{"id":3416,"date":"2009-04-10T19:59:00","date_gmt":"2009-04-10T17:59:00","guid":{"rendered":"https:\/\/www.zerodonto.com\/en\/2009\/04\/fixed-active-retainer-mac-lingual-orthodontics-using-active-retainers\/"},"modified":"2018-03-22T16:46:20","modified_gmt":"2018-03-22T15:46:20","slug":"fixed-active-retainer-mac-lingual-orthodontics-using-active-retainers","status":"publish","type":"post","link":"https:\/\/www.zerodonto.com\/en\/2009\/04\/fixed-active-retainer-mac-lingual-orthodontics-using-active-retainers\/","title":{"rendered":"Fixed Active Retainer (MAC): Lingual Orthodontics using active retainers"},"content":{"rendered":"<p>&nbsp;<\/p>\n<p>The objective of an orthodontic treatment is to create a dental occlusion responding to aesthetic and functional canons. An even harder task is to preserve the achieved results over the years. A good diagnosis, needed to set up the treatment plan and the use, after the therapy, of a fixed or removable stabilization appliance should ensure the stability of the results. It is nonetheless possible to run into dental malpositionings in subsequent years: it is not always easy to distinguish between a relapse of the treated malocclusion and the display of a tertiary crowding (1).<\/p>\n<p>In case a dental crowding appears in a patient who has already undergone an orthodontic treatment, the need to operate requires to ponder some issues. It is a fact that patients do not like putting the multi-brackets appliance again, both buccally and lingually. Another aspect to take into consideration is the further financial effort they have to undertake.<\/p>\n<p>To solve these problems Prof. Aldo Macchi and Dr. Nunzio Cirulli have devised the \u201cFixed Active Retainer\u201d (MAC, from the Italian \u201cMantenitore Attivo di Contenzione\u201d) (2,3). This device can be used both to solve relapsing dental misalignments and to perform anterior alignment therapies in patients who have never undergone this treatment. This device, simple to apply and well tolerated by the patients, has been refined over the years by its very developers in order to be used effectively to solve more complex malocclusions. For this reason, the device dealt with in this paper is called MAC 1, in order to distinguish it from its subsequent evolutions that will be dealt with in forthcoming articles.<\/p>\n<p>The MAC 1 is made up of a .012 inches thick Nickel-Titanium (Ni-Ti) wire bonded with a light-polymerizing composite resin to the teeth to be moved. The use of this aid takes advantage of the possibilities offered by Ni-Ti alloys, i.e.:<\/p>\n<p>&#8211; Great elastic memory and resilience, i.e. great ability to release the energy stored up in the deformation process.<\/p>\n<p>&#8211; Low modification of the stress condition during deactivation so that the applied forces are more lasting and constant in time.<\/p>\n<p>These were the features of the first Ni-Ti wires, that possessed \u201cshape memory\u201d but did not have \u201csuperelasticity\u201d yet. \u201cShape memory\u201d (4) is the ability of the material to recall its original shape after it has been deformed plastically when it is in its stabilized martensitic form (5).<\/p>\n<p>Shape memory was used by the Authors for their clinical procedure while superelasticity grants the application of constant and light forces.<\/p>\n<p><b>Clinical Procedure<\/b><\/p>\n<p>The tooth, or teeth, to be moved are etched with 37% orthophosphoric acid; subsequently the adhesive is applied. Afterwards the Ni-Ti sectional is fitted to the tooth to be moved with College pliers and is bonded with fluid composite. On the adjacent tooth, used as anchorage, the sectional is cut with a bur in order to remove excess wire. It can be necessary to reduce interproximal enamel (stripping) to regain some space in the arch.<\/p>\n<p><em>Fixed Active Retainer (M.A.C.)<\/em><!