- back to homepage -
 

New Orthodontics, (NO)
Fixed Functional Orthodontics, (FFO)
Risse-Technique

Enthusiastic International Interest for FFO
An Evolutionary Orthodontic Turnaround by New Physics!

 

1. The meaning of an orthodontic treatment

1.1 Patients and physicians are delighted on "New Orthodontics" by:

  • Reduced pain
  • individual precision
  • highest effectivity in biological speed
  • short treatment times
  • reduced costs
  • new wires with Ni-Ti characteristics and individual formability for individual bendings and activations
  • Defensive medicine
     

1.2 The spirit of success

  • A nice sympathetic smile is one secret of self-confidence and prosperity.
    Individual positioning of teeth are the presupposition of attractivity and for a long life of teeth and health.
  • Slightest malpositions or artificial positioning of teeth easily cause inflammation of soft tissues and loss of bone of those malpositioned teeth.
  • Full automized or full programmed techniques by Ni Ti´s or thick wires especially heavy wires easily are the reason for artificial positioning of teeth and occlusion with danger for relapse, periodontal disease and Temporo Mandibular Joint (TMJ) - diseases and special sorts of so called migraine and headaches.
  • All dental work on teeth for the whole life needs a healthy, individualy, well-positioned foundation.
  • Common orthodontic edgewise systems with the slots .018 x .025 or even bigger are programmed for artificial precision.

 

1.3 Orthodontics: mechanics or medicine?

Orthodontics - implanted, activated mechanics
What defines their quality? - technical concepts or biological demand?


 

2. Contemporary text-book philosophies in orthodontics and physics

2.1 A. Contemporary edgewise techniques:

All common orthodontic edgewise concepts are based on rigid anchorage concepts of "reactive members", requiring huge occluso-gingival slot dimensions and by this huge cross-sections of integrated wires (Burstone).
They are definitely declared by Burstone to be against the biological demand of biological environments and are definitely declared to be hard to get under control for fine and sophisticated control by the operator (doctor).
"It would be a mistake to design primarily on the basis of active member (biological part) and to find oneself using slots that were relatively too small to control the anchor teeth (reactive member) or to withstand the forces of mastication." (Burstone, C.J.: Application of Bioengineering to Clinical Orthodontics, in Orthodontics: Current Principles and Techniques, ed. T.M. Graber and B.F. Swain, C.V. Mosby Co., St. Louis, 1985, p. 221) 

Pronounced technical concepts of classical physics and technical precision, metrics and rigid systems are still common orthodontic edgewise standard.

 

2.1.1 Active / reactive members (Burstone)

(Burstone, C.J.: Application of Bioengineering to Clinical Orthodontics, in Orthodontics, Current Principles and Techniques, ed. T.M. Graber and R.L. Vanardall, Jr., 2000 S. 270)

Textbook:

Active members

"For active members a low load-deflection rate is desirable for two important reasons:

(1) a mechanism with a low load-deflection rate maintains a more desirable stress level in the PDL because the force on a tooth does not radically change magnitude every time the tooth has been displaced; and
 
(2) a member with a low load-deflection rate offers greater accuracy in controlling force magnitude. 
For example, if a high load-deflection spring is used (e.g., an edgewise vertical loop), the load-deflection rate might be 1000g/mm; this means that an error in adjustment of 1 mm could produce an error in force value of approximately 1000g.

However, if a low load-deflection spring is used, such as one with a rate of 10g/mm, an error of 1 mm in activation affects the force value by only 10g.
Flexible members with low load-deflection rates require long ranges of activation to build up to optimal force values; hence they give the orthodontist greater control over the magnitude of force used."
 

Reactive members

For reactive members
"If a low load-deflection rate is desirable for the active member of the appliance, the opposite is true for the reactive member.
The reactive member should be relatively rigid; that is, it should have a high load-deflection rate.
The anchorage potential of a group of teeth can be enhanced if the teeth displace as a unit.
 
If individual teeth in the reactive unit tend to rotate around separate centers of rotation, higher stress distributions are produced in the PDL and the teeth can be more easily displaced.
Another factor to consider is, that the equal and opposite forces produced by the active members usually are distributed to localized areas, with just one or a few teeth involved.
Localized tooth changes in these areas can be minimized if the reactive members of the appliance are sufficiently rigid.
In short, the load-deflection rate is an indicator of the force required per unit deflection.
In the reactive part of the appliance, a high load-deflection rate is needed when the orthodontist is dealing with a relatively rigid member."
 

2.2 B. "Light wire" philosophy 

Exactly in opposition to this position of Burstone and contemporary edgewise orthodontics are the positions and findings of Begg, Storey and Smith more than 50 years ago.
 

