Dental Straight Wire Appliances Guide

ADJUNCTS
IN
SWA
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com


LIST OF CONTENTS
INTRODUCTION
HISTORY & DEVELOPMENT

LINGUAL STRAIGHT WIRE APPLAINCE
HEADGEARS
UTILITY
RETRACTION & INTRUSION
EXTRUSION
SPRINGS
TPA & LINGUAL ARCHES
IMPLANTS
DISTALIZATION
INTRAORAL ELASTICS
CONCLUSION
REFERENCES

INTRODUCTION

DEVELOPMENT OF STRAIGHT WIRE
ORTHODONTIC APPLIANCES
Early fixed appliances
Late 1800s
Edward Angle

EARLY FIXED APPLIANCES


DEvELOPmENT OF FIXED
APPLIANCES
Standard Edgewise appliance
Early 1900s


DEvELOPmENT OF
STRAIGHT WIRE APPLIANCES
Pre-adjusted edgewise appliance
1970s
Refined manufacturing process with
“built-in” adjustments specific for each
tooth
Advances in material sciences made
attachment much smaller

BANDED APPLIANCES


BONDED APPLIANCES


PRE-ADjUSTED EDGEWISE
APPLIANCE OR THE
STRAIGHT WIRE APPLIANCE
Larry Andrews - studied normal
occlusion and individual tooth positions
Developed prescriptions for individual
tooth position
Elements of “ideal” tooth position are
built into the appliance
Minimizing active “wire manipulation” The Straight Wire Concept

APPLIANCE
First order / in-out - Horizontal plane
Second order / tip - Mesio-distal
angulation
Third order / torque - Labio-lingual
angulation

3 - Dimensional control of tooth position

FIRST ORDER OR IN-OUT


APPLIANCE
First order / in-out - Horizontal plane
Second order / tip - Mesio-distal
angulation
Third order / torque - Labio-lingual
angulation


SECOND ORDER OR TIP

4


THIRD ORDER OR TORqUE

4

To “Torque” is the least efficient
tooth movement using orthodontic
appliances

CERAmIC APPLIANCES


SELF LIGATING APPLIANCE


COmPONENTS OF THE FIXED
APPLIANCE
Bands
Molar Tubes
Brackets
Buccal Tubes
Arch Wires
Auxiliaries: Elastomeric products, Coil
springs, Lingual arches, Extra-oral
appliances

POSTERIOR ATTACHmENTS
MOLAR TUBES


APPLIANCE
Bands
Molar Tubes
Brackets
Arch Wires
Auxiliaries: Elastomeric products, Coil
springs, Lingual arches, Extra-oral
appliances

ANTERIOR ATTACHmENTS
Brackets


ARCH WIRES
Maxillary and mandibular
Size and cross-section of wires vary
Material varies eg. Nickel Titanium alloy
(NiTi), Titanium Molybdenum Alloy
(TMA), Stainless Steel


TAPERED ARCH FORm


SqUARE ARCH FORm


OvOID ARCH FORm


UPPER ARCH FORM
SUPERIMPOSITIONS

LOWER ARCH FORM
SUPERIMPOSITIONS


APPLIANCE
Bands
Molar Tubes
Brackets
Arch Wires
Auxiliaries:


LINGUAL STRAIGHT WIRE
APPLIANCE (LSW)


EASE OF FLOSSING AND
PROXImAL SLICING


ROTATIONAL CORRECTION


LATEST IN LSW


EXTRA ORAL FORCES - HEAD GEAR


DISTALIzATION USING
HEADGEARS


Very efficient



Reciprocal forces are not transmitted to other teeth



Molar movements depends on direction of force in relation to
the C Res of the molar & magnitude of force


Biomechanics of Headgears:


C Res



Moments


HIGH PULL HEADGEAR
Produces intrusive &
Posterior direction
of pull
Long face class II
patients with high
MPA
Force through c res
– Intrusion & distal
movement of molar
Adv-effective, no reciprocal forces
6-8 months – class
Disadv- Patient compliance
II-classI

