more
easily, creating friction in the system. Hence, we have chosen to
use the middle size wire which is the .019 x .025 wire in the .022
slot. This wire size has demonstrated the best balance between
minimal deflection and ability to slide through the posterior
brackets.”
0.019 X 0.025 SS wires in .022 slot give good overbite control
128
Soldered Hooks
0.7 mm soldered brass hooks or 0.6

soldered soft SS hooks can be used.
There is greater variability in hook positions

in the upper arch due to the tooth size
variation among upper lateral incisors.
129
Passive tiebacks:
Before starting space closure, it is recommended that the rectangular steel

0.019 X 0. 025 wires be left in place for atleast 1 month with passive tiebacks.
This allows time for torque changes to occur on individual teeth and for final
leveling of the arches so that sliding mechanics can proceed smoothly when
active tie backs are placed.
130
Active tiebacks
Type I active tie back (distal module)
Step I
Place 0.019 X 0.025 rectangular SS wire with elastomeric modules or wire

ligatures on all brackets.
Step II
The 0.010 ligature is used, with one arm beneath the archwire. This makes the
tieback more stable , and helps to keep the ligature wire away from the gingival
131
tissues.
Type II active tie back (mesial module)
Step I
Place 0.019 X 0.025 rectangular SS Wire with elastomeric modules or

wire ligatures on all brackets , except the premolar brackets.
Step II
This follows the same principle as type I, but the elastomeric module is
attached to the soldered hook on the archwire. The final elastomeric
module is placed after the archwire & tieback. 132
Active tieback using NiTi coil spring

Indication:
Large spaces need to be closed, or if there are infrequent adjustment opportunities.
The optimum force for space closure is 150 gms when using NiTi coil springs
For space closure. The 150 gms spring were found to be more effective than
100 gms but no more effective than 200 gms springs.
Samuels et al, 1998, AJODO.
133
NiTi springs produce more consistent space closure than elastomeric

space closure.
Samuels et al, 1993, AJODO.
Force decay is rapid in first 24 hrs and is affected by environment &

temperature. Force decay did not occur with the same extent with NiTi
springs.
Nattrass et al,1998, EJO.
According to MBT, Space closure with NiTi springs without requiring

replacement at monthly visits, is largely a theoretical advantage.
134
Spaces resistant to closure : Alternative mechanics
• Tiebacks with two modules.

• Looped archwire can be made.
• Hycon device.
135
Hycon device
• The device consists of a centimeter segment of 21 X 25
rectangular wire, to which is soldered a 7 mm screw
device.
136
U/L .019 x .025 SS

with Hycon device
Post treatment
137
Obstacles to space closure

• Inadequate leveling : overbite control should be achieved
before space closure.
• Damaged brackets : the use nonconvertible first molar
tubes is recommended.
• Incorrect force levels : force levels need to be in balance.
• Interference from opposing teeth : This can prevent the

lower space closure, and it is necessary to carefully
check the occlusion case.
• Soft tissue resistance : care is needed to maintain good

oral hygiene & avoid too rapid space closure.
138
Finishing the case
139
Finishing the case
With the introduction of MBT mechanics, finishing and detailing

was no longer considered as a separate and lengthy procedure.
In fact, because of the built in features of the PEA appliance, there
was a gradual flow towards the finishing stage, with less work
required at the end.
Finishing and detailing is redefined as :

The corrections of errors made prior to finishing and detailing,
overcorrection as needed, and settling of the case.
140
Finishing the case
• During the closing stages of the treatment

attention needs to be given to the following
considerations;
• Horizontal
• Vertical
• Transverse
• Dynamic
• Cephalometric and esthetic
141
Finishing the case
Horizontal considerations: Co-ordination of tooth fit
Good fit: 20%

