 Introduction

 History
 Properties of Orthodontic wires
 Classification
 Indications
 Advantages
 Disadvantages
 Design Components
 Commonly Used Appliances
 Soldering and Welding
 Conclusion
Weinstein has said

“There is only one disease that is malocclusion.

The medicine is force and there are number of
ways of applying this force”
 HISTORY

Victor Hugo Jackson

 chief proponent of removable appliances in the US

Charles Hawley
 Introduced Hawley’s appliance in 1908

Martin Schwartz
 In mid 20th century developed a variety of split plate
appliances
Philip Adams
 Modified arrowhead clasp into ‘Adams Crib’

 Became the basis for English removable appliances

 Still the most effective clasp for orthodontic purpose

George Crozat
 In early 1900s developed a removable appliance

entirely in precious metal

 Effective clasps on I molars modified from Jackson’s

design
 Heavy gold wires as framework

 Lighter gold finger springs for desired tooth movement

 At the beginning of the twentieth century

• vulcanite baseplate that covered the palate

• molars and premolars capped for retention.
• Although the materials changed, removable
appliances remained the principal appliance for
orthodontic treatment in UK and Europe for the next
70 years.
• In contrast, it had little impact on American
orthodontics, which at that time was dominated by
Edward Angle.
 Development of Removable Appliances
in Europe

1. Angle’s dogmatic approach to occlusion, with its

emphasis on precise positioning of each teeth had
less impact on Europe
2. Social welfare systems developed much more
rapidly in Europe- providing limited treatment for
large number of patients
3. Precious metals for fixed appliances were less
available in Europe
In the UK, the establishment of the National Health
Service in 1948 favoured use of removable
appliances.
• only ten specialist orthodontists

• so the vast majority of orthodontic treatment was

provided by general dental practitioners.

• Department of Health, and the then Dental Estimates

Board, were of the view that the near exclusive use of

removable appliances was the most cost effective way
of providing UK orthodontic care.
1970s: The length of postgraduate orthodontic training
increased from one to two years
1980s: to three years.
Postgraduates were able to complete supervised
treatment of multibanded cases before they qualified.
A series of technical advances
• Prewelded, preformed orthodontic bands
• Directly bonded attachments
• Pre-adjusted edgewise bracket reduced the need
for complex individually formed archwires.
 Measurements of treatment outcome

 The quality of outcome not as high as with fixed

appliances
 Higher discontinuation of treatment associated with
the use of removable appliances
 Dental practitioners now refer their patients on to
specialist orthodontists.
 Specialist orthodontists favour the use of fixed
appliances due to the ability to precisely position
teeth
 Scope of removable appliances

The use of removable appliances still varies widely

between clinicians, but it is possible to achieve
adequate occlusal improvement with these
appliances, provided suitable cases are chosen.
It is vital to emphasize that cases suitable for removable
appliance treatment are those that require simple
tipping movements only, and surprisingly few
malocclusions will fall into this category.
 Properties of Orthodontic wires
1) Esthetics Kusy, AO 1997
2) Stiffness
3) Strength
4) Range
5) Springback
6) Formability
7) Resiliency
8) Friction
9) Biohostability
10) Biocompatibility
11) Weldability
1) Esthetics:
-desirable property -no compromise on mechanical
properties
-composite wires

2) Stiffness/Load deflection rate:

-Magnitude of force delivered by the appliance for a
particular amount of deflection.
LDR=Load/Deflection
 Fα Edr4 d α l3
l3 r4
E- Modulus of elasticity
d- Deflection
r- Radius
l- Length

Doubling radius = Increases force 16 fold

Doubling length = Reduces force 8 fold
L3 α d (2l)3 α 8d

1α d 1 α 16d
r4 (r/2)4
Low stiffness or LDR implies
i. Low forces will be applied
ii. Forces more constant as appliance deactivates
iii. Greater ease & accuracy in applying a given force

-For active components low LDR

-For retentive components high LDR

‘Variable Cross-section Orthodontics’-Burstone

‘Variable Modulus Orthodontics’
NiTi ≤ TMA ≤ ss wire
3) Strength: Force required to activate an archwire to a
specific distance- Kusy
Shape and cross-section of wire have an effect

4) Range: Distance to which an archwire bends

elastically, before permanent deformation occurs-
Proffit

5) Springback: The extent to which the wire reverses its

shape after permanent deformation.
Wire can be activated to a large extent hence fewer
activations will be needed
6) Formability: Ability to bend wire in desired
configuration.