STRAIGHT PULL
HEADGEAR


Class II Malocclusion with
no vertical problems



Prevent anterior migration
of maxillary teeth, translate
them posteriorly



Buccal force to molar Expansion of inner bow


CERvICAL HEADGEAR
Short face Class II
maxillary protrusive
cases with low MPA
& Deepbites
Extrusive &
distalizing effect


UNILATERAL mOLAR
DISTALIzATION WITH
UNILATERAL FACE BOWS


COIL SPRING

Closed or open coil springs

SEPARATE CANINE
RETRACTION


ROOT TORQUING
AUXILLARY


HELICAL SPRING FOR ENMASSE ROOT MOVEMENT


INTRUSION IN PEA
INTRUSION ARCH WIRES
Intrusion can be accomplished in two ways with
intrusion arches.
1. With continuous archwire that bypasses the
premolars and canine teeth.
2. With segmented base archwire. So that
there is no connection along the arch between
the anterior and posterior segments and an
auxiliary depressing arch.

UTILITY ARCH (2X4 APPLIANCE)
This auxiliary archwire was developed and refined by
Ricketts for bioprogressive therapy.
The utility arch engages only two molars and the four
incisors. It is commonly known as a 2 X 4 appliance.
MOLAR
SEGMENT

INCISAL
SEGMENT
VESTIbULAR
SEGMENT

ANTERIOR
VERTICAL
SEGMENT

POSTERIOR
VERTICAL
SEGMENT

CINCHING
dISTALLY

TIP-bACk
bENd

GAbLE
bENd

MATERIAL FOR UTILITY
ARCH
Blue elgiloy of 0.016" x 0.016"
0.016" x 0.022”
Dimension in an 0.022" slot.
A utility arch can even be made with
0.014" or 0.018" round wires.

It produces 60-100 gms on the lower incisors for
intrusion.
The overall effect is intrusion and possible torquing
of the lower incisors as well as tipping back of the
molars.
Retraction can be achieved by grasping the end of
the molar segment with a Weingart plier distal to the
molar tube and then turning this segment gingivally
after pulling the wire posteriorly through the tube.
This type of activation prevents proclination of the
lower incisors during intrusion

RETRACTION UTILITY ARCH
Retraction and intrusion
of the incisors by
incorporating loops in the
archwire anterior to the
anterior vestibular
segment.
Retraction and intrusion
can be produced by
activating the retraction
arch in a similar fashion
previously described of
the intrusion utility arch.
The incorporation of the
loop into the design allows
for a longer range of
activation.


RETRACTION
&
INTRUSION


T-LOOP POSITION ANd ANCHORAGE CONTROL


MOdIFIEd "T" LOOP
ARCHwIRE


MUSHROOM LOOP


k- SIR APPLIANCE
The K-SIR (Kalra
Simultaneous Intrusion
and Retraction)
archwire is a
modification of the
segmented loop
mechanics of Burstone
and Nanda
K-SIR archwire: .
019“x.025" TMA
archwire with closed Uloops 7mm long and 2mm
wide.

90° bends placed in archwire at level of Uloops.
Centered 90° V-bend creates two equal and
opposite moments (red) that counter tipping
moments (green) produced by activation
forces.

Archwire with off-center 60° V-bend placed
about 2mm distal to U-loop.
Off-center V-bend creates greater moment
on molar, increasing molar anchorage and
intrusion of anterior teeth.

20° antirotation bends placed in archwire just
distal to U-loops.


Trial activation performed on each loop.
Archwire after trial activation.

Neutral position of loop determined with
mesial and distal legs extended
horizontally. In neutral position, loop is
3.5mm rather than 2mm wide.

K-SIR archwire in place prior to cinching back.
First molar and second premolar are
connected by segment of .019"x .025" TMA
wire.
Archwire cinched back to activate loop about
3mm, so that mesial and distal legs are barely
separated.

INTRUSION
Intrusion refers to the apical movement of the
geometric center of the root (centroid) in
respect to the occlusal plane or plane based
on the long axis of the tooth.
True intrusion is achieved by moving the root apices
of the anteriors closer to the bony base.