They found:

  • "Occlusion is never a static condition."
  • "Needless confusion will result from attempts to apply complicated formulas to living tissue"
  • "Human bodies differ in too many complex respects to respond like inorganic mechanical machines."

Begg, Storey and Smith are requiring light and "differential" forces for all treatment procedures!

They found:

  • "The light arch wire technique can produce universal tooth movement with light optimal forces
  • least discomfort to patients
  • minimum loosening of teeth
  • least injury to tooth-investing tissues
  • light forces move teeth most rapidly
  • light forces are the most easily controlled forces
  • The light wire differential force treatment may well be the most precise and exacting of all techniques yet developed."
     

2.3 C. Contemporary edgewise concepts out of time by modern physics!

  1. "Physics, engineering and mathematics are disciplines that can be similarly applied with great profit to the field of orthodontics". (Burstone)
     
  2. "However, one variable that we are in a position to control is the force we place on a tooth."
    (Burstone, C.J.: Current Principles an a Techniques
    Application of bioengineering to clinical orthodontics : Current Principles and Techniques,
    Ed. T. M. Graber and B.F. Swain, C.V. Mosby co., 
    St. Louis, 1985, pp 193.)
     
  3. "In defining a treatment goal in all three dimensions, this determines only one correct force system".
    ("Nach einer dreidimensionalen Definition vom Behandlungsziel gibt es nur ein korrektes Kraftsystem") (Melson, Birte in: Rationale Biomechanics I, Seminar, 2-3. Febr. 2001, Hamburg and all over Europe).
     

Ad 1. and 3.
Modern physics, so-called "New Physics", are in clear opposition to these two central statements in contemporary edgewise orthodontics meaning technical, mathematical, dual logic (yes/no) artificial precision, an exact, precise date or number or force. In applying an exact force would mean a precise treatment. Full engagement of a wire in its slot is recommended for a precise force transmission and precise treatment in contemporary orthodontics.
Modern Physics strictly are in opposition to this theory, proving them to be basically wrong in complex systems. In orthodontic medicine they cause artificial results with a high rate of relapse, and in combination with high force levels they cause a high level of damage and injuries. The Begg-Technique already found the direction for "producing universal tooth movement".
The Risse - F.F.O. concept recommends a calculated amount of clearance between edgewise wire and edgewise slot in a dynamic, flexible low-force system on the level of adaptive dominance. (Fuzzy sets).
The "universal tooth movement" in Begg round-wire-systems is reduced to a smaller range, defined by a flexible, adaptive edgewise equilibration.
 

Ad 2.
"However, one variable that we are in a position to control is the force we place on a tooth." (Burstone, C.J.).

This saying is misleading in many ways: 
We don't place force on a tooth!

  • We are loading a mechanical system with energy by mechanical tension or stress.
  • This mech. energy system or engine is implanted in a biological environment. 
  • This engine itself is working independently as a function of the dialogue with biological reactions on the loading, based on the quality of the "forces".
  • Rigid force systems defined by huge slots and thick wires and "controlled bodily movements" of contemporary orthodontics need artistic skills to achieve and to apply "low force" levels regionally at all!
  • Doubling the size of the cross-section of a wire may cause eight times higher forces. A deflection of 1 mm would result in 8 times higher forces. This means a difference of for instance 50 g to 400 g by a deflection of 1 mm! Recommended "forces" are 50g. 
    "If a beam is rigid attached on both ends, meaning a wire is attached in two brackets the wire is getting twice as strong!" (Proffit). It would realistically cause a force of 800g! 
    A mistake in bracket positioning and precise contemporary edgewise orthodontics control (no clearance, precise engineering) may cause these unwanted force levels easily!
  • The same force on different sized surfaces in the bone on the other hand means different pressures. Therefore a change from bodily movement towards a slight tipping reduces the stressed surface significantly with a significant higher pressure on this small area!
  • Contemporary orthodontics try to achieve low force levels by means of special alloys (but often with reduced individual formability) and by distance, long sectionals and loops and by precise geometrics and bodily movement in order to distribute high, rigid forces on a bigger-surface for low pressure locally.
    Concepts of maintaining bodily movement in contemporary edgewise orthodontics to prevent any tipping normally must fail in bio-dynamics.
    A high force level on a tipped tooth focuses the force for the whole root surface on a small area causing excessive pressure, squeezing off the blood supply, causing pain, necroses...
  • In applying force into reality we are in combination with time levels. This means we are not working by theoretic force vectors but by impulses, as:

force x time is defined as an impulse!