7) Resiliency: Amount of energy stored in a body.

9) Friction: While closing spaces in continuous archwire
technique, involves relative motion of bracket over wire.
Excess friction- loss of anchor
- binding
Least amount of friction desired

9) Biohostability: Ability of a wire to accumulate, or be a site of

accumulation of bacteria, spores or viruses

10) Biocompatibility: Resistance to corrosion and tissue

tolerance to elements in the wire.

11) Weldability: Ease by which a wire can be joined to other

metals by actually melting the 2 metals in the area of the
bond
 mm inch thou of gauge
an inch
1.5 0.059 60 -
1meter = 39.37in
1.25 0.049 50 -
1.0mm = 0.3937in
1mm = 40 1.0 0.039 40 19
thousandths of an 0.9 0.035 36 20
inch 0.8 0.032 32 21
1mm = 0.040in 0.7 0.028 28 22
0.6 0.024 24 23
0.5 0.020 20 24
Definition:

Mechanical Orthodontic Appliances are instruments

which apply pressure or offer resistance to the teeth
for the purpose of stimulating alveolar bone change
bringing about changes in the position of teeth.
 Classification

 Appliances that affect actual tooth movement

through adjustment of springs or attachments within
the appliance- ACTIVE PLATE

 Appliances that stimulate reflex muscle activity

which in turn produces desired tooth movement-
FUNCTIONAL APPLIANCES
II. According to site of appliance placement
1. Extraoral
2. Intraoral
3. Combination

III. According to plane of movement

1. Transverse
2. Saggital
3. Vertical
IV. Based on method of curing
1. Heat cure
2. Self cure
3. Light cure
 Indications
Minor tooth movement technique may be considered
o Malposition limited to relatively few teeth

o Desired movement not more than few mm

o Adequate space between adjacent teeth to permit

entry of teeth to be moved

o Allowable axial inclination corrected by tipping

forces
o Correctable etiologic factors

o Favorable periodontal and periapical prognosis

o Absence of contraindications
• Excessive flaring of maxillary anterior teeth
• Diastima closure
• Crossbite correction
• Anterior crowding

 Preprosthetic
• Closing of spaces
• Uprighting of teeth
 Preventive Periodontic
• Migration of mandibular incisors

 Correction of Speech Defects

 Facilitation of Oral Surgical Procedures
 Retention after corrected malocclusion
•
 Procedural
• To gain space

 Preventive and interceptive orthodontics

 Advantages Disadvantages

1.Tipping movement 1.Only simple malocclusion can be

2.Can be removed corrected
-for cleaning of teeth & appliance 2.Multiple rotations cannot
-if in pain be corrected
-on socially sensitive occasion 3.Uncooperative patients may
3.Less conspicuous leave out the appliance-
4.Can be undertaken by general prolongs treatment
practitioner with adequate 4.Multiple tooth movement
training - one at a time- prolongs Rx duration
5.Manufactured in lab 5.Lower appliance not well tolerated
-less chair side time 6.Cases other than I premolar
-more patients can be treated extraction cannot be treated easily
6.Inexpensive
 Components of removable appliances

 Retentive Components
 Baseplate
 Active components
 Retentive Components

Retention: Means whereby displacement of appliance is

resisted.

Clasp: any hook or band attached to a natural tooth and

used to anchor a partial denture or an orthodontic
appliance.
Circumferential Clasp

• Fabricated using wire 0.9mm

• -Also known as ‘C’ clasp or Three Quarter Clasp
 Simple clasp used to engage buccocervical undercut
 Cannot be used in partially erupted teeth
Jackson’s Clasp

- Fabricated using 0.9mm wire

- Also known as Full clasp or ‘U’ clasp
- Engages both buccocervical undercuts
 Simple design

 Offers adequate retention

 Inadequate retention in partially erupted teeth

Triangular Clasp

-Fabricated using 0.6mm wire

-used between adjacent posterior teeth
-Indicated for additional retention
Adam’s Clasp
-Also known as Liverpool Clasp,
Universal Clasp,
Modified Arrowhead Clasp

