Z-Spring

Lab: 2
The name is self-explanatory as the spring is bent into the shape of a 'Z' with two coils. It is an
active component of removable orthodontic appliance (palatally situated). It is used to push one
anterior tooth from the lingual (palatal) side in a labial direction (linguo- labially or palato-
labially).

COMPONENTS
1. Three equal arms, the first of them (active arm) has a non-traumatic end in the shape of a
small coil directed incisally or occlusally to prevent trauma to the soft tissue. This arm is
directed to the mesial side.
2. Two coils 2-3 mm. in internal diameter to increase the flexibility of the wire and decrease the
applied force. The direction of first coil should be opposite to second coil (if the first coil is
upwards, the second coil will be directed downwards) to keep the spring in one plane.
3. Retentive arm (tag): It is that part which is embedded in the acrylic base plate for retention of
the spring into the acrylic. It is zigzag in shape and parallel to the palatal midline.

PROPERTIES
1. Constructed from 0.5 mm hard stainless steel wire for incisors and 0.6 mm for canines.
2. Its width is equal to the mesiodistal width of the tooth from the contact areas.
3. The active arm sits on the cingulum and the level of the coils with the arms should be
perpendicular on the palatal aspect of the tooth to prevent slippage of the wire.
4. The spring is covered by a thin layer of acrylic called boxed-in, to prevent food stagnation in
the area during eating, damage to the wires slippage of the spring in an incisal direction.
USES
1. The main use is the correction of an anterior crossbite of one tooth (proclination of an in
standing incisor).
2. Correction of rotation of one incisor less than 90° together with a Hawley arch (couple force
system).

ACTIVATION
The active arm is pulled by the Angle pliers upwards and forwards so that the spring is
activated in a 45° to the base plate (the spring should be kept perpendicular on palatal surface of
moved tooth) so that it will not interfere with the path of insertion.
This activation will open the coils so that the distance between the active arm and the third arm
increases by 2 mm. This gives a small force for tooth movement for a long duration (2-3
weeks).
ANTERIOR ANCHORAGE
It is important to put additional retentive clasps on the anterior teeth, e.g.: (Adams clasp on the
adjacent incisor, Adams clasp on 4│4 or C-clasp on C│C).

DESIGN OF REMOVABLE APPLIANCE

1. Z-spring
2. Adams clasps on 6│6 and 4│4 (or D│D).
3. Hawley arch: it must be included in cases of rotated incisors (couple force system) and in
cross bite (to control amount of tooth proclination).
4. Acrylic base plate.
5. Posterior bite planet (in case of anterior crossbite).

ALTERNATIVES
1. T-springs when space is very limited as in the premolars.
2. Screw.
MODIFICATION
The modified Z-spring has a non-traumatic end, extending on the labial surface of the incisor or
canine to give a slight mesiodistal movement in addition to the palato-labial movement.
 Recurved Z-Spring
Lab: 3
The basic form is a combination of two Z-springs joined at the anterior region to form one
active arm. Its properties are similar to Z-spring.

COMPONENTS
1. One large active arm
2. Four small connecting arms
3. Four equal coils each of them 2-3mm in internal diameter.
4. Two retentive arms.

PROPERTIES
1. Constructed from 0.5mm hard stainless steel wire.
2. Its width is equal to the mesio-distal widths of the teeth to be moved measured from the
contact area (as in Z-spring)
3. The level of the coils with the arms should be perpendicular to the palatal aspect of the teeth.
4. The spring is covered by a thin layer of acrylic.
5. The outer coil should be opposite in direction to the inner coils to keep the spring in one
plane.
6. The inner coils are separated by 0.5-1 mm.
USES
1. Correction of crossbite of more than one incisor.
2. Correction of mild rotations and irregularities of more than one incisor together with a
Hawley arch (couple force system).

ACTIVATION
Similar to the Z-spring by opening the four coils. So that the active arm is 2 mm anterior than
the passive state and also must be kept perpendicular on the palatal surfaces of moved teeth
otherwise it will not procline the teeth and slippage will occur.

DESIGN OF REMOVABLE APPLIANCE

1. Recurved Z- spring
2. Adams clasps on 6│6 and 4│4 (or D│D).
3. Hawley arch: it must be included in cases of rotated incisors (couple force system) and in
crossbite (to control amount of tooth proclination).
4. Acrylic base plate
5. Posterior bite plane in case of anterior crossbite.