  • The quality or character of a system is defined by the slot size and by wire sizes.
    As a trampoline works by means of low force x long time, contemporary orthodontics are created as "springboards" with high "forces" x short time and the steady demand to make it to a "trampoline" with low "forces" x long working range during action by means of complicated, irritating and unnecessary vehicles!
     

Why not create a "trampoline system" directly?
(Reduction of slot sizes and wire sizes)

This perhaps may mean the "worst" of all, an attack on customs!

"New Physics" starts another attack on customs against precise engineering in/with complex systems!
These findings of modern physics declare precise engineering as a great mistake in complex systems, causing chaos the more complex a systems is!

In 1965 Lotfi Zadeh changed the "World of Physics by the Principles of Fuzzy Sets, Fuzzy Logic" and "Principle of Incompatibility" (1),(2),(3),(4),(5),(6),(7),(8),(9),(10),(11),(12), (13) and proved all positions of Begg, Storey and Smith postulated several years before to be absolutely correct and blamed orthodontic edgewise-principles of Burstone and contemporary edgewise theories and techniques (2002) on the basis of reactive member philosophy and artificial, dual-logic precision "of physics, engineering and mathematics" (Burstone/Melsen...) to be false and by this highly dangerous for patients and for clinicians concerning malpractice claims!
Beside acute or chronic TMJ problems, a small misaligning by artificial positioning may cause heavy side-effects of periodontal disease, "long teeth" and differential sorts of "migraines" or Temporo Mandibular Joint diseases. (TMJ).

They are a terrible foundation for crowns, bridges and against any attractive smile. Long lasting recovery of bone is hardly achievable in not treating its cause, the malposition.
As explained above sophisticated prevention or even treatment by means of common rigidity based orthodontics, slot-sizes of .018 x .025 and even bigger, is hardly possible.


  1. Lotfi A. Zadeh: Fuzzy Sets, in: Information and Control 8, 1965, 338-353
  2. Lotfi A. Zadeh, outline of a new approach to the analysis of complex systems and decision processes, IEEE Transactions on Systems, Man and Cybernetics, 1 (1973), 28-44
  3. Werner Heisenberg, in Physics and Philosophy, S. Girzd Verlag, Stuttgart, 1978 p.p. 27-40
  4. Werner Heisenberg "Cognitive Science", Neural Nets, 1 (1988) 269-273
  5. E. von Goldammer, ICS-Buch, Kybernetik und Systemtheorie-Wissenschaftsgebiet der Zukunft? Symposium Dresten, Nov. 91
  6. - Hans-Georg Gadamer, Wahrheit und Methode, J.C.B. Mohr (Paul Siebeck) Verlag Tübingen (Truth and the Method) 1960,
    - Hermeneutik, Greece and Philosophy, 1999 J.C.B. Mohr (Paul Siebeck) Tübingen.
     
    Gadamer refers to Aristoteles, who devided strictly between theoretical knowledge, the arts and praktikal knowledge.
    The science of arts are:
     
    Theoretical knowledge
    - so called exact sciences (dual logic)
    - so called evidence based sciences 
     
    Practical knowledge
    Comprehension of complexity and variety of actual situations and interactive actions. They never will be comprehended or grasped by dual logic metrics of theoretics.
    Analytic sciences would do it by means of records, register, cover, collections, measurements…
     
  7. Hans-Peter Dürr Ph.D., Nobel-price-winner of alternative medicene, 1987, Director of Max-Planck Institute, München, Werner Heisenberg-Institute.
  8. Cramer, F., Director of Max-Planck Institute, Göttingen, Germany in: Evidence Based Dentistry, Walther Michaelis, DÄV-Hansa, Köln / München 2000:
    "Physics finished to be the leading guide for Natural Sciences. In so far Medicine has to develop a new paradigme."!
  9. Carl Friedrich von Weizsäcker again and again discussed the general validity of the Quantum Theory and Quantum Mechanics, in:
    Aufbau der Physik, dtv 1988 (Construction of Physics)
  10. W.S. McCulloch & W. Pitts
    A Logical Calculus of the Ideas Immanent in Nervous Activity, in: Bull. Math. Biophys. 5 (1943) p. 115
  11. W.R. Ashby, Design for a Brain, John Wiley, N.Y. 1952
  12. Norbert Wiener, Cybernetics, or Control and Communication in the Animal and the Machine, John Wiley, 1948
  13. Heinz von Foerster, Cybernetics of Cybernetics, Cybernetic Systems Program, San Jose, CA, 1986 

 

3. Reactions for protection

3.1 Instructions of American Association of Orthodontists

- AAO officials recommend orthodontists to give a written advice on TMJ (Temporo Mandibular Joint - dysfunction) problems in the consent document before orthodontic treatment against malpractice claims! 
The AAO-Bulletin, April 2002, Vol. 20, No 3, assumes: "A-TMJ- dysfunction is a risk in 70 percent of cases involving women between the ages of 20 and 40."(by contemporary edgewise orthodontic).

