Straight Wire Technique: the McLaughlin – Bennett treatment philosophy

Abstract of the course

1-year International Program in Orthodontics

The aim of the course is to provide the elements to formulate the diagnosis and planning of orthodontic treatment according to the philosophy of doctors Richard McLaughlin and John Bennett.

The McLaughlin-Bennett MB 5.0 system represents the most advanced version of the MBT orthodontic system, conceived by doctors McLaughlin, Bennett and Trevisi in the 1990s, which today has become one of the most widely used treatment philosophies in the world.

The goal is to teach a method of diagnosis, treatment planning and orthodontic therapy that is standardized and easily reproduceable in daily clinical practice.

The course has an extremely practical approach; several hours will be dedicated to the hands-on sessions (with typodont) so that the participant can immediately apply the notions learned during the course in daily clinical practice. For this purpose, the modules to be used for diagnosis, clinical examination and treatment planning will be given to the course participants.
Furthermore, the students will have the Demo version of the cephalometric software installed on their laptop PC free of charge throughout the course duration, in order to carry out the cephalometric analysis and treatment planning.

MODULE 1

Orthodontic diagnosis and treatment planning; the Straight Wire MB 5.0 orthodontic appliance. 

The patient first visit 

• Medical history, dental and orthodontic history, physical examination 
• Analysis of the temporomandibular joint (TMJ) and respiratory function; diagnosis and treatment of sleep apnea syndrome (OSAS) 
• Facial and intra-oral photographs; the aesthetic analysis of the face according to Arnett 
• The models of the dental arches 

The radiological examination 

• Orthopantomography, latero-lateral and posterior-anterior headfilm, 3D CBCT radiology 
• Cephalometric analysis of hard tissues according to McLaughlin 
• Cephalometric analysis of soft tissues according to Arnett-McLaughlin; getting a repeatable natural head position (NHP) 

Orthodontic treatment planning 

• The problem list and treatment goals 
• The dental Visual Treatment Objective (VTO) according to McLaughlin 

The normal occlusion 

• The Andrews 6 occlusal keys 
• Tooth-to-tooth or fossa-cusp occlusion according to P.K. Thomas 

The evolution of the Straight- Wire technique from its origins until today 

• Historical review: the thoughts of Andrews, Roth, McLaughlin and Bennett
• The MBT pre-adjusted appliance 
• The MB 5.0 pre-adjusted appliance, latest evolution of the MBT system 

Bracket placement in orthodontics and the bracket positioning chart according to McLaughlin and Bennett 

• Direct bonding (clinical sequence) 
• Indirect bonding (laboratory and clinical sequence) 
• The new indirect bonding systems with digital technology and 3D printer 

Hands-on session 

• Execution of cephalometric analysis of hard and soft tissues on lateral headfilm brought by the course participants: a free demo of the cephalometric software valid for 9 months will be installed on PC laptop 
• The dental VTO on a clinical case brought by the course participants 

MODULE 2

Class I malocclusion and intra-arch treatment mechanics; Class II malocclusion, inter-arch treatment mechanics Part I; therapy of impacted canines.

Class I malocclusion

• Dento-alveolar discrepancy: crowding and diastemas
• The dental bimaxillary protrusion
• Inter-proximal reduction (IPR) or “stripping” as a useful method to gain space in the arch
• The agenesis of the lateral incisors: when to open and when to close the spaces

Class I malocclusion

• Dento-alveolar discrepancy: crowding and diastemas
• The dental bimaxillary protrusion
• Inter-proximal reduction (IPR) or “stripping” as a useful method to gain space in the arch
• The agenesis of the lateral incisors: when to open and when to close the spaces

The intra-arch treatment mechanics

• Leveling and aligning, overbite correction (OVB), space closure
• Laceback, bendback, passive and active tieback
• The sequence of archwires in extraction and non-extraction cases 
• The individualized arch form, in compliance with the basal bone shape and the functional matrix
• The anchorage needs in extraction cases
• Bracket placement in cases of canine substitution (lateral agenesis)

The diagnosis of Class II malocclusion

• Skeletal and dental malocclusion; cephalometric analysis and face analysis
• The McLaughlin-Arnett analysis for the treatment planning (mandibular advancement therapy or distalization of the upper arch)
• The vertical control in the treatment of Class II malocclusions
• Analysis of slide from centric relationship (CR) to centric occlusion (OC)
• The diagnosis of respiratory problems associated with Class II malocclusions