Parts
Bridge
Arrowhead
Retentive arms
Advantages:
 Small, neat, unobtrusive, occupies minimum space

 Rigid, offers excellent retention

 Used on any tooth in the arch

 If broken can be repaired by soldering

 Permits modifications in design

 Extensive wire bending incorporates stresses in the

wire
 Modifications
Adams clasp with single arrowhead:

Adams clasp with J hook

Adams clasp with helix

Adams clasp with additional arrowhead

Adams clasp with soldered buccal tube

Adams clasp with distal extension

Double clasp on maxillary central incisors

Schwarz Clasp

Designed by C. M. Schwarz
Oldest & for a considerable amount of time most
generally used
Adj: Arrowhead bent towards papilla to engage
undercuts
 Can be used in deciduous or permanent teeth

 Skill to fabricate

 Can be used only on posterior teeth

Duyzings Clasp

-Simple design
-engages buccal undercut of molars
-half clasp can also be constructed
Adj: Bending towards the tooth or undercut area
Eyelet Clasp

-similar to triangular clasp

-used as single eyelet or multiple eyelet clasp
-eyelets placed in embrasures
Adj: Bending eyelet interdentally towards the tooth
 No sharp bends, breakage unlikely

 Does not interfere with eruption of teeth

 On single tooth does not have firm grip

Delta Clasp

• Designed by William J. Clark

• Similar to Adams clasp in principle
• Engage interdental undercuts
Adj: -hold retentive loop and twist inwards
-bending towards interdental undercut as it
emerges from acrylic
Southend Clasp

-0.7 mm wire
-spans two adjacent margins of anterior teeth
Adj: readapting into interdental area
 Esthetically more pleasing
Ballend Clasp

• Wire having a knob or ball like structure on one end

• utilizes interdental undercuts
• Indicated when additional retention required
 Baseplate
Greatest portion of removable appliance
1-2mm thick
3 main purposes
1. Act as vehicle to carry all parts of the appliance
2. Serve as anchorage
3. Become an active part of appliance itself
 ANCHORAGE

Anchorage resists forces of reaction generated by active

components. Thus, sites of anchorage must be equal in
magnitude but opposite in direction to those generated
by active components.
Simple Anchorage: Teeth which offer greater resistance
to movement, used as anchorage for movement of
lesser resistance
• Usually made of Acrylic
• As thin as possible(1-2mm)

• Closely adapted

• Extend as far as necessary to obtain anchorage

• Lower baseplate- U shaped, relatively thicker

• Shallow lingual sulcus reinforced with ss wire or bar

Heat cure
Self cure
Light cure
Biocryl: Biostar pressure molding machine
 BASEPLATE

Anterior Upper Parallel to occ plane

Posterior Lower Inclined to occ plane

Anterior biteplane

-Platform behind upper incisor teeth

-Height enough to separate
posterior teeth by 1.5-2mm
-Reduce overbite of anterior teeth
-‘opening the bite’
-Height of plane gradually increased
Proclination of upper incisors
*Placement of labial bow
*Sved biteplane
Sved Biteplane

-Introduced by Sved in 1944

-Covers incisal edges of upper anteriors
-Pressure transmitted axially
-Retention questionable
-Ideal in growing individuals
Posterior Biteplane

• displacing activity of mandible

• unilateral posterior crossbite
• wide enough to contact buccal & palatal cusps
• occlusion disengaged
• equal on both sides
• after correction appliance acts as retainer
Lower Inclined Plane
• Catlan more than 200 yrs ago
• Anterior crossbite
• 45 degrees to occ plane
• Upper incisors guided into
correct position labially
• indicated when incisors are in
early stage of eruption
 If used for more than 6wks-
anterior open bite results
 May need frequent cementation
Pre-treatment Post-treatment
 Active components

 Labialbow
 Springs
 Elastics
 Screws
 LABIAL BOWS

May have 2 functions

1) Serve as active element for movement of teeth
2) Hold the plate in place & retain the teeth
Labial Bow with ‘U’ loop

• 0.7 mm wire
• flexibility depends on vertical height of ‘U’ loops
• Only minor overjet reduction or incisor alignment
required
Adj: Compressing of ‘U’ loop
Displaced palatally by only 1mm
Long Labial Bow

