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HYCON DEVICE
The history of the Hycon
Hycon Clip on
Hycon Clip on user manual
Hycon Tube
Hycon Tube user manual
Ordering information
DEVICEYH C N
made easy!
Hycont u b e
Hyconclipon
were all about solutions
The Hycon Device... fast, precise and successful space closure
welcomefrom the desk of DR. WINFRIED SCHTZ - ORTHODONTIST
The screw is one of the oldest elements of force used in removable
orthodontics. Its function accepted by and familiar to every
orthodontist, allowing the handler to apply an exact defined pressure
to the periodontium. The defining aspect of the Hycon Device is that its
capacity goes beyond that of a standard screw, forming an impeccable
functional unity with the help of a multiband apparatus, preferably the
straight-wire-technique. By working with the multiband appliance,
the new force element eases the job and can offer new ways of
treatment
Relentless to the space, gentle to the tooth....The Hycon Device
were al l about solut ions
hycon contents
Introducing the hycon device
hycon options
hycon tube user manual
Activation profiles
hycon clipon user manual
Activation profiles
2-5
6-7
8-10
11
12-14
15
h y c o n c a t a l o g c o n t e n t s
When I started working as an orthodontist, I was not sure of the force generated by my closing loops. I was concerned about the periodontium tissue. The idea to close the space by means of screw mechanics eased my mind. Since 1984 all my space closing has been done by the Hycon - it has never failed me. Sometimes my colleagues tell me, that they are able to treat cases with the Hycon device, that before would have been beyond therapy. This is especially important for the periodontal compromised adult patients.
the hycon device.... fast, precise and successful space closureAdenta has worked closely with Dr. Winfried Schtz of Germany to engineer a unique device to provide a techni-cal approach for a step by step tooth movement: mesially, distally, but more specifically for space closure. With each activation, the Hycon Device enables to move the tooth in a precise and controlled motion, insuring permanent blood supply to the surrounding periodontal structures. This device permits exact and controlled activation in small steps. With each 360 degree turn the Hycon screw moves by .014 / 0.35mm - precisely.
Hycon ClipOn - self-ligating lockingclip in closed state.
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H y c o n D e v i c e
f o r s p a c e c l o s u r e
Closing spaces with a different mechanical principleDr. Schtz
The ADenta Companies: Germany - phone: +49-8105-73436-0 email: [email protected] website: www.adenta.com page 2
The Alphabet of HYCON Features
Activated in small defined rates - .014 per turn.
Brings about pain free function.
Compatible with all straight arch systems
Demands only minimum of tissue turnover.
Enables the application of intermitting forces.
Facilitates disassociation of activation length and generated force.
Gives the opportunity for additional tissue regeneration.
Helps reduce chair-time - as activated by the patient.
Improves and simplifies treatment.
Makes tooth movement predictable.
Operates with screw power.
Overcomes any friction of the arch wire.
Permits easy and precise control of anchorage.
Provides almost ideal bodily tooth movement.
Speeds up space closure.
Warrants permanent blood circulation for the
involved periodontium.
Holding pin of the Hycon Tube to be inserted into auxiliary tube.
The Hycon ClipOn requires no auxiliary tube, simply clip onto archwire.
the hycon device.... fast, precise and successful space closuremade easy!
HYCON TUBE HYCON CLIPON
Self-ligating locking clip open
Archwire indicated
H y c o n D e v i c e s
The ADenta Companies: Germany - phone: +49-8105-73436-0 email: [email protected] website: www.adenta.com page 2
The ADenta Companies: USA - phone: 215-942-2070 Toll Free: 1-888-942-2070 email: [email protected] website: www.adentausa.com page 3
An interesting investigation idea from India:Alkaline phosphatase as an indicator substance
The alkaline phosphatase (bone specific also known as bones alkaline phosphatase (BAP)) is an enzyme that is active in the alkaline milieu. It is generated as a by-product of bone synthesis, produced by the osteoblasts and additionally serves as a marker for bone regeneration processes. From this Prof. Dr. Anmol Khala concluded, that out of the quantity of measured alkaline phosphatase the activity of the bone metabolism and consequently the rate of bone turnover can be determined.