Treatment of the growing patient

• The Twin Block appliance
• Fixed functional appliances

Extraction treatment in Class II malocclusions 

• The selection of teeth to be extracted on the basis of the anchorage emerged from the dental VTO 
• Biomechanics in the McLaughlin-Bennett MB 5.0 appliance 

Treatment of Class II malocclusions in the adult patients 

• Orthodontic camouflage in Class II malocclusions: guidelines and mechanics 
• Orthognathic surgery according to Arnett in Class II malocclusions 

The impacted canines 

• Etiology and diagnosis 
• Early therapy of ectopic canines in the mixed dentition 
• The orthodontic-surgical treatment of the impacted canine in the permanent dentition: the palatal and buccal approach 
• The versatility of the MB 5.0 appliance in the therapy of the impacted canines 

Hands-on session 

• Indirect bonding: bracket positioning according to McLaughlin-Bennett 
• Indirect bonding with digital technology and bonding trays made with a 3D printer 
• Execution of silicone bonding trays on plaster models brought by the course participants, for the transfer of the brackets onto the patient’s teeth 
• Placing brackets on plaster models of patients who will start treatment 

MODULE 3

The correction of Class III malocclusion, inter-arch treatment mechanics part II; the vertical and transversal problems.

The vertical problems

• Open bite and deep bite: diagnosis and orthodontic treatment mechanics 

The transverse problems

• Diagnosis of skeletal or dentoalveolar contraction of the maxilla: according to the University of California of Los Angeles (UCLA)
• The expansion of the maxilla in mixed dentition, in permanent dentition, and in the adult patient
• Maxillary expansion and its relationship with nasal breathing and obstructive sleep apnea syndrome (OSAS)
• Skeletal expansion versus dentoalveolar expansion

Class III malocclusion

• The vertical, horizontal and transversal components in the Class III malocclusions
• The differential diagnosis between true Class III and pseudo-Class III malocclusion (CR-CO discrepancy)
• Orthopedic maxillary advancement with face mask in the growing patient: skeletal and dentoalveolar components
• Extraction and non-extraction treatment of Class III malocclusion in the permanent dentition
• Camouflage treatment in the Class III malocclusions
• Orthognathic surgery in the Class III malocclusion

The asymmetries

• The differential diagnosis and treatment of skeletal asymmetry, dento-alveolar asymmetry, CR-CO lateral sliding

Temporomandibular joint disease (TMJ)

• The causes and treatment of TMJ pathology
• The relationship between occlusion and craniomandibular disorders

The finalization of the orthodontic case

• The American Board of Orthodontics (ABO) standards

The orthodontic retention

• The wraparound retainer
• The Cad-Cam fixed retainer
• The vacuum-formed retainers

MODULE 3

Hands-on session

FRIDAY AFTERNOON

The MB 5.0 intra-arch treatment mechanics

• Positioning of lacebacks, passive and active tiebacks, bendbacks on typodonts

SATURDAY (ALL DAY)

Wire bending

• First, second and third order finishing bends on stainless steel archwires
• Creation of sectionals to be used in cases of second premolar extraction
• The bite-opening curves on stainless steel archwires

Analysis and discussion of clinical cases brought by the participants

• Course participants are encouraged to bring clinical cases at each module, with facial and intra-oral photographs, orthopantomography, latero-lateral headfilm, cephalometric analysis of hard and soft tissues, dental VTO
• A cephalometric software will be installed on participants’ PC laptop throughout the course duration for advanced diagnosis and treatment planning

INSTRUMENTS REQUIRED FOR THE COURSE (HANDS-ON SESSION) 

• Personal Computer (laptop) for the execution of cephalometric tracings; the cephalometric software demo will be installed free of charge throughout the duration of the course 
• Dental caliper (to measure the size of the teeth, and to mark the position of the black and red reference lines on the plaster model for indirect bonding) 
• Bracket positioning pliers 
• Bracket gauge 
• Scaler – utility instrument 
• Mathieu plier 
• Tweed pliers (2 pliers) 
• Bird-beak plier 
• Weingart plier 
• Turret plier 
• Ligature cutter 
• Archwire cutter