In this AAO-Bulletin Vol. 20, No 3, 2002, an example of a 35 years old female patient was given, to explain what TMJ problems really may mean:
This patient suffered from:

  • "couldn´t find her bite 
  • loss of hearing 
  • history of migraine headaches
  • chronic sinusitis along with otitis media 
  • tingling in her fingers 
  • in orthodontic progress more ear and headache pain
  • consultation of several doctors and a neurologist."

3.1.2 The patient should be informed too of high risks for getting dark, dead teeth and of shortening of roots as a result of high continuous forces endangering preferrably the front teeth!
The combination of shortened roots on top and parodontal disease from the bottom is a horrible vision for stability and existence of those teeth continuing for restauration plans by crowns or bridges by loss of a tooth.

 

3.2 How to solve problems of contemporary edgewise orthodontics?

It is shockingly simple:

  • Reduction of slot sizes and reduction of cross-sections of wires!
    Firstly as presuppositions for a basicly different technical concept in not treating by "force" but by "light impulses", "doses" and by so-called "Fuzzy sets" (New Physics) or "differential forces" (definition by Begg).
  • Application of New Physics instead of Classical Physics and statics or metrics in a biological world of variability and active and individual and biological reactions!
  • Even the complex mechanical system in one jaw positioned in a physical environment needs the application of New Physics because of complexity.

In physics a change of paradigm happened from Classical Physics towards physics of relativity - Physics of environments - so-called New Physics!
This dramatic change of paradigm in physics passed orthodontic edgewise science in general! This essential change in physics is the reason of exploding progress in nearly any modern discipline or machine or engine, but it passed edgewise-orthodontics completely. It is still not yet existing in common edgewise orthodontics - an unpardonable negligence of officials in orthodontic sciences and teaching departments for edgewise orthodontics.

  • In applying New Physics orthodontics is getting much easier (!), enables individual precision (!) and defensive medicine (!)
     
  • Last but not least:
     
    To fulfil the demands of the "
    active members"! 
    and
    to be and to act on the base of simple and
    Plain Logic.

"Active members"
(Burstone)

"For active members a low load-deflection rate is desirable for two important reasons:

  1. a mechanism with a low load-deflection rate maintains a more desirable stress level in the PDL because the force on a tooth does not radically change magnitude every time the tooth has been displaced; and
  2. a member with a low load-deflection rate offers greater accuracy in controlling force magnitude. 
    For example, if a high load-deflection spring is used (e.g., an edgewise vertical loop), the load-deflection rate might be 1000g/mm; this means that an error in adjustment of 1 mm could produce an error in force value of approximately 1000g.

    However, if a low load-deflection spring is used, such as one with a rate of 10g/mm, an error of 1 mm in activation affects the force value by only 10g.
    Flexible members with low load-deflection rates require long ranges of activation to build up to optimal force values; hence they give the orthodontist greater control over the magnitude of force used."

It does make no sense to stress the demands of the reactive members and mechanical anchorage concepts with the result of a rough, oversized, clumsy system, being in the range that the driver/orthodontist is absolutely not in the position to control this system at all! - (see above, Burstone himself.)
By this all artistics of contemporary orthodontics by means of loops, long sectionals, alloys and "straight throughs" are not more than insufficient tricks to make contemporary dimensions compatible to the capacity of an orthodontist and to the biological demand, the active members.
By this contemporary biomechanics is more or less reduced to efforts of correcting an oversized system by complicated means being still insufficent.
It has nothing to do with real biomechanics, as real biomechanics means treatment and not correction of an engine.

  • Individuality is controlled by Fuzzy-Logic, see New Orthodontics!

 

3.3 The "Solution" by contemporary edgewise orthodontics

The prominent member of orthodontic teaching society, Dr. Ronald Roth, postulated his question on his Heritage Lecture, AAO-Philadelphia 2002:

"How did we get so lost?"

Means to solve this question by Dr. R. Roth: 

"Excellence of Orthodontics":

"Aesthetics, function, stability".

"All of them are measurable". (Roth)

That´s the problem of Contemporary Edgewise-Orthodontics!:

Variability is not measurable!

Even if variability or aesthetics, function or stability may be measurable, the main question remains: By what means do we get them? 
Variability never will be controllable by metrics or statistics on metrics of /in variability and especially in vitality!
This is the philosophy of the Mechanical Determinism of the late 19th century!- the state of knowledge of Angle´s time, more than 100 years ago!

