American Journal of ORTHODONTICS

Founded in 1915 Volume 81, Number 3 March, 1982
Copyright © 1982 by The C. V. Mosby Company
ORIGINAL ARTICLES
A segmental approach to
mandibular molar uprighting
Dr. Roberts
William W. Roberts, Ill, D.M.D.,* Frederic M. Chacker, D.D.S.,** and
Charles J. Burstone, D.D.S., Ph.D.***
Philadelphia, Pa., Lawrenceville, N. J., and Farmington, Conn.
Diagnosis and treatment in molar uprighting are discussed. The over-all objective in molar uprighting is ideal
positioning of the molar which will eventually become an abutment tooth for a fixed prosthesis. The ideal position
will provide an optimal periodontal environment for the molar(s). The specific objectives concerning protection
against inflammatory periodontal diseases and occlusal traumatism, which together determine the optimal
periodontal environment, are explained. Emphasis is placed on the biomechanics of molar uprighting which will
achieve the desired periodontal treatment result. The specific technique recommended for the instances in which
the molar is considerably angulated involves a segmental approach which utilizes a modification of the Burstone
root spring. Proper application results in the dissociation of the correction of angulation and the extrusion of the
molar tooth. It is explained that molar extrusion is, for the most part, an undesirable side effect of molar
uprighting. When extrusion of the periodontally involved molar is required, then it should follow the correction of
molar angulation. Other advantages of this approach involve the precision and ease of symmetrical preactivation,
favorable load/deflection considerations, the low level of patient discomfort, and the reduced tendency of normal
function distorting or dislodging the spring. This technique is compared by these parameters to other popular
molar-uprighting techniques. It is recognized that a multidisciplinary approach to this type of dental therapy is
ideal and that since treatment planning in individual cases varies greatly, each malocclusion and associated
periodontal involvement should be evaluated on an individual case basis.
Key words: Molar uprighting, periodontal diseases, molar extrusion, segmental biomechanics, prosthodontics
This article presents an approach to mandibu-
lar molar-uprighting treatment objectives, biomechan-
ics, and appliance selection which will be applicable in
many clinical situations. Mandibular molar uprighting
is a common adult orthodontic procedure, performed in
conjunction with periodontal and restorative therapy.
*Orthodontist practicing in Philadelphia, Pa., and Lawrenceville, N. J.
**Clinical Professor of Periodontology, School of Dentistry, Temple Univer -
sity, Philadelphia, Pa.
***Chairman, Department of Orthodontics, University of Connecticut, Farm-
ington, Conn.
0002-9416/82/030177+08$00.80/0 © 1982 The C. V. Mosby Co.
Treatment planning involves decision making by clini-
cians in addition to the orthodontist, with each adding a
point of view reflecting his or her area of expertise.
Understanding and appreciation of the treatment objec-
tives by all result in improved comprehensive dental
treatment for the patient.
TREATMENT OBJECTIVES
Ideal tooth positioning in molar uprighting is coin-
cidental with obtaining an optimal periodontal envi-
ronment. This, in turn, provides the following:
177
178 Roberts, Chacker, and Burstone Am. J. Orthod.
March 1982

1111011111111w
Fig.1. A, The inclined third molar exhibits radiographic signs of
occlusal traumatism. B, Correction of molar inclination and
stabilization improve the health of the molar periodontium.
1. Protection against inflammatory periodontal disease.
A. Elimination of the pathologic periodontal envi-
ronment which may exist in the presence of
tipped molar(s) and angular osseous crests.'
B . Correction of vertical osseous defects, if present,
through forced eruption.
2 3

II. Protection against occlusal traumatism.
A. Alignment of roots perpendicular to the occlusal
plane so that they may optimally withstand the
forces of occlusion (Fig. 1).
B. Improvement of crown/root ratios of periodon-
tally involved molars.
C. Provision of the shortest possible edentulous
span which also allows the necessary occlusal
support of maxillary posterior teeth and an in-
terarch cusp-fossa relationship, thus reducing
flexing of bridgework in the pontic area and
minimizing the related undesirable forces
transmitted to the abutment teeth.
When both of these treatment objectives are ful -
filled, the ensuing restorative dentistry is simplified.
Endodontic therapy may be avoided. Paths of bridge-
work insertion will parallel the long axes of the roots.
Periodontally compromising compensations in size and
contour of crowns will not be necessary to provide
proper contacts in centric occlusion and excursive
movements.
Occasionally, the orthodontic result may not justify
the means. It is hoped that the orthodontist would avoid
treatment in cases where the deleterious effects of tooth
movement, such as root resorption and aggravation of
periodontal diseases, could result in a weakened peri-
odontium. Treatment of the periodontally involved pa-
tient who is unable to maintain proper oral hygiene and
for whom forced eruption is otherwise indicated may
not be desirable, since the relationship of the alveolar
bone to the cementoenamel junction may not be main-
tained in the presence of the resultant inflammation.
4

