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An Atlas of Removable
.I Orthodontic Appliance~
11
Second edition
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L
GORDON C. DICKSON ~t "
B Ch D (Leeds), F D S, D Orth, R C S (Eng)
11
Orthodontic Consult.ont to the
Portsmouth Hospital Group

ALBERT E. WHEATLY f>jll

FBI S T, MOT A ~
Chief Technician, Dental Wing,
Royal Portsmouth Hospital

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PITMAN MEDICAL '.

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Labial Mo, ment of Upper

Variations of, and
Additions to, Labial Incisors (Schwarz)
CONTENTS 124
Arches 106
Rotation of a Single Tooth
More Variations of the 126"
Labial Arch 108
The Inverted Labial Arch Rotation by Contra-acting
110 Springs 132
Preface 8 Palatal Movement of Extraoral Traction 134
The Materials 10 Premolars and Molars Space-maintainers 112
Expansion Screws 114 Extraoral Anchorage 138
The Tools 12 72 Buccal Movement of
Anodic Polishing Mesial and Distal Move- Asymmetrical Radial
Expansion 120 Premolars 144 "i1\
Apparatus 14 ment of Incisors 74 Incisor Elongation 146 ;."'
Distal Movement of
Wire Bending 16 Lateral Movement of Buccal Segment The Andresen Appliance 150 ;.'!
Construction of the Adams Canines 76 ~
(Schwarz) 122 The Oral Screen 156
Clasp 24 Labial Movement of
Variations of the Adams Canines 78
Clasp 38 Distal Movement of
The Adams Clasp for Canines 80
Extraoral Traction The Labial Canine
40 Retractor 82
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Alternative Clasps Sleeving the Canine «:
42 Retractor 84
The Effect of a Finger- Adjusting the Retractor
spring 44 86
Resistance to Displacement The Cut-and-bend Spring
46 88
Resistance to Tooth Move- Palatal Movement of
Laterall:lcisors 90 ."1
ment (Anchorage)
50 The Sved Bite Plate 92
The Simple Cantilever The Effect of a Bite Plane
Spring 56 94
Boxing-in 62 The Labial Arch 96
Paired Cantilever Springs The Labial Arch as a
64 Retai ner 98
Double Cantilever Springs The Roberts Retractor
66 100
The Kinked Cantilever Construction of the I
Roberts Retractor ,i
Spring 68
Premolar Retraction 102 71
,.'
Springs 70 Apron Springs 104 ":1

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THE MATERIALS
Wire Tube
mm inches Internal Diameter,
in mm
Stainless steel wire 0.35 ~.014
Extra hard
This must be HARD POLISHED [British Standard
No. 3507 (1962) I. Hard drawn, un polished wire is Bright annea~
0.5 ~020 ~ 0.5
inferior and should not be used. It is specified in metric Hard
diameter measurement and the correct sizes for each
appliance will be found on the text-page opposite each
appliance.
0.5 ~020
Soft brass --
Stainless steel tube
Tubing may be HARD POLISHED or BRIGHT
ANNEALED. It is usually specified by internal diameter
0.6
Hard -
0.7 0.028 Bright annealed
only, the thickness of the tube wall being appropriate for
orthodontic purposes. Hardo~ ~
Stainless steel tape 0.8
Hard ~- 0.032
.
Bright annea~
As used in orthodontics, tape is supplied SOFT, ~0.9
POLISHED ONE SIDE, the other side being matt to 0.9 ~036
facilitate adhesion of cement. Hard ~ v.,
Hard polish~
~ 1.0
Acrylic resin
CLEAR acrylic denture base is used for the construction
1.0
Hard ~- ~040
of all appliances, chiefly as it allows blanching of the tissues Hard~ 1.25
over pressure areas to be detected visually, and also 1.25
Hard ~048
because it shows more clearly when food debris has
collected around the springs.
Hard~~056
1.5 Hard~ 1.5
Tape
PolishedOne Side; in mm

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Soft 3.0 x 0 0.175 Soft 2.0 x 0.1

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 .,.
THE TOOLS

For the vast majority of removable appliances four

instruments only are required.
7. Universal pliers
These are used for all wire bending with the exception of
the formation of loops or coils. The beaks are stout,
I
tapered and rectangular in section, and meet only at the
tips. Beaks which are in contact throughout their length
tend to eject a large diameter wire (Inset A). The beaks
of Universal pliers are parallel when gripping the wire
(Inset B). When the pliers become worn they should be
resharpened, maintaining a beak size of 1 mm square at
each tip and cutting back so that a O.6mm wire can be
passed between them at the base when the pliers are
closed.

2. Loop-forming pliers 1 2 3
These have round, tapered beaks around which loops or
coils of various sizes may be formed.
3. Wirecutters
The diagonal type of wire cutter is used and must have
hardened blades. ~
4. Hollow-chop pliers
Used for making bends in wires which are already
anchored at both ends in an appliance, these pliers have
one beak round and the other hollowed so as to wrap
round its opponent. They therefore exert pressure
simultaneously at three points on the wire. They may
also be used for increasing the bend in the labial canine
retraction spring shown on page 82.

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ANODIC POLISHING APPARATUS
1 3 ."

The anodic polishing bath illustrated is used for

reducing the diameter of stainless steel wire where a
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( 2 output
,

variation in thickness is required.

In use the positive pole is connected to the wire to be
thinned using a crocodile clip and so forming the anode.
The cathode (negative pole) is formed of a stainless steel
plate.
A current of 8 amps at 20 volts is suitable for most
1 Switch 5 Ammeter (to 20A)
purposes. A variable resistance is unnecessary as the 2 Neon Indicator Bulb 6 Transformer
current can be varied by moving the anode nearer to, or 3 Rectifier 20V, lOA Input 250V
further from, the cathode. 4 Voltmeter (to 25V) Output 20V
lOA

Composition of Solution
3 parts orthophosphoric acid
1 part glycerin
1 part aqua dest.

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011 . '''0
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 0:

WIRE BENDING, 1

50ft curves
For labial arches of all kinds, smooth curves are formed
by holding one end of the wire firmly on one hand and
forming a curve with the thumb of the other hand. The
thumb is then drawn firmly along the wire, creating a
smooth curve of large radius. Repeating the process will
increase the curve to any desired extent. Avoidance of
the use of pliers will ensure a bend without kinks.
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 WIRE BENDING, 1

50ft curves
For labial arches of all kinds, smooth curves are formed
by holding one end of the wire firmly on one hand and
forming a curve with the thumb of the other hand. The
thumb is then drawn firmly along the wire, creating a
smooth curve of large radius. Repeating the process will
I increase the curve to any desired extent. Avoidance of
the use of pliers will ensure a bend without kinks.
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WIRE BENDING, 2

Right angle bends

Holding the wire at right angles to the long axis of the
pliers the wire is held against the thumb and the bend
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I made by pressing the thumb firmly on the wire as
closely as possible to the plier beak. (For clarity in the
I illustration the thumb is shown a little too far back.)

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 WI RE BENDING, 3

Acute bends
These are formed by holding the wire along the beaks of
the pliers and bending firmly back with the forefinger.
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WIRE BENDING, 4

Small radius bends

Holding the wire at right angles to the plier beak the
wire is bent with the thumb placed a short distance
away from the bend.

22

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CONSTRUCTION OF THE ADAMS CLASP, 1

If desired the clasp may be pre-tightened by trimming

the plaster tooth as shown.