ALTERNATIVES
 Screw.
 Finger Spring
Lab. 4&5
It is an active component of removable orthodontic appliance (palatally situated).

USES
It is used for mesiodistal movement of any tooth (incisors, canines, premolars and even molars)
which is located within the line of the arch. However, it is mostly used for distal movement of
canines.

TYPES
1. Simple finger spring (self-supported finger spring)
2. Guarded finger spring (supported finger spring)

COMPONENTS
1. Coil
a) Internal diameter: 3-4mm.
b) Direction: It should be directed opposite to the direction of teeth movement so that when
activated the coil will be opened.
c) Location: The coil is located by drawing a line perpendicular on the line of occlusion from
the midpoint of the mesiodistal width of the tooth to be moved, and about 2mm away from the
palatal midline.
d) The coil is wound in a way that the active arm becomes upwards and the tag becomes
downwards so that can be activated more easily.
2. Active arm
a) It begins from the coil and continues to the labial or buccal aspect of the tooth.
b) It should end with a non-traumatic coil and can have a C-shape well adapted to the labial
surface of the tooth for better engagement of the tooth and to keep the tooth movement within
the line of the arch.
c) For canine, the active arm has a crank located away from the coil, while for other teeth it has
a small curve near to the coil.
d) When space is limited, the active arm is bent or a crank is added as a compensation for
placing the coil more distally and this will keep the active force parallel to the line of occlusion.
3. Tag
a) In the simple finger spring: The tag forms a zigzag shape, 5-6 mm long, parallel and 2mm
away from the palatal midline and elevated about 1mm from the palate for embedding in the
acrylic.
b) In the guarded finger spring: The tag (which starts with a guard) begins, about 2mm away
from the coil, with a small U- loop (2mm wide and 2mm long) and then extends below the
active arm parallel to the line of the arch 2mm away from the teeth, and ends with a small L-
shape. The guard prevents palatal displacement of the active arm and trauma to the mucosa.

ACTIVATION
1. The simple type is activated by opening the coils using an Angle pliers so that the tip of the
active arm is deflected 2mm or one third the mesiodistal dimension of the tooth to be moved to
give a small force for tooth movement (25-30g) for a 2-3 weeks duration.
2. In the guarded type, activation is done so that the tip of the active arm is deflected half the
mesiodistal dimension of the tooth to be moved to give a small force for long duration (3-4
weeks).
DESIGN
1. Two finger springs on 3│3
2. Two Adams' clasps on 6│6
3. Fitted labial arch on 1│1
4. Acrylic base plates

DIFFERENCES BETWEEN SIMPLE AND GUARDED FINGER SPRINGS

ADVANTAGES OF GUARDED FINGER SPRING

The active arm of the guarded spring is more:
1. Flexible in the horizontal direction because it is made of 0.5mm hard SS wire less
number of visits.
2. Stable in the vertical direction because it is located between the acrylic and the guard
prevents trauma to the palatal mucosa.
 Buccal Canine Retractor (BCR)
Lab. 6 & 7
USES
Simple BCR is used for distal movement of a mesially inclined canine which is located within
the line of occlusion, while modified BCR is used to move the mesially inclined buccally
malposed canine distally and palatally. It is particularly suitable in situations where the canine
overlaps the lateral incisor labially. Sometimes, BCR is used to retract the premolars, especially
in the lower arch.

COMPONENTS
Simple BCR: It has:
1. Main coil.
2. Mesial arm ends with a small non traumatic coil (acts as a site of force application)
3. Distal arm.
4. Occlusal part (extends over the contact area between 1st and 2nd premolars).
5. Tag (retentive arm).

Modified BCR: It has the same components of simple BCR but instead of a small non traumatic
coil, the mesial arm ends with a small U-loop and C-shape (act as a site of force application).
PROPERTIES
1- The main coil of 3-4 mm in diameter, it should be:
 located just distal to the long axis of the canine.
 2 mm away from the deepest part of the buccal vestibule.
 0.5-1mm away from the buccal mucosa to avoid trauma.
2- The mesial arm extends in a straight shape from main coil till reach the mesial aspect of
the crown of the canine which ends with either a small non traumatic coil or a small U-
loop (both of them should be located in the interdental area and as near as possible to the
cervical part of the crown)
3- The distal arm extends in a curved shape from the main coil till reaching the contact area
between the 1" and 2nd premolars (the purpose of the curved shape is to apply a
horizontal force that leads to distal movement of the tooth).
4- The tag extends in a straight shape and well adapted on the palate and ends with a small
L-shape towards the palate (to provide enough room for the acrylic beneath the tag also
to prevent rotation of the wire inside the acrylic).

