3-Piece-intrusion and insights on levelling a curve of spee - Dr. Gabriel Azevedo

"The presence of a deep overbite accompanied by a tight overjet led me to choose three-piece arch mechanics. This approach offers excellent Labio-lingual control of the lower incisors during the correction of the curve of Spee.

Had I opted for a simpler method, such as using a continuous archwire through the lower arch, it would have caused the incisors to procline, with minimal improvement in the overbite. To avoid this, I implemented segmental mechanics. Once I established a heavy rectangular wire in the posterior segment, I began by intruding the lower canines. This step was necessary before intruding the lower incisors. The intrusion was performed in two distinct stages to maximize anchorage control.

Including the canines in the posterior segment from the beginning would have significantly increased the load on the anchorage unit. This could have resulted in unwanted side effects, such as extrusion of the buccal segments. By dividing the process into two stages, I was able to minimize these effects and achieve better control over vertical tooth movement."

-Dr. Gabriel Azevedo