The form of the clasp is shown for upper teeth.

24
 CONSTRUCTION OF THE ADAMS CLASP, 2

Forming the bridge

A careful estimate is made by eye of the mesiodistal
width of the tooth. A piece of O.7mm wire about 12cm
'I
(Sin) long is held at right angles to the pliers at a point
where the width of their beaks is equal to about two-
thirds of the tooth-width.
Using the thumb and forefinger the two ends, which
should be of equal length, are pushed backwards as far
as the plier beaks will permit. The tips of the beaks are
then used to increase these bends to slightly less than a
right angle so that the ends of the wire cross each other.

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CONSTRUCTION OF THE ADAMS CLASP) 3

Forming the first arrowhead

As the length of the arrowhead will vary according to
the height of the crown of the tooth to be clasped, this
is first estimated and a bend made in a position which
will place the bridge about half-way up the crown. This
is made in two stages.
First stage: a right angle bend as shown opposite.

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 CONSTRUCTION OF THE ADAMS CLASP, 4

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Forming the first arrowhead (contd.) .&~.
Second stage: this bend is increased by bending the wire
backwards over the beak-tips (as on page 21).

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 CONSTRUCTION OF THE ADAMS CLASP, 5

Forming the second arrowhead

Holding the clasp in the position shown, the second
arrowhead is formed in the same way as the first (Inset
D). Each arrowhead is then squeezed lightly between the
plier beaks (Inset E) to increase the sharpness of the
arrowheads. This should not be carried to excess or the
wire willlatcr break at this point.

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 CONSTRUCTION OF THE ADAMS CLASP, 6

Aligning the arrowheads

Each arrowhead in turn is held in the pliers as shown and
bent until the plane of the arrowhead lies at about 45°
to the bridge.

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 CONSTRUCTION OF THE ADAMS CLASP, 7

Forming the tags

A right angle bend is formed at a level slightly below the
bridge by holding the arrowhead as shown (the thumb
has been withdrawn for clarity).
Over the contact point of the tooth a second, shallow
bend is formed and the clasp presented to the tooth. It
is essential that the bridge should not lie in contact with
the buccal surface of the tooth and these last bends
should be increased if necessary to achieve this.
Finally the tags are completed by bendi ng over the
I
palate and the ends turned under and forced into the ':-.
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plaster (page 25). The tags should lie out of contact with
the plaster so that they will later be completely
~) surrounded by acrylic material.
When the clasp has become slack in wear it is
tightened by increasing the bend in the tag at a point
immediately overlying the contact point of the tooth.

36
 VARIATIONS OF T.-IE ADAMS CLASP

The auxiliary clasp

A. A second arrowhead is formed as shown and united to
the bridge of the main clasp using hard solder and stain-
less steel flux. The minimum amount of heat should be
used and the solder should not be heavily polished,
~ A
otherwise it will be removed entirely from the surface I
II and will have no mechanical hold. Soldering may be
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carried out either on the model or after processing. tt
The incisor clasp
B. A single incisor can be clasped as shown in the left-hand j
diagram, the arrowheads resting against the mesiolabial
and distolabial aspects of the tooth.
c. Two central incisors can be clasped as shown.

I' Materials
f All clasps are made with O.7mm wire. B
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 THE ADAMS CLASP FOR EXTRAORAL TRACTION

Where upper first prcl!lolars have been extracted an

auxiliary arrowhead may be used (page 38) but this is
not easy to adjust. A variation is to place arrowheads on
the mesial of the second premular and the distal of the
molar as in diagram A.
This form of retention is of value in extraural
anchorage (page 138) but for convenience of accom-
modating adjustmenl loops or friction slopS, it is con- A
venient to offset the tubing in which the arch fits as
shown in diagrams B Jnd C.

Construction
Adams clasps: o. 7mm stainless steel wire
Extraoral arch: 1.25mm wire
Tubing: 1.25 internal diameter stain-
I, less steel
Attachment of tubing: Strapping with 2.0 x 0.1 mm
stainless steel tape or binding
\ViIh 50ft wire and soldering

B c

40
 ALTERNATIYE CLASPS

Both the clasps illustrated use the same principle as the

Adams clasp i.e. retention from the undercut areas
present on the mesiobuccal and distobuccal corners of
the molar teeth.
l
The ball-ended clasp
A, B. Prefabricated ball-ended wires are bent in the form
shown and sprung into the angular undercuts. Alterna-
A B
tively, stainless steel wire may be bent into a sharp,
closed curve and cut off short to replace the balls.

The Duyzings clasp

C. Two stainless steel wires are bent over the maximull'
contour of the tooth from mesial and distal aspects and
then curved back upon themselves so that the lower part
lies below the maximum contour and the ends are
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sprung into the undercuts. c
Materials
Both dasps are made from O.7mrn stainless steel wire.

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42
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THE EFFECT OF A FINGERSPRING

A. On the tooth
Owing to the fact that the palatal surface of an upper
incisor tooth has a downward and forward slope, it acts
as an inclined plane and the horizontal forward thrust of
a fingerspring is converted into an upward and forward
thrust. In the case illustrated in diagram A the palatal
surface is at 60° to the horizontal and the thrust may be
divided, as shown by the length of the lines, into an
upward component of two units and a forward com-
ponent of three units.
B. On the appliance
Reciprocally, in accordance with Newton's Third Law of
Motion, the tooth exerts a backward and downward
- - -- --
force on the spring, as represented in diagram B. It
follows that the clasps on such an appliance must be
placed, not only to resist the backward thrust of the A B
tooth, but also to resist a considerable downward dis-
placing force.

44 ..

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 RESISTANCE TO DISPLACEMENT, 1

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Downward displacement of an upper appliance I "''''...
I
In diagram A a labial arch is used to retract upper I'
incisors. There is a backward force on the incisor com-
bined with a downward force due to the inclined plane
effect. Reciprocally a forward and upward force is
exerted on the appliance. Only the forward force is .~
resisted by the clasped molar tooth (black) while the
palate acts asa fulcrum and receives the upward force.
In diagram B a palatally placed spring is moving the t
incisors forward. The inclined plane of the tooth here A
exerts a backward and downward force on the anterior
part of the appliance, which would pivot on the clasped
first molar (black). Additional clasps must be placed on
I the first premolars (black) to produce an upward com-
I
~i ponent and prevent displacement.

46
 RESIST ANCE TO DISPLACEMENT, 2

A lingually placed spring exerts a forward force on the

sloping surfaces of the lower incisors and consequently
receives an upward and backward thrust from the teeth.
A clasp placed on the first premolar (black) acts as a
fulcrum about which the appliance will pivot, tilting the
posterior end downwards.
The downward thru5t is countered by placing an
occlusal rest on the second 1110lartooth (black), so giving A
an upward thrust and stabilizing the appliance. (If the
second molar is unerupted the occlusal rest may be
placed on the distal portion of the first molar.)
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RESISTANCE TO TOOTH MOVEMENT A 'fi...
(ANCHORAGE). 1
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Retraction of labial segment 0 0
A. If, following extraction of first premolars, an attempt is
made to retract the entire labial segment at once, the
only teeth resisting this movement are the four
t(D (Dt
remaining posterior teeth. I t may be expected, therefore,
that the forward movement of these teeth will exceed
the backward movement of the incisors and canines. t@ Q)t
B. When the canines alone are retracted the incisors take
part in the anchorage. Only two teeth are being moved
against an anchorage of eight teeth. Although these will B
inevitably undergo some slight forward movement, this
l will be small compared with the distal movement of the
canines.
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C. The canines now being in the fully corrected positions, 0' to
I; an appliance designed to retract only the four incisors
can utilize all the six remaining teeth as anchorage, so
producing a major movement of the incisors with little t(b (Dt
further forward movement of these teeth.

