©1987 JCO, Inc. May not be distributed without permission. www.jco-online.
com
The Straight-Wire Appliance
17 Years Later
RONALD H. ROTH, DDS, MS, FACD, FICO
In 1976 this author published an article in
the Journal of Clinical Orthodontics entitled
"Five Year Clinical Evaluation of the Andrews
Straight-Wire Appliance".1 This article will
serve as a follow-up regarding the same topic,
namely, the Straight-Wire Appliance as de-
vised by Dr. Lawrence F. Andrews of San
Diego.
The Straight-Wire Appliance became
commercially available to the profession in
1970, and shortly thereafter, there was a great
deal of excitement about it and the value it
would have in making treatment time shorter,
results better and more consistent, and chair-
time less for the orthodontist. By 1973 it was
apparent that the Straight-Wire Appliance had
had an impact on the marketplace, and more
and more manufacturers sought to compete-
Dr. Roth is a Contributing Editor of the Journal of Clinical Orthodon·
tics and in the private practice of orthodon t ics at 320 N. San Mateo
Drive, San Mateo, CA 94401 .
Straight-Wire Applian ce , Attract , and Starfire are reg istered
trademarks of " A" -Company , Inc . Dr. Roth is a consultant to
" A"-Company, Inc.
I..eYeI Slot Une-Up
t . ·1·, .1-.4-
. ~~~~ .~.\-.--
•
Fig. 1 Contours and torque needed in bracket bases
to attain level slot lineup when teeth are in desired
finished positions.
632 © 1987 JCO, Inc.
or at least not fall behind in a situation where it
was becoming obvious that some form of pre-
adjusted appliance would soon become the
standard of the specialty of orthodontics.
This step has added to our progress, but
has also added to confusion regarding what
the "Straight-Wi re Appliance" really is and
what it is not! Perhaps it is unpopular or even
professionally dangerous to put this in print;
however, it is this author's belief that the truth
eventually will win out. The Straight-Wire Ap-
pliance as invented by Andrews is the only true
Straight-Wire Appliance currently available, in
that it has the design features necessary to
place the teeth in desired positions and at the
same time have the bracket slots line up
around the arch parallel to each other and to
the occlusal plane while providing tip, torque,
rotation, and inlout (Fig. 1).
It is probably true that in 1973 more orth-o-
dontists really understood the Straight-Wire
Appliance than in 1987. So much confusion
and rhetoric have shrouded the real issues
that it is almost impossible to find an ortho-
Fig. 2 Difference between pretorqued edgewise (A)
and Andrews Straight-Wire (B) appliances. (Courtesy
of "A"·Company, Inc.)
JCO/SEPTEMBER 1987
 ©1987 JCO, Inc. May not be distributed without permission. www.jco-online.com
dontist who can visualize, explain, and grasp
the concept of the Straight-Wire Appliance as
devised by Andrews. There is no perceived dif-
ference in the minds of most orthodontists be-
tween pretorqued and preangulated edgewise
brackets and Straight-Wire brackets. Yet there
is a difference, and it does make a difference
in the results in terms of tooth positioning if
one is to treat without putting offset bends
into the archwires (Fig. 2).
Nevertheless, it would be ludicrous to
think that an article of this type could change
the thinking of the majority of orthodontists.
The information necessary to understanding
the uniqueness of the real Straight-Wire Appli-
ance can be found in Andrews' writings.2-s In
this article, when I refer to the Straight-Wire
Appliance, I am referring to the Andrews
Straight-Wire Appliance and none other, and I
will abbreviate the term as SWA.
Experience with SWA
I began using the SWA in my practice in
1970 when Andrews gave me the first set of
prototype brackets that were welded onto
pinched band material and had been machin-
Fig. 3 Case with first commercially available
Straight·Wire Appliance.
VOLUME XXI NUMBER9
ed at great expense. The first set of brackets
was an upper 5 x 5 set (Fig. 3). I immediately
liked what I saw as treatment progressed on
that first patient. I purchased the first commer-
cially available brackets and started all my
new cases with the SWA. By mid-1973, I
switched my entire practice over to the SWA
and rebanded all the active patients who still
had pretorqued and preangulated edgewise
brackets (about 30 % of my practice at that
point). My practice has been totally SWA since
that time.
The original brackets were of the stan-
dard Straight-Wire prescription-that is, they
had the exact numbers found on the non-ortho-
dontic normal sample of Andrews. It was not
too long after this that the Andrews extraction
bracket series became available. The extrac-
tion brackets had counter-tip and counter-
rotation built in to offset relapse, and to keep
teeth from rotating and tipping into the extrac·
tion sites as they were being moved along a
rectangular wire. In other words, the brackets
were constructed to allow translation of teeth
as much as possible and to offset any relapse
tendency by overcorrection.
The original standard Straight-Wire
brackets were designed to treat only non-
extraction cases with an ANB differential of
less than 50 without the necessity of putting
offset bends into the wire.
Andrews later introduced different series
and sets of brackets for different combina-
tions of extractions, ANB differentials, and
anchorage requirements. He developed a
special classification of malocclusions and
prescribed various bracket series for treat-
ment of each, to allow translation of teeth
without the need for bending offsets and also
to allow for overcorrection in view of relapse
tendencies.
As the various extraction brackets be-
633
 ©1987 JCO, Inc. May not be distributed without permission. www.jco-online.com
THE STRAIGHT·WIRE APPLIANCE 17 YEARS LATER
came available, it became apparent to me that
inventory was becoming a problem because
the brackets were only available on bands (at
that time there was no bonding). Since my
