Introduction

Orthodontic appliances can be defined as devices which create or transmit forces to

individual teeth, a group of teeth or maxillofacial skeletal units so as to bring about changes
within the bone with or without tooth movement which will help to achieve the treatment goals
of functional efficiency, structural balance and esthetic harmony.

Orthodontic appliances can be classified based on the patients ability to remove it. Based
on this premise, appliances can be divided into fixed, semi-fixed or removable. Removable
orthodontic appliances are those that can be inserted and removed by the patient, for example
Hawleys retainer. Removable orthodontic appliances can be again divided into active and
passive appliances.

Active removable appliances are designed to achieve tooth movement mainly tipping by
means of active components such as springs, screws, bows and elastics. They are capable of
generating tooth moving forces. In passive removable appliances, they are designed to maintain
teeth in designated or present position such as retainers or space maintainers.

Advantages of removable orthodontic appliances are easier to fabricate, cheaper and less
iatrogenic damage. Proper oral hygiene can be maintained as appliances can be removed and
kept clean. Besides, less chairside time required as appliances are fabricated in the lab. Most
forms of tipping movement can be carried out by removable appliances as well.

There are a few disadvantages of removable appliances, treatment time might increase as
multiple tooth movements are difficult to achieve simultaneously at a time. Next, outcome of the
treatment depends on patient compliance and cooperation. There are increased chances of
appliances loss and also breakage. Speech might be affected when the patient is wearing the
appliances.
 All removable orthodontic appliances should fulfill certain requirements in order to bring
out desired orthodontic tooth movement without creating any harmful forces. These requirements
can be considered under biologic, mechanical and esthetic requirements.

For biologic requirements, appliance should bring out desired tooth movement without
bringing impact on periodontium. Appliance must be made up of biocompatible materials
without causing any irritation and allergic reactions. It should not interfere with normal growth
and functions. Beside, proper oral hygiene maintenance must be allowed.

Move on to mechanical requirements, the appliance should be able to deliver continuos

controlled forces in desired intensity and directions. It should be easy to fabricate and able to
withstand masticatory forces without breakage. Appliance should be universally accepted and
applicable, without causing discomfort to the patient.

The appliance should esthetically acceptable to the patient and should be inconspicuous
as possible.

At the time the appliance is to be delivered, several instructions should be given to the
patient. Firstly, the patient should be shown in the mirror regarding the insertion and removal of
the appliances. Do remind them to remove the appliance by engaging bridges of the clasp instead
of labial bow itself. Proper oral hygiene should be maintained by the patient to prevent
possibility of enamel decalcification. Appliances should be cleaned with soap and water to
prevent accumulation of debris and bacteria. Do report to dentist if there is any damage and
breakage of the appliances.
The removable orthodontic appliances are made up of three components:

1. retentive components.

2. active components.

3. base plates.
 Retentive component is also known as fixation. These components aid in retaining
appliance in position and resist displacement due to active components. Active components can
only be effective when there is a good anchorage or retention of appliance. Retention of
appliances is usually given in the form of wire components which is known as clasp.

Clasp engaged the undercut area of teeth in order to aid in retention of the removable
appliance. There are two types of undercut, proximal and cervical undercut.

Proximal
undercut

cervical
undercut

Proximal undercuts appear soon after eruption of the tooth which located at mesial and
distal side of the tooth extending from contact area to neck of the tooth. They are more efficient
in providing retention than cervical undercut. Adams clasp and Crozats clasp make use of these
undercut.

Cervical undercut present on the buccal and lingual surfaces of teeth below area of
maximum circumference and are visible from mesial aspect. They are less retentive than
proximal undercut and not suitable for partially erupted teeth. Circumferential and jacksons
clasp engage the cervical undercut.

An ideal clasp should be easy to fabricate, provide maximum retention, do not interfere
normal occlusion and no impingement on soft tissue. Most importantly, clasp should not apply
active forces on the teeth.
 There are many different types of clasp:

1. circumferential clasp
2. Jacksons clasp
3. Schwarz clasp
4. Triangular clasp
5. Ball-end clasp
6. Crozats clasp
7. Southend clasp
8. Adams clasp

1. Circumferential clasp (three quarter clasp)

It is one of the simplest clasp design and fabrication. 0.7mm stainless steel wire is used for
fabrication of the clasp. C clasp engage buccal cervical undercut extending from proximal
undercut of one side to the other proximal side then brought occlusally over the embrasure
and end as retentive arm lingually or palatally. It cannot be used in partially erupted tooth as
cervical undercut is not fully seen.
2. Jacksons clasp (full clasp)

It is fabricated using 0.7mm stainless steel wire adapted along the buccal cervical margin and
extends along mesial and distal undercuts, over the occlusal embrasure to end in two
retentive arms. Like C clasp, it cannot be used on partially erupted teeth.

3. Schwarz clasp

Schwarz clasp is also known as arrowhead clasp as it is made up of numbers of arrowheads

which make use of the proximal undercuts between two teeth. It is rarely used now due to
several reasons. It requires a special plier for fabrication which is difficult to fabricate and
time consuming. Next, it used up a lot of space in the buccal vestibule which leads to
irritation of soft tissues. Chances of breakage are high due to its elasticity and design.

4. Triangular clasp
 As its name suggest, these are small triangular shape clasp which engage the proximal
undercut between two posterior teeth carried over occlusal embrasure and end as a retentive arm
on the palatal aspect. It is usually used as additional retention instead of using alone as they
cannot provide adequate retention.

5. Ball end clasp

This clasp is made with 0.7mm stainless steel wire with a ball or sphere like structure
engage the mesial and distal undercut of adjacent teeth. The ball like structure is silver soldered
and ball end clasp is used as additional retention.
6. Crozats clasp

It is also similar to Jacksons clasp with additional wire soldered at the base of the clasp. This
soldered wire gives a better retention by engaging the mesial and distal proximal undercut.

7. Southend clasp

This clasp is used for anterior retention purpose with 0.7mm stainless steel wire. It can be
used when the upper incisor is not proclined and when there is only limited undercut. When
upper incisors are proclined, insertion and removal of appliances will caused unnecessary
flexed of the clasp which causes fracture later on. It is fabricated along the gingival margin of
upper incisors and ends as retentive area at palatal side. Retention is increased by bending the
arrowhead towards tooth surface.
8. Adams clasp

bridge

arrowhead

Most commonly used clasp in orthodontic removable appliances which consist of two
arrowheads, bridge and retentive arms. It is made up of 0.7mm Stainless steel wire in
permanent tooth and 0.6mm stainless steel wire in deciduous tooth. The two arrowheads
engage the mesial and distal proximal undercut which provides maximum retention and
connected by a bridge.

Adams clasp has a lot of advantages over other clasp

I. Simple, strong and easily constructed

II. Excellent retention
III. Comfortable to wear and resistant to breakage
IV. Can be used on any tooth even incisors
V. Can be used on deciduous and permanent tooth
VI. Number of modifications
VII. Easy to insert and removed
VIII. No special instruments is required for fabrication

Several modifications on adams clasp

Adams clasp with helix
Adams clasp with

additional arrowhead

Adams clasp with distal

extension Adams clasp with j-hook

Adams clasp with

soldered buccal tube Adams clasp with single
arrowhead