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 RESIST ANCE TO TOOTH MOVEMENT
(ANCHORAGE), 2

D. Distal movement of a buccal segment

Following extraction of an upper second molar the first
molar and both premolars of that side may be moved
distally, three teeth moving against an anchorage of njne
teeth. The labially displaced canine is not included in
either part of the appliance.

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RESISTANCE TO TOOTH MOVEMENT t~
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{ANCHORAGE),3

The proper application of extraora/ traction

A. At the commencement of extraoral traction designed to
move all the upper teeth posteriorly following extraction
of second molars, the labial arch is bent away from the
labial segment. All the exlraoral force is then directed
against the cheek teeth, which will move distally.
B. AI the completion of distil movement of the check
teeth the labial arch is bent back to rest against the
labial segment, not to press against it. When the extra-
B
oral force is applied the labial segment will move
posteriorly. At the next visit the labial arch will be seen
to stand away from the incisors until the extraoral force
~
I is applied. It can then once more be adjusted to rest
I against the anterior teeth.
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c. If the labial arch is adjusted (via the U-Ioops) to press
against the incisors, application of the extraoral force
will increase pressure on the incisors, but will not release
the forward force on the cheek teeth produced by the
tension in the U-Ioops. The anchorage problem
generated within the appliance is not removed by the
application of extraoral force.

54
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ACTIVATING THE CANTILEVER SPRING
.~~

A
A small, controlled and accurate amount of tension can
be given to cantilever springs by squeezing the coil in the
tips of the universal pliers as in diagram A. This
produces a slight flattening of the curve, exaggerated for
clarity in diagram B.

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58
THE SIMPLE CANTILEVER SPRING

The spring illustrated is moving an upper incisor 'over

the bite'.
The arm of the spring is set at right angles to the
intended path of the tooth to be moved and is left long
so as not to lose contact with the tooth towards the end
of its movement.
The coil is set ~lSfar away as possible from the tooth
to be moved.
The log is short and well within the thickness of the
acrylic.
The bite is raised on the cheek teeth either by a
thickness of acrylic resin or, as shown here, by a single
wire passing over the occlusal surfaces of the check
teeth. This is used where the thickness of acrylic capping
(sec I nset A) would be too little to stand the bite with-
out fracture.
Inset B shows the same spring adapted to move two
te,: .h

Co IstrLlction
-'prln gs: 0.5ml11 ' oxe'i-in
Retention: Adams .1SpSon 64/46
Bite-raiser: 1.0mrn wire or acrylic capping A
Base pia tc-:--.. Full palate

60
 ",

BOXING-If'1 \1

The purpose of boxing-in is to protect the spring from

damage and to act as a guide along which the arm can
slide. At the time the spring is constructed and tacked
to the plaster model with wax, it is covered with a small
amount of thin plaster which is shaped up with a knife,
care being taken to note the following points. 1
1. It should extend beyond the tip of the spring ,\I1d
should have a smooth outline.
2. It should have a smooth, flat upper surface.
3. It should continue this smooth, flat surface right in
between the teeth. 2
l
4. As the teeth move forward so the control exerted by
the capping is lost. I t is possible to use instead a guide
wire, as illustrated. This can be advanced as the teeth
move by squeezing the sides with pliers. The guide is
made of O.7mm soft stainless steel wire.
After appropriate protection the plaster is covered
evenly with baseplate wax and processing completed. A
check should then be made to ensure that the spring has
free travel without fouling any projection of the base-
plate.

62
PAIRED CANTILEVER SPRINGS

Where four incisors are to be moved over the bite, each

spring moves the central and lateral incisor nearest the
end of the spring.
Construction
Springs: O.Smm boxed-in
Clasps: O.7mm
Retention: Adams clclspson 64/4~~
Base pia te: Continued over all cheek teeth as capping

Inset A
This lateral view shows boxed-in spring and just
sufficient clearance to allow the upper incisors to move
forward without fouling the lowers.
Inset B
A double cantilever spring may be lIsed as an alternative
for the same tooth movement (O.6mm wire), but this
requires a greater degree of skill in adjusting.
B

64
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DOUBLE CANTI LEVER SPRI NGS

Forward movement of two upper lateral incisors may be

carried out by means of two sm,,11 double cantilever
springs which can be used to vary the direction of move-
ment, or where space for the spring is confined.

Construction
Springs: 0.5111111boxed-in
Clasps: Adams clasps on ~~j-=,§
Baseplate: Full palate (capping on cheek teetr if
the lateral incisors must pass over the
bite)
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Inset A
Lateral movement is produced by opening the right-hand
I
coil.

Inset [3
Forward movement is produced by opening the left-hand
coil.

66
THE KINKED CANTILEVER SPRING

Interference with the movement of the spring by the

palatal surface of a premolar may prevent a simple spring
moving a palatally displaced canine into the arch. This is
overcome by kinking the spring, which still behaves as a
lever pivoting on the coil.
Construction
Spring: 0.6 or 0.7mm boxed-in
Clasps: Adams clasps on 64/ 6
Baseplate: Full palate (capping-on cheek teeth if
the canine must pass over the bite)

Inset
1l10VC-
The position of the spring at completion of tooth
ment.

68
PREMOLAR RETRACTION SPRINGS

Two alternative springs are shown, one incurpora ting a ;.~~,

guide wire and one boxed-in, both moving the first prc-
molar distally into an extraction space.
Construction
Left side Right side
Springs: O.6mm O.6rnlll with guide wile
boxed-in
Clasps: Adams clasps Adams clasps on 06 .'
on ~J~ ,
Baseplate: Full palate Full palate, cut away
to expose spring
Inset
The spring must follow as closely (ISpossible over the
contact point.

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PALATAL MOVEMENT OF PREMOLARS AND
MOLARS

Buccally displaced teeth may be moved palatally by

means of springs passing between the teeth. On the left
an upper molar is being moved; on the right two pre-
molars are being moved, both using a buccally placed coil.
Materials
Clasp: 0.7mm
Spring: 0.6mm
Tape: 2.0 x 0.1 mm
Solder and flux
Construction
Springs: 0.6mm
Clasps: Adams clasps on'any cheek teeth not
being moved
Baseplate: Full palate, cut away to allow palatal
movement of teeth
Inset
This shows the level of the arm of the spring an d the
large coil in an alternative design where the spring is
attached to the molar clasp.
B

72

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 MESIAL AND DISTAL MOVEMENTS OF INCISORS

Four palatally placed fingersprings are used. .~

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A. This diagram shows distal movement, the position of the
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coil of each spring being carefully placed to carry the tt!'
tooth in the desired direction. Here the springs are 1(.'
boxed-in. ~~f
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B. This diagram shows mesial movement, but here the path
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of movement of the teeth is not only dictated by the 11,
-,'"
position of the coils of the springs but is guided by a
labial arch and a palatally placed guide wire which
prevents them 'wandering' in an anteroposterior plane.
The springs are not covered by the baseplate.
Construction
Springs: O.6mm
Labial arch: O.7mm
O.6mm A
Guide wire:
"1
Clasps: Adams clasps on 6/6
~
Baseplate: Full palate In A ___0
Full palate cut away in B

74
LATERAL MOVEMENT OF CANINES
~
.j

Simple cantilever springs are illustrated, the positioning

of the coil being dictated by the direction of tooth
movement. Both springs are uncovered and controlled
by guide wires, this facilitating insertion of the appliance
by the patient.
Construction
Springs: 0.6 or 0.7mm
Guide wires: 0.7mm
Clasps: Adams clasps on 6/6 .