Relative intrusion is achieved by keeping them where
they are, while the mandible grows and the posterior
teeth erupt.
Apparent intrusion is achieved by extrusion of the
posterior teeth

ABSOLUTE INTRUSION

RELATIVE INTRUSION
The difference between relative and
apparent is that when the vertical growth of the
ramus compensates for the increase in molar
height ; that is when the mandibular plane angle
is maintained

APPARENT INTRUSION
If mandibular plane angle increases
and if the mandible rotates backwards and
downwards

bURSTONE’S INTRUSION SPRING


By Burstone,
These springs are made of 0.017”x
0.025” TMA wire. The upper and
lower arches have to be leveled
and aligned and a rigid stainless
steel wire, preferably 0.017”x
0.025” dimension is engaged.
Anchor is reinforced by TPA and
lingual holding arch

CONTINUOUS INTRUSION
ARCH

The basic mechanism for intrusion consists of
three parts:
1. The posterior anchorage unit.
2. The anterior segment.
3. The intrusion arch itself.
Initial alignment of anterior teeth is not
necessary when performing intrusion.
The intrusion arch itself is fabricated from
0.017" x 0.025" TMA or 0.016" x 0.022"
TMA.

bURSTONE’S THREE PIECE
INTRUSION ARCH

The basic mechanism for intrusion consists of
three parts:
1. The posterior anchorage unit.
2. The anterior segment.
3. The intrusion spring itself.


The anterior segment is bent gingivally
distal to the laterals and then bent
horizontally creating a step of
approximately 3mm.
The distal part extends posteriorly to
the distal end of the canine bracket
where it is formed into a hook.
The anterior segment should be made of
0.021”x0.025” stainless steel wire to
prevent side effects created by
bending of the wire during force
application. www.indiandentalacademy.com

The intrusion cantilevers are made from
0.017" X 0.025" TMA wire.
The wire is first bent gingivally mesial
to the molar tube and then a helix is
formed. On the mesial end the
cantilever, hook is bent through which
the intrusion force can be applied to the
anterior segment.
The cantilever is then activated by the
making a bend mesial to the helix at the
molar tube, and then cinched back.

The anterior segment which is extended till
the distal end of the canine bracket, i.e., 2-3
mm distal to the center of resistance of the
anterior segment of teeth allows distal
placement of the intrusive force, which is
desired in a case of flared incisors.
A small distal force can be added by placing
an elastomeric chain extending form the
molars to the anterior segment of wire on
each side.
This force facilitate simultaneous intrusion
and retraction by redirecting the force
parallel to the incisor long axis.

THE CONNECTICUT INTRUSION ARCH

The CIA is fabricated from a nickel titanium
alloy. It incorporates the characteristics of
utility arch as well as those of the
conventional intrusion arch.
Two wire size are available 0.016” x 0.022”
and 0.17” x 0.25”.

The maxillary and mandibular versions have anterior
dimensions of 34mm and 28mm, respectively.
In most cases, the wire is not directly ligated into
the bracket slots.
The bypass, located distal to the lateral incisors, is
available in two different lengths to accommodate for
extraction, nonextraction, and mixed dentition cases.

MECHANICS

The CTA’s basic mechanism for force delivery
is a V bend lies just anterior to the molar
brackets.
When the arch is activated, a simple force
system results, consisting of a vertical force
in the anterior region and a moment in the
posterior region.

Incisor intrusion requires 50g of force
directed apically along the center of
resistance.
A pure intrusion arch would have a point
contact at the incisors.
The CTA’s point of force application is anterior
to the center of resistance, which will flare
the incisors.
A tight cinch-back—a sharp bend distal to the
molar tube, preventing forward slippage of the
wire—will prevent incisor flaring during
intrusion and produce some retraction of the
incisors during www.indiandentalacademy.com
molar tipback.

REVERSE CURVE NITI


When a reverse curve NiTi wire is introduced
with the concept that two equal and opposite
moments will be produced as it is two couple
system.
If the moments are not equal, as the system
to come into equilibrium vertical forces are
created.
Extrusion in the posteriors and intrusion in
the anterior will take place

EXTRUSION
The Extrusion Arch
1. The extrusion arch is a term coined to describe the
reverse action of already existing and well
established intrusion arch.
2. Anterior open bite can be addressed with arch wire
mechanics using asymmetrical V bends in the wire.
3. Wire used is

1. 16 x 22 SS or 17 X25 TMA with 900 offset bend at the molar.
2. Extrusive force of 100 gms for 4 incisors.

