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Volume : II No. 4 - December 2011

ORIGINAL ARTICLE
TWIN - ARCH TECHNIQUE. APOS Trends in Orthodontics..
REVIVAL OF THE "EDGEWISE –TECHNIQUE"? ASIAN PACIFIC
ORTHODONTIC SOCIETY
Journal of the Asian Pacific Orthodontic Society

ABSTRACT :
The Twin – Arch Technique is based on the concept of orthodontic treatments with two arch
wires simultaneously, even with relatively low dimensions. This method allows you to
achieve a good three dimensional control of tooth movements.
The use of the Twin – Arch Technique requires a bracket apt to accept two arch wires
simultaneously. The new SNB – Bracket (- Swiss Non – Ligating Bracket) offers these
features. It consists of PolyEetherEetherKetone ( Known as PEEK ) and has two slots
arrayed vertically in a distance of 2 mm from each other. Two metal gliders hold the wires in
place. The low dimensions of the slots ( 0.0016 x 0,0022 inch ) offer a “Light – wire
technique”. Two arch wires inserted in the appropriate slots, one in a distance of 2 mm
vertically from the other, can be compared to an equal broad metal band. This treatment
technique can be used either lingual or labial.
The PolyEetherEetherKetone from which the SNB – bracket is fabricated has a Teflon – like
surface which assists in reducing treatment time due to its low friction coefficient. This
becomes evident especially in relapse cases, with crowding in the anterior region. If torque
is to be generated for a single tooth or a group of teeth, various solutions are at hand. The
Twin – Arch Technique controls efficiently, “the dreaded bowing effect” in extraction cases.
The SNB – Bracket brings a new dimension into the orthodontic world which is most
apparent in extraction cases. Its Teflon – like material has a very low friction coefficient thus,
reducing the treatment time considerably. Through the use of low dimensioned arch wires,
the Twin – Arch Technique becomes a Light – wire system and simultaneously provides
good anchorage and torque control.
KEY WORDS : Edgewise Bracket - Twin-Arch Technique - Low Dimesioned Slots.

The treatment technique to work with two arch wires simultaneously is not new. The
background of this idea was to achieve a better control of the teeth movements. In the
literature you will find very little reference to that type of technique. Only in the 1930s
attempts were made to develop a new treatment method with this concept. Spencer
Atkinson was the pioneer. He created a bracket with a vertical and a horizontal slot,
positioned one on top of the other. 1 A documentation of a finished extraction case which
was treated with his Twin – Arch Technique can be found as an article of Robert Yudelson
in the American Journal of Orthodontics, - March 1967 edition under the title “ The
Universal appliance “ 2). The achieved result with relatively short treatment time is very
impressive. Unfortunately, this treatment concept did not gain acceptance.

Recently a new bracket has appeared on the market – the so called SNB – Bracket (Swiss
Non – Ligating Bracket). It consists of PolyEetherEetherKetone (Known as PEEK). This
new bracket is completely different from all the other conventional brackets. (Fig. 1). It
was designed to accept two arch wires simultaneously. This means that besides the base
arch, you can add a second arch wire at any treatment phase.

SNB - Bracket made of JACOB KARP

PolyEetherEetherKetone PRIVATE PRACTICE
RÄTERSTR. 20
D - 85551 HEIMSTETTEN, GERMANY
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Volume : II No. 4 - December 2011

APOS Trends in Orthodontics..

TWIN - ARCH TECHNIQUE.
REVIVAL OF THE "EDGEWISE –TECHNIQUE"?
ASIAN PACIFIC
ORTHODONTIC SOCIETY
Journal of the Asian Pacific Orthodontic Society

This bracket utilizes two metal gliders for its double slots. As a
result of this it can be considered as an easy handling self -
ligating bracket. ( Fig.2). It has no built –in devices as tip, toque
or angulations that you normally find in L. Andrews “ Straight –
Wire –System”.(Fig.3)3+4 . In contrast to the values of the
SWS, the construction of the SNB – Bracket is based on the
different angulations that the German anatomist
G.H.Schumacher had found ( Fig.4)5. I consider this more
relevant from a static point of view, looking at the lines of force
action.(Fig. 5+6).