Forced eruption without a constant alveolar crest/
cementoenamel junction relationship will result in a
lessened attachment apparatus and an increased crown/
root ratio and may create or aggravate furcation prob-
lems in multirooted teeth.
Inflammatory periodontal disease, considered in the
current literature to be a microbiologic phenomenon
mitigated by host responses,
5
requires special consid-
eration regarding orthodontic treatment, particularly in
the adult patient. Preorthodontic periodontal prepara-
tion should lead to reduction of inflammation, di -
minished pocket depth, and firm, manageable soft tis-
sues. During orthodontic treatment, this level of peri-
odontal control is also ideal. Recognition of pathologic
osseous architecture is critical to proper treatment
planning.
6
Though it is not common to encounter deep
periodontal pockets and infrabony defects on the distal
aspects of mesially inclined molars in the absence of
adjacent distal molars, when the latter are present, un-
desirable effects of distal uprighting may include the
increase of periodontal involvement on the distal as-
pects of these teeth. If this type of uprighting is at -
tempted, failure to be aware of the presence of inflam-
mation and to effect its reduction by repeated scaling,
root planing, and curettage may lead to acute exacerba-
tions of periodontal disease, such as abscesses or marked
edema. Regardless of prior periodontal involvement,
the molar that is moved distally during uprighting may
be surrounded distally by heavy fibrotic or muscular
tissue. In this instance, it may be necessary to perform
a surgical procedure to resect or otherwise recontour
this area.
Occlusal traumatism, one of the noninflammatory
forms of periodontal disease, varies greatly in its se-
verity. Histologic sections of teeth in marked trauma
may show an almost total loss of alveolar bone proper,
hemorrhage and/or diminished cellularity within the
periodontal ligament, and osteoclastic activity in both
the periphery of the alveolus and the root.? Proper orth-
odontic movement depends upon osteoblastic activity
as well as resorption. It is recommended that orthodon-
Volume 81 Segmental approach to mandibular molar uprighting 179
Number 3
tic procedures be instituted after a marked improvement
in the clinical and radiographic signs suggestive of
occlusal traumatism is observed subsequent to occlusal
adjustment and/or Hawley bite plane therapy. During
molar uprighting, the inclined, extruded molars (maxil-
lary and mandibular) should be adjusted to eliminate
occlusal contact and to re-establish a physiologic curve
of Spee. When these molars are the only posterior
occlusal supports, a Hawley bite plane should help de-
termine an appropriate vertical dimension.
Biologic limitations may also modify ideal tooth
positioning and/or treatment planning. The buccolin-
gual width of trabecular bone in the edentulous span
may be narrowed by the loss of dentition. The resultant
thin, primarily cortical bone may preclude mesial root
movement. Though tooth movement through cortical
bone is possible, the disadvantages of root resorption,
dehiscences, and prolonged treatment time generally
outweigh the advantages.
Commonly, second and third molars are tipped into
the first molar extraction space and there exists a Class
II relationship between the maxillary first and mandibu-
lar second molars (Fig. 2, A). The molars vary in de-
gree of inclination, tending to be more upright with
early loss of the first molar as a result of mesial drifting
of the erupting teeth. If the third molar is close to an
acceptable axial inclination, some combination of me-
sial root movement and distal crown movement applied
to the second molar will fulfill the treatment objectives
and create a pontic space approximately the size of a
premolar (Fig. 2, B) . When distal crown movement of
both second and third molars is indicated and the mo-
lars are in good buccolingual position, an appropriate
moment applied to the second molar will tend to move
the second and third molar crowns distally, rather than
move the second molar root mesially, if there is disar-
ticulation of both molars. (The opening of the inter-
dental embrasure between second and third molars
which results from distal uprighting facilitates the en-
suing restorative dentistry and periodontal mainte-
nance.)
TREATMENT BIOMECHANICS
A list of definitions helps clarify the terminology
which follows':
Activation—That force system that must be applied to a spring
or wire which is equal and opposite to the force system
desired (deactivation).
Alpha position—The anterior component of a spring or an-
terior point of attachment of a spring.
Beta position—The posterior components of a spring or the
posterior point of attachment of a spring.
Center of resistance—In a constraining system, such as a tooth
in its alveolus, the center of resistance is defined as that
A
Fig. 2. Creation of a pontic space the size of a premolar may
adequately fulfill molar-uprighting treatment objectives.
point where a force would result in translation of the tooth;
there would be no rotational effect.
Deactivation—The force system acting on the tooth from an
orthodontic appliance.
Moment of a force—The external effect of a moment of a force
is that it produces or tends to produce a turning or rotation
of the body on which the force acts. The magnitude of the
moment is equal to the product of the force times the per-
pendicular distance from the line of action of that force to
the point or line about which rotation is being considered.
Thus, M = F x D, where M = moment, F = magnitude
of force and D — the perpendicular distance from the line
of action of the force to the point being considered. A
moment can be expressed numerically in gram-millimeters
(Gm.-mm.) and is depicted by a curved arrow showing its
direction.
Preactivation bend—The final bend placed into a wire or
spring, which, when activated, will produce the desired
force system.
Pure rotation—All points on a tooth or body move around
the center of resistance.
Translation—All points on a tooth or body move in a parallel
straight line; the center of rotation is at infinity.
Since the forces of occlusion to the molar(s) are
eliminated by occlusal reduction prior to tooth move-
ment and facial growth is not a consideration in the
adult, molar uprighting provides a good clinical dem-
onstration of the results of moment and force applica-
tion. The center of resistance (CR) of a single-rooted
tooth with a parabolic shape is 0.33 of the distance
from the alveolar crest to the apex.
9
The CR varies with
the number of roots, their sizes and shapes, and the
nature of the attachment apparatus and gingival unit.
As the attachment apparatus is reduced by periodontal
disease, the CR approaches the apex. Conversely,
thick, fibrotic gingiva tends to move the CR coronally.
Application of force to a tooth directly through its
CR produces translation (Fig. 3). Clinically, orthodon-
tic forces are applied to teeth at crown level and rarely
pass directly through the CR. A force not passing
through the CR creates, in addition to translation, a
moment (equal in magnitude to the product of the force
times the perpendicular distance to the CR) which tends
to rotate the tooth about it s CR (Fi g. 4). Molar-
uprighting techniques depend upon this moment to pro-

