BOWS

Labial bow
Definition Labial bow is that component of the removable orthodontic appliance which helps in retracting and retaining the anterior teeth and also contributes for the retention of the appliance.

Functions of labial bows

1. Moving the teeth in a lingual or palatal direction. Spring tempered wire is used for this purpose. 2. Holding the lip away form the anterior teeth. his is a

restraining action that allows the front teeth to more in a labial direction. Hard wire is used for this purpose. !. Support for soldered springs or loops or for hoo"s to

attach elastic bands. #n these cases the labial wire is formed from $mm hard or spring tempered wire. %. &riction &riction of labial wire against anterior teeth act as a clasp to enhance the fit of plate. '. &ulcrum (hen rotating teeth with labial wire can serve as fulcurm. springs or screws

To summarize
)rincipal functions of labial bow are 1. o retain the teeth * passive function

2. Movement of teeth* active function

Components of labial bow

1. Hori+ontal bow portion 2. ,ertical loops !. -cclusal section %. .etentive arms.

1. Horizontal bow portion #t either contacts or stands slightly away from middle thirds of crowns of incisors /in most appliances0 and ends with right angle bends at distal third of lateral incisor1 mesial third of canines1 or distal third of canine /in long labial bow0. #t contacts only the most labially positioned incisor.

2. Vertical loops #t consists of parallel vertical legs 2oined by a smooth curve. Height of loops should be $ to 12mm usually e3tending 2* !mm above the gingival margin for purposes of hygiene.

#f canines have to be actively influenced by labial wire1 right angle bend of the vertical loop placed in canine area.

Loops allow for the ad2ustment of wire. 4onstricting the loops shortens the wire and opening the loops lengthen it. hese

ad2ustments cause a vertical deflection of incisor section necessitating a compensatory bend at the distal leg of loop or at the point where the end of the wire enters acrylic.

So repeated bending in this area leads to brea"age of wire.

. Occlusal crosso!er section Distal leg of the vertical loop enters the embrassure between canine premolar or between premolars /in long labial bow 0 crossing the occlusal surface and entering into acrylic.

#n unima3illary appliance occlusal crossover should be "ept as close to mesial surface of the premolar as possible1 in order to minimi+e any occlusal interference.

". #etenti!e en$s .etentive ends are placed in the palatal or lingual surface 5.'mm 1mm gap is placed in between retentive arm and palatal or lingual surface so that acrylic can flow into that area and it will get covered by acrylic .etentive arm should be 5.6 to 1cm long and a retention tag is "ept at the end of the wire to prevent dislocation from acrylic base plate.

T%pes of labial bows

1. Short labial bow 2. Long labial bow !. Split labial bow %. Labial bow with 7M8 loops '. Labial bow with hori+ontal and vertical loops 9. :ridge spring labial bow ;. &itted labial bow 6. Labial bow with modified reverse loops $. Labial bow sheethed in acrylic 15. Labial bow with soldered hoo"s 11. Labial bow with additional hoo"s 12. .obert8s retractor 1!. Mill8s retractor 1%. High labial bow 1'. High labial bow with apron springs 19. Labial bow with self straightening wires 1;. Labial bow with elastics 16. .ic"ett8s retention bow 1$. :egg retention bow 25. Labial bow in <ctivator 21. Labial bow in :ionator 22. Labial bow in &ran"el appliance

2!. ,an der Linden retainer

Classification of labial bows

1. Labial bows to mo!e canine palatall% 1. Long labial bow 2. Labial bow with 7M8 loop !. Labial bow with hori+ontal and vertical loop %. Labial bow with reverse loop '. :ridge spring labial bow 9. Labial bow with e3tended labial section

2. Labial bows use$ for retenti!e purposes a. &itted labial bow .b Labial bow with modified reverse loop .c Labial bow sheethed in acrylic .d :egg8s retention bow .e .ic"ett8s retention bow .f ,an der linden .etainer

. Labial bows use$ for attac&ment of elastics a. Labial bow with soldered hoo"s b. Labial bow with additional hoo"s ". Fle'ible bows ( supporte$ a0..obert8s retractor

). Labial bows use$ in o!er*ets a0.Mill8s retractor

+. Labial bow use$ to effect in$i!i$ual teet& mo!ement a0.High labial bow with apron springs