EXTRUSION ARCH


INdIvIdUAl TOOTH
dISTRACTION
Miniature tooth-borne distractor


SPRINGS


EXTRUSION OF PAlATAllY IMPACTEd
CUSPIdS
(Fig. 1). Materials needed are a Kobayashi hook, a
split rectangular extraoral hook, and a specially
bent .018" wire two helices, perpendicular to each
other and about 1/8" apart; mesial and distal legs
should extend about 1" past the helices.
(Fig. 2). Ligate the Kobayashi hook to the cuspid
bracket before bonding the bracket to the
exposed cuspid. Place a rectangular stabilizing
wire in the arch. Crimp the extraoral hook,
angulated labially and gingivally, onto the
rectangular stabilizing archwire opposite the
cuspid to be extruded
(Fig. 3 Place the distal helix of the .018" wire,
rotated toward the occlusal surface, over the
extraoral hook).
(Fig. 4 Ligate the distal leg of the wire to the
brackets over the stabilizing archwire). Adjust
the mesial leg to produce the desired amount and
direction of extrusive force.
(Fig. 5).Ligate the mesial leg to the Kobayashi
hook with a round elastic

FACIAllY BONdEd lINGUAl ClEAT FOR
EXTRUSION OF AN ECTOPIC CANINE

The cleat is oriented vertically and bonded
to the facial surface of the ectopic tooth.
An archwire is placed above one wing of the
cleat to extrude the tooth (Fig. 2). A light,
1/8", 2oz elastic can be extended from the
cleat to the lower arch to aid in the
eruption (Fig. 3). The elastic also minimizes
the negative effects of reciprocal
anchorage mechanics, which tend to intrude
the other maxillary teeth—particularly
those closest to the ectopic tooth.
The tooth can be extruded farther than
with traditional bracketing because the
superior wing of the cleat, where the
archwire lies, is immediately adjacent to
the gingiva (Fig. 4). Extrusion typically
takes three to four weeks


PAlATAllY IMPACTEd CUSPIdS wITH
THE EXTRUSION SPRING ARM
a rectangular stainless steel tube with inside
dimensions the same as the archwire on
which it is to be mounted (.016" ´ .022" or .
018" ´ .025"). A resilient wire is wrapped
counterclockwise around the tube (Fig. 1).
The end of the wire has a small loop for
threading the elastomeric ligature that will
activate the spring.
After bonding an eyelet to the exposed
impacted tooth. Slide the spring onto the
archwire (Fig. 2), and adjust the direction
and amount of force by bending the spring
arm.
To activate the Extrusion Spring Arm,
thread an elastomeric ligature through the
eyelet on the impacted cuspid and then
through the loop at the end of the spring
arm. Draw the spring to the eyelet with
finger pressure (Fig. 3), and tie the ligature.
Monitor the patient closely to ensure proper
healing and to track the amount of
extrusion.

A UNIvERSAl RETRACTION SPRING
available in right and left
versions, is a prefabricated,
highly standardized, stainless
steel retraction spring that is
adjustable to fit both .018" and
.022" SLOT.
designed for controlled
retraction of either canines or
upper incisors. No clinical
alteration of the spring is
needed, and the force system
produced is independent of
interbracket distance. The
spring is precalibrated to
deliver predictable moment-toforce ratios in three planes of
space.

wAvE SPRING
NITI SPRING
MORE
COMFORTABLE
ONLY 4MM IN
LEN GTH WHEN
PASSIVE


TPA & lINGUAl ARCHES


PASSIvE FIXEd APPlIANCES


lOwER "w"-SHAPE ARCH

Lower "W"-shape arch can expand cuspid width. A. Passive arch. B. After engagement.

Lingual chain elastic tips cuspid distally and rotates cuspid distobuccally.
Stabilizing lingual arch can be used in conjunction with continuous buccal arch.

TPA wITH TMA SPRINGS

For aligning impacted cuspids, .018" × .025" tubes with .017" × .025" TMA
springs can be soldered to stainless steel TPA.