• Used to close space between canine and premolar

• Can control the canine
• Used for retention
Split Labial Bow

• flexibility increased
• incisor retraction

Adj: at the ‘U’ loop

Labial Bow with Reverse Loop

• Prevents buccal drifting of canine

Adj: Done in 2 stages
1) Vertical loop opened by compressing with plier
2) This lowers the bow in incisor region
compensating bends at the base of the loop
Mills Bow /Extended Labial Bow

• Made of 0.7mm wire

• Extensive loops- flexibility greatly increased

Indications -Reducing large overbites

-Alignment of irregular incisors
 Flexible, lighter forces, long range of action

 In mixed dentition when canines not erupted

 Due to extensive loops less comfortable

High Labial Bow with Apron Spring
• Heavy base arch of 0.9mm wire
• Apron spring 0.3-0.4mm

Adj: Bent towards the teeth

 Retraction of teeth with severe proclination
 Light forces
 Longer range of action
 Not well tolerated by the patient
 Time consuming to fabricate
 Cannot be used in patients with shallow sulcus
Roberts Retractor

• Flexible bow constructed of 0.5mm wire

• Steel tubing to give support
• Coil placed at the point of emergence from the tubing
• Ajd: Vertical limb below the coil
Fitted Labial Bow
• 0.7 mm wire
• Adapted closely to labial surface of anterior teeth
• Used for retention
 Time consuming
Beggs Retenton Bow

• 0.7mm wire extends till last erupted molar

• ’U’ loops made between I & II premolars
 Allows settling of occlusion
 If not constructed well retention may not be good
 SPRINGS
Most commonly used active elements
Requirements:
 springs should deliver optimum force
 should possess high degree of elasticity
 should have long range of action
 Force systems delivered depend on
Intrinsic properties- cannot be altered by operator
-modulus of elasticity
-yield strength
Extrinsic properties- operator can exercise control
-length of wire
-thickness of wire

Small changes in diameter and length have a profound

impact on the force delivered
Effect of wire diameter on force delivered
-amount of activation
0.5mm- 3mm activation
0.7mm- 1mm activation- little margin of error

Effect of wire length

Coil- increase length of spring
Lower force with same amount of activation
 Classification of Springs

I. Based on direction of tooth movement

1. Springs for mesio-distal tooth movement
2. Spring for labio-lingual tooth movement
3. Springs for expansion of arches
II. Based on nature of support
1. Self supported springs
2. Guided springs
3. Auxiliary springs
III. Based on presence of loop or helix
Single Cantilever Spring
active arm
Parts coil
retentive arm
• 0.5-0.6mm wire

• coil with internal diameter of 3mm

• used to move teeth labio-lingually or mesio-diatally

Double Cantilever Spring / Z spring

• Constructed using 0.5 or 0.6 mm wire

• Spring perpendicular to palatal surface of tooth

• Indicated where incisors are to be proclined

Activation: Opening both coils

 If not perpendicular to palatial surface of teeth, it

tends to intrude teeth.

‘T’ Spring
• Constructed using 0.5 mm wire
• Buccal movement of premolars and molars

Activation: Pulling spring away from the baseplate

Coffin Spring

• Described by Walter.H.Coffin in 1881

• Made in 2 segments, large enough to make contact
with all teeth to be moved
• Made of 1.25 mm wire
• Spring stands 1 mm away from the soft tissues
Indications:
Transverse arch expansion – Unilateral crossbite with
lateral mandibular displacement

Advantage over screw – Differential expansion can be

obtained.

 Unless expertly made and adjusted, tends to be rater

unstable.
Activation
 Canine Retractors
• Type of spring
• used to move canine in distal direction

CLASSIFICATION
I. Based on location -buccal
-palatal
II. Based on presence of helix or loop
III. Based on mode of action -push type
-pull type
Buccal Self Sopported Canine Retractor

• 0.7 mm wire
• buccally placed canine is to be moved palatally and
distally
• coil just distal to long axis of tooth
Activation: by 1mm
Distal -closing the loop
Palatal -anterior limb is bent towards the tooth
after it emerges from the coil

 Uncomfortable to patient
 Stability increased- flexibility compromised
Supported Buccal Canine Retractor

• identical in design to self supported retractor

• 0.5mm wire supported in tubing

Activation: by 2mm
Reverse Loop Canine Retractor

• can be used in shallow sulcus

Activation: 1mm
i. cut off 1mm from the free end & readapt it
ii. opening the coil
‘U’ Loop Buccal Canine Retractor