Physiologic ReferenceThe Hycon minimizes tissue turnover.
The force exerted by turning the screw is entirely suffi-cient to overcome friction, without requiring an activa-tion greater than the periodontal space. This permits adequate stimulation of tissue response, ensuring permanent blood supply to the periodontium and the surrounding structures. An ideal situation for optimal metabolism, consequently osteoclast and osteoblast activity is given.
As friction is of little concern, the HYCON facili-tates utilization of arch dimensions that fully fit bracket slots and provide torque control. Deflection can be practically neglected because the activation is of such a short distance. These are important bio-mechanical aspects because they allow a close approach to ideal bodily tooth movement. As a result, tissue turnover is minimized providing a high efficiency of tooth move-ment while being stress free on the periodontium.
His experiment consisted of measuring the concentration of alkaline phosphatase in the gingival crevicular fluid of the shifted tooth. Here, the teeth - divided into two groups were moved by different mechanisms. Group 1 was drifted by sliding mechanics, while with group 2 the Hycon was put into action. After a 3 week treatment period, there was a significant difference in the amount of alkaline phosphatase. Based on the phosphatase level of unmoved teeth, set at 100 percent, a considerable increase could be discovered in both groups. While in group 1 there was an increase of 65 percent, in group 2 (the Hycon group) the measured level of increase was found to be approximately 140 percent. This indicates that group 2 had the highest metabolic activity.
Consequently, the largest rate of bone turnover and hence quickest tooth movement took place here.
H y c o n D e v i c e s
The ADenta Companies: Germany - phone: +49-8105-73436-0 email: [email protected] website: www.adenta.com page 4
100%
125%
150%
175%
200%
225%
250%
ALK
ALI
NE
PH
OS
PH
ATA
SE
LE
VE
L (
PE
RC
EN
TAG
ES
)
BASE LINE 7 DAYS 14 DAYS 21 DAYS
GRAPH 2: Increase of alkaline phosphatase level during tooth movement within 21 days.
Sliding mechanic Hycon Device Alkaline phosphatase level of unmoved teeth (Base Line)
Data reported by Dr. A. Khala 2005.
A New Space Closure PrincipleScrew mechanics versus elastic forces.
The HYCON is, activated in small steps at intervals
which can be determined according to the condition of the periodontal tissue. So by creating intermittent tooth movement, the Hycon allows recovery of the tissue in between activation steps.
In contrast to the characteristics of elastic elements of force, were the power being generated is proportional to the activation stretch - a screw driven mechanism enables the separation of activation distance and force. The screws force only plays a role insofar as being adequate enough to overcome frictional forces.
After the adjustment of the HYCON screw the ap-
pliance is once again passive. There are no existing elastic forces, what remains from the activation is a slight increase in tissue pressure. This is the physi-ological stimulus for the desired alteration processes.
Characteristics - ConceptsTotal control on activation.
The force necessary to move a tooth must overcome the friction between arch-wire and bracket, and also must stimulate tissue response.
With elastic forces the amount of stretching or deflec-tion is proportional to the total force required. There-fore, in order to achieve the appropriate amount of force, the activation length of an elastic mechanism has to be far greater than the periodontal gap.
In contrast to this the threaded screw-type mecha-nism allows the separation of force and distance. The movement of the tooth is determined solely by the advancement rate of the thread, and the amount of activation turns.
Being independent of elastic forces it is thus possible to exert a very precise activation at a fairly high force level, but at a very short distance.
This 22.8 year old male presented with a Class I dental and skeletal pattern. He showed a satisfactory profile and had previously been treated orthodontally with extraction of his lower second bicuspids. His upper lateral incisors were congenitally missing, however, upper space closure had not been completed during past orthodontic treatment. These spaces were closed during treatment with the Hycon.