Baseplate: Full palate, cut away to expose springs

and if necessary carrying bite platforms
on all the cheek teeth to allow the
canines to move over the bite

76
 LABIAL MOVEMENT OF CANINES

A covered canine spring is difficult for the patient to

insert if any degree of activation is applied: in this
appliance (designed by R. Hanney) the spring is kinked
in the middle of the arm and the baseplate is corre-
spondingly cut away. The spring thus has the protective
advantages of boxing-in yet the patient can engage the
kink with a fingernail and so compress the spring to
facilitate insertion of th{~ appliance.

Construction
Spring: O.6mm boxed-in
Clasps: Adams clasps on 6/46
Space-holding clasps-on <!?I O.6mm
Baseplate: Full palate, with cut-away in cover for
spring. Bite platforms where necessary

7'6

.........
DIST AL MOVEMENT OF CANINES ~~

Palatally placed cantilever springs are used, their coils

being placed so as to give movement of the canines along
the arch without displacing them either lingually or
buccally.
Inset
To avoid sliding down the mesial slope of the canine the
spring is carefully bent so as to fit between the lateral
incisor and canine and to take advantage of the flat
mesial surface of the tooth. Once movement has begun
it can be modified to fit round the neck of the tooth.

Construction
Springs: 0.7mm boxed-in
Clasps: Adams clasps on 6/6
Baseplate: Full palate ---

80
THE LABIAL CANINE RETRACTOR

This is one of the few springs in which the coil is made

to close rather than to open in action. The coil lies in
the labial sulcus.

Points to note
1. The end of the spring should be bent at a right angle
before being shaped to the curve of the tooth, like a
golf-club.
2. The loop should lie as high as possible in the sulcus
without interfering with any fold of soft tissue
commonly found in this area.
3. The tag should lie as close as possible to the second
premolar, and the posterior arm should not cut across
the first premolar position where it would interfere
with retraction of the canine.

Construction
Spri ng: O.7mm wire or O.6mm sleeved (see page 84)
Retention: Adams clasps on 6/6
Full palate, cut away to allow movement ,
Baseplate: !
of canines
B d
.~4
Inset A !
Shows (1) Posterior arm in contact with second pre-
molar and passing over the contact point of
this tooth.
(2) Golf-club end of anterior arm, sharpened at
tip.
Inset B
Shows (1) Path of action.
(2) Clear area behind the canine, unobstructed by
the spring.

82
 '&.
.'~i
SLEEVING THE CANINE RETRACTOR

1. Sleeve prepared (upper end chamfered).

2. Sleeve passed over the posterior arm.
3. Sleeved portion bent over to complete the posterior
arm and form the tag.
Materials 1
Spring: O.6mm hard polished stainless steel
Sleeve: O.6mm internal diameter soft (annealed)
stainless steel tube .

84

"'......
 .
- -
ADJ USTING THE RETRACTOR

7. Increasing the tension

As the coil is in the reverse direction to that of the
fingerspring it cannot be adjusted in the same way.
A B
Increased tension is rroduced by bending the anterior
arm using 'hollow-chop' pliers such as Marthews' or '.'
,
Andresen '5. ."
A. Position of the plier beaks on the anterior arm.
B. Resultant bend.

2. Lowering the spring on the tooth

'~
,~
C. Position of the plier beaks on the posterior arm. .,~,
D. Coil and anterior arm lowered. ",
3. Raising t he coil
E. Position of the plier beaks on the posterior arm.
F. Coil and anterior arm raised. This must be followed c D
by a downward bend of the anterior arm as ill A and
B.

~
~

E F

86
 ;...
THE CUT-AND-BEND SPRING
~'.'

Although the spring requires frequent adjustment, it can

be used where a low labial sulcus prevents the use of the
labial retractor described on pages 82 and 84, yet where
a palatal component of movement is needed. It is also
useful in lower appliances where there is rarely any
depth of sulcus. ~
The spring may touch the labial surface of the c.;anine \\
for palatal movement (as on left of illustration) but is
well clear of the tooth anteriorly except where the tip
touches the mesial aspect of the tooth.
To activate the spring the tip is bent back about 1mm.
When the tooth has moved by this amount, 1mm is cut
off the tip of the spring and the bend remade so,that the
shape of the spring is maintained (Inset B).
Construction
Spring: O.6mm
Clasps: Adams on §l~
Baseplate: Full palate
.~"'"
.«',
'\
IJ.:~""
',-."
"
'\,.II~
~
~

88
PALATAL MOVEMENT OF LATERAL INCISORS

Individual springs are preferred to a full labial arch which.

would foul the central incisors. Each spring is flattened
at the tip on an anvil, tapered in the anodic polishing
bath and bent to a golf-club and before adapting it to
the tooth. Pressure should be exerted as near to the tip
of the tooth as possible and the springs are activated ..
,,'\!
with hollow-chop pliers. '".

Construction
Springs: 1.0mm wire thinned to O.6mm
anodically
Retention: Adams clasps on 6/6
Baseplate: Full plate, cut away behind 2/2

90
THE SVED BITE PLATE ;~

This is illustrated in combination with canine retractors,

though it may be used alone. Pressureon the bite plane
by the lower incisors is transferred to the upper incisors
instead of to the soft tissues.

Construction
0.6mm sleeved ,"
Springs:
Retention: Adams clasps on 6/6
Baseplate: Full palate and cov"ering tips of upper
incisors, thickened to form bit.e plane

Inset A
This shows relationship of lower incisors to bite plane
which must be extended sufficiently to make it
impossible for the lower incisors to bite behind it. It is
necessaryto mount the models on an articulator for this
purpose,

Inset B
Should this open the bite on the cheek teeth by more
than 3 or 4mm, the plane should be lowered, and later
in treatment it can be raised by adding cold curing
acrylic resin,

92
 THE EFFECT OF A BITE PLANE

,,
A bite plane such as that used in the 5ved plate exerts a
variable force on the lower incisors depending on its
A
inclination. 42.59 (1. 50z)
A. A plane at 45° exerts as much forward force on the
opposing teeth asit exerts downward - for example, a 42.59 (1.50z)
force of 85g (30z) is divided into two forces each of
42.5g (1.50z). ,,'
B. A plane at 30° to the horizontal would divide a similar
force into 56.7g(20z) downward and 28.3g (loz)
horizontally.
C. A horizontal plane exerts all its force downwards.
It should be noted that the appliance itself receives
equal and opposi te pressures to those exerted on the B
opposing teeth.