Anterior and posterior teeth fit well, with little or
no adjustment in approximately 20 % of cases
20%
Mandibular excess: 60%
In 60% of the cases, as the finishing stage
approaches, it become clear that the
crowns of the upper anterior teeth do not
occupy enough space relative to the crowns
of the lower anterior teeth.
Maxillary excess: In 20 % of the cases there is an

excess of upper anterior tooth substance, relative to
the lower.
142
Finishing the case
Cases with mandibular excess:
Cases where posterior space closure is difficult in the upper arch while
maintaining the correct amount of overjet.
Case where the overjet is correct, but the buccal segments remain in
slight to moderate class II position.
Case where complete space closure in the upper anterior segment is
difficult while attempting to maintain the correct amount of overjet.
Case with maxillary excess:
In patients with large upper incisors.

In some class III cases where upper incisors are proclined forward and
lower incisors are retroclined.
143
Finishing the case
U/L : .016 x .022 SS
144
U/L .016 x .022 SS : spaces opened distal Maxillary laterals.
Finishing the case
The challenge lies in dealing with the 60% of the cases that show a relative
shortage of tooth mass in upper anterior segment. In the horizontal plane, this
difficulty relates primarily to:
• Tip in the anterior teeth
• Incisor torque
• Tooth size
Establishing correct tip of the anterior and posterior teeth.

Bracket tip is one of the main factors that influence the amount of space
occupied by each tooth. This in turn influences the way the upper teeth fit
the lower teeth.
The tip differential between upper and lower anterior

segments helps to achieve improved tooth fit within
the 60% group of patients where upper anterior teeth
do not occupy enough space relative to lower anterior
teeth.
145
Finishing the case
The shape of the incisor crown needs to be assessed during finishing.
Tipping the incisor crowns which are barrel or triangular shaped, will have
little influence on arch length occupied. However , barrel shaped crowns are
relatively rare. Triangularly reshaped crowns will normally be reshaped to
more rectangular form by the orthodontist.
146
Finishing the case
Establishing correct tip of the anterior and posterior teeth.
Upper premolar tip of 0 degrees not only positions them more towards class I
position but also helps in obtaining the tooth fit.
Using 0 degree tip brackets on all molars , and placing the bands parallel to
cusp tip allows the molars to settle in ideal class I relationship.
Incisor torque
It is frequently necessary to add torque bends to the rectangular steel wire
in the incisor region. In most Class II and Class I bimaxillary protrusive cases
it is beneficial to add an additional amount of palatal root torque to the upper
incisors and labial root torque to the upper archwire.
147
Finishing the case
Incisor torque
This can help in smile esthetics as well as tooth fit in many cases.
In general 5 degrees of additional upper incisor

root torque produces 1 mm increase in space
occupied by the incisors.
This effect is less on small teeth than on the large

teeth.
Little or no arch length change can be obtained from torquing triangular

shape teeth. So called, barrel shaped crowns produce less change than
parallel sided teeth.
148
Finishing the case
Controlling rotations
Maintaining the closure of all spaces
Space can be kept closed at the rectangular

wire stage by using passive wire tiebacks.
When treating premolar extraction cases,

figure of 8 ligature wires should be placed
across the extraction sites.
149
Finishing the case
Vertical considerations:
Correction of vertical crown positions, marginal ridge relationships, and

contact points should be completed during the rectangular HANT stage
of the treatment.
It is much better for stability to allow these relationships to be correct for

1-2 years before bracket removal.
Accurate vertical bracket placement.
Modifications in bracket positioning charts.
150
Finishing the case
Vertical considerations:
Final management of the Curve of Spee:
Low angle cases:

It it is beneficial to level the entire curve of Spee. This involves the
placement of bands or brackets on second molars to complete the
process.
If the curve of Spee is not fully corrected , the lower incisors will be
positioned more gingivally on the palatal surfaces of the upper incisors.
This may make it difficult or impossible to complete space closure in
the upper arch with stability.
High angle cases:

It is important to leave some curve of Spee in the back of the arch.
151
Finishing the case
Transverse considerations:
Archform/ archwire coordination.
The key to good archform management is to have a balance between

efficiency and accuracy.
152
Finishing the case
Dynamic considerations:
Establishing centric relation and checking for functional movements.
153
Finishing the case
Dynamic considerations:
Checking for temporomandibular joint dysfunctions:
Patients should be monitored during orthodontic treatment in case

TMJ symptoms develop.
If these symptoms are managed when they first occur, prior to the
formation of true internal derangement, then frequently normal TMJ
function can be restored.
154
Finishing the case
Cephalometric and esthetic considerations:
It is often helpful to take progress headfilms approximately halfway

through orthodontic treatment to determine how the skeletal dental
and the soft tissue components are being managed.
Progress head films allow reassessment of anchorage factors and

help revisions in treatment planning as treatment proceeds.
155
Finishing the case
The final stage of Finishing : settling the case.
Typically, a .014 or .016 round HANT wire is used in the lower arch,
coordinated to the IAF for the patient.
In the upper arch, a .014 round sectional wire can be placed from
lateral incisor to lateral incisor.
Patients can be seen at approximately 2- week interval during the settling phase.
Debanding can then be scheduled.
156
Finishing the case
Variations to general settling:
If diastemas were present in upper

and lower anterior segments, these
areas should be tied together lightly
with elastic thread or ligature wires.
If palatal expansion was carried out, a small

removable palatal plate, with .018 wires
extending interproximally in the gingival areas,
can be used to maintain expansion during the
settling phase.
157
Finishing the case
Variations to general settling:
If it is intended that settling may take longer than approximately than 6 weeks
it is beneficial to leave the lower rectangular steel wire in position during the
settling phase. This will help maintain the lower archform.
If the cuspids were labially positioned in the upper arch, the sectional wire in the
upper anterior segment can be extended to the cuspids to hold them in position.
158
Finishing the case
Finishing to ABO requirements:
Tooth alignment
Marginal ridges
Buccolingual inclination
Occlusal relationships
Occlusal contacts
Overjet
Interproximal contacts.
159
Appliance removal and
retention protocols
160
Appliance removal and retention protocols
The appliance removal appointment
Bracket removal : metal brackets
A debracketing instrument or old ligature

cutters are used.
If the archwire is removed with the brackets

attached to it this avoids the possibility of
loose brackets in the mouth.
161
Bracket removal : ceramic brackets
Archwires need to be taken out first, and

any excess bonding agent removed from
around the brackets, using a high speed
flame finishing bur
Band seating pliers are used to collapse the

ceramic brackets by squeezing mesiodistally,
So that it closes like a book. The pliers are
applied approximately 1mm away from the tooth
surface.
162

Band removal:
Band removal pliers can be used to easily remove most molar bands.
Lifting from distogingival aspect is normally effective.
Removal of the bonding cement and bonding agents:
Scalers or band removal pliers

High speed flame finishing bur without a water spray.
Polishing with rubber cup and pumice.
163
Positioners
Indications:
For patients who have shown excellent cooperation and who want ideal
settling, with best possible result.
For patients with persistent anterior or posterior tongue habits.
Positioners are most effective with patients who presented with an

open-bite tendency. This is because the positioners have a bite closing
effect.
164
Bonded retainers
Lingual bonded retainers:

MBT prefers to use lower canine to canine retainers for almost all
patients at the end of the treatment.
Palatal bonded retainers:

They are not used as frequently as lower bonded retainer because of
potential for breakage due to occlusal contact, or contact during biting.
165
Bonded retainers
Labial bonded retainers