mechanics were not concerned with transla-
tion per se, I began to wonder if it would be
possible to come up with a prescription for a
special set of overcorrection brackets that
would be applicable to most cases.
The Roth Prescription
This was the beginning of the Roth Pre-
scription. I had noticed that to achieve desired
tooth positions with the standard SWA, it was
necessary to finish the mechanotherapy
phase of treatment by placing compensating
and reverse curves in the upper and lower arch-
wires, respectively. I had also noticed that with
the standard SWA, it was necessary to be
careful with anchorage control, especially on
extraction cases, because the mesial inclina-
tion of the teeth in the buccal segments would
tend to make those segments drift mesially
during treatment.
I thought about the mechanics that I
used, and came to realize that not only did I not
attempt to translate teeth, but that I did not
believe there was an efficient mechanism at
the time to translate the teeth by sliding them
on rectangular wire without dealing with the
disadvantages of overcoming friction. I also
did not want to tip teeth excessively and then
upright them, because I have found it to be a
tremendous amount of effort to overcome the
effects of extreme tipping. My treatment
mechanics permitted tipping to a fair degree,
but not so much that one could not recover
from the tipping with a continuous wire within
three months.
Another issue was the question of where
the teeth should be at the end of the appli-
ance therapy so they would settle into non-
orthodontic normal positions. In other words,
if we built into the appliance the precise tooth
positions that we would like at the conclusion
of treatment and were clever enough to get the
634
teeth into those positions with the appliance
in place, would the teeth remain in those posi-
tions? Probably not, for I have never seen a
case with fixed appliances in which the teeth
did not move or "settle" into occlusion after
appliance removal. The issue then is, "Where
should the teeth be at the time of appliance
removal so that the most likely thing to occur
would be for them to settle into the non-
orthodontic normal tooth positions?" Overcor-
rection is obviously necessary, but how much
and where?
Andrews spoke about relapse of tooth
pOSitions, how teeth tend to tip and rotate into
an extraction site, and how they tend to
relapse back to the rotation and root diver-
gence. He also talked about the necessity for
incorporating more torque into the anterior
teeth if they were to be retracted , and the
necessity for leveling the curve of Spee before
appliance removal as a form of overtreatment.
My reasoning went like this: If teeth tend
to relapse back whence they started, and if
counter-tip, counter-rotation, counter-torque,
and leveling of the curve of Spee were applied
to the SWA in every possible direction, then it
should be possible to use primarily one pre-
scription for most cases, and to finish to an
"end of appliance therapy" goal in which all
tooth pOSitions are slightly overcorrected and
Fig. 4 Case immediately after removal of Roth
Prescription SWA brackets, showing "end of ap·
pliance therapy" tooth pOSitions.
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 ©1987 JCO, Inc. May not be distributed without permission. www.jco-online.com
from which the teeth will most likely settle into
non-orthodontic normal positions (Fig. 4). It
should make no difference how the teeth were
moved or how far they were moved or how
much they were tipped if the clinician properly
placed the brackets, filled the slots with a full-
size (.022" x .02S") rectangular wire, and
waited for bracket expression of tooth posi-
tions to occur. For instance, if a lower cuspid
had r of crown tip in the bracket and 2 0 of
counter-rotation, and the bracket was tied
securely to the archwire and the archwire fully
engaged in the slot, whether the tooth was
moved 2mm or Smm it should end up in the
same position, given sufficient time.
Overcorrection
I naturally started with the concept of
overcorrection when designing a comprehen-
sive prescription using then-available An-
drews extraction brackets. This started a
clinical trial-and-error evaluation that lasted
several years. Cases were evaluated by the
use of intraoral photographs and mounted
study models for tooth positions during treat-
ment, at the end of appliance therapy, and into
Fig. 5 A_ Extracted teeth with SWA brackets and Tru·Arch Form. Note normal shape of dental arch, which
necessitates exaggerated arch form. B. Ideal typodont with SWA brackets. Note similarity of arch form to that of
extracted teeth in A.
VOLUME XXI NUMBER 9
ROTH
settling. I found it was practical in the vast
majority of cases to use a single prescription
with overcorrection in all planes of space and
still meet the objectives of the "Six Keys to
Normal Occlusion" as laid down by Andrews. 4
Better yet, it was possible to do this and hardly
ever place offset bends into archwires-fin-
ishing with full-size wires that had only arch
form bent into them and were flat in terms of
curve of Spee or compensating bends.
In the Roth Prescription of the Andrews
Appliance, the anterior brackets were placed
slightly more incisally from Andrews' "middle
of the clinical crown", and the ingredients of
those brackets were adjusted accordingly.
This was to eliminate the need to place reverse
and compensating bends into the finishing
wires. The Tru-Arch Form was developed to
playa role in this overcorrection concept,
because arch form affects the rotational posi-
tioning of the teeth as well as the brackets
(Fig. 5).
Auxiliary attachments were added to the
brackets, such as double and triple tubes for
headgears and lip bumpers and rectangular
auxiliary tubes for Burstone or Bioprogressive
mechanics. Additional hooks on each bracket
635
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THE STRAIGHT·WIRE APPLIANCE 17 YEARS LATER