H y c o n D e v i c e s
The ADenta Companies: Germany - phone: +49-8105-73436-0 email: [email protected] website: www.adenta.com page 4
The ADenta Companies: USA - phone: 215-942-2070 Toll Free: 1-888-942-2070 email: [email protected] website: www.adentausa.com page 5
Holding pin of the Hycon Tube to be inserted into auxiliary tube.
Designed specfically with a support-wire which is inserted into the auxiliary-tube of the molar band from the mesial side and bent back.
A double buccal tube is required for the use of this appliance.
Available in .018 slot technique with a .018x.025 support wire.Available in .022 slot technique with a .021x.025 support wire.
HYCON
TUBE
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H y c o n D e v i c e
f o r s p a c e c l o s u r e
different attachment optionsare now available.2
The ADenta Companies: Germany - phone: +49-8105-73436-0 email: [email protected] website: www.adenta.com page 6
Designed specfically with a self-ligating locking clip which is attached directly to the arch wire.
Recommended when a double buccal tube is NOT available.
Available in .018 slot technique with a .018 slot locking clip.Available in .022 slot technique with a .021 slot locking clip.
Hycon self-ligating locking clip is shown in open state, reveiling the Hycons slot.
HYCON
CLIPON
The HYCON CLIPON was introduced in 2007 to provide our growing HYCON users in the United States. In general our European orthodontists use a double buccal tube in treating 90% of patients, however this was not the case for our orthodontists in the United States. In an effort to simplify installation the HYCON CLIPON was designed. If a double buccal tube is not avail-able, the HYCON CLIPON simply clips onto the archwire.
H y c o n D e v i c e s
The ADenta Companies: Germany - phone: +49-8105-73436-0 email: [email protected] website: www.adenta.com page 6
The ADenta Companies: USA - phone: 215-942-2070 Toll Free: 1-888-942-2070 email: [email protected] website: www.adentausa.com page 7
HYCON TUBE placement information
Straight arch technique, i.e. no bends that could pre-vent the arch from sliding into the molar tube.
Straight wire appliance with auxiliary tube on the molar bands.
Leveling and aligning must be completed with a heavy, straight, rectangular steel wire installed. The teeth should be grouped into blocks, normally two lateral and one front, with the defined spaces each distally from the front
The support wire is inserted into the auxiliary tube on the molar band from the mesial side, so that the nut points to the buccal side. (Fig. 3)
The HYCON is then fixed by bending the support wire back. Recommended instrument: Weingart type pliers or ligature director.
The tension wire (minimum .012 ligature wire) is bent into a U shape (Fig. 2a), inserted from the outer side into the two holes of the wire linking attachment (Fig. 2b), then pulled through and bent sharply in the direction of the tension. (Fig. 2c)
Fig. 2a Fig. 2b Fig. 2c
Fig. 2a-c: application of the tension wire on the HYCONS
Fig. 1: View of the HYCON TUBE
The HYCON TUBE consists of a bolt and nut combina-tion in which the nut is mounted on a support wire. A fric-tion brake is installed to prevent the bolt from uncontrolled turning.Rate of advancement per turn .014 (Fig. 1)
The HYCON TUBE is available with two support wire di-mensions: for .018 slot technique a .018 x .025 support wire and for .022 slot technique a .021 x .025 support wire. Please note that on some .022 molar attachments the dimension of the auxiliary tube may be .018 x .025.
Characteristics and Concept
The threaded (screw type) mechanism permits exact acti-vation in small steps at intervals. Thus it allows to apply intermitting forces. The devices high potential force rules out friction as a factor, thus permitting the use of a strong straight arch wire (Recommended arch wire dimension: .021 x .025 with .022 slot technique.)
Consequently the tooth movement very closely approaches the bodily type providing maximum torque control.
The HYCON TUBE01
Preconditions for the HYCON TUBE02
Preparing the HYCON TUBE03
Inserting the HYCON TUBE04
Fig. 3: insertion of the HYCON
TUBE into the auxiliary tube of double buccal tube.
block. The teeth of the front block should be laced with a figure 8 ligature wire. In addition, (elastic) ligatures should be used to hold the archwire to the front block teeth.