Both types of the BCR could be:

1. Self supported (0.7 mm) or called non-sleeved type.
2. Supported (0.5 mm or 0.6 mm) called sleeved type, in which the main wire inserted inside a
stainless steel tube with internal diameter 0.7 or 0.8 (from the beginning of the distal arm till the
end of the tag), the purpose of the sleeved type is to combine between the increased flexibility of
the main wire and the increased rigidity of the sleeved distal arm and the tag, so we can
decrease the interval between visits and decrease possibility of deformation of the spring and
trauma to soft tissue.
 5- The C-shape in modified BCR usually located in the middle of the crown and parallel to
the line of occlusion and should be well adapted to prevent trauma to the soft tissue and
food stagnation.
6- The spring should touch the dental cast in 3 points only (site of force application,
occlusal part and the end of the tag).

ACTIVATION
 Self-supported type close the active coil so that the mesial arm reaches 1/3 of
the mesiodistal width of the crown every 2-3 weeks.
 Sleeved type reaches 1/2 of the mesiodistal width of the crown every 3-4 weeks.
 In modified BCR we should activate mesial arm (with the U-loop and C-shape) palatally
to gain palatal movement in addition to distal movement.

DISADVANTAGES
1. Liable to deformation because, the spring is suspended buccally, therefore there is a high
possibility of trauma to the surrounding soft tissue.
2. Difficult to construct and adjust.
3. Uncomfortable to the patient (as it suspends buccally).
4. Esthetically not acceptable.

MODIFICATIONS
 Sleeved type ■ Can be soldered to the bridge of Adams' clasp.

NOTES
1. When the canine lies within the line of occlusion, we prefer to use finger spring over BCR
because:
a) The finger spring is protected by the acrylic, so it is more stable; less traumatic and more
comfortable to the patient.
b) Easier to construct and adjust. c) More esthetic.
2. The impression must be well muscle trimmed to help the technician position the coil so that it
is not likely to cause trauma to the sulcus and does not conflict with the muscle attachment in
this area.
 Fitted Labial Arch (FLA)
Lab. 8
Its name means fitted to the labial aspects of the teeth (incisors). It differs from Hawley arch in
that it is more adapted to the teeth while Hawley arch only touches the labial aspects. This
offers good retention on proclined upper incisors but it is less satisfactory on upright teeth. The
more severe the proclination, the more incisal position of the horizontal arms.

FUNCTION
1. Anterior retention.
2. Increase the Anchorage.

USES
It is used in the upper incisor region and rarely used for lower incisors because it is constructed
from 0.7 mm HSSW, i.e. it is considered to be rigid for the lower incisors due to their small
size.

COMPONENTS
1. Small U- loop 2 mm in width and height engaging the embrasure area between two adjacent
teeth (e.g, undercut area between 2 centrals). It should be away from the interdental papilla by
at least 0.5 mm to prevent trauma to it.
2. Two horizontal arches adapted to the labial surfaces of the incisors; at the level of the
junction between the incisal and middle thirds of the incisors.
3. Two small vertical arms extending from the horizontal arms and joining to the retentive arms.
They must pass over the contact areas between the central and lateral incisors to prevent
interference with opposing teeth.
4. Two retentive tags should be adapted in between the two teeth palatally to prevent the
interference with opposing teeth. Then the tags adapt to the palate (rugae area) being about 2
mm away from the palatal midline. They end in a small L-shape (0.5 mm) directed towards the
cast to allow space for the acrylic.
ADJUSTMENT
This is done by slight squeezing of the U-loop with a slight bending towards the labial surface
of the incisor teeth to increase the engagement in the undercut embrasure area, this done usually
every orthodontic visit (2-3 weeks).

MODIFICATION
1. The U-loop can be located between any two incisors or between incisors and canines. With
this modification, the clasp is not kept incisally but lies halfway up the labial face of the incisors
where some undercut may more easily be engaged between the teeth. This is important as the
greater length of wire renders the clasp more flexible and makes it necessary to engage a deeper
undercut.