180 Roberts, Chacker, and Burstone Am. J. Orthod.
March 1982

if(
1
I /
) " N.
1

Crk
, czL
N.1 •
.
1


Fig. 3. Force application through the center of resistance of a
tooth produces translation.
Fig. 4. Force application which does not pass through the cen-
ter of resistance produces a combination of rotation and trans-
lation.
duce the rotational tooth movement which corrects
molar inclination. (An additional moment is produced
by the straight wire in the molar tube.)
In Fig. 5, the hypothetical pure rotation anticipated
from the application of a moment (without an associ-
ated force) to a mesially tipped molar is diagrammed.
As the inclined, extruded molar is uprighted, it seems
to erupt. The "false" eruption during uprighting is ac-
tually a demonstration of the eruption, or extrusion,
which occurred during the period of time the molar
tipped into the extraction space. During molar upright -
ing by pure rotation, the CR does not move occlusally
(which means that the tooth is not erupting), yet
much of the molar crown rises above the occlusal
plane. The elevation resulting from this tipping effect is
particularly dramatic in the area of the mesial alveolar
crest. If a constant alveolar crest/cementoenamel junc-
tion relationship is maintained during correction of in-
clination, the angular osseous crest associated with the
tipped molar is not only eliminated but is somewhat
reversed in inclination, corresponding to the amount of
extrusion which occurred as a result of tooth loss."'
Some of the commonly used devices, such as tip-back
springs, produce, in addition to moments, extrusive
forces to molars during correction of inclination. In
most situations, molar extrusion is not indicated. As
will be discussed later, when extrusive forces are indi-
cated, they should follow correction of inclination.
In Fig. 6, a resisting force (ligature tie) added at the
level of the crown inhibits distal crown movement.
Uprighting by mesial root movement also results in
"false" eruption. The tipping effects of a moment,