0°

c
85g (30z)

94
-.. ,
t
r.
"~
j THE LABIAL ARCH
''t

I
I
I
;
I This, the simplest form of incisor retraction, is firm and

i positive in action but works over only a short range and

consequently requires frequent adjustment.
I The arch itself should make contact with the incisors
about half-way up the crowns; the U-Ioops lie over the
canines and should be tall enough to facilitate adjustment.
This is carried out by closing the loops with hollow-chop
pliers.
The baseplate is cut away a little at a time behind the
j incisors, keeping slightly in advance of their movement.
Construction
1
Labial arch: O.7mm wire
I Retention: Adams clasps on 6/6
Baseplate: Full palate-
i.'

l
i

96
\ \
 --" 'C',;;., 'o'-;"

THE LABIAL ARCH AS A RETAINER

:Jj/f"
"

The fitted labial arch

This is used to secure the incisors firmly after they have
bee'n rotated. It is here shown with a short steep bite
planeto maintain the position of the lower incisors
after they have been depressed (Inset B). .
Inset A shows the reverse loops which may be
employed with this arch or with the plain labial arch
when it is desired to control the position of the canines.
Construction
Labial arch: O.7mm wire
Retention: Adams clasps on 6/6
Baseplate: Full palate, thickened anteriorly to
form bite plane

>. .,
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~(

, ,

,""'"

98
 CONSTRUCTION OF THE ROBERTS RETRACTOR

The diagram shows how chamfered annealed stainless

steel tubing is slipped over the ends of the spring before
bending the posterior arms to form tags as in the con-
struction of the canine retractors.
I1I
Materials
0.5mm hard polished stainless steel wire I
I
0.5mm internal diameter bright annealed I
stainless steel tubing I

I
I

,llllllllllli
IIII

102
 THE ROBERTS RETRACTOR

This adaptation of the labial arch designed by G. H.

Roberts consists uf twO sleeved <:anineretractors ioined
to form an apron spring. It is suitable only for retraction
of the four upper incisors following previous retraction
of the canines. Forward relapse of the canines is
prevented by spurs on their anterior surfaces, contoured
to passincisally to the contact point.
The arch should lie half-way up the crowns of the
teeth (Inset A) and should extend only two-thirds of the
width of the lateral incisors; otherwise adjustment
becomes difficult towards the end of tooth movement.
The baseplate is cut away in advance of tooth move-
ment in the manner shown in Inset B.

Construction
0.5mm wire sleeved in 0.5mm internal
Retractor:
diameter soft stainless steel tubing
0.6mm wire I
Spurs: I
Adams clasps on 6/6
Retention:
Baseplate:
Full palate - I

illil
1
I 1111

I,ll
1

:llli 100
 APRON SPRINGS

I Il '!
' 'I
,
,!
l
-i- A high labial arch incorporatmg a step in each vertical
il '! arm carries a light wire spring which lies half-way down \
' 1l
the crowns of the incisors, If the incisors are spaced it is l
\
I important not to carry the arch too far across the lateral
11 ! incisors. . {
1III
I"
"1
After bending the spring into shape it is attached by
!; winding round the labial arch close to one of the angles,
~
I two or three tUrns being taken round each of the
N
horizontal and vertical arms (Inset A). It is activated by
1I
bending the upright arms of the apron spring with
hollow-chop pliers. The palate is cut away in advance of
the .tooth movement.

'..;t;:: h" fonstruction

#~t;: High labial arch: 1.Omm wire
:t Apron spring: 0.35mm
,- Retention: Adams clasps on 6/6 with
ancillary arrowheads on 5/5
Baseplate: Full palate -
inset B
ShoWsan individual apron spring to retract a central
.incisor. Here the spring is strapped on to the arch by
.:Srii1rHess
steel tape which is welded tightly round both
Wires.The spring is wound round the high labial arch
.".' I

pnbpth sides of the strap and again, loosely, at the ,.,

I ~posite~~d of the apron spring.
I

: 11,: ! IIII

104
11 II1 1111U11111111111
-~
,.

VARIATIONS OF, AND ADDITIONS TO, LABIAL

ARCHES

Sometimes,after the upper incisorshave been retracted,

it is found that the canine stands too far labially. The
'bridge spring' iIlustraled can be taped on to a 0.7mm
arch as at diagrams A and C or simply wound on as
shown at diagram B.
Materials
Labial arch: 0.7mm
Bridge spring: 0.35mm extra hard stainless steel
Tape: 2.0 x 0.1mm

B
~
C t

106
 ~ ~;
)'...
.
MORE V ARIA TlONS OF THE LABIAL ARCH

I
A. Flexible 0.7mm labial arch with bends to control the
canines.
IIII1
I B. Flexible 0.7mm labial arch with extended labial section
I1

li I1I1
I11
11

C, D.
to control canines. '

Flexible 0.7mm labial arches designed by J. R. E. Mills.

These may also be extended to control canines. They
:<b.j/
11 are activated mainly with the fingers.

..1
r

11
<hJ
AJJJ
.
I
I
I J
I
'
11
I
11

11 li

,;i I
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II
II
11 :: I

D
'I,
108
1:1

I1
11

..
 ill "

1.11: lit
THE INVERTED LABIAL ARCH
11 ,Il' 11111

:J
1
11
I
,I
1
'
..

I11 ..:.... I'I r

I Whilst lingually occluding upper incisors may be moved
'
'I1I 'I 1

111
.1

lIil
11

'I
I
t
'over the bite' by means of palatal cantilever springs
'I I I : alone, additional backward movement of the lower
I I i . incisors with an inverted labial arch greatly shortens
..
1.

treatment time. This arch exerts Class III intermaxillary

11
11

/11 Ildll
I :

,I
traction.
The bite is propped open on all the cheek teeth. It is
11 essential that a retrusive bite in the slightly open position
is taken and the models placed on an articulator before
bending the arch, the vertical arm of which should lie ':
well clear of the lower canine and premolar (Inset A).
I
The arch is activated by bending back slightly with I
,," I
the thumbs until the lower incisors will only just pass
behind it. As the mandible closes it swings forward
,.,ti'
," : I
f.~..
(Inset B) so that the arch is slightly flexed. The palatal
springs are simultaneously brought into action. It,
Construction
1.2Smm wire anodically .", ,/'
Inverted labial arch:
thinned to O.8mm wire or
sleeved as shown in Inset C
Palatal springs: O.Smm wire boxed-in
Retention: Adams clasps on 64[46 j
.~
Full palate and covering all
Baseplate:
cheek teeth sufficiently for A J

upper incisors tQ clear lowers ,~:

,;'.'
'0"

;!f;
.,,<C,

c ~
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","
i?-"".'

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W'
:.~

Il
i
:1

I) 110
 SPACE-MAINT AINERS

The appliance shown is to maintain the space for any

unerupted canine following extraction of first premolars.
Half-clasps aroLlnd the teeth adjacent to the space prevent
movement of the lateral incisors ancl second premolars.
The baseplate is cut away'well ckar of the erupting
canine and the tags of the half-clasps are placed so as to
allow further cutting of the baseplate if necessary.