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H y c o n D e v i c e
f o r s p a c e c l o s u r e
hycon t u b e placement information
The ADenta Companies: Germany - phone: +49-8105-73436-0 email: [email protected] website: www.adenta.com page 8
The tension wire connects the screw with the tooth or group of teeth on the other side of the space.
Connecting Option 1: The tension wire is fastened to the eye of a Kobayashi ligature (Fig. 4). This can, if necessary, simultaneously be used to stabilize the front group of teeth by means of a figure 8 ligature.
5. Connecting the HYCON TUBE
HYCON CLIPON
Fig. 4: Connecting the tension wire by means of a Kobayashi ligature.
Connecting Option 2: Preferably in the case of individual tooth movement, e.g. in the event of distalisation of the canine tooth, the tension wire can be ligated directly onto the bracket or on the power hook.( Fig. 5)
Connecting Option 3: The tension wire may also be con-nected directly to the arch, e.g. posted arch wires (Fig 6), Gurin Hook. In this respect, care is to be taken that the arch, in the course of activation, remains centered in the medial line. (Fig 7)
Fig. 7: A drop of self-curing resin applied to the midline mark is an easy way to prevent midline shift of the arch wire.
Fig. 6: Ligature wire attached to power hook of posted arch
Connecting the HYCON DEVICE05Using the small safety screwdriver which comes with the set (see page 10 for more details regarding the use of the Safety Screwdriver) , the patient usually activates the HY-CON about every three to four days by turning it clock-wise.
The HYCON has to be activated in 2 steps.
First step: To reduce the slack of the connection wire the patient should turn the screw clockwise until they feel a slight tension.
Second step: The patient then has to turn the screw for a given amount, please refer to page 11 for details on activation guidelines.
A practical hint for the patient.When tighting the device with the safety screw driver, the patient should simultaneously stabilize the tension wire with a finger nail to prevent it from twisting.
If there is still a space left after working the complete range of the screw, it is necessary to unscrew the device and to re-tighten the tension wire accordingly.
An inherent advantage of the method of space closure involving the HYCON is that there is less strain upon anchorage units. Activating the HYCON has an effect on both sides of the space. The additional use of means of anchorage (intermax. elastics, headgear, palatal bar) enables the orthodontist to control anchorage, in order to reduce or neutralize the effect of the HYCON on the side of the space where little or no tooth movement at all is required.
Activation of the HYCON DEVICE06
Reactivation07
Anchorage Control08
Fig. 5: Distalisation of a singel tooth (canine)
H y c o n t u b e
The ADenta Companies: Germany - phone: +49-8105-73436-0 email: [email protected] website: www.adenta.com page 8
The ADenta Companies: USA - phone: 215-942-2070 Toll Free: 1-888-942-2070 email: [email protected] website: www.adentausa.com page 9
Use of the Safety Screwdriver09In order to prevent lateral slippage the HYCON safety screw driver has a protective sheath around the blade.
Fig. 8: Frontal view of the HYCON safety screwdriver
In order to activate the HYCON the safety screwdriver first has to be placed over the head of the screw.
Fig. 9: Placement of the HYCON safety screwdriver
The safety screw driver is turned until its blade clicks into the groove on the screw head of the HYCON
Fig. 10: To lock into place turn the safety screwdriver clockwise.
Finally the activation of the HYCON can take place.
The direction of rotation is indicated by an arrow on the screwdriver grip.
Retraction and Intrusion of the Maxillary Front BlockIn case a combined retraction and simultaneous gentle intrusion of the upper front teeth is desired, it is recommended to bend an intrusion step right distally of the brackets from the lateral incisors. One should start with a slight intrusion step in an .016 x .022 wire (.022 slot system) then increase archwire dimension and
intrusion steps subsequently. Thus, with an.019x.025 or 21x25 instrusion archwire inserted one will reach the desired closure of the spcaes simultaneously with a gentle working instrusion.