Fig. 5. Elevation results from correction of molar inclination by
pure rotation.
regardless of whether or not the crown is permitted to
move distally, provide the elevation necessary to more
than level the angular crests associated with the mo-
lar(s) and to improve crown/root ratios of periodontally
involved molars. Frequently there exists, in addition to
the angular crest relationship, a vertical osseous defect.
When forced eruption is included in the treatment plan,
a light (maximum of 30 Gm. to the molar with little
loss of attachment apparatus") net vertical force should
be applied to the molar following the correction of in-
clination and re-evaluation. Control of periodontal
inflammation, by both patient and dentist, is facilitated
during eruption of the vertically upright molar, as com-
pared to the inclined molar. In addition, forced eruption
of the periodontally involved molar results in rapid ex-
trusion (approximately 5 mm. per month) which cannot
be well controlled during correction of inclination,
which generally requires 3 to 6 months.
Proper forced eruption maintains a constant cemen-
toenamel junction/alveolar crest relationship, not only
in the area of the vertical defect but also circumferen-
tially. Elimination of a vertical defect on one aspect of
a tooth creates an angular crest relationship with the
adjacent tooth on the opposite aspect. In Fig. 7, up-
righting followed by eruption of the second molar elim-
inates the mesial vertical defect associated with the
second molar and yet creates or increases the inclina-
tion of the angular crest relationship between the sec-
ond and third molars. Although the angular osseous
crest, as described by Ritchey and Orban' in 1953, is
physiologic periodontal architecture, it may encourage
a pathologic periodontal environment (particularly in
the periodontally susceptible patient) in a location in
which it is difficult for the patient to maintain adequate
oral hygiene. In this instance, osseous recontouring is
suggested.
Forced eruption is ideally a multistep process.
Orthodontic correction should be followed by a waiting
period sufficient to allow maturation of the osteoid ma-
Volume 81
Number 3
Segmental approach to mandibular molar uprighting 181


Fig. 6. Molar elevation occurs regardless of the distance the
molar crown is moved distally.
trix (approximately 2 months
12
). After calcification, os-
seous periodontal surgery is performed in order to level
the osseous architecture. Upon healing, the orthodontic
appliances should be removed, the crowns prepared,
and temporary or provisional bridgework placed. (Su-
pragingival provisional stabilization may also be placed
immediately following uprighting.) Endodontic therapy
also may be indicated at this time. It is important to
maintain the edentulous span after removal of orth-
odontic appliances in all molar-uprighting cases. After
debanding and/or debonding, significant relapse of the
molar(s) may occur within hours, so appliance removal
and provisional bridgework insertion should be well
synchronized.
APPLIANCE SELECTION
When treatment biomechanics indicate mild distal
crown tipping of the molar(s) and premolar spacing is
also present, an open coil spring approach is suggested.
This is also recommended in the case in which, because
of alveolar bone loss, the CR of the molar is located
near the apex. In this instance, the perpendicular dis-
tance from the point of force application to the CR of
the tooth is elongated, generating a larger moment from
a given distal force. The factors generally limiting open
coil spring uprighting do not result from the moment
but, rather, from the mesial and distal forces generated
by the spring. These limitations are (1) the anchorage
potential of the anterior stabilizing segment and (2) the
amount of molar translation which is acceptable as the
molar inclination is corrected.
For the markedly inclined molar(s) requiring distal

Fig. 7. Elimination of a vertical defect on the mesial aspect of
the second molar creates an angular crest relationship between
second and third molars.
crown tipping, or when some component of mesial root
movement and/or forced eruption is indicated, a mod-
ification of the root spring described by Burstone" al-
lows the flexibility to provide the desired combinations
of moments and forces (Fig. 8). The anterior stabilizing
segment consists of the following: (1) A lingual arch
wire (approximately 0.032 inch) bonded, or soldered to
bands, from canine to canine. Bonding the mandibular
incisors to the lingual arch wire adds stability to these
periodontally involved teeth. This is also recommended
when the mandibular second premolar is missing from
the quadrant containing the inclined molar, when sec-
ond and third molars are being uprighted or when the
second molar is considerably tipped, and when there is
concern about the possibility of well-aligned incisors
shifting in relation to each other. (2) Buccal edgewise
brackets (0.018 or 0.022 inch slots) banded or bonded
to the canine and premolars in the involved quadrant(s).
The canine bracket contains two horizontal slots.* (3)
A full-size rectangular stabilizing wire passing from
canine to premolar(s), stopped at both ends in order to
*Bowles Multiphase, Unitek Corporation, Monrovia, Calif.
182 Roberts, Chacker, and Burstone
Am. J. Orthod.
March 1982
ALPHA
t
4
-
3-4mm. BETA
2. LINGUAL
BUCCAL
3.
r - -
0
PASSIVE

