Posterior Cross Bite

Suggested Treatment Protocol

For use in conjunction with the appropriate wire and elastics sequence guidelines by case type.

Duration Interval Early Light Elastics

Phase Archwires Objectives Notes Disarticulation
in Weeks in Weeks Begun at Initial Bonding1

I. Damon Optimal-Force • Begin leveling and 10 10 Disarticulate and use Parrot 5/16", 2 oz – Posterior Cross Bond bite turbos or
Initial Copper Ni-Ti® alignment continuous light forces to Bite U5/6 Lingual – L5/6 composite buildups in
Light-Wire • Initiate arch development prevent opening bite. Be Buccal – Full time appropriate position for
.014 U/L without RPEs or W-arches patient. deep or open bite. Use
• Resolve 90% of rotations lingual buttons on 5s & 6s.
PRN, .013 U/L if crowding
• Begin A/P and vertical
is severe or periodontal
correction
support is compromised

.018 U/L 6–8 6–8 Dolphin 5/16", 3 oz – Posterior

Cross Bite U5/6 Lingual – L5/6
Buccal – Full time

II. Damon Optimal Force
High-Tech Copper Ni-Ti
Edgewise
.014 x .025 U/L
10 weeks into this stage:
Take Panorex & reposition
brackets. Follow with .018
Cu Ni-Ti if brackets are
drastically repositioned.
• Complete leveling and 10 10 Dolphin 5/16", 3 oz – Posterior
alignment Cross Bite U5/6 Lingual – L5/6
• Continue arch Buccal – Full time until ½ cusp
development overcorrected, then nights.
• Resolve remaining
rotations
• Begin torque control
• Consolidate minor
spacing

.018 x .025 U/L 6–8 6–8 If using .017 x .025 Ni-Ti Zebra 5/16", 4.5 oz – Posterior
with 20˚ anterior torque, Cross Bite U5/6 Lingual – L5/6
maintain Zebra Cross Bite Buccal – Now overcorrected, have
configuration. patient wear often enough to
maintain overcorrection.

1 In patients with very thin attached tissue, severe crowding or periodontal issues, waiting to start elastics until the second appointment may help prevent labial gingival recession.
Posterior Cross Bite (continued)
Suggested Treatment Protocol

Duration Interval Early Light Elastics

Phase Archwires Objectives Notes Disarticulation
in Weeks in Weeks Begun at Initial Bonding

III. Posted Stainless Steel • Take wax bite; coordinate 20 – 30 8 Using the same arch Zebra 5/16", 4.5 oz – Posterior
Major .016 x .025 U/L patient-specific arch form shape as lower, expand Cross Bite U5/6 Lingual – L5/6
Mechanics • Consolidate any U .016 x .025 1/2"or more Buccal – Now overcorrected, have
.019 x .025 U remaining minor spacing so that when pressing it at patient wear often enough to
.016 x .025 L • Express majority of the 7s, it narrows to the maintain overcorrection.
(PRN, .019 x .025 L) remaining torque same shape as the lower
(proportional widening).
• Overcorrect A/P
The diligent use of cross Overcorrect upper arch
bite elastics may shorten by approximately 2 mm,
this phase. then transition to
U .019 x .025 slightly
expanded at the 6s and 7s.

IV. TMA® • Make final buccolingual, 15 – 20 4–6 For Phase IV, employ the elastics
Finishing .019 x .025 U torque, A/P and occlusal until protocol specific to the case type
.017 x .025 L adjustments sectioning outlined in the other wire/elastics
wire, sequence recommendations.
then 2

These wire/elastics sequence recommendations have been shown to be effective when treating with Damon System mechanics. They are not a replacement for professional expertise.