'11 Construction
ill
Half-clasps: O.6mm stainless steel wire
III
Retention: Adams clasps on 6/6
Baseplate: Full palate -----

ill ! I
"

I1 I
I1I11

11
I I
11 i
!~
.

'j
,

!
!I
112
I
.~
:J

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I
J
 ~ ..
~~i.
EXPANSION SCREWS, 1 t'I
[ : 11
11,11 ,1"1 k-
,,
I , 1I

Direct lateral ex{x1nsion

ii I I;:::: 1IIIil The appliance shown is to move lingually, occluding
! I upper molars and premolars into normal relationship
with their opponents.
Correct placing of the screw is of the utmost
importance and the following points should be carefully
observed.
After plastering the screw according to the maker's
instructions it should be placed:
1. as deep in the palate as possible,
2. between the first premolars, .
3. with its long axis parallel to the occlusal plane,
4. at right angles to the median raphe.
Rate of activation
Using a screw with one end threaded, this is one
quarter-turn per day; a screw with both ends threaded,
one quarter-turn every other day.
Construction
Screw: A screw of hard metal such as stainless
steel, with guide pins intact, should be
used and its length should be adequate
Retentton: Adams clasps on 64/46
Baseplate: Full palate, divided down the centre
after processing

114

..
 EXPANSION SCREWS, 2

.I'
11 11
Radial expansion
1I I Lateral movement of the premolars and canines is
11

I . 11
achieved by uniting the two halves of the appliance
11
across the posterior border with a tie-wire so that the
appliance hinges at the back and opens fanwise. It
follows that the screw must open on a curve. Special
screws have been manufactured to permit this to take \
place, but it is quite satisfactory to use a loose, soft-
metal screw such as the Badcock screw with the guide I
pin cut off (Inset B).
The screw must be positioned as follows:
1. as far forward as possible,
2. as high in the palate as possible (Inset A),
3. at right angles to the median raphe,
4. with its long axis parallel to the occlusal plane.
Rate of activation
The screw is given one quarter-turn twice a week.

Cons truction
Screw: Soft metal with guide pin removed
O.9mm stainless steel wire I
Tie:
Labial arch: O.7mm stainless steel wire 11
Retention: Adams clasps on §/6
Baseplate: Full palatc, divided through the mid-
line after processing

116
;
~
i
 1' ijli! ".;
1
":/1
EXPANSION SCREWS, 3

Asymmetrical expansion
Correction of unilateral lingual occlusion of the cheek
teeth (and sometimes a canine and a lateral incisor)
presents problems in anchorage due to the tendency of
the lingually occluding side to resist movement more
than the normal side. The appliance illustrated raises the
bite on the cheek teeth on both sides and carries a lingual
flange on the normal side, to engage with the lower
cheek teeth and so to add them to the anchorage. A
short stainless steel screw should be used, placed near to
the centre of the segment to be moved, with its long {
axis parallel to the occlusal plane and at right angles to
the line of the cheek teeth. Spurs or half-clasps engage
W.
Rate of activation
The screw is usually turned at the rate of two quarter-
turns per week.
Construction
Spurs: O.6mm stainless steel wire
Screw: Short, stainless steel
Retention: Adams clasps on 64/46
Baseplate: Full palate, divided as shown and
carrying a smoothed-off biting section
on the small segment and a biting section
indented by the lower teeth and with a
lingual flange on the 'fixed' side

118

~II
 ASYMMETRICAL RADIAL EXPANSION

The illustration shows an appliance to regain space loss

in the region of a labially displaced lateral incisor.
As the appliance is joined by a tie at the posterior
il border a soft metal screw is used. The guide pin is I
11
removed and the screw angulated so as to lie along the I
circumference of a circle which has the tie as its centre.
As with all other screws, it must lie parallel with the
ill occlusal plane.
Rate of activation
The screw is turned at the rate of two quarter-turns per
week.
I
Construction
III Screw: Soft metal (8adcock type)
iI Tie: O.9mrn stainless steel wire
Spurs: 0.6mm on ill.
Retention: Adams clasps on 64/46
11 Baseplate: Full palate, divided as-shown

I'

I'

120
11

DIST AL MOVEMENT OF BUCCAL SEGMENT

~ 4
~
~

(SCHWARZ)
11

Distal movement of an upper buccaTsegment after

extraction of the second molar can be accomplished by
means of the appliance illustrated. A hard metal screw
is placed with its long axis parallel to the line of the
segment to be moved and to the occlusal plane. A short,
steep inclined plane is incorporated to assist anchorage
.
by applying some forward pressure to the lower incisors
(Inset). A spur or half-clasp on the left lateral incisor i
prevents this tooth drifting distally.
!
~
,~.
Rate of activation
I:
The screw is turned at the rate of one quarter-turn per
week.
Construction
Screw: Hard metal (stainless steel) with gu'jde
pin
Spur: O.6mm stainless steel wire
Retention: Adams clasps on 64/46
Baseplate: Full palate with anterior inclined plane,
divided by two cuts, one across the
screw and the other exactly parallel with
the buccal segment to be moved and
with the long axis of the screw

122
I
 111111
LABIAL MOVEMENT OF UPPER INCISORS
I
(SCHWARZ)
11
iill
I
Although this appliance is somewhat bulky it has the
merit that the screw can be adjusted by the patient. Tne
11
screw should be placed as close as possible to the
incisors and as low as possible without tilting and while
retaining parallelism with the occlusal plane (Inset).
11I11
Spurs or half-clasps are placed distally on 2/2 and
mesially on 3/3. ---
I
The bite is raised on all the cheek teeth so as to clear
the overlap of the incisors.
Rate of activation
The screw is turned at a rate of one or two quarter-turns
per week, the slower rate being used if the appliance
tends to slip off the teeth.
Construction
Screw: Stainless stecl, minimum bulk
11
Spurs: O.6rnrn on :3.)LXl
Retention: Adams clasps on ~4j!~
Baseplate: Full palate, with capping over molars and
premolars, divided transversely as shown

,"

I
I1II

124
 ROTATION OF A SINGLE TOOTH, 1 ~
11 tJ
:111
h
III
11
I Rotation may, with difficulty, be carried out by I
III
I using a 'couple' - a pair of springs exerting pressure in
I opposite directions on the mesial and distal corners of an
1\1 incisor tooth. Unfortunately, this frequently results in
'I' shortening of the tooth and is not applicable to canines
which are of unsuitable shape.
The long 'whip' or 'capstan' spring illustrated is
II111
attached to a standard twin-wire channel or W-Iock as
shown in Inset C. Construction of the band and channel
may be in welded stainless steel or, for those who do not
possess a welder, in white gold alloy which is soldered.
When first made, the spring will project from the
mouth and is held down by a projection from a separate
removable appliance (Inset A). which will usually com-
plete the alignment of the tooth without further adjust-
ment. Subsequently the spring may be kinked outwards
to continue the movement and over-rotate the tooth, so
reducing the retention period. This over-rotation usually
results in labial displacement of the tooth and if this is
expected a labial arch may be incorporated (Inset B). In
this case the retaining spur may be welded or soldered to
the arch.