 

3.3.1 The leading teaching staff in edgewise orthodontics

Years over years are passing in which orthodontic edgewise scientists try to 
solve the problem to measure complex variability by metrics and analytics.

a) Europe, USA
Still in 1994 (JCO/March, page 136) Prof. Birte Melsen and Prof. Giorgio Fiorelli are creating a "Computer-Based Mechano-therapy" on Burstones concepts: "A more rational approach, developed by Burstone in the 1960s, is based on fundamental laws of physics and allows every problem to be confronted logically and analytically." (Burstone: C. J.: Application of bioengineering to clinical orthodontics, in orthodontics: Current Principles and Techniques, ed. T. M. Graber and B.F. Swain, C. V. Mosby Co., St. Louis, 1985, pp 193-227)

b) Germany
Prof. Dr. Dr. Diedrich / Germany,
"Concept and Development of a Measuring System for in Vivo Recording of Orthodontically Applied Forces and Torques in the Multiband Technique."
In J. orofac. Orthope./ Fortschr. Kieferorthop. 57 (1996), 298-305 (Nr. 5)
"The measuring technique presented in this paper is designed to permit these force systems to be recorded in vivo for the first time, allowing account to be taken of the individual situation "tooth-periodontium- bone."

The problem of measurability remains. Diedrich attempts to measure and to focus a single and short part of a complex dynamic process.
(Artificial) Measurements are no (individual) treatments!
All these sciences are the "scientific" attempts to predict the result of a football game by a precise measuring of the conditions of the players!

New Physics and Physics of relativity left this way of science since years. This sort of science for complex-systems is out of time since years. Pupils at school find it in their textbooks already!
Sciences on this level of contemporary edgewise orthodontics by means of classical physics cause useless millions of dollars and rigid treatment systems and artificial results….. who may dare to sum it up?

Leading officials in Europe and US are personally informed of this change in paradigm in physics and of the necessary consequences for orthodontics. Their reaction is silence! 
Therefore the internet enables the question:
Who is responsible for malpractice claims?
The practitioner?

 

3.3.2 Australian concepts of the 50´s confirmed by New Physics

In the early fifties this concept of contemporary edgewise orthodontics was left already by the so called Begg-Philosophy, supported by Storey and Smith - in Australia! This technique introduced "light wires" and "differential forces" already! This technique is done by round wires only, but the direction was extremely progressive and modern. Their concepts are very close to New Physics and Fuzzy sets! Findings in Physics by Fuzzy Sets proved these concepts of differential forces and light wires to be right!

 

3.4 New Edgewise Systems - the consequence: 

3.4.1 The software of FFO
New Orthodontics and Fixed Functional Orthodontics, FFO, is a technique on the basis of New Physics and on Begg, Storey, Smith - Philosophies - but in edgewise techniques - magnifying the clinical possibilities and effectivity of round wires and round wire slots extremely!

In applying New Physics by suitable materials, a lot of common malpractice problems of oversized edgewise techniques on philosophies being out of time are avoidable and in addition by this sophisticated soft technique adult patients with "migraines" and periodontal bone-loss problems can be treated by means of light wire/small slot-edgewise-systems and techniques much easier without dramatic unwanted side effects.

New bio-efficient Edgewise-Technique:

It is called,

  • "New Orthodontics" - because of relying on New Physics
  • "Biofunctional Orthodontics" in focussing the functional aspect and background of this technique
  • "Fixed Functional Orthodontics (FFO)" focussing the fact, that this technique is not a removable technique, but a fixed edgewise technique
    slot size: .016 x .020
    wire sizes: .010 x .020 til, .014 x .020

 

3.4.2 The hardware of FFO

Features of FFO-Hardware

Slotsize: .016 x .020

Wire sizes: .010 x .020 - .014 x .020, stainless steel (ss) 

Braided wire: .014 x .020

Most frequently used wire sizes: .010 x .020 til .012 x .020 ss wires.
These wires are excellent for:
Intrusion, extrusion , expansion, contraction torque and uprighting., bite opening, molar distalisation by differential use of torque and tipping.