2. Proclined incisors provide too much undercut at the gingival margin. A simple fitted wire
gives good retention on proclined incisors (eliminating the U-loop)
3. Small coils can be added to the fitted labial arch to receive J- hooks for extra-oral traction.
 ADAMS' CLASP
LAB. 9
In 1949, Dr. C. P. Adams introduced the most important, best-designed clasp for orthodontic
appliances. It is very important because nearly all removable appliances have adams' clasps; it
is the major retentive component of the appliance in the patient's mouth (and therefore aids in
anchorage and allows the active components to work properly).

COMPONENTS
1- Bridge:
Its height should be equal to 1/2 of the anatomical crown or at the end of the buccal
developmental groove. Its width is equal to the distance between the mesiobuccal and
distobuccal cusp tips. The bridge should form 45° with the long-axis of the tooth because:
 The u-loop will be engaged into available undercut areas. The best undercut Area is
located below the tip of the cusp tip
 It will be non-traumatic as above 45◦ is traumatic to the cheek and below 45°It will
interfere with opposing teeth.
2. U-loops:
• situated at the available undercut area.
• height equals half the height of the bridge.
• it forms 45° with the bridge.
3. Occlusal part:
It contains 3 angles:
 angle A: it determines the angle of The bridge.
 angle B: located at the occlusal contact area between 2 adjacent teeth on the buccal side.
 angle C: located at the contact between 2 adjacent teeth on the lingual or palatal side.
4. Retentive arms:
Located at the lingual (palatal) side, ending 2mm away from the palate midline and ended with
small L-shape to provide enough amount of acrylic below the tag and preventing its
dislodgement from acrylic, the mesial one can be straight, while the distal one should be curved
mesially to decrease the palatal extension of acrylic and minimizing discomfort to the patient.

PROPERTIES
 It is a neat clasp, constructed with one pair of pliers only (Adams' pliers).
 It utilizes minimal space in the buccal vestibule.
 Its bridge is used as a grasp for removal of the Appliance. The bridge can receive a lot of
modifications and attachments.
 It is constructed from 0.7mm hard stainless steel wire.
 It can be used on any tooth except lower permanent and deciduous incisors. However,
when the centrals are very proclined, then the U of Adams' clasp will be difficult in the
insertion of the appliance so we use a fitted labialarch.

MODIFICATIONS
1. It can be-done as double Adams clasp on 5 and 6.
2. It can be done with one U-loop and the other U-loop omitted, especially on tilted molars or
partially erupted molar.

3. We can do it on a molar and solder to it half an Adam's clasp done on an adjacent tooth
ending with 3 U loops.

4. ATTACHMENTS: The bridge of the Adams clasp can have several modifications, we can
add:
 A hook which can receive inter or intra-maxillary traction elastics or whip spring.

 A small coil or tube which can receive sliding Hawley arch or the inner bow of the face bow.
5. Buccal canine retractor or Hawley arch may be soldered to the bridge of the Adams' clasp.

ADJUSTMENT
The Adams' clasp is checked every visit for loosening and adjusted as necessary so that the U-
loops fully engage the undercut. This is done by decreasing angles A, B, or C (mostly B or C)

Note: Sometimes, frequent adjustment by decreasing these angles cannot be done due to
interference with insertion and removal of appliance, so we can do some approximation of the
U-loops toward each other to increase their engagement to the undercut and hence increase
retention.

FRACTURES AND REPAIRS

If it is not skillfully made and adjusted, the wire may become excessively work hardened and
will be liable to fracture. Fracture at the arrowhead can sometimes be repaired by soldering. The
other common site of fracture is where the wire passes across the occlusion and, should this
occur, it is best to replace the clasp.
ALTERNATIVES
1. Arrow-head clasp
2. Ball-end clasp