A. For both rotation and expansion .021 x .025 TMA is used with arch parallel
to brackets. B. Engagement requires 1st-order moments.

For expansion without rotation,.032" x .032" arch is flared buccally. B.
Engagement does not require 1st order moments.

IMPlANTS


dISTAlIZATION
MAGNETS


dISTAlIZATION OF MOlARS
wITH REPEllING
MAGNETS GIANEllEY ETAl JCO 1988
Anchorage – Modified
Nance appliance
Wire extending from
1st premolars
Acrylic button
anteriorly contacting
the incisors
Auxillary wire with a
loop at its end
soldered - premolars
bands

Distalization of Molars with
Repelling Magnets


Incisor brackets – passive
sectional wire- maintain incisor
alignment



Repelling surfaces of magnets
brought into contact by passing
an .014 ligature through the loop,
then tying back a washer anterior
to the magnets



Force- 200-225 gms , dropped as
space opened



3mm in 7 weeks



Anchor loss – 1mm


MOlAR dISTAlIZATION
wITH SUPERElASTIC NITI
wIRE GIANEllY JCO 1992


100gm Neosentalloy upper
archwire



3 markings



Stops crimped, hook added



Insert wire such that posterior
stop abuts mesial end of molar
tube, anterior stop abuts distal of
premolar



Anchorage reinforced by class II,
or Nance appliance

MOlAR dISTAlIZATION
wITH SUPERElASTIC NITI
wIRE
Case report :


12 yr / F



Unilateral class II



Class II against upper 1st
premolar



Overcorrected- 4 months


NICkEl TITANIUM dOUBlE-lOOP SYSTEM FOR SIMUlTANEOUS
dISTAlIZATION OF FIRST ANd SECONd MOlARS

Mandibular molars
and 2nd premolars
banded, other teeth
bonded
Lip bumper- prevent
extrusion
Maxillary molars
and bicuspids –
banded, aligned
80 gm Neosentalloy
– maxillary archwire
placed – marked
Distal to 1st
premolar
5mm distal to 1st
molar tube
Stops crimped on www.indiandentalacademy.com
markings

After 5months- overcorrected

Sectional NiTi archwires – crimp stops
Mesial and distal to 2nd premolar
5mm distal to 2nd molar tube
Uprighting springs on 1st bicuspids
Class II elastics
Simultaneous, bodily movement

AdvANTAGES
Minimal patient co-operation
Ideal for simultaneous distalization
Anchorage easily controlled , without need for TPA/Nance
Due to streching of transeptal fibres, 1st molars can be
distalized using lighter 80 gm force


k -lOOP
By Kalra in 1995
The appliance consists of a K-loop to
provide the forces and moments and
Nance button to resist anchorage


K-loop made of .017”x.025”TMA wire with
each loop 8mm long and 1.5mm wide

Legs of appliance bent down 200


Wire marked at mesial of molar tube distal of
premolar bracket

Bend placed 1 mm distal to distal mark and 1 mm
mesial to mesial mark. Stop should be well
defined and about 1.5mm long


K-loop in place with 2mm activation


Activation sequence
Open loop 1mm at (1); Open loop
1mm at (2); Open at (3) to regain
the 200 bent of mesial and distal
legs


PENdUlUM APPlIANCE
Indications
Distalization of upper first molars
before eruption of second molars.

Contra-indications.
Lack of teeth anterior to the first
molars to retain the appliance.
Upper second molars have erupted.

2. PENdUlUM APPlIANCE
Byloff and Darendeliler (1997) and Byloff et al., 1997
showed that the appliance moved molars distally
without creating bite opening, but the molars did tend
to tip.
Ghosh and Nanda (1996) also found that the pendulum
appliance is a reliable method for distalizing maxillary
molars at the expense of moderate anchorage loss..
Hilgers (1992) reports that when the appliance is
placed before the eruption of the second molars,
two-thirds of the tooth movement is molar
distalization, one-third is experienced as forward
shift of the anchor bicuspids and oppsite occurred if
2 nd molars erupted