Construction
Incisor band: 3.0 x 0.1 mm soft stainless steel tape
OR 3.0 x 0.15mm white gold tape
Channel: 3.0 x 0.1 mm (OR 2.0 x 0.1 mm)
stainless steel tape OR 3.0 x 0.15mm
(OR 2.0 x 0.15mm) white gold tape
Spring: 0.35mm extra hard stainless steel wire
Retaining spur: 0.7mm soft stainless steel wire
Labial arch: 0.7mm stainless steel wire
Retention: Adams clasps on 6/6 (or other
available teeth) -
Baseplate: Full palate, cut away from tooth to C
~~-§
be rotated
126
ROTATION OF A SINGLE TOOTH, 2
11

Although the appliance shown on page 127 may he

modified to suit rotation of a premolar tooth, the
appliance illustrated opposite offers more control as the
labial arch is extended distally to an attachment on the
molar clasp on one side. Such attachment may be made
by welding straps of steel tape over both arch and clasp
or by soldering. In this appliance the end of the rotation
spring is formed into a three-quarter collar around the
arch as shown' in Inset B. The thicker wire of the arch
forms a protection for the more vulnerable rotation
spring (Inset A).
At the completion of treatment by either appliance,
cold curing acrylic resin may be added to the cut-away
portion of the baseplate after removing the band and the
appliance converted to a retainer.
Cons truction
Premolar band: 3.0 x 0.1 mm stainless steel tape OR
3.0 x 0.15mm white gold tape
Channel: 2.0 x 0.1 mm stainless steel tape OR
2.0 x 0.15mm white gold tape
Strap: 2.0 x 0.1 mm stainless steel tape
Spring: 0.35mm extra hard stainl~ss steel wire
labial arch: 0.8mm stainless steel wire
Retention: Adams clasps on 6/6
Baseplate: Full palate, cut away around
premolar tooth

128

J'
 ft,
ROTATION OF A SINGLE TOOTH, 3
,
ft'

4<1
With the development of acid-etch preparation of
enamel prior to bonding with composite filling
materials, it has become possible simply to attach a "
spring to the labial or buccal aspect of a tooth (diagrams "
'.
A and B). The spring may be attached with carding wax 1
to an adjacent tooth while the composite sets. !
'"
Over-rotation
To achieve good final alignment it is common practice
to over-rotate and to retain in the over-rotated position a
for six months. To avoid displacing the adjacent tooth
it is necessary to bend a dog-leg in the spring as in
diagrams 3 and 4.
Construction
Spring: 0.35mm extra hard stainless steel wire
Composite: Any composite filling material B
suitable for acid-etch retention
Baseplate, etc: As on page 129,

3 4

~J ''''',.,'' ~ ~
:,:' "'''\t

130

,r'
 ROTATION BY CONTRA-ACTING SPRINGS

11

When two springs act in opposite directions on

opposite corners of an incisor tooth the force produced
is known as a 'couple'. Such an appliance is illustrated
and its purpose is to rotate the two lateral incisor teeth.
Some ingenuity is required to kink the springs and
the labial arch so as to follow the rotary movement of
the teeth (Inset). Nevertheless, such an appliance can be
effective, provided that slight shortening of the lateral
incisor is acceptable.
Construction
Springs: O.5mm stainless steel wire (boxed-in)
Labial arch: O.7mm stainless steel wire ,
Retention: Adams clasps on QUi
Baseplate: Full palate, relieved around 2/2

,,!I

I
I

132
 "',
''f
I

-::
EXTRAORAL TRACTION, 1 :.
st.;
..1#
"
"

f ;
I
\:
When it is necessary to retract the upper labial segment 1,
.J I
without exerting any forward force on the cheek teeth, ,,' I.
the appliance illustrated maybe used. It differs onIy in . I
1
its application from that shown in plan view on page
137. 1
I
Four clasps provide firm retention and a flexible
U-Ioop labial arch is attached distal to the canines, .r

taking care not to obstruct any distal movement of these "

I
teeth. The extraoral 'whiskers' are attached either by "

:!
strapping and soldering or by banding with soft wire and
soldering as shown in the Insets on page 137. The
junction of the labial arch and the extraoral arch is the
vulnerable point and it may be reinforced by sliding
tubing over the labial arch prior to bending.
Several forms of cervical traction can be constructed
with webbing and elastic but as ready-made neckbands
and neckpads (such as Orthoband) are easily available
and quite satisfactory it is this which has been illustrated.
Construction
Ex traoral arch: 1.25mm stainless steel wire
labial arch: O.9mm stainless steel wire
Retention: Adams clasps on §jl!~-

<ij CdbJbd Ud~

134
EXTRAORAL TRACTION, 2

Backward movement of all the upper teeth may now be

readily accomplished with removable appliances if the
second molars have bccn extracted; this applies also if
4/4 have been extracted and the space lost. Firm reten- I
-tion is required and a Coffin spring is used to increase I
upper arch width and so avoid development of a molar I
cross- bi te.
I
Movement is in two phases. The cheek teeth are I
moved distally in Phase I by opening the U-Ioops and I
standing the arch 2mm away from the incisors. In Phase I
11(retraction of the labial segment) the labial arch is
allowed to rest on the incisors but should not prcss I
until the elastic traction is applied. This avoids moving 1
thc cheek teeth forward again (sec page 55).
I
Construction .
Coffin spring: 1.25mm stainlcss stecl wire
Extraoral wires: 1.25mm stainless steel wire I
Labial arch: 0.9mm stainless steel wire
Retention: Adams clasps on 64/46 I
"
Baseplate: Two sections extcndlng from mesial J
of 3/3 to distal of 6/6 I I
Attachment of Strapping with 2.0 x 0.1 mm I
extraoral arms: stainless steel wire OR binding with
soft wire and soldcring

la

136
 ~
EXTRAORAL ANCHORAGE, 1

.
~

Forward movemenl of anchor teeth during retraction of

anterior teeth may be anticipated and prevented by
applying extraoral traction at night to a removable
appliance which is worn during the whole of the 24
hours.
The appliance illustrated carries a bite plane (Inset A)
and palatal canine retractors (boxed-in) with guide wire
(Inset B). Additional retention is provided by Adams
clasps on 1/1 (Inset C) (page 38) and modified Adams
clasps on 65/56 (page 40). The extraoral traction arch
is inserted into molar tubes and stands clear of the
incisors. It may be reinforced, as shown, by stainless steel
tubing before attaching the traction wires.
Construction
Canine retractors: 0.6mm stainless steel wire J.
Canine guide wires: 0.5rnm stainless steel wire
Anterior clasp: 0.6mmstainless steel wire
Adams clasps: O.7mrn stainless steel wire
Molar tubes: 1.25rnm internal diameter
Labial arch: 1.25mrn stainless steel wire
Extraoral ;Hch: 1.25mm stainless steel wire
Anterior tubing: 1.25mm internal diameter soft
Labial arch, tubing and extraoral arch strapped and A
soldered

\(

B ~

138
EXTRAORAlANCHORAGE,2
I

Class I1 division 1 treatment may need to be supported

by extraoral traction. The common sequence of canine
retraction with buccal canine retractors (page 84) and I
incisor retraction with a Roberts retractor (page 100) is , I.
illustrated opposite. Retention is by Adams clasps on 4
6/6 with auxiliary arrowheads on 5/5 but the alternative .'"
i
clasp illustrated on page 41 may beused.
Note: Normally the extraoral arms should lie in the
same plane as the arch but have been bent clear in .' ,I'
the illustrations to show details of construction.

