RICKETTS' BIOPROGRESSIVE TECHNIQUE

RICKETTS’ BIOPROGRESSIVE TECHNIQUE

“THE LIGHT SQUARE PROGRESSIVE TECHNIC”

Bioprogressive technology refers to a comprehensive concept developed by Ricketts in the late 1950s.

At the heart of this concept is the diagnosis, to which Gugino attributes 75% of the success of the treatment, with 25% coming from the development and implementation of the mechanical systems.

This true orthodontic philosophy meets aesthetic, occlusal, periodontal and functional matrix neutralization objectives.

To achieve the defined objectives, the bioprogressive technique has diagnostic means (clinical examination, evaluation of the teeth, skeletal analysis), development of the treatment project (visual objective of treatment in the short and long term) and therapeutic means.

The latter include special attachments and use specific wires (Elgiloy, currently abandoned in favor of TMA) based on the segmentation of the arches. The use of the basic Ricketts arch and its derivatives, as well as different means of anchoring, are the specificities of the technique which is characterized by its progressiveness.

Thus, balance or harmony (Leonardo Da Vinci) , a fundamental value of the concept, are respected by a technique at the service of treatment, developed by considering the patient in their entirety.

The term “bioprogressive technique” may not be the best suited to this therapeutic philosophy. Indeed, it restricts to a mechanical aspect what actually designates a global concept developed by Ricketts in the late 1950s, published in 1976, finalized with the collaborators Bench, Gugino, Hilgers and Schulholf in 1980 and still evolving.

Bioprogressive therapy is not a simple orthodontic technique , but more importantly, it implies a total orthodontic philosophy.

Broadcast in Europe by Gugino in 1965, it was relayed in France by J. Philippe, Langlade and Lejoyeux .

Derived among other things from the classic Edgewise, it provides a response to those practitioners who, for aesthetic, functional or stability of results reasons, were not entirely satisfied with the methods they were using.

One of the essential points of this concept is the diagnosis: Gugino attributes 75% of the success of orthodontic treatment to it, 20% coming from the coherence of the treatment steps and only 5% from the manufacture, installation and activation of the mechanical system.

COMMANDMENTS OF BIOPROGRESSIVE THERAPY PROPOSED BY RICKETTS:

Patient awareness training and motivation education
Progressive unlocking of malocclusions to normalize functions
segmentations of the arches according to the degree of difficulty presented by the case
orthopedic correction of base shifts.
Anchoring in cortical bone.
Muscle anchoring.
Consolidation and preliminary idealization of the mandibular arch.
Completion of each step before starting the next one.
treatment of the inter-incisal overlap before that of the overjet
Overcorrection.
control of applied forces according to the principle of Stoner’s four “D”s (direction, degree, distribution and duration).
design of mechanical systems based on individualized objectives and the degree of difficulty presented by the teeth and the functional envelope.

RICKETTS BASIC ARCH (UTILITY ARCH WIRE)

Made with .016*x .016inch or .017*x .017inch square wire, it only affects the anchor molars and the incisal sector, and it gingivally contours the canines and premolars.

It consists of a posterior molar segment and an anterior incisal segment and a lateral gingival bridge, each segment being separated from the neighbor by a vertical recess called a vertical leg. There are several types:

BASE ARCH OF INGRESSION : It allows the intrusion of the incisors thanks to a tip back of 20 to 40 ° at the level of the molar sector, it also includes a molar toe-in and a radiculo-vestibular torque for anchoring.

BASE EGRESSION ARCH : designed to ingress the incisors, made like the base intrusion arch except that the tip back is replaced by a tip forward.

RICKETTS’ BIOPROGRESSIVE TECHNIQUE

EXPANSION BASE ARCH : “internal coils”

This arch is used to advance the incisors, at each angle of the arch the wire forms internal turns at this angle, it is used in compression which tends to lengthen the arch.

RICKETTS’ BIOPROGRESSIVE TECHNIQUE

BASIC CONTRACTION ARC “external turns”:

Used to move the incisors back, each angle at the level of the detachment would be surmounted by an external spire. Activation is done by pulling posteriorly to the molar tube and performing a sinch-back .

THE SECTIONAL ARC :

Canine retraction (Las Vegas loop) : formerly constructed in blue elgiloy .016 * .016 inch carrying a “Las Vegas” loop (double closed loops with helical turns), the retraction sectional was replaced by the TMA “T” loop described by Burstone, much less invasive for the patient and of larger section (.016*x.022 inch or .017*x.025 inch), therefore presenting better control.
Leveling: they are no longer used today, replaced by modern super elastic and shape memory alloys (Chinese or Japanese Nitinol).
Stabilization: These are sections of rigid ideal arches put in place after leveling.

RICKETTS’ BIOPROGRESSIVE TECHNIQUE

THE CONTINUOUS ARC:

These are leveling arches (most often modern alloy) or finishing arches (ideal arches used for final correction and coordination of the arches) chosen from the five forms described by Ricketts et al.

CONCLUSION

The bioprogressive technique is based on a concept which affirms the primacy of diagnosis in the success of our treatments.

The practitioner is faced with a mass of information concerning the patient as a whole which he must evaluate, organize according to his own operating scheme in order to arrive at the planning of therapeutic objectives and therefore of treatment sequences.

In addition, it allows early intervention that uses growth, thus optimizing the aesthetic result and the stability of the treatment.

However, thanks to the use of light forces it perfectly meets the requirements of adult treatment.

RICKETTS’ BIOPROGRESSIVE TECHNIQUE