JAMES J. HIlGERS,JCO 1992



Nance button



.032 TMA springs



Broad swinging arc
(Pendulum) of force from
midline of palate to upper
molars


Fabrication :
Pendulum springs consist of
1.
Recurved molar insertion
wire
2.
Horizontal adjustment loop
3.
Closed helix
4.
Loop for retention in acrylic
button
Springs- close to center of
Nance button
Anterior portion- retentionocclusally bonded rests
- Band
upper 1st premolars, solder
retaining wire to the bands

Preactivation and placement:


Springs bent parallel to midline of the
palate



Molar bands cemented



Anterior portion of appliance later
cemented



Pendulum spring brought forward &
engaged in lingual sheath



As molar distalizes, moves on an arc
towards midline- counteracted – opening
horizontal loop



Nance button- extend to about 5mm
from teeth



Anterior retention loops fixed on
model, later soldered to bicuspid
bands



Acrylic pressed against the palatal
vault



Pendulum springs inserted


PENdUlUM APPlIANCE
Pend-X
Jack-screw-One-quarter turn
every 3 days


PENdUlUM


Distal jet appliance
alDo carano, Mauro testa
jco 1996



Fixed lingual appliance

Appliance design :
 Wire extending from acrylic
through tube ends in a bayonet
bend-inserted into lingual sheath


Coil spring



Clamp



Anchor wire to 2nd premolar


Distal jet applaiance
alDo carano, Mauro testa
jco 1996
Reactivation- sliding clamp
closer to first molar
After distalization –
- clamp-spring assemblyacrylic,
- premolar arms cut off.


Distal jet appliance
Advantages :
Bodily movement
Easy insertion
Well tolerated
Esthetic
Unilateral, Bilateral
Permits simultaneous use of full bonded appliances


Open Coil Jig
3
1.

Heavy round wire

2.

Light wire

3.

Fixed Sheath

4.

Hook

5.

Sliding Sheath

6.

4

Open coil spring

6

5
1

2

lokar

A similar mechanism, called the Lokar
distalizing appliance, has been developed
by Ormco Corporation. It has reported
advantages of ease of insertion and
ligation. To date, no published clinical
trials have emerged on either of these
appliances. www.indiandentalacademy.com

lokar Molar Distalizing
appliance
A- Inserts into molar attachment with a rectangular wire
B- Compression spring
C- Sliding sleeve
D- Groove
E- Flat guiding bar
F- Round posterior guiding bar
G- Immovable posterior sleeve


lokar Molar Distalizing
appliance
Nance button
Can be used in conjunction with complete edgewise
appliance
With headgear
Easy insertion, activation


sectional jig appliance
Sumit ,o.p..kharbanda and
hari prakesh ajodo (1998).
A modified nance
appliance ,soldered to both
the 1 st and 2 nd premolars
bands used for anchorage
control
The niti coil which exerts
70-75 grams of force over
a compression of 1 to 5
mm .
The sectional jig assembly
was inserted posteriorly
into double buccal tubes of
first molars.

The mean distal movement of first
molar was 2.78 mm
The rate of movement per month was
0.86mm/momth
Their was increases overjet of 1mm and
2.6 degree mesial tiping of 2 nd
premolar.
But their was distal tipping and
clockwise rotation of molar

First class appliance For
rapiD Molar
Distalization
Forniti et al ( ajodo 2004)
The appliance consists of
bands on 2 nd premolar and
molar.
A Nance palatal used for
anchorage .
On buccal side a 10mm long
screws with 4 holes for
activation .
The patient were told to
activate each vestibular
screw a quarter turn in a
counter clockwise direction
once daily (o.1mm).

In just 2.4 months ,4mm of distal
movement with 4.6 o tipping occurred .
Increase overjet of 1.2mm ,and mesial
movement of second premolars of 1.7mm
with 2.2 o of mesial tipping


Mini –Distalizing
appliance
One of the recent
versions of molar
distalization
Both distalization
with expansion
occurs.