--more--><\/p>\n<p><span lang=\"EN-US\" style=\"line-height: 115%; mso-fareast-language: en-us; mso-bidi-language: ar-sa mso-bidi-: en-usfont-family:'Calibri','sans-serif';\"><br \/>\n<a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine2.jpg\"><span style=\"font-family: arial;\"><img loading=\"lazy\" decoding=\"async\" style=\"cursor: hand;\" title=\"prof. Aldo Macchi MAC\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine2.jpg\" alt=\"prof. Aldo Macchi MAC\" width=\"590\" height=\"311\" border=\"0\" \/><\/span><\/a> <a href=\"http:\/\/bp0.blogger.com\/_i8bsCdF-MXo\/SFg1MKk-lfI\/AAAAAAAAAzU\/KG7vqOJioO8\/s1600-h\/Immagine3.jpg\"><span style=\"font-family: arial;\"><img loading=\"lazy\" decoding=\"async\" style=\"cursor: hand;\" title=\"MAC application\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine3.jpg\" alt=\"MAC application\" width=\"590\" height=\"308\" border=\"0\" \/><\/span><\/a> <a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine3.jpg\"><span style=\"font-family: arial;\"><img loading=\"lazy\" decoding=\"async\" style=\"cursor: hand;\" title=\"prof. Aldo Macchi orthodontic therapy\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine4.jpg\" alt=\"prof. Aldo Macchi orthodontic therapy\" width=\"590\" height=\"305\" border=\"0\" \/><\/span><\/a><span style=\"font-family: arial;\"><br \/>\n<\/span><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine5.jpg\"><span style=\"font-family: arial;\"><img loading=\"lazy\" decoding=\"async\" style=\"cursor: hand;\" title=\"MAC bonding procedure\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine5.jpg\" alt=\"MAC bonding procedure\" width=\"590\" height=\"384\" border=\"0\" \/><\/span><\/a> <\/span><\/p>\n<p>The system of forces that takes place determines the development of a single force (F) on the anchorage tooth and of a momentum (M) on the tooth where the wire is fixed with the composite.<\/p>\n<p><span style=\"font-family: trebuchet ms;\"><br \/>\n<\/span><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine6.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"cursor: hand;\" title=\"orthodontic moment\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine6.jpg\" alt=\"orthodontic moment\" width=\"590\" height=\"296\" border=\"0\" \/><\/a><\/p>\n<p>The fulcrum or \u201carticulation\u201d of this system is the point where the wire undergoes maximum bending. At this level the outer surface of the wire undergoes a transformation from austenite (state in which shape memory is at its maximum) to martensite (state in which superelasticity is at its maximum). According to the Authors\u2019 experience the single force is so light as not to cause significant movements, while the momentum always causes the desired movement on the malpositioned tooth. Moreover as the malpositioned element achieves the desired alignment the lever arm increases, increasing, on its turn, the momentum arm on the tooth itself.<\/p>\n<p>When the alignment is finally achieved the \u201carticulation\u201d of the sectional disappears and the alloy returns to its austenitic phase. In this phase it exerts its shape memory at its best and works as a perfect stabilization aid.<\/p>\n<p>&nbsp;<\/p>\n<p>Clinical cases<\/p>\n<p><b>First case<\/b><\/p>\n<p>To solve the misalignment of the 12 a .012 inches Ni-Ti sectional is bonded on the 12 and anchored on the 11. Subsequently another sectional was put between the 21 and the 22 to align the central and left lateral as well. The same sectionals were used as stabilizers after the alignment, achieved in about 3 month, was complete.<\/p>\n<p><span lang=\"EN-US\" style=\"line-height: 115%; mso-fareast-language: en-us; mso-bidi-language: ar-sa mso-bidi-: en-usfont-family:'Calibri','sans-serif';\"><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine8.jpg\"><span style=\"font-family: arial;\"><img loading=\"lazy\" decoding=\"async\" style=\"cursor: hand;\" title=\"MAC\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine8.jpg\" alt=\"MAC\" width=\"590\" height=\"407\" border=\"0\" \/><\/span><\/a> <a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine9.jpg\"><span style=\"font-family: arial;\"><img loading=\"lazy\" decoding=\"async\" style=\"cursor: hand;\" title=\"prof. Aldo Macchi appliance\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine9.jpg\" alt=\"prof. Aldo Macchi appliance\" width=\"590\" height=\"401\" border=\"0\" \/><\/span><\/a> <\/span><\/p>\n<p><strong>Second case<\/strong><\/p>\n<p>To solve the misalignment of the 21-22 a .012 inches Ni-Ti sectional was bonded on the 21 and anchored on the 22. The same sectional was used as a stabilizer after the alignment, achieved in about 3 month, was complete.