• can be used in sallow sulcus

Activation: free end is cut by 1mm & readapted
 Requires frequent adjustment
Palatal Canine Retractor

-canine placed palatally requiring distal buccal

movement
-coil of 3mm placed between the initial & final position
of canine
Boxing & Guarding

• Boxing to protect from damage

• Spring lies in the recess between baseplate &mucosa
• Guard to prevent distortion during removal
 -often cranked
Activation: 1-2mm by opening the coil
-should not be bent where it merges from the baseplate
Dr.Safeena
 Screws

Used for moving individual teeth or group of teeth

Types of screws
2 types of expansion screws
 Skeletal expansion screw

 Dental expansion screw

Types of Screws

Maxillary expansion

Mandibular expansion

Bilateral expansion

Sectional expansion

Radial expansion

Expansion in three directions

Activation
Screw is turned 90 degrees
Will drive the parts of the plate apart by 0.2 mm
Narrows periodontal membrane by 0.1 mm on each
side
Ideal orthodontic condition for transformation of bone
Uses : Baseplate divided into sections driven apart by
one or more screws

1) Split along midline – Bilateral crossbite and minor

crowding of incisors
2) Split into a larger and a smaller part
Pretreatment
Post-treatment
3) Lingually locked and crowded upper central
incisor tipped forward using springs after
space provided by moderate expansion
4) Expansion and reduction of overjet
5) Y-Plates – For alignment of crowded canines by
saggital and lateral expansion
 Elastics

Resembles rubber band

Made of latex rubber
Available in various diameters – force applied depends
on their diameter
Colour coded for easy identification

Uses :
For movement of singe teeth and groups of teeth
For intermaxillary traction
Molar intrusion with removable a appliance
Giuilio Alessandri Bonatti, Daniela Giunta
JCO Aug 1996

CASE 1
After 4 months Prosthetic replacement

CASE 1
CASE 2
CASE 2
 Soldering
Soldering is the joining of two metals by the use of filler
metal which has a substantially low fusion
temperature than that of the metal parts being joined
Fusion temperature of filler metal ≤ 450°

Brazing
Fusion temperature of filler metal ≥ 450°
Dental solders
Dental solders are alloys used as intermediary or filler
metals to join two or more metallic parts.
Composed of gold, silver, copper, zinc, tin, nickel
Requisites of a solder
1. Good tarnish & corrosion resistance
2. Fusion temperature should be lower than that of
parts being joined. (50°-100° less)
3. Should be free flowing and adequately wet the metal
parts for good adhesion
4. Strength of solder comparable to metals being
joined
5. Colour of solder should match with parts being
soldered
Flux: in Latin means ‘flow’
• Removes oxide coating to increase flow of the molten

solder
• Dissolves any surface impurities

• Prevents oxidation of metals

• Reduces melting point of dental solder

Flux used commonly

Borax Glass- 55%
Boric acid- 35%
Silica- 10%
Fluoride fluxes- Boric acid : Potassium fluoride(1:1)
Antiflux
Material used to confine the flow of molten solder over
metals being joined
Graphite
 Stainless steel is difficult to solder
1) No union between solder & steel
under conditions of stress & strain in the mouth-
Joint failure
2) Heating to temperature required for soldering
anneals- useless for spring purpose
3) Passive surface film of chromium protects it from
further oxidation- inhibits flow of solder
 Good design
 Accurate control of heat distribution
 Use of fluoride containing flux
Soldering technique
• Miniature butane blow lamp
• Jet of fine needle flame 1cm long
• Reducing zone of flame
• Twisting one wire around the other
• Overheating-burning of wire and solder –rough pitted
surface on soldering.
• Soldering to be performed in one heating if possible.
• Localization of heat to the site of solder.
 Welding

