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Done By : Hala Abu Asbeh

Edited By : Aseel Ayman & Dyala Kokash

Lect. Date : 29/1/2019

Doctor : Dr. Susan Al- Khateeb

subject: Principles of Orthodontic removable appliances

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**Slides are included**

“Principles of Orthodontic Removable Appliances”

Removable appliances : a term generally used to describe appliances consisting


of an acrylic base plate that is held in place with clasps, and that commonly
incorporates active components such as springs or expansion screws.

Components of removable
appliances
Type equation here.

Active Retentive Anchorage Connecting


component component component base plate

Example
s
Buccal canine Palatal Expansion Robert’s
Double
retractor finger screw retractor
cantilever
spring

✓ Features of Springs (Active component) :

1. Made of Stainless steel wire containing 18% nickel and 8% chromium


(18/8 S.S) .

2. Elasticity : The property which enables a material to return to its original


shape and dimension (without deformation)

3. Malleability: The property of a metal to be deformed by compression


without cracking . (without broken)

4. Tasteless > to be more comfortable

5. Immune to corrosion (due to this both material nickel and chromium) .

1
• Scientifically, the connection between the length, thickness, and the
amount of deflection of a cantilever spring of round section is expressed by
the formula:

D  PL3/T4
D : amount of deflection (property of being bent) P : amount of pressure(force) L : length of spring T : the thickness

“The deflection of the wire is directly proportional with pressure (force) &
length and inversely proportional with the thickness”

- If we increase the pressure, the defection increase


- If we increase the length of the spring, the deflection and elasticity
increase and will be easier to bend .
- If we increase the thickness, the deflection decrease and will be harder to
bend .
According to this formula: For a given cantilever spring:

- Deflection will be double when pressure is doubled.‫بتزيد بنفس المقدار‬


- Deflection will increase by eight times if the length of the spring is
doubled.
- Deflection will increase 16 times if the thickness is halved.

✓ Cantilever spring
✓ Incorporation of coils . (why do we put a coil ?)
Increase the effective length of the spring and so increase their deflection
and elasticity .
For the maximal effect, they should be made reasonably large (2.5mm
diameter) and be placed close to the attachment point of the spring.

✓ When a tooth is contacted by a spring at a single


point, it will move in the direction of the
resultant force, which is perpendicular to the
tangent at the point of contact with the tooth .

2
✓ Anchorage component : Resistance to unwanted tooth movement

Example : patient has crowding , we extract the upper first premolar and we want to move the
canine backward.. we will use Buccal canine retractor or palatal finger spring. (if the canine starts to
move backward, the first molar will move forward according to Newton’s Third Law ‫لكل فعل رد فعل مساو‬
) ‫ له في المقدار ومعاكس في االتجاه‬and they will close that space ) this is not what I want 

sometime we need a little movement to the first molar put here when the space is critical and I need
the whole space for the canine to reduce the overjet and to move the canine backward.. we must do
anchorage component to keep the first molar (anchorage it ) on it’s place .

✓ Retention : - Clasps - Base plate


Base plate (connector) > hold together the other component of the appliance .

1) Buccal canine retractor


to move buccally erupted canine into the arch (move it palatally ).

• Gauge of the wire: 0.7 mm


Coil
• Direction of movement: Distally, occlusally, and palatally

• Components: 1- Active arm


Cross
2- Coil > for adjustment over

3- Retentive arm

4- cross over > that’s crossing over the tooth


Retentive arm

- Retentive arm is imbedded in the acryl (base plate) . Active


- This is a modification of buccal canine retractor which called “Self- arm

supported buccal canine retractor” > it helps to move the tooth a little
more palatally
- Try to differentiate between Active arm and active component of the
removable appliance ‫االكتف ارم هوه الجزء الي بالمس السن من االكتف كومبوننت‬

3
2) Double cantilever (Z spring ) :
used to procline retroclined incisors( have 2 cantilever ) .