<\/p>\n<p><span style=\"font-family: trebuchet ms;\"><br \/>\n<\/span><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine10.jpg\"><span style=\"font-family: trebuchet ms;\"><img loading=\"lazy\" decoding=\"async\" style=\"cursor: hand;\" title=\"MAC 1\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine10.jpg\" alt=\"MAC 1\" width=\"590\" height=\"406\" border=\"0\" \/><\/span><\/a><span lang=\"EN-US\" style=\"line-height: 115%; mso-fareast-language: en-us; mso-bidi-language: ar-sa; mso-bidi-: en-us;\"><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine11.jpg\"><span style=\"font-family: trebuchet ms;\"><img loading=\"lazy\" decoding=\"async\" style=\"cursor: hand;\" title=\"prof. Aldo Macchi therapy\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine11.jpg\" alt=\"prof. Aldo Macchi therapy\" width=\"590\" height=\"285\" border=\"0\" \/><\/span><\/a> <\/span><\/p>\n<p><strong>Third case<\/strong><\/p>\n<p>To solve the misalignment of the 11-21 a .012 inches Ni-Ti sectional was bonded on the 21 and anchored on the 11. The same sectional was used as stabilizer after the alignment, achieved in about 3 month, was complete.<\/p>\n<p><span style=\"font-family: trebuchet ms;\"><br \/>\n<\/span><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine12.jpg\"><span style=\"font-family: trebuchet ms;\"><img loading=\"lazy\" decoding=\"async\" style=\"cursor: hand;\" title=\"prof. Aldo Macchi clinical case\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine12.jpg\" alt=\"prof. Aldo Macchi clinical case\" width=\"590\" height=\"378\" border=\"0\" \/><\/span><\/a><span lang=\"EN-US\" style=\"line-height: 115%; mso-fareast-language: en-us; mso-bidi-language: ar-sa; mso-bidi-: en-us;\"><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine13.jpg\"><span style=\"font-family: trebuchet ms;\"><img loading=\"lazy\" decoding=\"async\" style=\"cursor: hand;\" title=\"prof. Aldo Macchi clinical case 2\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2008\/06\/Immagine13.jpg\" alt=\"prof. Aldo Macchi clinical case 2\" width=\"590\" height=\"373\" border=\"0\" \/><\/span><\/a><\/span><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Conclusions<\/strong><b><br \/>\n<\/b><br \/>\nThe Fixed Active Retainer 1 (MAC 1) is the first fixed active retainer ever made (2,3). This device, devised by Prof. Aldo Macchi and Dr. Nunzio Cirulli, has been used since 1996. It is easy to be made and low in cost: it makes it possible to solve anterior misalignments of little importance. It can be used at any age and is well tolerated by the patients, turning out to be more comfortable than lingual brackets (6,7) and completely invisible compared to buccal brackets.<\/p>\n<p>In order to solve more severe dental malpositionings Prof. Aldo Macchi has developed, over the years, more complex and sophisticated devices. These devices, constituting an evolution of MAC 1 to reach MAC 4, will be dealt with in forthcoming articles.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>Bibliography<\/p>\n<p>1. F Van der Linden: Theoretical and practical aspects of crowding in the human dentition. J.A.D.A. 89: 139- 153, 1974.<\/p>\n<p>2. A Macchi, S Rania, N Cirulli. Una proposta per la gestione dei disallineamenti anteriori: il Mantenitore Attivo di Contenzione (MAC). Mondo Ortodontico 5:389-393, 1999.<\/p>\n<p>3. A Macchi, N Cirulli. Fixed Active Retainer for Minor Anterior Tooth Movement. J Clin Orthod 34:48-49, 2000.<\/p>\n<p>4. G Sander. Festigkeit und elastizitat kieferorthopadisher drahte unter berucksichtgung der superelastischen materialen. In: Informationen aus der orthodontie und kieferorthopadie. Huthing P.Heidelberg.<\/p>\n<p>5. GF Andreasen . A clinical trial of alignment of teeth using a 0.019 inch thermal nitinol wire with a transition temperature range between 31 and 45 degrees. Am J Orthod 78:528-37, 1978.<\/p>\n<p>6. Miyawakaki, M Yasuhara, Y Koh. Discomfort caused by bonded orthodontic appliances in adult patients examined by retrospective questionnaire. Am J Orthod. 115:83-88, 1999.<\/p>\n<p>7. PM Sinclair, MF Cannito, LJ Goates, LF Solomos, CM Alexander. Patient responses to lingual appliances. J Clin Orthod 20:396-404, 1986.