Space Closure and Midline CorrectionIn case of a dentoalveolar shift of the midline and resulting asymmetrical spaces, it is recommended to lace a front block with a figure 8 Kobayashi ligature, with the eye pointing to the wider space, that is, the side to which the midline should be corrected. First, the HYCON is applied to this one side only, until the midline shift is roughly corrected. Then, the HYCON is applied on the other side as well. Minor corrections in the mid-line can be completed by asymmetrical activation.
Maximum AnchorageIn situations in which a maximum of anchorage is required (mostly in the upper jaw), it is recommended to distalize the canines first. In this case the incisors should be laced with a figure 8 ligature wire (e.g.) while the connecting wire of the HYCON is ligated to the canine only.
In a second step, the incisor block can be retracted as explained above.
Stabilization after Space ClosureWith space closure completed as desired, it is recom-mended to keep the result stable and passive for some time, depending on the amount of completed tooth movement and the related adaptation of soft tissue.
Activation by the patientWhen tightening the device with the screwdriver, the patient should simultaneously stabilize the connecting wire with a fingernail to prevent it from twisting.
10 Practical Hints - Hycon Device
H y c o n t u b e
The ADenta Companies: Germany - phone: +49-8105-73436-0 email: [email protected] website: www.adenta.com page 10
h y c o n a c t i v a t i o nCLINICAL CRITERIA
AN
CH
OR
AG
E SI
TUA
TIO
N O
F C
ASE
PR
ESEN
TED
HYC
ON
AC
TIVA
TIO
N G
UID
ELIN
ES
[
] in
dica
tes
an a
ltern
ativ
e po
ssib
ility
of a
ctiv
atio
n -
base
d on
indi
vidu
al fi
ndin
gs
*
addi
tiona
l mea
sure
s of
anc
hora
ge a
re n
eces
sary
(int
erm
axilla
ry e
lasti
cs, H
G) s
ee b
ack
page
** a
dditio
nal p
rolo
nged
inte
rval
bet
wee
n ac
tivat
ion
shou
ld b
e gi
ven
occa
siona
lly (d
ue to
tiss
ue re
spon
se)
Impo
rtant
inst
ruct
ion
to b
e gi
ven
to th
e pa
tient
.N
ote
: G
erne
raly
two
step
act
ivat
ion
is r
equi
red.
Pre
act
iva
tion
: To
red
uce
the
slac
k of
the
conn
ectio
n w
ire th
e pa
tient
sho
uld
turn
the
scre
w c
lock
wis
e un
til th
ey fe
el a
slig
ht te
nsio
n.A
ctu
al a
ctiv
ati
on
: O
nly
turn
the
scre
w in
acc
orda
nce
with
the
inst
ruct
ions
giv
en b
y th
e or
thod
ontis
t. (A
ccor
ding
to th
e ab
ove
dire
ctio
ns)
IMP
OR
TAN
T -
THE
HYC
ON
FU
NC
TIO
NS
PAIN
LESS
LYD
iscl
aim
er:
Ple
ase
be
ad
vise
d t
his
act
iva
tio
n g
uid
eli
ne
ca
n n
ot
take
th
e p
lace
of
the
ort
ho
do
nti
st e
xpe
rtis
e a
nd
vis
ua
l in
spe
ctio
n.