evolved for the use of short Class II or Class III rotate mesially, thus necessitating extra distal
elastics, so that less unfavorable canting of rotation. The torque in the lower buccal
the occlusal plane and fewer posterior inter- segments remains normal, because overcor-
ferences would be created with interarch rection in this plane only leads to problems
elastics. and interferences. The two lower molars have
exactly the same degree of root torque since
Maxillary Prescription the appliance rests on the mesiobuccal cusp
(the torque measurement for the non-
The Roth Prescription has extra torque in
orthodontic normals was taken from the buc-
the maxillary incisors (5 ° more than normal).
cal groove).
There is correspondingly less negative torque
in the upper canines to offset the reciprocal ef-
fect of building more positive torque into the Archwires
incisors. The upper canines have 2 ° more
The archwires are relatively flat around
distal tip, because they are being retracted in
the incisors (both upper and lower), curve more
most treatment. In addition, they have a 2 °
tightly around the cuspids and bicuspids, and
rotation to the mesial. There is a "Super
then curve gently toward the distal through the
Torque" set of maxillary anteriors for cases
entire buccal leg. The most prominent point in
like Class II, division 2, where an extreme
the front curvature of the arch is the first
amount of torque may be needed.
bicuspid; the most prominent and widest point
The upper buccal segments are distally
in either arch is at the mesiobuccal cusps of
uprighted to 0°, the bicuspids are rotated 2°
the first molars.
mesially to offset the rotation that accom-
One must remember that the archwire
panies distal traction, and the upper molars
does not fit at the cusp tips and incisal edges,
have 14 0 distal rotation (twice the amount
but at the approximate middle of the crowns. If
found on the non-orthodontic normals) and
one looks at the arch from the occlusal and
14 ° buccal root torq ue (50 more than normal).
notices where the bracket slot is in relation to
There is a 0 0 upper molar rotation set for cases
the tips of the cuspids, it is easy to see why the
where only two upper bicuspids are extracted;
archwire has to be shaped in the form that we
it is recommended that the "Super Torque"
use.
anteriors be used in these cases to minimize
It is also necessary to understand that to
the tooth-size discrepancy created by taking
develop an anterior guidance in harmony with
out only two upper bicuspids (half a molar is
average mandibular movement, the labial sur-
smaller than a full bicuspid). The increase in
face of the front of the lower arch and the
torque and tip of the upper incisors makes
lingual surface of the upper arch must be
them occupy more space in the arch, as does
curved in harmony with the arc of movement of
the mesial rotation of the upper first molars,
the mandible past the maxilla in a lateral
due to the 0 0 rotation brackets on those teeth.
border movement. Average mandibular move-
ment requires a fairly broad arch form across
Mandibular Prescription
the anterior teeth. According to Lee and Lun-
In the mandibular arch, the incisor deen's work with mandibular movement,6 a
brackets are the same as the non-orthodontic fairly broad anterior arch form would be re-
normals. The lower canines have r mesial tip quired on 73% of our population! Of the re-
0
and 2 distal rotation. The entire lower buccal maining 27%, half would require an even
0
segment has a 3 distal tip from normal and a broader anterior arch form, and only 14%
4 ° distal rotation. These teeth settle more would require the commonly used "orthodon-
mesially than the uppers and simultaneously tic" narrow anterior arch form. If one violates