ADDITIONAL RETENTION
1. Fitted labial arch
2. C-clasp

STEPS OF CONSTRUCTION
1. Take 10 cm of stainless steel wire and make it straight.
2. Make a 90° angle near the centre.
3. Make another 90° angle to determine the width of the bridge.
4. Make a U-loop on the mesiobuccal corner to determine the height of the bridge.
5. Bend the U-loop 45° to engage the mesiobuccal corner of the tooth.
6. Repeat the steps 4 and 5 on the distobuccal corner.
7. Make a sharp bend 1/2 – 2/3 of the bridge height towards the mesial marginal ridge of the
first molar at its occlusal surface to determine the bridge angulation.
8. Pass the wire at the marginal ridge between 6 and 5.
9. Make the mesial tag and finish it vertical to the palatal surface 0.5mm for space of acrylic.
10. Repeat steps 7, 8 and 9 on the distal arm.
11. Bend the distal arm mesially to minimize acrylic size in the horse shoe design.
Notes: We need to trim the cast mesially and distally at the points of undercut in the tooth to
allow for engagement of the clasp in them.
 Hawley Arch
Lab: 10
An important and very common labial bow, designed by Dr. Hawley in the 1920's to be used on
the anterior teeth as a retentive and /or an active component.

COMPONENTS
1. Smooth curve bow: are starts from the mesial third of one canine to the mesial third of the
canine on the other side. Its height is at the junction between the incisal and middle thirds of
incisors.
2. Two U-loops:
 The width of the U-loop is from the junction between the mesial and middle thirds of the
canine to the distal proximal surface of the canine.
 The height of the U-loop must extend 2 mm apical to the gingival margin of the canine.
 The U-loop should be 1-2 mm away from the gingival tissue to be non traumatic.
3. Occlusal parts: The free end of the U-loop should cross over the contact area between the
canine and 1st premolar to form the occlusal part which must be very well adapted to prevent
the interference with the opposing teeth.
4. Two retentive tags: They follow the curve of the palate and end by 0.5 mm vertical bend on
the palate (L-shape), about 2 mm away from the mid-palatal suture.
USES OF THE HAWLEY ARCH AS A RETENTIVE COMPONENT
1. To increase the retention and anchorage in the anterior segment.
2. To construct Hawley retainers which consist of Hawley arch on the anterior teeth, Adams'
clasp on the 1 molars, and acrylic base plate. These retainers are used to maintain the teeth in
their position following orthodontic treatment.
USES OF THE HAWLEY ARCH AS AN ACTIVE COMPONENT
1. Correction of incisors rotation (which is less that 90°) in combination with Z spring or
Recurved Z-spring (i.e. couple force system).
2. Retraction of proclined incisors (overjet reduction) when the overjet is not more than 6 mm.
3. To close very mild spacing between the incisors by slight retraction.

ADJUSTMENT (IF IT IS RETENTIVE)

When used as a retentive component, we slightly squeeze the U-loops so that the labial arch
contacts the teeth lightly.

ACTIVATION (IF IT IS ACTIVE)

1. for de-rotation: by slight squeezing of the U-loops with activation of the Z-spring or
Recurved Z-spring to achieve couple force.
2. for retraction:
 by slight squeezing of the U-loops (so that the labial bow about 1 mm behind the labial
aspect of the incisors)
 with at least 1 mm trimming of the acrylic behind the incisors to allow for their
retraction.
To differentiate retentive from active Hawley arch:
In retentive Hawley , the acrylic behind the incisors should have a scalloped appearance
engaging the interdental areas,
While in active Hawley the acrylic will be trimmed to form a smooth curved arch.

Closure of a U-loop moves the labial bow incisally.

A second adjustment is necessary to bring the bow on to
the correct position on the labial surface of the incisors

MODIFICATIONS
1. Soldered Hawley arch: instead of forming occlusal part and retentive tags, a horizontal arm
extends from the U-loop to the bridge of Adams clasp to be soldered there.
2. Reverse Hawley arch: here the U-loops are made closed. It is used to correct slight buccal
malposition of the canine. Activation is by widening of the closed U-loop. It can also be
soldered to the bridge of Adams clasp.
 Robert's Retractor
Lab: 11
It is an active component, designed by Dr. Roberts in 1956. It consists of 2 sleeved buccal
canine retractors joined anteriorly at the central midline, used for overjet reduction.

