General Protocols and Archwire Sequence Provided by Drs. Takemoto and Scuzzo*

Alias Lingual Bracket System

Open Coil Springs

To resolve rotations when teeth are too crowded and bracket placement isn’t possible, place an open coil spring 1.3x – 1.4x the interbracket distance to help open the space.

Buccal Attachments

A variety of clear buccal attachments may be used to enhance buccal leveling, using inter-maxillary elastics, and for creating space.

Bite Turbos/Bite

Blocks As with labial treatment, the patient’s bite may create a bracket to tooth interference. With lingual treatment, it is common after initial bonding for the lower anterior edge to contact the upper anterior bracket(s). Temporary resin fillings (bite turbos/bite blocks) should be placed to prevent this.


Wire Sequence

Non-Extraction Cases

Initial Leveling
Archwire Objective
.013 CuNiTi For severe crowing
Option: .014 CuNiTi For moderate crowding
Completing Leveling and Rotational Control
Archwire Objective
.016 CuNiTi Complete leveling and alignment including rotation correction; partial arch form stabilization
.016 x .016 CuNiTi Initial torque leveling and arch form stabilization
Torque and Arch Form Control
Archwire Objective
.018 x .018 CuNiTi Complete torque leveling and arch form stabilization
Finishing or Detailing
Archwire Objective
.0175 x .0175 TMA If necessary for torque refinements and/or final detailing
Option: .016 TMA .018 x .018 SS Final detailing
Control width of both U&L arches in cases with initial width discrepancy

Extraction Cases

Initial Leveling
Archwire Objective
.013 CuNiTi For severe crowing
Option: .014 CuNiTi For moderate crowding
Completing Leveling and Rotational Control
Archwire Objective
.016 CuNiTi Complete leveling and alignment including rotation correction; partial arch form stabilization
.016 x .016 CuNiTi Initial torque leveling and arch form stabilization
Torque and Arch Form Control
Archwire Objective
.018 x .018 CuNiTi Complete torque leveling and arch form stabilization
.0175 x .0175 TMA Torque establishment
Space Closure
017x .017 SS or .018x.018 SS (if full torque control is needed with reduced posterior wire size for sliding)
Option: .016x.016 SS (if there is no need for torque control)
Finishing or Detailing
Archwire Objective
.0175 x .0175 TMA If necessary for torque refinements and/or final detailing
Option: .016 TMA .018 x .018 SS Final detailing
Control width of both U&L arches in cases with initial width discrepancy

Note: .018 x .018 archwires may fit snuggly due to normal manufacturing tolerances.

* These are general protocols provided by Drs. Takemoto and Scuzzo, who also recommend providing a detailed and highly individualized treatment plan. Ormco is a medical device manufacturer and does not dispense clinical advice.