 

3.4.3 The software of light edgewise wires

Features of the .010 x .020 ss-wire

  • It is a light wire with a force level of a .016 x .020 Ni-Ti
  • Ni Ti - elasticity in the required ranges but bendable and formable for individual control and teeth navigation.
  • Similar continuous low force plateau like in Ni Ti´s during-deactivation. -By this, a steady recovery of stressed parodontal tissues and support of blood supply supports biological vitality and reactivity.
  • Differential use of individual stiffness: This is a new term and means:
    construction by stops in front of molars for stabilisation or slight expansion. Hereby weaker lateral parts of a blank against the stiff curved front part of a blank are equilibrated. By this, a stopped elastic wire is stabilizing and supporting all individual bendings of torque, angulations, pronounced-spee or anti-spee,
  • no collapse in transvers and vertical dimensions as it is regularly happening with automized Ni Ti wires without stops
  • very effective in correcting a deep curve of spee or a deep bite, simultaneously by a differential control of angulation and torque engagement
  • differential handling of force levels and working range of the stiff front part to the softer lateral parts of a blank by integration of open loops in front of cuspids, especially in the lower-jaw
    Open loops in combination with stop-bendings in front of molars means support for transverse and sagittal expansions as well as for support of anti-spee with a long working range 
  • individual positioning of the most prominent part of curvature of anti-spee or transverse expansion mesiodistally.
     

Terms of "stop"

A stop in lower ss-wires means a sort of by-pass


 

  • Upper und lower molars in general are treated by a small intrusive step:
    A stop in braided wires in front of

upper wire


 

and lower wire

or by a 
Braided .014 x .020 - wire 
Normally in contemporary orthodontics braided wires are used as levelling wires.
 
In FFO this wire is the most prominent working wire, too, in form of a differential stopped wire, pronounced integration of spee, anti-spee and both at the same time, differential expansion if wanted and needed.

  • Just a levelling wire does not exist in FFO orthodontics!
  • As a levelling wire is not wanted, consequently there exists no division in levelling, working and adjusting phases as this division neither is existing in nature!
    A division of a process in different parts is not existing in nature!
    Any relevant stimulation is causing a "working phase" and any stimulation in nature is in the range of dynamics and definitely not in the range of metrics and statics like in contemporary edgewise orthodontics!
  • Differential stiffness management of a braided wire by stops is highly effective in all dimensions in similar ways as described above with the .010 x .020 ss-wire.
  • Any bending in the braided wire can be done in a much pronounced manner, as the wire stiffness of a .014 x .020 braided wire is extremely low. By this you can manage your wanted individual stiffness-degree easily, being safe in just stimulating natural systems instead of being on the side of dominating nature by artificial, dangerous forces and force amounts.
  • Characteristics of contemporary edgewise orthodontics mean steady activities for force-reduction management for demands of biologic members because of huge slots. By this all benefits of a differential force management in reduced slots and by means of very thin wires in the FFO-Technique are not existing in contemporary edgewise orthodontics.

 

3.4.4 The software of treatment: the sequence of hardwares, timing, dose and their qualities 

3.4.4.a Wire-sequence

  • Be aware: Like in chest the first wire is the most important wire.
  • Just levelling procedures as a first preparation management is the biggest mismanagement and is complicating the severity of a case in most instances!
  • A braided wire or a .010 x .020 wire as a 2/4 are usually the first wires.
  • They are preparing anchorage, bite opening and space conditions, as well as navigations for eruptions.
  • After a first three months period a definite decision for an extraction - or a non- extraction therapy is possible in most cases. Then the possibilities of space management can be calculated much easier on the basis of first reactions. 
  • After this stage, after a period of three to 6 month most severe problems for further treatment planning and treatment management are solved and easy.
  • The patient can understand what happens, the orthodontist mostly is in the good situation to explain and demonstrate first improvements and further steps on the basis of first positive developments. Up to this stage pain was already on a very reduced level and will continue like that.
  • Patient and orthodontist is realizing that everything is flowing and adapting, an absolutely new exciting experience of orthodontics.