,. Labial bow use$ wit& au'illaries a. Labial bow with soldered hoo"s b. Labial bow with additional hoo"s c. High labial bow with apron springs d. Labial bow with self straightening wires

-. Labial bow use$ in mi$line $iastema case a. Split labial bow

.. Labial bows use$ in functional appliances a. Labial bow in <ctivator b. Labial bow in :ionator c. Labial bow in &ran"el appliance

Ot&er labial bows a. Short labial bow b. 7=8 loop labial bow c. >3tended labial bow

/rmamentarium for Labial Bows

.1 ?oungs loop bending pliers. .2 <deurer plier .! .uhland plier .% Mar"ing pencil .' wire cutter

S&ort labial bow

he short labial bow has a bow which contacts the most prominent labial teeth and two = loops that end as retentive arms distal to canine. #t is used in cases where simplest form of incissor retraction is re@uired #t is constructed using 5.9 or 5.;mm wire.

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Construction
a"e the wire of length from one molar to other molar along labial or buccal surface of teeth. &orm a bow using fingers adapting it on the labial surface of the incisors at the middle and incissal thirds of the teeth. wo mar"s are placed on the bow

corresponding to the contact points between lateral incisor and

canine on either side. Aive a right angled bend towards the gingival margin at the points on the bow. Mar" should be made about 2mm beyond the free gingival margin on the vertical arm on either side. &orm 7=8 loops at the mar"ed points using round bea" of youngs loop bending plier. Distal arm of vertical loop is adapted on to the palatal or lingal aspect of the cast to form the tags.

/cti!ation
#t is activated by compressing the 7=8 loop using ?oung8s loop bending plier so that the hori+ontal bow portion is displaced palatally by 1mm.

Lon0 labial bow

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Construction
Long labial bow is constructed in same manner as short labial bow e3cept that the distal arm of the 7=8 loops are adapted over the occlusal embrasure between the two premolars.

1ses
#t is used when simplest of incisor retraction re@uired including canines.

/cti!ation
#t is activated by compressing 7=8 loop using ?oung8s loop bending plier so that the hori+ontal bow portion is displaced 1mm palatally.

Split labial bow

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Construction
he two types of split labial bow are 1. ype : and !. Split labial bow with single arm. ype < and 2.

T%pe /
< short labial bow is constructed as described earlier and to split in the middle by using wire cutter. #t can also constructed from the midline in two sections by forming a bow and later a loop which continues as a retentive arm. #t can have either one arm or two arms depending upon its use

/cti!ation
Labial bow is activated by closing the 7=8 loops while maintaining the arch form.

/$!anta0e
&le3ibility is more.

1ses
&or minor correction of spaces and to flatten the arch.

2rawbac3s
&lattening of arch occurs in cases where it is not re@uired when activated without care.

T%pe B
#t is constructed in two arms and each one e3tends from the opposing central incisor. he free end of buccal arm made to

hoo" on the distal surface of the central incisor.

/cti!ation
#t can be activated either by closing 7=8 loop or by cutting 1mm at the free end of the buccal arm and readapting on the tooth.

/$!anta0e
his labial bow is used mainly in correcting midline diastema and protrusion of the teeth.

#obert4s retractor
#t is designed by AH .oberts. 5.'mm wire is used #t can be used for severe protrusion of teeth.

Light force is applied as thinner wire is used for construction of labial bow.

.ange of action is more as more length of wire in incorporated.

Special /rmamentarium
)lastic sleeve or Metal tubing

Construction
<dapt the dispensed 5.'mm stainless steel wire on to the labial surface of incisors using fingers place the wire on the cast at the middle third of the cast1 mar" two points on each on the distal surface on the lateral incisors as shown in the figure and place a bend which runs appro3imately parallel to the root of canine. Mar" a point at about 2 to ! mm above the gingival margin and place a coil at that point ta"e care to see that the internal diameter of the coil is not less than ! mms then insert the metal tubing or plastic sleeve to the distal arm of the coils and adapt the retentive arms in the palatal surface.

/cti!ation
#t is activated by placing a bend in the vertical limb of the wire1 where it emerges from the coil so that wire is displaced palatally about ! mm. #t can be activated by closing the coil also.

<s the incisors move palatally1 the bow will drop anteriorly and the level of hori+ontal part will have to be ad2usted.

2raw bac3s
#t is uncomfortable to the patient1 cannot be given on the lower arch as the sulcus is shallow.