H.G. Schumacher : the functional anatomie

Opening and closing mechanism

Mild curve of Wilson and mild curve of Spee

A.L. Andrews : Six keys of normal occlusion
The low dimensions of the SNB slots (0.016 and 0,016 x 0,022
inch) accept arch wires with a maximum size up to 0,016 inch.
For that reason, new arch wire sizes had been developed to
guarantee a real Light – Wire –System. In the first stage of
leveling the use of a NiTi wire of 0,00725 inch is recommended.
After the force of this wire had been transmitted to the teeth, a
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Volume : II No. 4 - December 2011

APOS Trends in Orthodontics..

TWIN - ARCH TECHNIQUE.
REVIVAL OF THE "EDGEWISE –TECHNIQUE"?
ASIAN PACIFIC
ORTHODONTIC SOCIETY
Journal of the Asian Pacific Orthodontic Society

the following bracket in the gingival slot (or vice versa ) you
make it work actively or passively (Fig.10 passive and Fig.11 –
12 active). In general, during the first phase of leveling, only
one arch wire is used. If more anchorage is required you can
enhance it by adding a second round wire (or eventually a
square sectional wire - Fig. 13). Two arch wires inserted in the
appropriate slots, one in a distance of 2 mm vertically from the
other, can be compared to an equal broad metal band thus,
creating a high amount of stability. You can see on the Figures
14 and Figure 15, that according to the different angulations of
the premolars and canines, the special shape of the SNB –
Brackets allows insertion of a straight wire (no mushroom form
needed) in the gingival slot.

Mild curve of Spee in a finished case

Two arch wires simultaniously

Choice of arch wires

NiTi size of 0,00915 was next. That means, you get a

measurable increase of 60% of the force of magnitude and not
the “next arch wire size”. The choice of the arch wire sizes
SNB - Brackets placed on the lingual side
continuous from 0,011 to 0,0131 through 0,016 inch and, at
every step you always get an increment of 60% of force. After
leveling has been accomplished, you might also switch to
stainless steel wires. Their low dimensions guarantee easy
bending procedures.

The Twin- Arch-Technique was derived from the Two

Dimensional – System and it utilizes treatment procedures with
only round arches. (Fig. 8). Basically the SNB – Bracket was
developed as a pure lingual bracket for minor movements
(especially on the lingual side) in tip, torque and angulations
that have less importance ( Fig. 9 ). The positioning of the
bracket is according to the anatomical situation which is not
always easy. If you insert an arch wire in the incisal slot and in
Arch wire pasivve
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Volume : II No. 4 - December 2011

APOS Trends in Orthodontics..

TWIN - ARCH TECHNIQUE.
REVIVAL OF THE "EDGEWISE –TECHNIQUE"?
ASIAN PACIFIC
ORTHODONTIC SOCIETY
Journal of the Asian Pacific Orthodontic Society

Arch wire active and passive

Straight arch wire. Shock-absorber, for bracket protection

In lingual treatments, extraction cases represent problems. For

that reason, after the first leveling, the SNB offers the possibility
to work with two arch wires simultaneously. As soon as the
situation allows it, you can switch to SWS wires because in the
relatively thin wires, coordination bends are easily incorporated
(Fig.16). If torque is needed, it is best to use two arch wires in
concert with each other. One wire is placed with protrusive
Arch wire active action in one slot. With a second wire inserted in the other slot
you pull distally. (Fig.17-18).With this procedure one can
torque a single tooth or a group of teeth.

Sectionals for enhancement of anchorage

Coordinated arch wires

No mushroom form necessary

The principles of the torque
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Volume : II No. 4 - December 2011

APOS Trends in Orthodontics..

