School of Dentistry

ORTHODONTIC LECTURE 7

REMOVABLE APPLIANCE DESIGN

Introduction

Removable appliances are best used in simple malocclusions where only tipping of teeth is
required, or as an adjunct to fixed appliance therapy. They are relatively easy to use, but
cannot be used routinely in the lower arch because they encroach on tongue space and
retention is poor.

Design Elements

Force (Activation)
Retention (Fixation)
Anchorage
Baseplate (including bite planes)

Force Activation

i) Springs and bows

Neat and, as long as they are activated correctly, provide light continuous force. .
Many types are available. Most easily divided into those for retroclining or those for
proclining (individual teeth or groups of teeth). Typically fabricated from 0.5mm SS.

Palatal finger spring )

Buccal canine retractor )
Roberts retractor ) Retroclination or distal movement
Plain labial bow with U loops )

Z spring )
T spring ) Proclination or labial movement
Safety pin spring )

ii) Screws

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 Bulky
Intermittent force
Rely on patient for activation
Useful for moving blocks of teeth
Pitch 0.2mm per ¼ turn

Retention Fixation

Required both posteriorly and anteriorly.

A) Posterior

Adams clasps can be placed on 6s, premolars, or even deciduous molars.

0.7mm S/S.
They engage mesio-buccal and disto-buccal undercuts.
The number needed depends upon the force applied: More needed for screw appliances
and incisor proclination, due to larger displacing forces.
Tubes for headgear can be soldered onto bridge.

B) Anterior

Typically fabricated from 0.7mm SS:

i) Fitted labial bow - 21|12 or 321|123
ii) Southend Clasp - Fitted around gingival margins 1|1.
iii) C clasps- engage canines
iv) Ball clasps- engage between incisors

Anchorage

Is the source of resistance to force generated in reaction to the active components, e.g. when
moving canines distally the anchor teeth will move mesially. The amount of mesial movement
of the anchor teeth is determined by force, number of teeth in anchor unit, and their resistance
to movement. The root area of the teeth is the important factor when considering their
anchorage potential.

In an upper removable appliance the anchorage is supplied by all teeth contacting the
baseplate, and the bone of the palatal vault. Anchorage can be supplemented by the addition
of headgear.

Baseplate

Is made of methylmethacrylate resin and carries other components. Can be formed into bite
planes which can clear occlusal interferences and reduce deep overbites.

i) Flat anterior bite plane

Decreases over bite. Opens bite sufficiently so that upper and lower incisor tips are at
the same level, discluding the posterior teeth. This leads to passive over eruption of
posterior teeth thus opening the bite. Once removed however there will be a space
between the incisors, which must be controlled, otherwise the overbite will relapse.
Flat anterior bite planes will only work predictably in growing patients.

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ii) Inclined anterior bite plane

Sometimes used after a functional appliance to maintain the postured bite, however
they tend to just procline lower incisors.

iii) Posterior bite plane.

Remove occlusal interferences by capping the posterior teeth. Used when incisors or
buccal segments are to be pushed over the bite.

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SOME USEFUL DESIGNS

1. Hawley Retainer

Fitted bow 3-3

Cribs 6|6

2. Expand Crossbite

Cribs 64|46
Midline screw

Molar capping

3. Procline instanding 2|2

Z springs 2|2 - 0.5mm

Cribs 64|46

Molar capping

4. Retract Buccal Segments

Cribs 64|46 - EOT tubes

on 6|6.
2 screws parallel to arch.

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