• Gauge of the wire: 0.5 mm > bcz incisor is a small tooth, single rooted & we don’t need
heavy force with large thickness

( when there’s two teeth I can increase the diameter into 0.6 mm )

• Direction of movement: Proclination of incisors (labially) + rotation (with 2


points of force application ) , no movement within the arch(mesial or distal)

• Used in cases of class II div 2 malocclusion

• Components: 1- Active arm 2-Coils 3- Retentive arm

4- Guard . (sometimes if I have deep bite and I want to open it, I put acryl like
anterior bite plate and the patient will bite on it instead of the guard and at
the same time it acts as a guard )

• In case of rotation, I should have another point of force application (2 point of


force application ) the first one pushing from the inside (the double cantilever )
and another point either pushing or just holding from the outside .

Example :

▪ If I have a left tooth, and the mesial side is outward (goes


labially )and distal side inward.. we should move the
mesial side palatally & the distal side labially and the
active arm should placed distally and activate the labial
bow to push it mesially > so the centre of the tooth is the access of rotation
4
▪ If mesial side is correct , the distal side only is rotated
palatally I want to hold the mesial side and push the distal
side so the access of rotation will be mesially without
activate the labial bow (passive > just holding)
And activate the distal part by the active arm

Note: The free arm on the same side of the direction of


movement when I do rotation Free arm

3)Robert’s retractor

• Indications:

To retrocline proclined upper incisors

• To be able to use this appliance:

- Space should be available

- Overjet should be increased

- Overbite should be reduced (bcz the retroclination of incisors will increase the bite)

• Gauge of the wire:

- 0.5 mm + tubing with sleeve (inner diameter = 0.5 mm)

• Direction of movement: Retroclination of incisors Sleeve is a tube we put the


• Components: 1-Labial bow wire inside it to increase the
thickness and make it stronger
2-Coils > to increase the length .

3-Retentive arm

“We activate the robert’s retractor by closing the 2 loops”


5
4) Expansion screw

• Used to treat crossbites .


• Narrow maxilla and we want to expand it .

➢ We put a retentive components on the sides and we cut the

Acryl from the middle and give this expansion screw

➢ We start to open that screw 0.25 mm once a week by a key,


we ask the patient to open it at home > so we have 1 mm
expansion per month
➢ after a while, we start to see a space between the acryl until I
have a good bite.

“Mesial and distal movements”

1-Palatal springs

- It Moves a tooth in line of the arch Mesial and distal movements


- For incisors and canines it is made of 0.5mm S.S wire and for molars it is made
of 0.6mm S.S. wire.
- The mode of action: it moves teeth along the arch
- Used either to close diastima or to move canine
backward
- The coil must be on the other side opposite to the
direction of movement

• Adjustments

- correct point of contact

- Activate 2-4 mm in the free arm of the spring

If I have a canine in a good position &I just want to


move it distally > I use palatal finger spring
but if it’s placed buccaly > I use buccal canine
retractor 6
2- Buccal springs

- Move a tooth palatally as well as distally


- Made of 0.7mm S.S wire

• Adjustments

Close the coil by 1-2 mm every time

“Labial movements”

• Incisors

• Double cantilever spring

-Made of 0.5 mm S.S wire

-Wire guard to enhance the stability

• Adjustments

1-2 mm of activation

“Buccal movement”

• T-Spring

Its the Same as double cantilever but it’s used for posterior teeth

Very limited uses

• Premolars and molars

0.5 mm for premolars and 0.6mm for molars.

• Adjustment

Pull the free end of the spring away from the baseplate

7
“Labial and buccal movements”

• Coffin Spring

- More than one tooth to be moved

- 1.25mm S.S. wire

- Extra retention is needed

• Adjustment

2-3 mm expansion

- We cut the acryle in the midline and open the 2 parts and ask the patient
to wear it
- It’s use is limited
- we prefer the expansion secrew because it gives gradual force (easier for
patient to use it )
- and the coffin spring is more susceptible to deformation and breakage .

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