5ill4s retractor
#t was designed by C...>. Mills in 1$9'. #t is used for retracting severe proclination of anteriors and large over2ets where labial bow is not much of use.

Construction
=sing fingers1 form a bow1 which e3tends on to the four incisors and at the distal end of the lateral incisors1 place a sharp 7=8 bend towards the cervical portion of the teeth and readapt the wire on to the teeth towards the midline close to the midline place vertical bend to the wire on either side and ! to % mms beyond the gingival margins of the teeth place another

gentlebent laterally on either side to adapt the wire parallel to gingival margins at about the distal contact point of canines bring the wire vertically down and adapt it as retentive arms.

2isa$!anta0es
:ul"y Less comfortable to the patient 4annot be ad2usted precisely.

Hi0& labial bow an$ Hi0& labial bow wit& apron sprin0s
=seful in retracting the teeth with severe proclination. his

design of labial bow with apron springs does not slip over the inclined planes of the teeth with severe proclination as the movement of the retractor is along the arc of rotational radius along which the teeth moves while correcting the proclination.

Lighter force Longer range of action 4an be used to correct single tooth mal*position also by soldering a 7 8 spring to the high labial bow.

Special <rmamentarium 1. <rtery forceps 2. Soldering unit !. Solder and flu3

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Construction
&or constructing high labial bow the wor"ing cast should be made from impression which has recorded the functional depth of the sulcus. < 5.$D1mm wire is formed to ta"e the shape of the arch at about the labial sulcus at the midpoint of the wire ma"e a 7,8 shaped bend to provide relief for frenum. hen readapt the

wire hori+ontally on either side of the frenum in the sulcus and bring it vertically down along the distal aspect of the canines on either side then the retentive arms are adapted on to the palatal surface beyond the distal contact point of the canines. #n case of high frenal attachments high labial bow can be split in the midline and a small loop is made at the free ends along the midline.

Construction of /pron sprin0

<pron spring is made by winding one end of a 5.%mm wire on to the base wire tightly and forming an apron for one1 two or a group of teeth as re@uired and winding it bac" on to the base wire tightly in the opposite direction. &inally the apron spring is soldered on to the base wire at the point where it is tightly tied to it. 4are should be ta"en while winding the wire of the apron spring not to twist the wire to prevent incorporation of stresses.

/cti!ation
<pron spring is bent towards the teeth for activation either by fingers or by pliers.

2rawbac3s
#t is not well tolerated by patients #t is time consuming for fabrication #t cannot be used in lower arch.

#e!erse loop labial bow

=sed to control canine position =sed when minimum palatal movement of anterior is re@uired because this bow is too stiff for ad2ustments )revents buccal drift of canine anteriors during retraction of

Construction
=sing fingers1 a bow is made out of 5.;mm wire e3tending from one canine to other canine. )lace the wire on the cast at the middle third of the tooth mar" two points one each at the contact point between canine first premolar on other side ma"e a right angled bend and at a point 2*! mms above the guigival margin ma"e a reserve loop such that its medial arm passes between lateral incisor and canine over the contact point to form the retentive arm on the palatal aspect.

/cti!ation
-pening the loop. <s the bow is rigid it should be

activated by only 1mm at any time.

Labial bow wit& self strai0&tenin0 wire Construction

< self straightening wire of 5.%mm is wound on to the labial bow mesial to the 7=8 loop then re@uired amount of wire is ta"en1 a hoo" is bent at the free end E is attached to the other side of the labial bow. #t can be made on one side on both sides. (hen made on one side it has a tendency to flatten the arch anteriorly1 the use of two wires mimi+es the effects.

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.ange of action is more 4an be used for mild proclination or spacing

2raw bac3s
#ndividual tooth movements cannot be carried out #t has a tendency to flatten the arch.

Labial bow wit& elastics Construction

< short labial bow is constructed using 5.;mm stainless steel wire as described earlier ta"ing care to see that the hori+ontal portion /bow0 lies at the 2unction of middle third and cervial third of anterior teeth.

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wo hoo"s made of 5.;mm wire are soldered on to the distal arm of the vertical 7=8 loop on either side to carry the elastics to retract the incisors.

/cti!ation
:y changing the elastics

/$!anta0e
4ontinuous force is present Less chances of slippage of elastics due to the presence of labial bow.