636 JCO/SEPTEMBER 1987

 ©1987 JCO, Inc. May not be distributed without permission. www.jco-online.com

ROTH

mandibular movement with anterior arch form original positions.

that is too narrow, the result is improper
anterior guidance, or what is called "over-
coupling " of the anterior teeth. On a post-
orthodontic case, this usually results in either
anterior collapse or restricted lateral move-
ment. In any event, the arch form shown is ap-
plicable to the vast majority of cases.
Root Positions
If one looks at the root pOSitions of a set
Appliance Configuration
of extracted teeth with the Roth Prescription in
place, it becomes apparent that there is a lot of
overcorrection in the appliance and some in
the arch form , but this is what it takes to get
the teeth in the desired positions (Fig. 6). The
amount of overcorrection shown on the ex-
tracted teeth will never be expressed intra-
orally for the following reasons:
1. There is an angle of deflection between the
bracket slot and the archwire.
2. Ultimately the force values drop so low that
they are below the values needed to move the
teeth , even though full bracket expression has
not been obtained.
3. The teeth tend to relapse back to their
4. We need to build in offsets for the unde-
sirable side effects of tooth-moving
mechanics.
The overcorrection concept built into the
Roth Prescription has worked very well, as has
the concept of hav ing one prescription for
most cases. The Roth Prescription was intro-
duced in 1976, and the values have remained
unchanged since that time.
The configuration of the appliance has
changed since its introduction. The original
standard SWA was introduced with single-
wing brackets, and shortly thereafter Siamese
brackets were introduced. The molar tubes
were bulky and were "capped" to form tubes.
Later the brackets were made smaller, and
power arms were cast as integral parts of the
brackets designed by Andrews to place the
force at the centroids of the teeth and effect
translatory movement.
Because the brackets had to be cast
rather than machined to be cost-effective and
still have the contours and torque in the

Fig.6 A. Extracted teeth with Roth Prescription SWA brackets and full-size rectangular wire, showing overcorrec-
. tion built into brackets. B. Extracted teeth with standard SWA brackets, showing non-orthodontic normal tooth
positions.

