Controlling rotations

Rotation control is an important aspect of finishing and detailing. Fortunately, the in-out compensation built into the preadjusted appliance, combined with correct bracket positioning, is most effective in controlling rotations. The most obvious example of this is the 10° of rotation that is introduced into the brackets of the upper molars, and the 0' of rotation placed in the lower molars. This combination is most beneficial in allowing the upper molars to occlude properly in a Class I position with the lower molars.

It can be beneficial in Class I and Class II cases to place upper premolar brackets approximately 0.5 mm to the mesial. This allows the buccal cusps of the upper premolars to rotate distally toward a Class I position, and the palatal cusps of these teeth to rotate mesially so that they occlude more accurately into the fossae of the lower arch. If anterior teeth show rotation at the beginning of treatment (Fig. 10.9), it is beneficial to place the bracket slightly in the direction of the rotation to aid in their correction (p. 61). Also, it is beneficial to place lower canine brackets slightly to the mesial. This rotates the mesial aspect labially and provides better contact with the distal aspect of the lower lateral incisors.

Fig. 10.9 Accurate bracket positioning at the start of treatment can assist in rotation control during the finishing stages.

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