4.
r
/ 0 c J
PREACTIVATION

5. COMPENSATION
Fig. 9. Stages of fabrication of the uprighting spring.
prevent spacing and inserted into the occlusal slot of the
canine bracket.
There are several alternatives to stabilizing the an-
terior segment as suggested in the previous paragraph:
(1) The lingual arch wire may be replaced by bracket-
ing of the incisors labially and continuing the labial
stabilizing wire from the premolar area on the side of
the uprighting to the canine or beyond on the opposite
side. In this manner, segmental molar uprighting may
also be incorporated into concomitant comprehensive
orthodontic treatment. (2) The lingual arch may extend
to the premolars and molars, if desired, and lingually
bonded to each tooth in the anchorage segment.
The alpha (anterior) portion of the uprighting spring
inserts into the gingival slot of the canine bracket. The
beta (posterior) attachment, into which inserts the beta
portion of the uprighting spring, is ideally a rectangular
buccal tube, bonded so that gingival irritation is mini-

Degree
of
Preactivation
70 Cr;
Force
of
Deactivation
ALPHA
BETA
ALPHA BETA
+45
o
+45
o

III
r i l l
I I I
o
-20
0
0


Fig. 10. The deactivation forces which result from typical de-
grees of preactivation.
mized and placed far gingivally in order to facilitate
occlusal adjustment of the molar. Prior to correction of
inclination of the molar, the canine and premolar(s)
should be consolidated and aligned. Ideally, molar ro-
tations and cross-bite should also be corrected with a
light continuous wire, offset to the angulation of the
inclined molar.
Fabrication, preactivation, and compensation com-
pose the three steps which prepare the uprighting spring
for insertion (Fig. 9). The spring is composed of ap-
proximately 0.018 by 0.025 inch wire for insertion into
a 0.022 by 0.028 inch bracket. A 0.018 by 0.025 inch
bracket would require a corresponding wire size. The
uprighting spring is constructed to fit passively (in all
three planes of space) into alpha and beta positions.

Fig. 8. Buccal and occlusal views (photographed at different stages of treatment) of the molar-
uprighting appliance. The spring is offset lingually in the edentulous area for added patient comfort.
Volume 8I
Number 3 Segmental approach to mandibular molar uprighting 183