Construction
Retention: Adams clasps on 65/56
Springs: Canine retractor 0.6nlm sleeved;
Roberts retractor 0.5mm
sleeved
Labial arch: 1.25mm stainless steel wire
Molar tubes: 1.25mm internal diameter
Exlraoral whisker: 1.5mm stainless steel wire

~
140
 THE SIMPLE CANTILEVER SPRING, 1

Partsof the spring A arm

A. A simple cantilever spring consists of three parts. The
tag is embedded in the acrylic resin of the supporting
baseplate. The coil is the active part of the spring and is
normally made so that it tends to open, rather than coil
close, in use. The arm of the spring undergoes only slight
JI
I bcnding and may be regarded as a rigid lever.
I
Direction of pressure
B. As friction between the spring and the tooth can be tag
ignored, the direction of pressure will always be at right
angles to the Mm of the spring and, if the spring has to
1
work over a long angular range, this will change con- B c=l==::::-::::-=::::-:
siderably during tooth movement. The path traced by ./-::;../'
the tip of the spring is known as the Path of Action. ./
.//
/
li C. The longer the arm of a spring the greater will be its ~
./
./
./
/'
/'
/

range of action. A short spring not only has a short

y-;::"./
range of action but, as it moves, its tip describes an arc
of a small circle. As its length increasesso this arc
becomes straightened and its path of action is nearer to
a straight line. As length increases, so the spring must be
made of thicker wire to exert the same force.
c Ac::=====c~I
,

\ \
\ \
\ \
\ '/ ,
\ 'l "-
// "-
\ 'l
\ Go-
'/
,
,
"
 1
EXTRAORAL ANCHORAGE, 3 "

The second stage of Class I1division 1 treatment follows

in the same way as the canine retraction. A Roberts
1 i
retractor is constructed as described on page 102 and a '! I
double Adams clasp made for 65/56. Some ingenuity is ". ,}
necessary to pass the tags of the retractor and the clasps , . , "",,..,,,,, h, , i
,r
,
between canines and first premolars. Tubes are attached t".'
/ I
I, ,I'
to the clasps (page 140) and a labial arch with U-Ioop § {

stops inserted into them: the bridges of the clasps may

have to be contoured so that the buccal tube will accept
the extraoral arch.
(
During treatment the baseplate is cut away behind
the incisors and it may be necessary to close the extra-
oral U-Ioops to bring the arch back and avoid discomfort
II \c':J ,/
t

to the lips. However, at no time should this arch rest on

the teeth: the tooth movement is produced by the
Roberts retractor.

Cons true tion

Retention: Double Adams clasps on 65/56
O.5mm stainless stcel wire !
Retractor:
Sleeve: 0.5mm internal diameter soft I
tubing I
Molar tubes: 1.25mm internal diameter
stainless steel I!
Extraoral arch: 1.25mm stainless steel wire i
Extraoral whisker: 1.5mrn stainless steel wire !
!
I
I

142
 ~
BUCCAL MOVEMENT OF PREMOLARS ,,-. "
," ..," 'c..~~

"

'.

The disadvantage of simple fingersprings to move '5

I
palatally placed upper premolars into the arch is that
they are extremely difficult for the patient to insert, the I
spring usually coming to lie on the occlusal surface of the
tooth. ~

The Adams T-spring illustrated falls into the correct

k
place as the appliance is inserted.
So that the T-piece will not slide into the gingiva as
the tooth moves, its initial contact must be near the
occlusal surface: it will slide gingivally as the tooth
moves. It is then boxed-in shallowly.

Construction
T-spring: Q.5mm stainless steel wire

144
.,~
INCISOR ELONGATION, 1 ~
..

Without access to bands and welders it has been ,11

impossible to exert vertical traction on teeth. The advent
of acid-etch retained composite resins has reversed this
situa tion.
A
Two methods are shown: on the left, a hook made of
stainless steel tape has been laboratory-welded to a piece
of fine stainless steel gauze (BS No. 155). This is cemen-
ted to the tooth by the acid-etch technique. This give"
a very positive hold to the spring.
On the opposite page is illustrated a simpler
technique in which a fairly thick ~Io.bof composite, I
resin is attached to the tooth and then grooved by means
of a number 1 or 2 fissure bur. Diagram D shows the
spring resting on the slot. B I
..
J

81

D
146
 INCISOR ELONGATION, 2

.
t
A simple removable itppliancc C,\l1be adapted to I
elongate incisors (or canines) which nMY have becn
delayed, for example, by a supernumerary tooth.
A simple sleevcd fingerspring is employed but it is
important to note the position of the coil so that the
arm will follow the tooth without slipping off. It i<. .~
activated by flattening a section of the coil. \
!,\(\.f
Construction
\," ",,\
Clasps: Adams on 6/6
Spring: 0.5ml11staliilcss steel
Sleeve: 0.5mm internal diameter soft stainless steel

"

. I
I
" 148
:~

;~ j
 Diagram 8
THE ANDRESEN APPLIANCE, 1 The appliance is shown here in plan view with a Coffin
spring in position. The appliance overlies the palatal half
of the occlusal surfaces of the cheek teeth.

This appliance consists essentially of an upper and lower

baseplate united together in such a manner as to hold
the mandible forward. It is used mainly in the treatment
of Class 11division 1 malocclusions, and tooth movement
is produced by the pull of the muscles of mastication t I
which try to return the mandible to its rest position. If
I
required the backward pull of the mandible can be I
reinforced by extraoral traction. This is shown in the ,
large illustrations to show the placing of the extraoral I
'whiskers', but it is required in only a relatively small
proportion of cases. ! rI
I
I
Diagra m A B
The Coffi n spri ng. I
I
Diagram C
The points of insertion of the labial arch and extraoral .~
wires.

c I

I
I

150
 ~ Diagram F
THE ANDRESEN APPLIANCE, 2 rull extension of the acrylic resin between the teeth
should be allowed, when cutting away from the occlu<,al
surfaces. In the mouth these extensions will bear on the
I
upper teeth as shown, causing them to move distally. I
Diagram D I
The baseplate is cut away behind the upper incisors but I
should not be removed from the tips of the lower
I
incisors. I
.

0 F I

I
Diagram G I

When the acrylic is cut away from the occlusal surfaces

of the lower teeth the interdental extensions act as I
I
shown, causing them to move mesially. I
Diagram E
f
Removal of the acrylic material from the occlusal
surf,lCcswill allow adjustmcnt of the occlusal level of
the check teeth.

E G

I.
152 .

,J
THE ANDRESEN APPLIANCE, 3

Construction
A bite is taken in the protrusive position, without
straining and open 2-4 mm. This is mounted on an
articulator and the appliance waxed as shown in
diagrams Band C. After trimming the models very I

closely they are flasked together as shown in diagram H. I

The reverse half forms a plug in the palate and a raised I
bite is impossible. The appliance is completed in the I
usual way.
Materials I
Baseplate: Deeply extended and thickened in
lower molar region, rising to clear
tre gingiva and contact only the :1
teeth in the lower incisor region.
Upper as shown in diagram A
. I
.
I
Coffin spring: 1.25mm I
I

Labial arch: O.8mmsleevedor 1.0mm anodical1y 11

thinned to O.8mm .:

Extraoral wires: 1.25mm

H
,I

I
I

I
,

154
THE ORAL SCREEN

The oral screen is an active orthodontic appliance worn

during sleep and tr,tnsferring the pressure of the
circumoral soft tissues to the upper incisor teeth. It is
ncccss,HY, therefore, to raise the screen away from the
dentoalveolar structures except those tceth to be movcu.
This is known as waxing out and is carried out as follows.
I. Wax is added to the areas shown, filling in anteriorly
to the lower incisors and into the other hollows
indicated.
2. A sheet of baseplate wax is applied to the whole Mea
except the most prominent upper incisors. .

3. !\ second sheet of wax is applied over the whole ,\rea

,Ind then scraped cIW,\Yover the tips of the prominent I
incisors, so thelt these protrude very slightly through I
the wax. I
2
4. After applying d separating medium a double thick- I
ness of wax is atbpted over the entire ,Hea ,\I1d
triml11ed aw,IY from allll1ucous folds. It should extend
distally no further back than the middle of the upper I
first molars. This is then removed anu converted to 11
lle.n (\crylic resin.
I
I
I
I
J
~
.

3 4

156