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>Prof. Aldo Macchi<\/p>\n<p>Surgeon<br \/>\nSpecialist in Odontostomatology<\/p>\n<p>Specialist in Orthognathodontics<\/p>\n<p>Director of the Odontostomatology Clinic of the University of Insubria &#8211; Varese<\/p>\n<p>Professor (Med. 28) at the University of Insubria where he teaches Dental Materials and Prosthetic Technology in the Dentistry and Prosthesis Degree Course. He is Appointed Professor of Biomechanics \u2013 that he teaches at the Orthognathodontics Specialization School \u2013 University of Insubria.<\/p>\n<p>He has written over 108 scientific papers in Orthognathodontics, Odontostomatologic Surgery, Dental Materials and Computerized Medicine: many of these publications deal with Orthodontic Biomechanics and the Lingual Orthodontic Technique. He has held numerous courses and seminars in Orthodontics in various Universities in Italy and abroad.<\/p>\n<p>E-mail <a href=\"mailto:aldo.macchi@uninsubria.it\">aldo.macchi@uninsubria.it<\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>Dr. Nunzio Cirulli<\/p>\n<p>Specialized in Orthognathodontics<\/p>\n<p>Ph.D. in Ortho-phono-rhino-stomato-gnathodontics at the University of Bari.<\/p>\n<p>Contract Professor at the University of l\u2019Aquila and at the University of Santiago de Compostela \u2013 Spain.<\/p>\n<p>Spokesman, with clinical and research works, in numerous national and international conferences.<\/p>\n<p>Author of publications and translations on specialized national and international magazines.<\/p>\n<p>He has held courses of Orthodontic in various Universities in Italy (Rome <i>La Cattolica<\/i>, Turin, Genoa, Varese, Messina) and abroad (Madrid, Barcelona, Valencia).<\/p>\n<p>He is Ordinary Member of the Italian Orthodontic Society, of the European Society of Lingual Orthodontics, of the European Orthodontic Society and of the World Federation of Orthodontists.<\/p>\n<p><strong>For information:<\/strong><\/p>\n<p><a href=\"mailto:info@studiocirulli.it\">info@studiocirulli.it<\/a><\/p>\n<p><a href=\"mailto:zerodonto@gmail.com\">zerodonto@gmail.com<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; The objective of an orthodontic treatment is to create a dental occlusion responding to aesthetic and functional canons. An even harder task is to preserve the achieved results over the years. A good diagnosis, needed to set up the treatment plan and the use, after the therapy, of a fixed or removable stabilization appliance should ensure the stability of the results. It is nonetheless possible to run into dental malpositionings in subsequent years: it is not always easy to distinguish between a relapse of the treated malocclusion and the display of a tertiary crowding (1). In case a dental crowding appears in a patient who has already undergone an orthodontic treatment, the need to operate requires to ponder some issues. It is a fact that patients do not like putting the multi-brackets appliance again, both buccally and lingually. Another aspect to take into consideration is the further financial effort they have to undertake. To solve these problems Prof. Aldo Macchi and Dr. Nunzio Cirulli have devised the \u201cFixed Active Retainer\u201d (MAC, from the Italian \u201cMantenitore Attivo di Contenzione\u201d) (2,3). This device can be used both to solve relapsing dental misalignments and to perform anterior alignment therapies in patients who [&hellip;]<\/p>\n","protected":false},"author":33,"featured_media":2578,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[47],"tags":[],"coauthors":[61,63],"class_list":["post-3416","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-invisible-orthodontics"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Fixed Active Retainer (MAC): Lingual Orthodontics using active retainers | Zerodonto | Dentistry in Blog<\/title>\n<meta name=\"description\" content=\"FIXED ACTIVE RETAINER (MAC): LINGUAL ORTHODONTICS USING ACTIVE RETAINERS\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" 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He is Appointed Professor of Biomechanics \u2013 that he teaches at the Orthognathodontics Specialization School \u2013 University of Insubria. He has written over 108 scientific papers in Orthognathodontics, Odontostomatologic Surgery, Dental Materials and Computerized Medicine: many of these publications deal with Orthodontic Biomechanics and the Lingual Orthodontic Technique. He has held numerous courses and seminars in Orthodontics in various Universities in Italy and abroad. 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