VOLUME XXI NUMBER 9 637

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THE STRAIGHT-WIRE APPLIANCE 17 YEARS LATER

Fig.7 Case treated with Roth Prescription SWA. A. First archwires. B. Second archwires. C. Third archwires. D.
Fourth archwires. E. Fifth archwires. F. Finished case one day after appliance removal. G. Typodont of same
case after complete settling of occlusion. Note that standard SWA brackets have level slot lineup, indicating at·
tainment of non·orthodontic normal tooth positions.

JCO/SEPTEMBER 1987
638
 ©1987 JCO, Inc. May not be distributed without permission. www.jco-online.com
bracket bases, the early Roth Prescription also
included power arms (Fig. 7). With most of the
Roth Prescription brackets having the same
values as some of the Andrews extraction
series brackets, this avoided the costly and
time-consuming step of making new molds to
provide shorter elastic hooks.
At first the brackets were available
welded to special bands that were designed to
get the bracket to fit on the middle of the
clinical crown. Later, as direct bonding
became a reality, the appliance was made
available on coined bases and then on flexible
mesh pads. Ultimately a brazed micromesh
became an integral part of the bracket base
itself. The effect, of course, has been to
diminish the size of the appliance as much as
possible for esthetics and patient comfort.
Later versions of the Roth Prescri ption i n-
cluded shorter "L"-shaped hooks made by
blocking out part of the molds when making
the plastic patterns. As the prescription
gained popularity, new molds were made that
had short ball hooks for elastics cast as in-
tegral parts of the brackets. At that point the
prescription was available only with twin
brackets.
In 1984 the "Attract" brackets were intro-
duced (Fig. 8). These were single-width
brackets that had rounded contours and
micro-molar tubes. The base of the bracket
Fig. 8 Roth Prescription "Attract" brackets.
VOLUME XXI NUMBER 9
ROTH
slot was the width of a twin bracket, and with
the use of the new nickel titanium wires it was
possible to rotate teeth while maintaining
minimum size for esthetics and patient com-
fort. These brackets were also made with short
ball hooks in the Roth Prescription.
The latest version of the SWA is a perfect-
ly clear bracket containing an agent that is
chemically bonded to the bracket base and
will also chemically bond with standard direct
bond adhesives (Fig. 9). These brackets are the
same size as the metal twin brackets and do
not require the bulk of ceramic brackets to pro-
vide sufficient strength. They are grown from
100% pure liquid alumina (sapphire) into a
single crystal, which gives the unique crystal-
clear appearance. All Straight-Wire angula-
tions, tips, and torques are grown integrally in
the crystal (compound-contour, torque-in-
base) or, as in the case with tip, machined to
tolerances better than .005". State-of-the-art
diamond machinery is used to fabricate these
brackets. Sapphire is the second-hardest
material next to the diamond.
Over the years, thanks to technological
advances, the appliance has become smaller,
more comfortable, and more esthetic. The
bracket configurations currently available are
twin, single, Attract, Steiner, and Lang-bond-
able, on bands, and in a variety of prescrip-
tions.
Fig.9 Roth Prescription "Starfire" sapphire
brackets.
639
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THE STRAIGHT·WIRE APPLIANCE 17 YEARS LATER
Treatment Time
So much for the technical aspects of the
SWA. The question remains: " Has the SWA in
fact fu Ifi lied its prom ise of better, faster, and
more consistent results with less time and ef-
fort on the part of the orthodontist? " In this
author's opinion, the answer is, unquestion-
ably and emphatically, " Yes! "
In certain cases the SWA will decrease
treatment time significantly. This is true pri-
marily in the nonextraction case with relatively
mild dentoalveolar malocclusion, or in the per-
manent dentition phase after the jaw relation-
ship discrepancy has been successfully
reduced in the mixed dentition phase. Another
example is where there has been an extreme
arch length deficiency, permanent bicuspids
have been extracted early, and the remainder
of the permanent teeth erupt leaving little if
any space in the arch. In most such cases,
proper placement of the SWA brackets and
use of nickel titanium wires will reduce treat-
ment time to six to 12 months.
In more severe cases or when full extrac-
tion sites must be closed, the treatment time
saved might more realistically be three to six
months. However, in all cases the chairtime
Fig. 10 Case shown in 1976 article.'
640
saved for the orthodontist is significant. When
I take into account the SWA features , bonding,
and the use of nickel titanium wires, I can
honestly say the chairtime required to treat a
case in my office has decreased to 20% of
what it was when we were using pretorqued
and preangulated edgewise appliances on
bands and bending rectangular steel wire to
detail tooth positions.
Advantages of SWA
The SWA will not diagnose cases, it will
not set up the treatment plan , and it will not
figure out the mechanics needed to correct the
malocclusion. But a properly placed SWA will
detail the tooth positions better, more con-
Sistently, and faster than one can by bending
offsets into the archwires. The key is to get the
brackets properly placed; if they are not prop-
erly placed, they must be reset. This requires a
lot of self-discipline and persistence, but the
benefits are well worth the effort: it allows one
to detail and finish cases utilizing a rec-
tangular wire with only arch form bent into it.
When the SWA is properly placed, arch-
wire changes need not be scheduled. Arch-
wires can be changed on a routine checkup ap-
JCO/SEPTEMBER 1987
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-
ROTH