R
ECIP
RO
CAL
SPA
CE C
LOSU
RE
A
NCH
ORA
GE
DEM
AN
D: N
ON
E
( EQ
UAL
BLO
CKS
AD
JAC
ENT
TO S
PAC
E )
R
ECIP
RO
CAL
SPA
CE C
LOSU
RE
A
NCH
ORA
GE
DEM
AN
D: L
ITTL
E *
( D
IFFE
REN
T BL
OC
KS A
DJA
CEN
T TO
SPA
CE
S
PACE
CLO
SURE
: ON
E SI
DE
STAT
ION
ARY
A
NCH
ORA
GE
DEM
AN
D: M
AXIM
UM
*
( AN
CH
OR
UN
IT:
WEA
K )
A
DO
LESC
ENT
PATI
ENT
OP
TIM
AL
TISS
UE
RES
PO
NSE
NO
PER
IOD
ON
TOSI
S
2 f
ull t
urn
s p
er
week
[
3 f
ull t
urn
s p
er
week
]
2 f
ull t
urn
s p
er
week
2 x
t
urn
per
week
[
3 x
t
urn
per
week
]
V
ITA
L A
DU
LT P
ATI
ENT
NO
RM
AL
TISS
UE
RES
PO
NSE
NO
/LIT
TLE
PER
IOD
ON
TAL
ISSU
E
2 f
ull t
urn
s p
er
week
[
3 x
t
urn
per
week
]
2 f
ull t
urn
s p
er
week
[
3 x
t
urn
per
week
]
2 x
t
urn
per
week
[
1 f
ull t
urn
per
week
]
AD
ULT
PA
TIEN
T
RED
UC
ED T
ISSU
E R
ESP
ON
SE *
*
R
EDU
CED
MA
RG
INA
L B
ON
E RID
GE
2
x
tu
rn p
er
week
2
x
tu
rn p
er
week
1 x
t
urn
per
week
[
2 x
t
urn
per
week
]
The ADenta Companies: USA - phone: 215-942-2070 Toll Free: 1-888-942-2070 email: [email protected] website: www.adentausa.com page 11
Fig. 1: View of the HYCON CLIPON - clip in closed
position.
The HYCON CLIPON is available for arch sizes.018 x .025 and .022 x .025
The following color marking of the elastics is to beobserved in the choice of each quadrant:
a) Yellow: upper mandible right/lower mandible left.b) Black: upper mandible left/ lower mandible right.
Characteristics and Concept
The threaded (screw type) mechanism permits exact acti-vation in small steps at intervals. Thus it allows to apply intermitting forces. The devices high potential force rules out friction as a factor, thus permitting the use of a strong straight arch wire (Recommended arch wire dimension: .021 x .025 with .022 slot technique.)
Consequently the tooth movement very closely approaches the bodily type providing maximum torque control.
Straight arch technique, i.e. no bends that could pre-vent the arch from sliding into the molar tube.
Leveling and aligning must be completed with a heavy, straight, rectangular steel wire installed. The teeth should be grouped into blocks, normally two lateral and one front, with the defined spaces each distally from the front block. The teeth of the front block should be laced with a figure 8 ligature wire. In addition, (elastic) ligatures should be used to hold the archwire to the front block teeth.
The HYCON CLIPON is held using a Weingart plier such that the slot-shaped mouth shows horizontal to the plier jaws and towards the exterior. Note: Apply only enough pressure on the pliers to hold the HYCON CLIPON!
Holding the HYCON CLIPON without pressure - clip in open state (yellow arrow) Fig. 3a -3c magnified x 1.
The slot of the HYCON CLIPON is pushed over the arch-wire from the buccal side until the slot is fully loaded. Only now increase pressure with the plier until the locking mech-anism closes and clicks into place.
archwire indicated
The HYCON CLIPON01
Preconditions for the HYCON CLIPON02
The tension wire (minimum .012 ligature wire), is bent into a U shape (Fig. 2a), inserted from the outer side into the two holes of the wire linking attachment (Fig. 2b), then pulled through and bent sharply in the direction of the tension. (Fig. 2c)
Fig. 2a Fig. 2b Fig. 2c
Fig. 2a-c: application of the tension wire on theHYCONS
Preparing the HYCON CLIPON03
Inserting the HYCON CLIPON04
Fig. 3a Fig. 3b Fig. 3c
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H y c o n D e v i c e
f o r s p a c e c l o s u r e
hycon c l i p o n placement information
The ADenta Companies: Germany - phone: +49-8105-73436-0 email: [email protected] website: www.adenta.com page 12
1st Possiblity: Distally of the first molar, in the case that the first and second molars are banded and are connected by a strong steel arch.
Fig. 5: Attaching the HYCON CLIPON onto the arch - distally from the first molar.
2nd Possibility: In case the second molar is not banded, the HYCON CLIPON has to be placed mesially to the first molar and connected with a ligature to the molar at-tachment.
Fig. 7: a, b Correct and incorrect placement of theHYCON CLIPON on the arch.