Fig. 11. A, Molar uprighting requiring mesial root movement. B, Pretreatment radiograph of the molar
shown in A. C, Mesial root movement is evidenced by the radiographic shadow of the original tooth
position (8 weeks' active treatment).
After the spring has been contoured buccolingually,
one leg is engaged into its respective bracket and ad-
justed so that the opposite leg lies passively (occluso-
gingivally and buccolingually) at the level of the oppo-
site bracket, without engaging the bracket. The reverse
procedure is then followed, making the spring com-
pletely passive if inserted into the alpha and beta at-
tachments. The alpha and beta helices are then pre-
activated the designated degrees, depending upon the
desired forces and moments (Fig. 10). It is important to
measure the degree of preactivation from the inclina-
tion of the bracket and not from the level of the occlusal
plane. Preactivation bends should be tested during fab-
rication, at insertion, and during treatment, since tooth
movement alters the force system. Typical activations
(in the case where there is no loss of attachment appara-
tus) for equal and opposite moments are 45 degrees to
the attachments in the alpha and beta positions.
It is recommended that the moment generated not
exceed 3,000 Gm. mm. to a molar which demonstrates
no radiographic evidence of loss of attachment appara-
tus. The degree of uprighting spring preactivation will
vary greatly, depending not only upon the magnitude of
the desired moment but also upon the size and chemical
composition of the wire used for uprighting and the
interattachment distance. Symmetric alpha and beta
activations are indicated for correction of inclination,
so that there are no net vertical forces which result in
eruption of the molar or anterior segment. If eruption is
also indicated, either to attempt correction of a vertical
defect or to level the osseous crests and marginal ridges
between second and third molars, the spring can be
preactivated to produce pure molar eruption (Fig. 10).
Compensation for bending in the span of wire be-
tween alpha and beta loops, which occurs upon trial
activation and alters the desired force level, is made by
bending in a mild reverse curve, equal and opposite to
the curve observed upon trial activation. After final
placement of the uprighting spring, the span of wire
between alpha and beta helices should then be straight.
If some component of • mesial root movement is
planned, the alpha leg should be stopped at the mesial
aspect of the canine bracket and the beta leg stopped at
the distal aspect of the molar bracket. In this instance,
the molar attachment must be a bracket instead of a
tube. The soft tissues of the cheek and tongue habitu-
184 Roberts, Chacker, and Burstone
Am. J. Orthod.
March 1982
ally rest in this long edentulous span, and it is important
to minimize the patient's discomfort by lingually off-
setting the uprighting spring so that it lies over the
edentulous ridge (Fig. 11). Stopping the wire in this
manner does alter the force levels at alpha and beta
positions, but for clinical purposes it is fairly effective
in producing mesial root movement of the molar. In the
instance where there is a short edentulous span, tightly
common-tying from canine to molar brackets will in-
hibit distal molar crown movement. In the long edentu-
lous span, however, this kind of ligature tie will loosen
during normal function. Buccolingual compensation
for rotation of the molar should also be incorporated in
the wire design when mesial root movement is at -
tempted.
DISCUSSION
Molar uprighting and the associated periodontal
considerations have been frequently addressed in the
recent dental literature. Some uprighting springs de-
scribed generally delivery net extrusive forces to the
molars.
14-16
In the instance in which extrusion is indi-
cated, generally for correction of infrabony defects,
extrusion during the correction of inclination is unde-
sirable because it occurs too rapidly compared with the
change in molar inclination. Excessive occlusal ad-
justment is then required to keep interferences from
slowing the correction of inclination and also damaging
the periodontal support.
Many clinicians advocate the use of an uprighting
spring with the stabilizing arch wire passing through
the molar tube and exerting an intrusive force to the
molar, equal and opposite to the force of activation of
the uprighting spring. '
7 18
This design is biomechani-
cally similar to that which is described in this article
and may be properly adjusted to produce the same type
of movement that we recommend.
The advantages of the uprighting spring recom-
mended in this article are as follows:
1. Symmetrical preactivation is an extraoral proce-
dure. Force levels are easy to determine and to check
periodically .
2. Few adjustments are necessary during treatment
because of load/deflection considerations in spring
design.
3. In the edentulous span, the wire is not disturbed
by normal function because it is positioned at the level
of the gingiva.
4. Patient discomfort is minimized by offsetting
the spring over the edentulous ridge.
CONCLUSION
It is important, particularly after a discussion of
orthodontic appliance selection, to reaffirm the biologic
nature of molar uprighting. 'The concepts and quantita-
tive measurements hypothesized result mainly from
clinical impressions. Individual cases must be consid-
ered on an individual basis. Treatment varies greatly
from case to case, depending particularly upon the mit-
igations of periodontal disease. Although the hypothe-
ses presented should be clinically useful, there is a need
to examine scientifically the extent of the differing re-
sponse of teeth that are periodontally involved, as com-
pared with those of a physiologic periodontium.
An interchange of information among clinicians
and investigators of the various disciplines is neces-
sary. Orthodontic movement must serve to establish an
environment which provides for physiologic function
as well as the re-establishment of what is considered
"proper tooth position. "
REFERENCES
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3. Ingber, J.: Forced eruption. Part I. A method of treating isolated
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4. Kennedy, J. E.: Effect of inflammation on collateral circulation
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10. Weinmann. J.: Bone changes related to eruption of the teeth,
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11. Reitan, K.: Some factors determining the evaluation of forces in
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13. Burstone, C. J.: Mechanics of the segmented arch technique.
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junct to fixed prostheses, J. Am. Dent. Assoc. 76:312-315,
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15. Goldman, H. M., and Cohen, D. W.: Periodontal therapy, ed. 6,
St. Louis, 1980, The C.V. Mosby Company, pp. 564-627.
16. Toncay, 0. C., et al.: Molar uprighting with T-loop springs, J.
Am. Dent. Assoc. 100:863-866, 1980.
17. Vanarsdall, R. L., and Swartz, M. L.: Molar uprighting, Ormco
Catalog No. 740-0014, Ormco Corporation, Glendora, Calif.,
1980.
18. Broussard, G.: Personal communication, Sept ember, 1981.