As proper case
selection is ideal
for success with
any appliance .
MDA should only be
used in strong
muscular patients
where growth and
subsequent
mechanics can
compensate for
transient open bite
that results from
expansion and RMD.


intraoral BoDily
Molar Distalizer

Ahmet and korkmaz
(Ajodo jan 2000)
The Nance button
was covered palatal
aspect of incisors
and functioned as as
anterior bite plan to
disclude the
posterior teeth .
The spring is made
up of 0.032x 0.032
TMA wire

The spring has 2
components
1 the distalizer
section of the
spring applied a
crown tipping
force
2 the up righting
section applies up
righting force to
the first molars
Distal tipping and
extrusion of
molars were not
statically

BiMetric systeM For Molar
Distalization (WDa)
Dr.Wilson-Tandem yoke
with bimetric arches for
molar distalization (EJO
JUNE 2000)
Anteir segment made of
0.022’’and posterior
0.040’’.
Before distalizing a TPA
used to align the molars



Coil spring- between molar
tube & the yoke



5/16 “Elastics- 12 hours a
day



The Omega adjustable
stop –to modify & control
arch length



.061 Omega loop



Coil springs &
intermaxillary hooks.


FixeD piston appliance
- greenFielD


.036 “ tubing- soldered to
biccuspids



.030 “ ss wires- first molars



Nance button



NiTi coil


ManDiBular Molars
With
skeletal anchorage

The anchor plates are made of
pure titanium plates are placed
behind the second molars at the
anterior border of the
mandibular ramus .
Implantation was performed
under local anesthesia and the
titanium plates were secured
with pure titanium screws
The diameter and the length of
the monocortical screws 2 and 5

Extraction
of 3 rd
molars
A- single
molar
distalizatio
n
B- en masse
distalizatio
n


MoDiFieD Frozat appliance


elastics


intraoral elastics

1) CL I elastics or horizontal elastics

or intramaxillary elastics or intraarch elastics:-

The force recommended is 1 ½ to 2 ½
oz for non extraction cases and 2 to 4
oz. in extraction cases.


2) CL II Elastics / intermaxillary
elastics / interarch elastics
The force recommended is 1 ½ to 2
½ oz. in non extraction case and 2
to 4 in extraction cases.


3)

Class III elastics
Recommended force is ¼” elastic
with 3 ½ oz


4)

Anterior Elastics.
(Force-1 to 2oz.)


5] Cross Bite Elastics
Force recommended is 5-7 ounce


6) Cross Palate Elastics


7) Diagonal
elastics)

Elastics

(Midline

Force used is 1 ½ to 2 ½ ounces.


8) Open Bite Elastics
These are used for the correction
of open bite. It can be carried
out by a vertical elastic,
triangular or box elastic.
Vertical elastic runs between the
upper and lower brackets of each
tooth


9]

Box Elastics
Force used

¼” 6 oz or 3/16” 6 oz.


10)Triangular Elastics
Elastics
used.

of

1/8”


3

½

oz

is

11) Vertical Elastics (Spaghetti)
Force used is 3 ½ oz.


12]

M and W Elastics
Force is ¾” 2 ounce.


conclusion

There are a plethora of appliances
available in the market today, each
telling its own advantages, but as a
clinician its our duty to access each
individual case and decide which one is
most suitable.

reFerences
JCO Volume 1985 Sep(664 - 665): Technique Clinic
Extrusion of Palatally Impacted Cuspids - DR. CHARLES
E. MEYERS, LTC, DC, U
JCO Volume 1995 Sep(579 - 579): Clinical Aid: Facially
Bonded Lingual Cleat for Extrusion of an Ectopic Canine
DONALD J. RINCHUSE, DMD, MS, MDS, P
JCO Volume 1995 Nov(709 - 712): Treatment of
Palatally Impacted Cuspids with the Extrusion Spring
Arm SALLY J. TERRY, MARK E. THOMSON, D
JCO Volume 1998 Apr(255 - 260): Nickel Titanium
Double-Loop System for Simultaneous Distalization of
First and Second Molars ALDO GIANCOTTI, DDS, M.

JCO Volume 1998 Apr(255 - 260): Nickel
Titanium Double-Loop System for
Simultaneous Distalization ALDO
GIANCOTTI, DDS, MS,PAOLA COZZA, MD,
DDS, MS
JCO Volume 1994 Apr(222 - 242): A Universal
Retraction Spring - POUL GJESSING, D

thank you
Leader in continuing dental education


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