Correct position Incorrect position
never attach the hycon CLIPON to a free standing end of the arch
Fig. 4: a, archwire inserted and clip in open state.Fig. 4: b ,c Closing the HYCON CLIPON by applying pres-sure with the pliers - clip in closed state (yellow arrow)
The tension wire connects the screw with the tooth or group of teeth on the other side of the space.
Connecting Option 1: The tension wire is fastened to the eye of a Kobayashi ligature (Fig. 8). This can, if neces-sary, simultaneously be used to stabilize the front group of teeth by means of a figure 8 ligature.
5. Connecting the HYCON TUBE
HYCON CLIPON
Fig. 8: Connecting the tension wire by means of a Ko-bayashi ligature.
Connecting Option 2: Preferably in the case of individ-ual tooth movement, e.g. in the event of distalisation of the canine tooth, the tension wire can be ligated directly onto the bracket or on the power hook. Fig. 9
Connecting Option 3: The tension wire may also be connected directly to the arch, e.g. posted arch wires (Fig. 10), or Gurin Hook. In this respect, care is to be taken that the arch, in the course of activation, remains centered in the medial line. Fig 11.
Fig. 10: Ligature wire attached to power hook of posted arch
Connecting the HYCON DEVICE07
Fig. 9: Distalisation of a singel tooth (canine)
Placing the HYCON CLIPON onto the arch05
Fig. 7a correct position Fig. 7b incorrect position
The HYCON CLIPON is to be inserted in accordance
with the color code (see point 1). The HYCON CLIPON
should not cause any interference in the occlusion. In general: the thin wall of the clip slot always has to show towards the occlusal side. In the case of minor occlusal interference one can reduce the points of contact with a sutitable bur on the occlusal side of the clip.
Avoiding Occlusion Interference -HYCON CLIPON
06
Fig. 4a Fig. 4b Fig. 4c
Fig. 6: Attaching the HYCON CLIPON onto the arch, mesi-ally to the first molar.
H y c o n D e v i c e s
The ADenta Companies: Germany - phone: +49-8105-73436-0 email: [email protected] website: www.adenta.com page 12
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anchorage units. Activating the HYCON has an effect on both sides of the space. The additional use of means of anchorage (intermax. elastics, headgear, palatal bar) enables the orthodontist to control anchorage, in order to reduce or neutralize the effect of the HYCON on the side of the space where little or no tooth movement at all is required.
Use of the Safety Screwdriver11In order to prevent lateral slippage the HYCON safety screwdriver has a protective sheath around the blade.
Fig 13. Frontal view of the HYCON safety screwdriver
In order to activate the HYCON the safety screwdriver first has to be placed over the head of the screw.
Fig 14. Placement of the HYCON safety screwdriver
The safety screwdriver is turned until its blade clicks into the groove on the screw head of the HYCON
Fig 15. To lock into place turn the safety screwdriver clockwise.
Finally the activation of the HYCON can take place.
The direction of rotation is indicated by an arrow on the screw driver grip.
Using the small safety screwdriver which comes with the set, the patient usually activates the HYCON about every three to four days by turning it clockwise.
The HYCON has to be activated in 2 steps.
First step: To reduce the slack of the connection wire the patient should turn the screw clockwise until they feel a slight tension.
Second step: The patient then has to turn the screw for the given amount. Please refer to page 15 for details on activation guidelines.
A practical hint for the patient.When tightening the device with the safety screw driver, the patient should simultaneously stabilize the tension wire with a finger nail to prevent it from twisting.
If there is still a space left after working the complete range of the screw, it is necessary to unscrew the device and to re-tighten the tension wire accordingly.
An inherent advantage of the method of space closure involving the HYCON is that there is less strain upon
Activation of the HYCON 08
Reactivation09
Anchorage Control10
Fig. 11: A drop of self-curing resin applied to the midline mark is an easy way to prevent midline shift of the arch wire.