- They may be useful for short term measure for impatient adults,
allowing earlier removal of brackets.
- In adolescent treatment, labial bonded retainers can be useful in a
“pause” phase, while awaiting eruption of more teeth.
166
Removable retainers
Hawley type retainer in deep bite cases

where the upper retainer needs to carry
a bite plane.
Wire and acrylic removable retainers can be useful in the conventional

wrap – around or Begg type for maintaining space closure after
extraction.
167
Vacuum formed retainers
They are rapid and economical to make, require no adjustment, and if well
made are easy, comfortable, and esthetic to wear.
168
References
McLaughlin RP, Bennett JC. The dental VTO: an analysis of orthodontic
tooth movement. J Clin Orthod. 1999 Jul;33(7):394-403.
McLaughlin RP, Bennett JC. Bracket placement with the preadjusted

appliance. J Clin Orthod. 1995 May;29(5):302-11.
Bennett JC, McLaughlin RP. Overjet reduction with a preadjusted

appliance system. J Clin Orthod. 1992 May;26(5):293-309.
McLaughlin RP, Bennett JC. Anchorage control during leveling and

aligning with a preadjusted appliance system. J Clin Orthod. 1991
Nov;25(11):687-96.
McLaughlin RP, Bennett JC. Finishing and detailing with a

preadjusted appliance system. J Clin Orthod. 1991
Apr;25(4):251-64.
169
References
Bennett JC, McLaughlin RP. Controlled space closure with a

preadjusted appliance system. J Clin Orthod. 1990 Apr;24(4):251-
60
McLaughlin RP, Bennett JC. The transition from standard

edgewise to preadjusted appliance systems.J Clin Orthod. 1989
Mar;23(3):142-53.
Bennett JC, McLaughlin RP. Management of deep overbite with a
preadjusted appliance system. J Clin Orthod. 1990;24(11):684-96.
170

MBT Philosophy: Dr. R. Saikiran 1 Year PG Department of Orthodontics

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MBT PHILOSOPHY

• Space closure and sliding mechanics

• Finishing the case

• Appliance removal and retention protocols

• The MBT bracket system is based on a more

• It is a bracket system for use with light

“ Father of the preadjusted bracket system”

First generation of PEA leaned heavily on science and tradit

Wide range of Various

Bracket positioned at Heavy force levels

The work of Roth

This was based essentially on early clinical experiences by Roth while

Bracket positioned at Emphasis on

The work of McLaughlin and Bennett

Treatment mechanics recommendations included accurate bracket positioning,

Standard SWA Ovoid archwire

Bracket positioned at Light forces and

The work of McLaughlin ,Bennett and Trevisi

Bracket positioned with Light forces and

The work of McLaughlin ,Bennett and Trevisi

In order to complete a modern systemised method of treatment mechanics,

TM Ovoid / tapered /square

Bracket positioned with Updated Light forces

• The use of three arch forms

Victory Series™ Bracket

Unitek™ Full-Sized Twin Bracket

APC™ Light Cure Adhesive System

Victory Series™ Low Profile Brackets

Smartclip™ Self-Ligating Appliance System

Torque in the base

All torque in the base : Full size and clear

Design of bracket base

Lower premolar brackets may be

JCO) bicuspid bracket Enlarged base

A stress concentrator in the base of

Approximately 20% of cases have upper 2nd bicuspids with

U/L 2nd 2nd premolar

Upper anterior tip Lower Anterior tip

SWA tip MBT tip

This normally translates into a reduced need for patient cooperation..

Reduced tendency of bite deepening during early stages of treatment.

This X-ray shows a case treated with a bracket with excessive

Andrews 2.8 2.7 1.5 1.3

Upper molar tip Lower molar tip

2nd molar 1st molar 2nd molar 1st molar

Andrews 0.4 5.7 2.9 2.0

Effective 50 mesial tip Effective 50 mesial tip

Better performance than expected

Upper incisor torque Lower incisor torque

Greater palatal root torque in upper incisors

SWA MBT SWA MBT

U: Lateral incisor U: Central incisor

Upper canine Lower canine

Upper canine torque appeared to be satisfactory

Upper premolar Lower premolar

Original SWA -7 -7 -22 -17

Upper premolar value proved to be satisfactory.

Upper molar Lower molar

Original SWA -9 --9 -35 -30