Welding is process by which surfaces of metal are

joined by mixing, with or without use of heat
Design of welder for orthodontic purpose
Fred in 1938
Mc Keag in 1939
Principle design features- speed & power
Cold welding- done by hammering or pressure.
Hot welding- Heat of sufficient intensity to melt metals
being joined.
3 methods of welding used in dentistry
1) Spot welding
2) Pressure welding
3) Laser welding
Spot welding
Convenient method of uniting pieces of metal of the
same kind
Clean, Quick, produces joints that are strong & reliable
Basic Principles- Heat & pressure
Electric current conducted through 2 copper electrodes
Resistance offered generates very high temperature
Copper electrodes simultaneously apply pressure on
metals
Metal melts at contact points and pressure squeezes
metal into each other
 Circuite diagram:
Spot Welder
Pressure Welding
Metal parts placed together
Sufficiently large force applied perpendicular to the
surface- welding occurs
Force applied should be sufficiently large

Laser Welding
High intensity pulse of light that can be focused
Select duration & intensity of pulse- metal melts in
small region without micro structural damage to
surrounding areas
 APPLIANCES

Classification
1. Retention
2. Preventive & Interceptive
3. Active tooth movement
 Transverse
 Saggital
 Vertical
Hawley’s Appliance

Designed by Charles Hawley in 1908

Most frequently used retainer
Short labial bow
Adams Clasp on molars
Modifications :
 Long labial bow – Closing space distal to canine

 Labial bow soldered to bridge of Adams clasp –

avoids risk of space opening due to cross over wire

 Fitted labial bow – Offers excellent retention

 Anterior bite plane – To retain or correct deep bite

cases
 Expansion screw with split labial bow

 With tongue crib.

 With Z spring on second molars for lingual

movement of molars
 Alexander,s Retainer

• ‘C’ clasp on molars

• Anterior labial bow
 High Labial Retainer
Harvey L. Lavitt
JCO Jan1972
• Control over each tooth seperately
• Springs for correction of rotation and uprighting
• Both active and retentive
• More esthetic
A Removable CUSPID-TO-CUSPID Retainer
DOUGLAS J. SHILLIDAY (JCO 1973)
Begg’s Wraparound retainer

Popularized by P.R.Begg.
Bow extending till last erupted molar
 No crossover wire, eliminates risk of space opening

up
Clip-on Retainer
Wire runs labial to incisors, passes between canine and
premolar
Both labial and lingual wire segments embedded in
strips of acrylic
Brings out correction of rotation in lower anterior
segments
Van der Linden Retainer
JCO May2003
Kesling’s Tooth positioner
Described by H.D.Kesling in 1945
Made of thermoplastic rubber like material
Spans interocclusal space and covers clinical crowns
and a small portion of gingiva
 No activation needed

 Difficulty in speech

 Risk of TMJ problems

Essix Retainers- Fabrication and supervision for
permanent retention
John. J. Sheridan, Willaim Ledoux, Robert Mcmin
JCO Jan 1993
 Wraparound cantilever retainer
Timonthy J. Tremont
JCO Feb- 2003
•Ideal for a well finished case
•Cantilever arm- middle of first bicuspid

soldered to labial bow

•Bow adjusted by giving a slight bend in the cantilever arm
• Thermoplastic copolymer retainer
• Thin, yet strong, cuspid-cuspid
• Low cost & ease of fabrication
• Brilliant appearance of teeth caused by light reflection
• Thickness- .030”Space cut at distogingival margin

to allow removal removal

•Pontic can be incorporated for missing anterior tooth
 Habit Breaking/Restraining Appliances

Tongue crib appliance

Tongue crib anchored to oral cavity by clasps and labial
bow
Used for interception of habits like tongue thrusting and
thumb sucking.
Oral Screen/Vestibular screen

• Introduced by Newell in 1912

• Shield of acrylic placed in the labial vestibule
• Designed to screen oral cavity
• Metal ring projecting between upper and lower lips
• Used to intercept habits like thumb sucking, tongue thrusting
and mouth breathing.
Modifications
• For interception of tongue thrusting :

• Additional screen placed in the lingual aspect,

attached to the vestibular screen by means of a thick

wire
• For mouth breathing- when airways are open

• Fabricated with a number of holes that are gradually

closed.
• Open bite in deciduous & mixed dentition

• Mild disto-occlosion with premaxillary protrusion

 Space Maintainers

Space maintenance is a process of maintaining the space

previously occupied by a tooth or several teeth before
the eruption of permanent tooth.

Classification
 Functional- teeth incorporated to aid in mastication,

speech and esthetics.