TWIN - ARCH TECHNIQUE.
REVIVAL OF THE "EDGEWISE –TECHNIQUE"?
ASIAN PACIFIC
ORTHODONTIC SOCIETY
Journal of the Asian Pacific Orthodontic Society

Left - arches passive; right-arch wires active

Treatment of extraction cases on the lingual side, normally

create difficulties. The only logical consequence was to place
the SNB – Brackets on the labial side. (Fig.19).The sequence of Activation and space closure
the Fig. 20 to Fig. 29 shows perfectly how the “dreaded bowing
effect” can be controlled even with low dimensioned arch
wires. The next step to place the SNB –Bracket even on the
labial side of the maxilla was unavoidable. With adequate
angulations of the brackets for the four upper front teeth, the
missing pre - adjustments were sufficiently compensated.
(Fig.30). Pre - adjusted brackets for the upper front teeth will
certainly soon be in the company’s program.

Extraction case

SNB-Brackets on the labial side

Bowing effect

After the extraction two NiTi 0.0131 inch for space closure In the maxilla one wire only, in the mandible two arch wires
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Volume : II No. 4 - December 2011

APOS Trends in Orthodontics..

TWIN - ARCH TECHNIQUE.
REVIVAL OF THE "EDGEWISE –TECHNIQUE"?
ASIAN PACIFIC
ORTHODONTIC SOCIETY
Journal of the Asian Pacific Orthodontic Society

Uprighting of the canine with two arches

No dreaded bowing effect through two simultaneous arch
wires

In the mandible labial, in the maxilla lingual

Final space closure

Two arch wires - labial and lingual Left: brackets angulated Right : after leveling
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TWIN - ARCH TECHNIQUE.
REVIVAL OF THE "EDGEWISE –TECHNIQUE"?
The Twin – Arch Technique is especially apt for space closure
after the extraction of a lower front tooth. The two
simultaneously inserted arch wires support the parallel bodily
space closure (Fig. 31 - 34).
Large space after extraction of one lower incisor
Tooth 46 is missing
Start of treatment with pontic in place
Volume : II No. 4 - December 2011
APOS Trends in Orthodontics..
ASIAN PACIFIC
ORTHODONTIC SOCIETY
Journal of the Asian Pacific Orthodontic Society
Bodily space closure through "Tandem-Effect"
The PolyEetherEetherKetone from which the SNB – Bracket is
fabricated has a Teflon – like surface which assists in reducing
treatment time due to its low friction coefficient. This becomes
evident especially in relapse cases, with crowding in the
anterior region. The figures 35 – 37 show the extremely short
treatment time (within 3 weeks!) of a relapse case due to the
reduced friction.
Bodily space closure
Relapse
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Volume : II No. 4 - December 2011

APOS Trends in Orthodontics..

TWIN - ARCH TECHNIQUE.
REVIVAL OF THE "EDGEWISE –TECHNIQUE"?
ASIAN PACIFIC
ORTHODONTIC SOCIETY
Journal of the Asian Pacific Orthodontic Society

First arch wire change

End of treatment after three weeks

After all the described advantages of this bracket, as well as its

esthetic effect, has to be mentioned. The compositions of the
colors do not diverge significantly from the average color of the
tooth enamel. Finally the economic factor is also not
insignificant. You can use it either on the labial or on the lingual
side or a combination of both, according to your requirements.
All in all – this is a very interesting treatment concept which has
certainly a lot of potential to ensure continuous improvement
for success.

REFERENCES
1. S.R.Atkinson. Patent recognized Sept. 1. 1931
2. R. Yudelson American J. of Orthodontics Vol.53 No.3 March 1967
3. Andrews L.F. Six keys to normal occlusion. American J. of Orthodontics 62: 296-309
4. Andrews L.F. The straight – wire appliance: origin and controversy, commentary. J.Clin.Orthod.
1976; 10: 99 – 114.
5. Darstellung der Occlusionsebene, Spee’sche Kurve Kompensationskurve und
Winkeleinstellungen, Angulationen der Zähne zur Occlusionsebene ( Schumacher, G.H., Die
Funktionelle Anatomie des orofazialen Systems, Hütting Verlag, Heidelberg 1985) (Footnotes)