3.4.4.b Retraction and coordination of upper front - Risse-Retraction-Loop -

  • All retractions of premolars and especially of canines are mainly done by sliding mechanics alongside of stopped braided wires and by differential use of elastomerics. The braided wire is loaded with individual bendings for molar angulations, pronounced curve of spee in deep bites and differential integration of torques for the front, as well as by an elastomeric block of centrals against loss of anchorage.
    Because of being stopped or slightly extended, there is normally no collapse in transverse or vertical dimensions to be seen, because of creating a differential stiffness of the braided wire temporarily by stops. Distal tipping of the canines occurs by a controlled tipping. In tipping distally the highly elastic braided wire is activated automatically by an elastical deformation up to a stand-still of the canines. Then the loaded, elastically deformed braided wire automatically starts uprighting activities for the roots of tipped canines. By this the dynamic system is activated by itself during one activation period twice. So a bodily displacement by several tipping intervals occurs easily. 
    A vertical collapse like in Begg-technique is easily avoidable as well as a transverse collapse. Because of differential variations of use of stops even a transverse expansion is possible. 
    After a canine displacement half-way the retraction of the centrals are started.
    For detailing angulations and vertical functional aspects a .010 x .020 or a 
    .011 x .020 ss wire may be used in between, supported by bite opening procedures in the lower jaw. 
    Be aware the position of the top of the root of the canines in most cases are in a correct position mesiodistally. Differential growth - and space problems cause a pronounced mesial malposition of the crowns. 
    All uncontrolled levelling activities cause a mesial-drift of the roots of protruded positioned canines!
    After bringing the roots of the canines in a forward "uprighted" position by contemporary uncontrolled Ni-Ti levelling first, horrible "controlled bodily retraction mechanics" under rigid anchorage control...... in contemporary edgewise orthodontics are started to bring the roots backwards again! 
    Be aware in using rigid forces for a so-called bodily movement a slight tipping which is not avoidable in biological systems is concentrating the whole load not equally on the whole root surface but on a tiny regional surface caused by tipping. Necroses are the immediate reactions with no movement of the canines distally but of the molars mesially! (loss of anchorage + change of direction + pain...)
    All these artificial complications, caused in contemporary edgewise treatment concepts, easily can be avoided by FFO concepts and FFO-systems. It saves time and costs and protects from huge slot size systems and enables "light anchorage control"...
  • After Cl. I relationship of molars and canines is reached the retraction of the front -teeth (centrals) is the finishing part. In Cl. II cases it is done by the Risse R-Loop. It is a bulloop with an angulation of 45° degrees in the middle of a bulloop and an integrated lever arm! This loop guarantees by correct management a precise intrusion and retraction of the upper front within a time range of 6 months, whereas loss of anchorage is minimal. Very often this Risse R-Loop (size .012 x .020 ss) is the finishing arch, too, because a high individual adaptation and individual function by masticatory activities and clearance in the slots is reached in most cases.
  • If not, a braided .014 x .020 stopped wire is necessary for Cl I function and individual positioning. In case of small new spaces between laterals and canines, a finishing R-Loop may be useful.

3.4.4.c Powerchains / Elastomerics

  • In all stages of treatment a differential use of different powerchains/elastomerics , single and/or in blocks are main supporting and complementing "engineering/navigating - means of treatment for molar-distalisation, expansion and transfer of effects of differential bendings of/in wires with differential stiffness. Their dynamic force-and dynamic friction-behaviour fits to the dynamic structure of FFO mechanics. Powerchains or elastomerics are of equal differential value as wires and slots. Their differential handling is transmitting slot size- wire size equilibration and their characteristics.

 

4. Resumé

The FFO-Technique and Philosophy underlines the demand of all patients and of all insurers for a defensive and effective medicine.
Malpractice claims, especially in USA, by use of this FFO-technique will be reduced to a minimum. 

 

4.1 Software of FFO

  • FFO is continuing some main concepts of Begg, Storey and Smith, like light wire, differential forces and the fact, that occlusion is never a static condition.
  • FFO is based on findings of Storey and Smith, for effective individual tooth movement and anchorage concepts as well as for a minimum of pain, undermining resorption and root resorptions or TMJ-problems or "migraines".
  • FFO is based on findings of A.M. Schwarz for the effect "that heavy forces, when exerted on teeth, cause the periodontal membrane and tooth investing bone to be compressed too much, so that blood supply is cut off from the compressed parts of the periodontal membrane and alveolar bone".
  • FFO is integrating modern findings for paradontal membrane stimulations by means of a sophisticated, change of stress and recovery by differential use of time and pressure location.
  • FFO is focussing dynamics of occlusion during development - not the effects of attrition for extraction concepts - but rather to prevent extractions by sophisticated navigation of erupting teeth and preparation / reconstruction of age - adapted-tooth angulations.
  • FFO is using and integrating the potential energy in tooth angulations for differential movements, drifts and anchorage.
  • FFO is integrating differential torque and differential tipping and their differential counteracting.
  • FFO is based on differential qualities of stiffness of a blank.
  • FFO is based on differential use, creation and handling of differential stiffness degrees of a given light wire by differential use of stops.
  • FFO integrates slight differential (controlled) dynamic tipping by simultaneous dynamic activation of a light wire.
  • FFO is integrating and using differential degrees of friction during "dynamic slidings".
  • FFO is based on the Principle of Roux, the principle of life, of - Functional adaptation-. 
  • FFO is based by this on stimulation, on a regulating support of active vital systems for self regulation by adaptive dominance.
  • FFO is strictly opposing statics and metrics of contemporary orthodontic edgewise concepts of Burstone 
  • FFO is strictly against uncontrolled Ni-Ti levelling in straight wire concepts, although FFO is integrating Andrew´s / Roth´s prescription inventions.
  • FFO is strictly based on active member demands and strictly against contemporary edgewise positioning on reactive member concepts for rigid anchor demands and high force levels and huge slot sizes of Burstone.
      