Fitte$ labial bow

=sed to secure the #ncisors firmly after they have been derotated D retracted.

#t is similar to short labial bow or reverse loop labial bow e3cept the hori+ontal bow part is closely adapted on to the labial surface of the teeth. .everse loop helps to control the canine.

6'ten$e$ labial bow

5.;mm of wire Labial bow is e3tended to opposite arch Large vertical loops can be provided which help to reduce the stiffness of the wire #t inhibits forward Mandibular movement and can tip Mandibular anteriors lingually

/cti!ation
:y :ending the incisor segments lingually.

Sol$ere$ labial bow Construction

4onstruct a bow similar to long labial bow and instead of adapting the retentive arms onto the palatel side adapt them straight to the bridge of the adams clasp on either side and solder them on to the clasp.

/cti!ation
4an be activated by closing the loop.

1ses
&or retention of teeth after active treatment is completed. #n retraction1 helps in consolidating spaces1 can also be used for attachment of self straightening wires. Since no wires passes

between upper and lower teeth occlusion settles down during retention phase

#ic3ett4s retention bow Construction

#t is used for retention of lower anterior teeth. < bow is made of 5.;mm wire using fingers e3tending from one canine to another "eeping it at the middle third of the teeth at about the contact point between the canine and premolar1 the free ends are received over the hori+ontal arm1 and the wire passed up and above the contact point between the lateral incisors and canine on to the lingual surface.

/$!anta0e
=sed for retention as the hori+ontal arm is e3tended over the canine1 it helps in controlling the canines.

Be004s retention bow

he design of this labial bow is uni@ue in the sense that it serves the purpose of both the active component and retentive component of removable orthodontic appliance. to use a separate retentive unit in the design. hese is no need

#t allows the setting of occlusion at the end of the active phase of the orthodontic treatment as it is a single unit of wires1 with no wires crossing the occlusal surface.

2raw bac3s
#f it is not constructed well1 retention may not be very good. #t can get distorted easily while ad2usting.

Van $er Lin$en #etainer 2esi0n he labial arch of ,an*der linden retainer is made of 5.526F stainless steel wire. Labial arch should completely adapt to the labial surface of the anterior teeth and clasps to the canines. (ire can cross through the occlussal surface either mesial or distal to canines. #t should have a rigid labial arch which should not distort during normal use.

5o$ifications
1. Labial bow wit& !ertical 754 loop 7M8 loop offers the possibility of moving the crown palatally canine rotation is also possible by moving the center section of the loop to the mesial or distal direction.

2.

Labial bows wit& &orizontal 8 !ertical loops 4onsists of both hori+ontal E vertical loops with in the

labial bow.

Hori+ontal loop is used to control the canine position E vertical loop is used to maintain the position of anterior.

Labial &ow wit& e'ten$e$ labial section =sed to control the canine in position

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Labial bow wit& mo$ifie$ re!erse loop Li"e reverse loop labial bow1 the loop begins distal to the

canine and occlusal cross over segment passes between lateral

incisor E canine bends of loop are made at right angles. #t is used to hold the rotated canine in position.

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Sol$ere$ &oo3s wit& labial bow Hoo"s are soldered to vertical loop to engage elastic band.

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Labial bow s&eat&e$ in acr%lic (hen a labial bow is covered with acrylic the incisor

section should be bent in a cruvilinear fashion for retentive purpose. he acrylic covering is appro3imately 2mm wide E should not touch incisal edge.

< broad acrylic surface offers e3cellent retention following correction of rotated teeth.

,.

Bri$0e sprin0 wit& labial bow Some times after the upper incisor have been retracted it

is found that canine stands to far labially. #n such cases the bridge spring of 5.!mm hard stainless steel wires is wound on 7=8 loop.

Labial bows use$ in functional appliances Labial bow use$ in acti!ator

Labial bow is an important part of activator. <ctivator mostly has a single labial wire in ma3illary arch. Some times an additional labial bow is used in mandibular arch.