Fig 12. HYCON and safety screw driver
H y c o n c l i p o n
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Practical Hints - HYCON DEVICERetraction and Intrusion of the Maxillary Front BlockIn case a combined retraction and simultaneous gentle intrusion of the upper front teeth is desired, it is recom-mended to bend an intrusion step right distally of the brackets from the lateral incisors. One should start with a slight intrusion step in an .016 x .022 wire (.022 slot system) and increase archwire dimension and intrusion steps subsequently. Thus, with an.019x.025 or 21x25 intrusion archwire inserted one will reach the desired closure of the spaces simultaneously with a gentle work-ing intrusion.
Space Closure and Midline CorrectionIn case of a dentoalveolar shift of the midline and resulting asymmetrical spaces, it is recommended to lace a front block with a figure 8 Kobayashi ligature, with the eye pointing to the wider space, that is, the side to which the midline should be corrected. First, the HYCON is applied to this one side only, until the midline shift is roughly corrected. Then, the HYCON is applied on the other side as well. Minor corrections in the mid-line can be completed byasymmetrical activation.
Maximum AnchorageIn situations in which a maximum of anchorage is required (mostly in the upper jaw), it is recommended to distalize the canines first. In this case the incisors should be laced with a figure 8 ligature wire (e. g.) while the connecting wire of the HYCON is ligated to the canine only.
In a second step, the incisor block can be retracted as explained above.
Stabilization after Space ClosureWith space closure completed as desired, it is recom-mended to keep the result stable and passive for some time, depending on the amount of completed tooth movement and the related adaptation of soft tissue.
Activation by the patientWhen tightening the device with the screwdriver, the patient should simultaneously stabilize the connecting wire with a fingernail to prevent it from twisting.
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ANCHORAGE SITUATION OF CASE PRESENTED
HYCON ACTIVATION GUIDELINES
[ ] indicates an alternative possibility of activation - based on individual findings
* additional measures of anchorage are necessary (intermaxillary elastics, HG) see back page** additional prolonged interval between activation should be given occasionally (due to tissue response)Important instruction to be given to the patient.
Note: Gerneraly two step activation is required.
Preactivation: To reduce the slack of the connection wire the patient should turn the screw clockwise until they feel a slight tension.
Actual activation: Only turn the screw in accordance with the instructions given by the orthodontist. (According to the above directions)
IMPORTANT - THE HYCON FUNCTIONS PAINLESSLYDisc la imer : P lease be adv i sed th i s ac t i va t ion gu ide l ine can not take the p lace o f the or thodont i s t exper t i se and v i sua l inspec t ion.
RECIPROCAL SPACE CLOSURE
ANCHORAGE DEMAND: NONE
( EQUAL BLOCKS ADJACENT TO SPACE )
RECIPROCAL SPACE CLOSURE
ANCHORAGE DEMAND: LITTLE * ( DIFFERENT BLOCKS ADJACENT TO SPACE )
SPACE CLOSURE: ONE SIDE STATIONARY
ANCHORAGE DEMAND: MAXIMUM * ( ANCHOR UNIT: WEAK )
ADOLESCENT PATIENT
OPTIMAL TISSUE RESPONSE
NO PERIODONTOSIS
2 full turns per week [3 full turns per week]
2 full turns per week 2 x 1/2 turn per week [3 x 1/2 turn per week]
VITAL ADULT PATIENT
NORMAL TISSUE RESPONSE
NO/LITTLE PERIODONTAL ISSUE
2 full turns per week [3 x 1/2 turn per week]
2 full turns per week [3 x 1/2 turn per week]
2 x 1/2 turn per week [1 full turn per week]
ADULT PATIENT
REDUCED TISSUE RESPONSE ** REDUCED MARGINAL BONE RIDGE
2 x 1/2 turn per week 2 x 1/2 turn per week 1 x 1/2 turn per week [2 x 1/2 turn per week]
h y c o n a c t i v a t i o n
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81 Clover Road, Ivyland, PA 18974 phone: 215-942-2070 email: [email protected] website: www.adentausa.com
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GutenbergstraBe 9, 82205 Gilching, Germany. phone: +49-8105-73436-0 email: [email protected] website: www.adentausa.com