ALTERATION OF APPARATI’S DITRTNO TREATMENT*

KY LOUIS S. JIT~h-~~on-, l:.A., D.D.S., HOIJSTON, TEXAS

M ODELS are used herein for convenience of illustration, but in both parts
of this clinic it is to be assumed that, the patient’s mouth is being used,
with bands in place on the anchor teeth.
I. Aft,er the auxiliary springs have produced such an amount of tooth
movement away from t,he lingual arch (Fig. 1) that it is desired to readapt
t,he arch, the following method may be used : J:end a piece of mire (scrap
may be used) to the approximate shape of the body wire, only a little smaller.

Solder its ends to the distal extremities of the body wire, taking care: after
the first end is soldered, to set that tile secontl cntl lies tjassively in contact
with extremity of body wire before soltlering (Fig. 2). The auxiliary springs
arc removed, the bocly wire clot ill its incisal region, and, with a frw trials in
the mouth, the free ends are bent to the positions in which it is desired that
they touch the teeth. A splice of new mire is then soldered across the gap,
giving the readapted arch. The extremities of the arch arc then held in
the flame ancl freed of t,he extra wire.
806 Louis 8. Winsto?z

This is a substitute for the longer technic of taking impression, remov-

ing molar bands, pouring up work model on which to remake the arch, and
then recementing the bands. I use it only occasionally, when it is desired to
economize time, and when I am certain that the molar bands have been
recently cemented and are safe.
II. When molar bands are cemented on, in my experience, regardless of
their accuracy of fit. or the care with which they are pushed to place, they
usually go on in a slightly diEerent position than they occupied when the
impression w’as taken and they were removed. This results in a misfit of the
lingual appliance. If the mesial portion of the band has been forced a little
too far gingivally, the result will be pressure by the body wire on the incisors;
if the distal of the band has been pushed on a little too far, the result is that
the body wire will stand off from the incisors. Likewise, if the lingual of
t,he band goes on too far, the half-round wire on the opposite end of the arch
will lie palatal to its tube when only the one half-round wire is inserted;
while, if the buccal of the band goes on a little too far, when the half-round
wire is placed in the tube the half-round wire of the opposite side will lie
occlusal to its tube (Fig. 4).
The first two difficulties, namely, the arch pressing on the incisors or
standing away from them, are obviously to be corrected by making the
necessary amount of bend, either occlusally or gingivally, immediately an-
terior to the half-round wire.
The correction of the third and fourth difficulties, namely, when the
opposite half-round wire lies palatal or occlusal to its half-round tube, is il-
lustrated in this clinic. We desire a tortional bend or twist, but t,o do that
with the arch cold will frequently break off the half-round wire. We there-
fore select the point on the arch where the twist should be made, and, hold-
ing that point in the flame, twist by means of pliers grasping the nearest
half-round wire, the farthest end of the arch being held in the fingers (Fig.
5). The point selected will usually be in the premolar region. Then try in
the mouth, and repeat if necessary until the arch stands as in Fig. 6.