T&e purposes ser!e$ are 1. #t contacts the anterior teeth and applies force in posterior direction. 2. #t can stand away from anterior teeth1 reducing lip pressure against them. !. #t can function in transmitting the reciprocal force

generated by muscles to opposite 2aw. %. #n open bite bases1 it helps to orient the lips to improve their posture. '. #ts appearance can have a positive psychologic effect on child E parents by alleying their fears that the child might swallow the appliance. #n functional appliances 2 types of labial wise are used 1. =nima3illary 2. :ima3illary

1nima'illar% wire 9:.- or :..mm &ar$ or sprin0 tempere$;

his wire originates and affects teeth in the same 2aw. he

Hori+ontal segment of the wire. <ppro3imates middle third of incisor crowns /Haupl /1$!9001 vertical loop is formed in canine areas which allows for digital ad2ustment of wire. -cclusal crossover ta"es place either between canine E first premolar or between premolars. < space between the wire E teeth must be

maintained in occlusal crossover area to allow for unimpeded tooth movement.

o lessen the possibility of wire brea"ing where it enters the plastic1 2 to !mm of wire should remain e3posed where it crosses the occlusal embrasure. #t is either accomplished by coating that portion wire with wa3 during fabrication or by placing short piece of rubber or plastic tubing over wire.

#n addition to 7=8 shaped loops labial wires for functional appliance can be modified using canine loop design to move lateral incisor.

Bima'illar% wires 5.$mm spring tempered wire is used. he bima3illary wires of >schler /1$;10 were designed to ta"e optimal advantage of orbicular oris muscle. :est suited for appliances that are worn at night

hey have a negative segment upon which the lip of opposing 2aw acts and a positive incisor segment that contacts and deliver force to the teeth.

#t is formed to apply force to either ma3illary or mandibular tooth.

Labial bow use$ in Bionator

5.$mm hard wire Labial wire contacts the incisal third of anterior teeth. <t the middle of canine1 it angles downwards to begin the buccinator loop.

<t the middle of mandibular premolar crown another band brings the wire bac" to the hori+ontal plane.

#t e3tends distally1 remaining appro3imately 2mm away from mandibular teeth

<t the distal surface of primary molar or mesial surface of first molar the wire curves upward E returns mesiallly. -cclusal cross over ta"es place between canine E first premolar or primary molar. his type holds the chee" away from posterior teeth allowing ad2ustment in incisor region.

Ton0ue screenin0 t%pe of Bionator

Labial bow is placed in the middle of space between ma3illary E mandibular incisors.

Class <<< t%pe of Bionator

Labial bow adapted to mandibular anterior teeth.

Labial bow use$ in Fran3el appliance

he labial bow used in fran"el appliance is different from the conventional labial bow which is used in removable

orthodonic appliances.

5.$mm wire is used for fabrication.

&ran"el appliance ma"es use of an unconventional labial bow either for upperDlower arch depending on the type of fran"el appliance.

:ow part of the labial bow which is used for the upper arch e3tends between the distal surface of the related incisors and is located at the middle third of incisors from the distal surface of lateral incisors it runs vertically upwards towards the gingiva and at about half the length of the canine root it curves towards the distal side and runs gently downwards to form a tag and get incorporated into the buccal sheild.

he bow part of the labial bow used for mandibular arch e3tends between distal surface of canines and is located at the gingival third of lower anterior teeth from distal surface of canine. (ire moves vertically downwards1 half way through the functional depth of the sulcus and curves distally to form a tag which gets incorporated into a buccal shield. he labial bow of mandibular

arch should be in tight contact with anterior teeth to restrict the anterior growth of mandible.

=urpose of labial bow

Labial bow of ma3illary arch is mainly used for connecting the buccal shields stabili+ing the appliance and act as a guide while positioning the appliance. he labial wire of &ran"el

appliance rest on ma3illary incisor but it is not activated or Gpinched upF as is often done with Hawley8s appliance to close spaces. his action tends to tip the incisors e3cessively to the

lingual and their apices labially if the teeth roc"s on the lingual alveolar plane it may even restrict full mandibular hori+ontal growth as the bite is deepened and upper anterior segment e3erts a retruding effect on the lower incisors and mandible at full closure when the appliance is not worn. here is some

restraining effect on ma3illary teeth and arch1 however1 although McBamara8s research indicates this is minimal1 but Lee Araber has shown that in selected cases the &ran"el8s aplliance actually has a head gear effect1 holding bac" 1ma3illary downward and forward progression. #ncisors can be tipped lingually1 and space is closed if needed1 by prefunctional appliance treatment with fi3ed or removable appliance and this is preferred to the activation of &ran"el labial wire.

he labial bow of mandibular arch restricts the anterior growth of mandible and avoids tipping of lower incisors.