pointment, because it takes so little time to
bend or place an archwire with only arch form
in it.
The SWA also allows one to take full ad-
vantage of the newer, multistranded braided
wires-in particular, nickel titanium wires.
These wires are at best difficult to bend, and
bends do not stay in nickel titanium wires. The
blank, preformed archwires in the SWA allow
full bracket engagement and expression effi-
ciently and gently, as in the case of .0215" x
.028" Sentinol w ire (GAC international, inc. ,
Central ISlip, NY).
In addition, heavy steel wires such as
.021 " x .025" can be easily placed in the SWA
with the fingers , without the use of pliers,

Fig. 11 Finished case from Figure 10 immediately after retention.

Fig.12 Case from Figure 10 nine years out of retention, demonstrating stability. Note how roots of anterior teeth
have subtly relapsed closer together and how cuspid roots have come back slightly from overcorrection.

VOLUME XXI NUMBER 9 641

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THE STRAIGHT·WIRE APPLIANCE 17 YEARS LATER
because by the time the teeth are well enough
aligned to place such a large wire, the bracket
slots are aligned in both height and torque
with automatic in/out. We get what has been
called a "level slot lineup". This allows the use
of heavy wires without having to resort to
heavy forces. There is less trauma to the
tissues, less jiggling and roundtripping of
teeth, and less root resorption.
Cases that have been treated with the
SWA over the past 17 years have stood up well
both in stability of tooth positions and in
periodontal health. The tooth positions have
been esthetic and have allowed a good settl-
ing of the occlusion as well as the attainment
of functional occlusal goals (Figs. 10-12).
All in all, the SWA is alive and well. I think
it has proven itself under the test of time. It has
been upgraded with technical advances, and
perhaps its more recent "facelifts" have made
it look like a different appliance. The tooth
positioning ingredients, however, are the
same as ever.
642
The Straight-Wire Appliance has been of
great benefit to the patients and to that
pe rcentage of orthodontists who have been
perceptive enough to realize its benefits.
REFERENCES
1. Roth , R.H .: Five Year Clinical Evaluation of the Andrews
St raight-W ire App liance, J . Clin . Orthod . 10:836-850,
1976.
2. Andrews, L.F.: The Straight-Wire Appliance, AAO Film
Library.
3. Andrews, L.F .: The Straight-Wire Appl iance, PCSO
Bulletin , 1970.
4. Andrews, L.F.: Th? Si x Keys to No rmal Occlusion, Am.
J . Orthod . 62:296·309,1 972.
5. Andrews, L.F.: The Straight-Wire Course Syllabus.
6. Lee, R.L. : Mandibular Border Movements Engraved in
Plastic for Articulator Controls, Part 1, J. Prosth . Den!.,
1969.
7. Roth, R.H. : Treatment Mechanics for th e Straight Wire
Appliance , in Orthodontics: Current Principles and
Techniques, C.V. Mosby Co., S!. Louis, 1985.
JCO/SEPTEMBER 1987