COMPONENTS
1. Smooth curve labial bow: extends from the distal third of the lateral incisor to the distal third
of the lateral on the other side. It is situated at the junction between the incisal and middle thirds
of the incisors.
2. Two mesial limbs: straight arms extend from the labial bow to the coils.
3. Two coils: about 3 mm in internal diameter, 2 mm away from the deepest area of the buccal
vestibule, 0.5-2mm away from the gingival tissue, and 1mm mesial to the long axis of the
canine.
4. Two distal limbs: slightly curved arms start from the coils and extend to pass over the distal
proximal contact area of the canine to form the retentive tags
5. Two retentive tags: the same as in the Hawley arch.
WIRE GAUGE
The Roberts Retractor is constructed from 0.5 mm HSSW with sleeving of the distal limbs and
retentive tags by 0.5 mm internal diameter SS tube. This design will apply suitable biologic
force on the incisors, also good support is gained from the sleeve.
However, it has certain disadvantages:
1. It requires hard stainless steel tube (i.e. not economic).
2. Difficult in construction.
3. May fracture at the point between the coil and the sleeve.
 Therefore, the Roberts Retractor can be constructed from 0.7 mm HSSW without the
need for a sleeve. In this condition, the force will be heavy, so it needs lighter activation.

USES
For retraction of the incisors when the overjet is more than 6 mm. It is usually used in the 2nd
stage of treatment of Class II div. 1 malocclusion (the first stage includes 4│4 extraction and
3│3 distalization).

ACTIVATION
 For the sleeved type, it is done every 3-4 weeks by closing the coils so that the labial bow
move 2-3 mm backwards on each side, in addition to 2 mm trimming of the acrylic
behind the incisors.
 For the Roberts Retractor which is made of 0.7 mm, the amount of activation is half that
for the sleeved type and it is done every 2-3 weeks.
 Making a Removable Orthodontic Appliance
Lab: 12
The steps for making a removable orthodontic appliance are:
1. Do the necessary wire bending
2. Fix the springs and clasps to the cast by wax on the occlusal and labial surfaces of the teeth,
so that they do not move during fabrication of the acrylic. Wax is applied to the coils and arms
of springs which are not to be embedded in the acrylic base plate to be free during activation.
3. Soak the cast in water for about 5 minutes until no more air bubbles come out of the cast.
This is done to prevent the monomer from getting into the cast and fusing the acrylic with the
stone of the cast.
4. Use Orthocryl (cold cure acrylic) by the sprinkle method (salt and pepper) to construct the
acrylic base-plate by successively applying polymer and then monomer.
5. Cure in a hydro-flask under 2 bar pressure to eliminate porosity. The hydro-flask contains
water at 40°C to accelerate the curing reaction.
6. The wax is cleaned and the acrylic base plate is finished with a carbide bur and polished with
pumice and rouge.

ADVANTAGES OF SPRINKLE METHOD OVER DOUGH METHOD

1. The acrylic penetrates under the wires.
2. Does not contaminate the fingers with acrylic.
3. Less time consuming.
ADVANTAGES OF USING COLD CURE ACRYLIC
1. Easier technique (no waxing, wax elimination, and packing).
2. Less time consuming as it cures within 10-15 minutes.

ADVANTAGES OF USING ORTHOCRYL

1. A polymer composed of large particles which prevent the dripping of the acrylic.
2. Acrylic curing is accelerated under pressure and heat (short curing time (10-15 minutes).

SOLDERING (BRAZING)
Soldering entails heating the metals to be joined with a flame and applying a solder which
encases the pieces to be joined; oxidization of the solder and metal is prevented by the use of a
flux.
In the process of soldering, two pieces of metal are heated and a molten solder is allowed to
flow in between. To make a satisfactory joint the molten solder must "wet" the metal, and for
this to occur the metal must be absolutely clean of impurities, including oxides.
For soldering, we need a butane torch (as a source of heat), silver solder and flux.
Stainless steel tends to soften (be annealed) if heated above the recrystallization temperature.
This can be minimized by using a low-fusing silver solder and by applying heat very locally to
the area to be joined. A small, hot, reducing flame from a suitable blow-lamp or torch must be
used and the work quenched in cold water immediately after the solder flows.
In Latin, the word flux means "to flow". The purpose of flux is to remove any oxide coating on
the substrate metal surface when the solder (filler metal) is fluid and ready to flow into place.
They protect the alloy surface from oxidation during soldering and dissolve metallic oxides as
they are formed.
It is important to securely join metal parts without losing desirable mechanical characteristics.
The heat applied during welding or soldering must, therefore, be localized and of short duration.
 Designing a Removable Appliance
Lab: 13
DESIGNING A REMOVABLE APPLIANCE
Assuming that a proper diagnosis was carried out, and the decision was that the case can be
treated with a removable appliance; a well-designed appliance is needed, to do that we have to
know the components of a removable appliance.
There are four components that need to be considered for every removable appliance:
1. Active component(s) A
2. Retentive component(s) R
3. Anchorage Anch
4. Baseplate (Acrylic) B