     
  • FFO - engineering is based on New Physics 
    New Physics is a change of paradigm in General Physics from Classical Physics towards physics of relativity, or physics in differential realities of environmental engineering of complex systems.
  • FFO is based on the Principle of Incompatibility. This means, to apply engineering of precise metrics and classical physics is causing more and more unprecise results the more complex the integrated systems are.
  • Contemporary edgewise orthodontics are based on "reactive members" for rigid forces, metrics, statics in a dynamic, vital system. By this contemporary orthodontics is highly oversized and is hardly to be under control by the operator by force amounts and by technical, dual logic precision concepts of a complex mechanical edgewise system.
  • Classical, static, dual logic engineering in vital dynamic systems is highly out of time and the source for US malpractition claims. 
  • The difference between Classical Physics and contemporary orthodontics, New Physics and FFO or New Orthodontics may be visualized by the way of driving a car:
    By contemporary orthodontics or by Classical Physics a car is navigated by means of precise 30 degrees to the left or to the right!
    Modern Physics and New Orthodontics of FFO are handling complex systems (car) in a dynamic, complex surrounding by means of soft, fuzzy dates like: a bit to the left and a bit to the right and in supporting self-optimising and adapting regulations of stimulied systems by qualified doses.
  • The "illogical" fact is, fuzzy sets in complex dynamic systems or a fuzzy engineering are highly and more precise and much easier to handle as so called dual logic or metric, precise dates!
     
    By this, FFO, New Orthodontics is characterized by easy handling, high efficiency and high individual precision and stability excluding most negative side-effects of contemporary edgewise techniques.

 

4.2 The FFO-Risse technique realizes the vision of Steiner 1953:

Steiner stated, "that the edgewise appliance principles might someday be applied by using an arch wire of extremely elastic metal of a diameter which may be only a small fraction of that of the cross section of the present edgewise arch wire".
 

4.3. The "ranking" of dates in formulas, mathematics, physics, physical systems and biological systems and their interactions.

FFO is realizing this concept in changing the weights between wires, slots and fixations.
The dominating factor of an orthodontic edgewise system is the slot, not the wire.

  • The slot size defines the character and roughness of a system.
  • The slot size defines the sizes of integrated wires.
  • The slot size and the wire sizes define the heavyness of fixation.
  • The wire stiffness is defined by Ws = Ms x Cs. 
    Besides the alloy the cross section contributes forces by the amount of the fourth power of its diameter!
    The length of a wire (loop, sectionals) reduces forces only by a cubic! Therefore length versus cross section to reduce forces makes no sense!
  • Force reduction techniques of contemporary edgewise orthodontics exclude the new world of creativity for dosage of small sized systems. 
  • The slot is the counterpart of any wire. 
    The equilibration and relation of slot size to wire sizes realizes wire characteristics.
  • The clearance of low sized wires in low sized slots defines more or less Fuzzy Sets or stimulations for the biological environment. 
    This creates doses, adaptive dominance, individual precision and easy handling.
  • Once integrated one large quantity or rigidity into a mechanical system, every depending part has to adapt in size or rigidity in order to be relevant. (Risse)
     

4.4 Efforts for FFO-Risse-Technique

  • FFO is a new way of thinking like in New Physics - so it needs some theoretic background 
  • FFO additionally needs some instructions concerning navigating erupting teeth and growth as well as navigating erupted teeth. In FFO teeth are not just moved, they have to be navigated!
  • FFO-needs instructions about blanks and wires - especially on thin wires and blanks, meaning on the vast variability of options and possibilities by these fantastic wires - as well as on some basics in physics. 
  • FFO needs instructions of the huge variability of differential options for differential navigation by FFO techniques .
  • There are great similarities between orthodontics and sailing. 

Therefore, don´t treat patients by means of icebreaker mechanics and
straight- through navigation.
- See FFO instructions as instructions for a new sailing boat!

 

Seminars and courses

  • Seminars and courses on New Orthodontics/FFO are available all over the world.
    For more information on courses and seminars please contact
    Dr. Georg Risse, Institute for Biofunctional Orthodontics, IBO, 
    Muenster (Germany) , Bogenstr. 15/16,
    risse@ibo-tech.de

 

(First Edition: June.2002)

 

© 2000 / 2003 - Dr. G. Risse