Orthodontic Appliances
Second edition
GORDON C. DICKSON
B Ch U (Leeds).F D S, D Orth, R C S (Eng)
Orthodontic Consultant to the
Portsmouth Hospital Group
ALBERT E. WHEATLY
F B I S T. M O T A
Chief Technician, Dental Wing, Royal
Portsmouth Hospital
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CONTENTS
Preface 8
The Materials 10
The Tools 12
Anodic Polishing
Apparatus 14
Wire Bending 16
Construction of the Adams
Clasp 24
Variations of the Adams
Clasp 38
The Adams Clasp f o r
Extraoral Traction
40
Alternative Clasps
42
The Effect of a Fingerspring 44
Resistance to Displacement
Palatal Movement of
Premolars and Molars
72
Mesial and Distal Movement of Incisors 74
Lateral Movement of
Canutes 76
Labial Movement of
Canines 78
Distal Movement of
Canines 80
The Labial Canine
Retractor 82
Sleeving the Canine
Retractor 84
A d j u s t i n g the Retractor
86
The Cut-and-bend Spring
46
Resistance to T o o t h Movement (Anchorage)
50
T h e Simple Cantilever
88
Palatal Movement of
Lateral Incisors 90
The Sved Bile Plate 92
The Effect of a Bite Plane
Spring 56
Boxing-in 62
Paired Cantilever Springs
64
Double Cantilever Springs
94
The Labial A r c h 96
The Labial A r c h as a
Retainer 98
The Roberts Retractor
100
Construction o f the
Roberts Retractor
102
A p r o n Springs 104
66
The Kinked Cantilever
Spring 68
Premolar Retraction
Springs 70
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THE M A T E R I A L S
Stainless
steel wire
resin
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THE TOOLS
Universal pliers
pliers
pliers
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WIRE BENDING, 1
Soft 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, 2
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WIRE 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
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C O N S T R U C T I O N OF T H E A D A M S C L A S P , 7
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A.
B.
C.
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Adams clasps
Extraoral arch:
Tubing.
Attachment of tubing
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A L T E R N A T I V E CLASPS
ball-ended clasp
C.
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A. On the tooth
Owing to the tact 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 convened into an upward and forward
thrust. In the case illustrated in diagram A the palatal
surface is at 60 c 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
tooth, but also to resist a considerable downward displacing force.
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R E S I S T A N C E TO D I S P L A C E M E N T , 1
Downward displacement
of an
upper
appliance
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RESISTANCE TO DISPLACEMENT, 2
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D.
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The proper
application
of
extraoral
traction
B.
C.
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B.
of pressure
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of its movement.
Ihe coil is set as far away as possible from the tooth
to be moved
The tag 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 cheek
teeth. This is used where the thickness of acrylic capping
(see Inset A) would be too little to stand the bite without fracture;
Inset B shows the same spring adapted to move two
teeth
Construction
Springs:
0.5mm boxed-in
Retention: Adams clasps on 64/46
Bite-raiser: 10 mm wire or acrylic capping
Baseplate:
Full palate
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BOXING-IN
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P A I R E D C A N T I L E V E R SPRINGS
0.5mm boxed-in
0.7mm
Adams clasps on 64/46
Continued over all check teeth as capping
Inset A
This lateral view shows boxed-in spring and just
sufficient clearance to allow the upper incisors to move
f o r w a r d w i t h o u t f o u l i n g the lowers.
Inset B
A double cantilever spring may be used as an alternative
for the same t o o t h movement ( 0 . 6 m m wire), b u t this
requires a greater degree of skill in adjusting.
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Inset
The position of the spring at completion of tooth movement
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P A L A T A L MOVEMENT OF PREMOLARS A N D
MOLARS
0.6mm
Adams clasps on any cheek teeth not
being moved
Full palate, cut away to allow palatal
movement of teeth
Inset
This shows the level of the a r m of the spring and the
large coil in an alternative design where the spring is
attached to the molar clasp.
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A.
B.
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0.6mm
0.7mm
0.6mm
Adams clasps on 6 / 6
Full palate in A
Full palate cut away in B
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0 . 6 m m boxed-in
Adams clasps on 6 / 4 6
Space-holding clasps on 4 2 / : 0 . 6 m m
Full palate, with cut-away in cover for
spring. Bile platforms where necessary
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D I S T A L M O V E M E N T OF CANINES
Inset
To avoid sliding d o w n the mesial slope of the canine the
spring is carefully bent so as to f i t between the lateral
incisor and canine and to take advantage of the flat
mesial surface of the t o o t h . Once movement has begun
it can be m o d i f i e d to fit r o u n d the neck of the t o o t h .
Construction
Springs:
Clasps:
Baseplate:
80
0 . 7 m m boxed-in
Adams clasps on 6 / 6
Full palate
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to note
Inset A
Shows (1) Posterior arm in contact w i t h second premolar and passing over the contact point of
this t o o t h .