ACTIVE COMPONENT(S)
 These components achieve the tooth movement. The selection of the correct active
component will depend primarily on the direction of tooth movement, type, and number
of teeth that are to be moved.
E.g. a Z-spring is used to move a single tooth in a labial direction. If it was desired to have an
additional mesial or distal direction movement, then a c-end is added to the active arm in the
direction of the desired tooth movement.
Z spring is made of 0.5mm hard stainless-steel wire if it was to be used on the incisors. For the
canines, a higher gauge of 0.6mm hard stainless steel is needed.
When more than one single tooth is to be moved in a labial direction, it is preferable to use a
recurved Z-spring instead of the individual Z-spring.
 There are two main active components: springs and screws. Springs are considered the
first choice because they are activated by the operator (no cooperation is needed), less
bulky, and cheaper than screws. Screws have one unique advantage in one situation. This
is where retention is highly demanded, and it is required to retain the appliance using the
teeth to be moved
The following table represents a summary of the available active components and their
indication:

RETENTIVE COMPONENT(S)
These components hold the appliance in place so that it can apply the required force. These
components engage undercuts within the dentition and are usually more rigid than the active
components to resist dislodgement.
The major retentive component is the Adams' clasp, almost all removable appliances must have
one or two of these retentive clasps. These clasps can be used on all teeth except the lower
anterior.
The golden rule in retention is that there must always be anterior and posterior retention. This
does not mean that retention must be on the incisors, but as far anteriorly as possible.
Posterior retention is almost always very easy to locate as, invariably, Adams' clasps can and
should be placed on both U6s. Where anterior retention can be placed will be determined by:
• The type of teeth present (and to an extent their position - it may not be possible to clasp
rotated teeth)
• Their condition
• The amount of space needed to undertake the active tooth movement.

The overall layout of the distribution, e.g. what shape the distribution should form, such as a
square/rectangle or triangle. Retentive components may be distributed asymmetrically
depending on the case.

The following table represents a summary of the available retentive components and their uses:
ANCHORAGE
It can be defined as resistance to unwanted tooth movement. As active components are applying
force to move the teeth (action resulting in wanted teeth movement), there is another force equal
in magnitude and in the opposite direction (reaction). This reactive force must be lower than the
force magnitude required to move the teeth. To do that, we need to increase the number of the
"Anchor" teeth, so that the result of dividing the reactive force on the anchor teeth will not
affect tooth movement (ie, there is no tooth movement in the anchor teeth).
Anchorage is an imaginary component, it is provided by the retentive components and the base
plate contacting teeth. It is possible to have an appliance with good retention but poor
anchorage, or vice versa.
E.g. an appliance to move the molars distally, to re-open space loss by drifting, will have
adequate retention provided by the Adams' clasps, however, if the screws are activated at the
same time there is a risk of having unwanted tooth movement that the other teeth move
anteriorly rather than having the molars distalized. So, when bilateral screws are used, activate
them alternately.

E.g. An appliance designed to move an upper anterior incisor in cross-bite, with only two
Adams' clasps to provide posterior retention, will have adequate anchorage and will seem to fit
in the mouth well until the Z-spring is activated. The appliance will suffer a downward
movement in the anterior region. So, anterior retention is always required.
Baseplate
This is made from acrylic and connects the components of a removable appliance. It should fit
properly and contact all anchor teeth (contributes to anchorage and prevents unwanted drift of
teeth), and sometimes transmits force from active component. Two extensions of baseplate can
be used:

When designing a removable appliance, consider the followings:

 Identify the required tooth movement. This will help in selecting the appropriate active
component, and whether there is a need to add a modification to the base plate or not.
 Consider the space required to move the tooth, therefore avoid using the retentive
component on adjacent teeth when it will interfere with tooth movement.
 Think of anterior retention.
 Remember, retentive components cannot be used on teeth that need to be moved, except
when the screw is used as active component (eg fitted labial arch on anterior teeth with a
screw to procline them).
 Fitted labial arch cannot be used on retroclined teeth
Examples of Removable Orthodontic Appliances

Removable appliances to distalize upper & lower first permanent molars

A removable appliance to align buccaly malposed canines

A removable appliance to create space for upper canines by retracting 4&5