 Nonfunctional- acrylic extension over edentulous

area to prevent space closure

Class I: Unilateral maxillary posterior
Class II: Unilateral mandibular posterior
Class III: Bilateral maxillary posterior
Class IV: Bilateral mandibular posterior
‘C’ Space Regainer
Tongue Blade Therapy
Lip Bumper/ Lip Shield
Extends into the vestibular sulcus to the labial fold
No contact made between shield and incisors
Eliminates persistent hyperactivity of mentalis muscle
Class II div 1 malocclusion
Class I flush terminal plane with large overjet
Shield the lower lip away- used for interception of lip
sucking habit
To augment anchorage
Distallisation of first molars
As space regainers- early loss of deciduous molars
Denholtz Appliance
Lip bumper for the maxillary arch
Design similar to madibular lip bumper
 Crozat Appliance Treatment of Buccal
Crossbite JCO 2003,
June
Frank Marasa
 ACCO
• Acrylic Cervico Occipital anchorage
• Margolis 1976 & Spengeman 1967

• Acrylic on labial bow

• Auxiliaries- springs for posterior rotation

- minimal anterior crowding

- minimal distalization
Jacobson splint- Used phase therapy or prefixed
appliance guidance.
Verdon combination appliance-When
mandibular protraction desired
 Fixed Removable approach to presurgical
Orthodontic Treatment
H.S.Orton, P.M.Noble
Lower full edgewise appliance JCO May 1990
Upper labial sectional edgewise appliance
Expansion plate with dams clasp for fixation
Design variation for class II div 2 cases
Clasps on I premolar and I molar
Palatal spring to intrude and procline upper incisors
Bonding for Retention of Removable Appliances
Leonard Gorelick, Arnold Geiger
JCO 1986 JUNE
Anatomic factors prevent adequate
retention
•Bell shaped posterior teeth
•Teeth with abnormal axial

inclination
•High palatal vault- poor tissue

adaptation of acrylic
• Large tori that limit tissue support

Bondable eyelet
Composite bonding material
 Bonded Composite Button for Removable
Appliances JCO 2003 June
Stephen Edward Grimm III
• Composite button made on lingual surface
• Undercut made on the gingival side of the button

• Prevents the spring from being displaced

• Allows full force to act on the tooth
Instructions to patient
• Discomfort
• Phonetics
• Increased salivation
• Cleaned after eating
• Initially full time wear except while eating for 6mts
• Later night time wear
 Conclusion

“All you can do is push, pull or turn a tooth. I have given

you an appliance and now for God’s sake use it”
Edward.H.Angle
 References
 Orthodontic treatment with removable appliances- W.
W.J.B. Houston, K.G. Issacson
 The Design, construction and use or Removable
Orthodontic Appliances – C. Philip Adams
 Removable Orthodontic Appliances- T.M. Graber,
Bedrich Neumann
 Orthodontics Principles and Practice- T.M. Graber
 Contemporary Orthodontics- Proffit
 References

 Orthodontics. Post graduate dental hand book- Spiro.

J. Chakonas
 An Introduction to Orthodontics- Laura Mitchell
 Removable Partial Prosthodontics - McCracken’s
 Dentofacial Orthopedics with Functional Appliances,
Thomas. M. Graber, Thomas Rakosi, Alexandre G.
Petrovic
 Removable Orthodontic Appliances. M.S.Rani
 References

 High Labial Retainer Harvey.L.Levitt

JCO Jan1972
 A Removable cuspid-to-cuspid Retainer
Doglus J. Shilliday JCO 1973
 Crozat Princilples and Technique. Wendell H. Taylr. JCO June
1985
 Crozat Appliance Treatment of Buccal Crossbite Frank
Marasa. JCO June 2003
 Essix Retainers- Fabrication and supervision for permanent
retention John. J. Sheridan, Willaim Ledoux, Robert Mcmin.
JCO Jan 1993
 Van der Linden Retainer JCO May2003
 References

 Molar intrusion with removable a appliance

Giuilio Alessandri Bonatti, Daniela Giunta
JCO Aug 1996
 Wraparound cantilever retainer
Timonthy J. Tremont, JCO Feb- 2003
 Notes & Compilation of Articles.
Dr.Arundhati P. Tandur
 Space maintainers in Pedodontics, Dr.N. Shivakumar,
Library thesis, Department of Pedodontics, Manipal