(2) Golf-club end of anterior a r m , sharpened at
tip.
Inset B
Shows (1) Path of action.
(2) Clear area behind the canine, unobstructed by
the spring.
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T H E C U T - A N D - B E N D SPRING
ion
Spring:
Clasps:
Baseplate:
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0.6mm
Adams on 6/6
Full palate
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T H E SVED B I T E P L A T E
0.6mm sleeved
Adams clasps on 6 / 6
Pull palate and covering tips of upper
incisors, thickened to f o r m bite 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
necessary to m o u n t the models on an articulator for this
purpose
Inset B
Should this open the bite on the check teeth by more
than 3 or 4 m m , the plane should be lowered, and later
in treatment it can be raised by adding c o l d c u r i n g
acrylic resin.
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B.
C.
A.
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THE L A B I A L ARCH
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0 . 7 m m wire
Adams clasps on 6/6
Full palate
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The
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0 . 7 m m wire
Adams clasps on 6 / 6
Full palate, thickened a n t e r i o r l y to
f o r m bite plane
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APRON SPRINGS
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0.7mm
0.35mm extra hard stainless steel
2.0 x0.1mm
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MORE V A R I A T I O N S O F THE L A B I A L A R C H
A.
B.
, D.
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SPACE-MAINTAINERS
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E X P A N S I O N SCREWS, 1
Direct
lateral
expansion
of activation
Retention:
Baseplate:
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E X P A N S I O N SCREWS, 2
Radial
expansion
of activation
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E X P A N S I O N SCREWS, 3
Asymmetrical
expansion
21/.
Rate
of activation
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A S Y M M E T R I C A L R A D I A L EXPANSION
of activation
week.
Construction
Screw:
Soft
metal (Badcock type)
Tie:
0.9mm stainless steel wire
Spurs:
0.6mm on 3 1 / .
Retention: Adams clasps on 6 4 / 4 6
Baseplate:
Full palate, divided as shown
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Construction
Screw:
Spur:
Retention:
Baseplate:
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Construction
Screw:
Spurs:
Retention:
Baseplate:
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R O T A T I O N OF A S I N G L E T O O T H , 1
Spring:
Retaining spur:
Labial a r c h :
Retention:
Baseplate:
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R O T A T I O N OF A S I N G L E T O O T H , 2
Construction
Premolar band:
Channel:
Strap:
Spring:
Labial a r c h :
Retention:
Baseplate:
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R O T A T I O N OF A S I N G L E T O O T H , 3
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R O T A T I O N B Y C O N T R A - A C T I N G SPRINGS
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E X T R A O R A L FRACTION, 1
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EXTRAORAL TRACTION, 2
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EXTRAORAL ANCHORAGE, 1
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EXTRAORAL ANCHORAGE, 2
Labial arch:
Molar tubes:
Extraoral whisker:
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Adams clasps on 6 5 / 5 6
Canine retractor 0 . 6 m m sleeved;
Roberts retractor 0 . 5 m m
sleeved
1.25mm stainless steel wire
1.25mm internal diameter
1.5mm stainless steel wire
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EXTRAORAL ANCHORAGE, 3
Construction
Retention:
Retractor:
Sleeve:
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INCISOR E L O N G A T I O N , 1
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INCISOR ELONGATION. 2
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T H E ANDRESEN APPLIANCE. 1
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Diagram B
The appliance is shown here in plan view with a C o f f i n
spring in position. The appliance overlies the palatal half
of the occlusal surfaces of the cheek teeth.
Diagram C
The points of insertion of the labial arch and extraoral
wires.
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Diagram D
The baseplate is cut away behind the upper incisors but
should not be removed from the tips of the lower
incisors.
Diagram E
Removal of the acrylic material f r o m the occlusal
surfaces will allow adjustment of the occlusal level of
the cheek teeth.
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Diagram F
Full extension of the acrylic resin between the teeth
should be allowed, when cutting away from the occlusal
surfaces. In the mouth these extensions will bear on the
upper teeth as shown, causing them to move dislally.
Diagram G
When the acrylic is cut away from the occlusal surfaces
of the lower teeth the interdental extensions act as
shown, causing them to move mesially.
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Construct'on
A b i t e is taken in the protrusive position, w i t h o u t
straining and open 2 - 4 m m . This is m o u n t e d on an
articulator a n d the appliance waxed as s h o w n in
diagrams B and C. After t r i m m i n g the models very
closely they are flasked together as shown in diagram H.
The reverse half forms a plug in the palate and a raised
bite is impossible. The appliance is completed in the
usual way.
Materials
Baseplate:
C o f f i n spring:
Labial a r c h :
Extraoral wires:
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