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Bilateral toe-in b e n d s m a d e a p p r o x i m a t e l y
Molar Mesial-In Rotations
halfway b e t w e e n the canine a n d m o l a r brack-
ets will result in m o l a r mesial-out (M-out) cou- Bilateral toe-out bends made approximately
ples a n d c a n i n e d i s t a l - o u t (D-out) c o u p l e s halfway between the canines and molars will
Transverse Arch Wire Activations 39
Mc
Mc Mc
Figure 3. Bilateral toe-outs located halfway between
Figure 2. Bilateral toe-ins located halfway between the molar and canine brackets are symmetrical V-
the molar and canine brackets are symmetrical V-
bends. M-in molar rotations will occur and although
bends. M-out rotations of the molars will be the pre-
not intuitively obvious, no molar expansion will oc-
dominant orthodontic effect in this case.
cur.
'-F
Me
Figure 4. The larger angle of wire entry of a 2 x 6
Me
arch wire with an asymmetrical V-bend can be de- Figure 5. Toe-in bends closer to the molar than the
termined by placing the wire over the brackets as canine brackets result primarily in molar expansion
shown. In this case, the larger M c is at the molar and M-out molar rotations. The orientation of the
bracket. The equilibrium forces of the smaller Mc smaller M c at the canine will determine whether its
will either enhance or attenuate the magnitude but, associated equilibrium forces wiI1be additive or sub-
will not change the direction of, the net equilibrium tractive with those associated with the M c at the mo-
forces acting at each bracket. lar.
Mc
Figure 7. Toe-out bends closer to the molar than
the canine brackets result primarily in molar con- Figure 8. Toe-in bends close to the canine brackets
striction and M-in rotations. The orientation of the result primarily in molar constrictiori with little or
smaller M c at the canine will determine whether its no molar rotation. The smaller M c at the molars will
associated equilibrium forces will be additive or sub- have associated equilibrium forces that will either
tractive with those associated with the M c at the mo- slightly enhance or attenuate the net constrictive
lar, equilibrium forces at the molar brackets.
42 Joe RebelIato
Molar Expansion
Mo Bilateral toe-outs placed closer to the canines
will result in a reversal of the previous situation
with all couples, m o m e n t s a n d forces in the
opposite direction (Fig 9).
Clinical Uses
This activation of the 2 x 6 a r c h wire allows for
e x p a n s i o n o f i n t e r m o l a r width with minimal
changes in m o l a r first-order rotations.
Step Bends
W h e n a 2 × 6 arch wire with a step b e n d is
placed over the canine a n d m o l a r bracket slots,
Me similarly oriented angles o f entry are revealed.
Figure 9. Toe-out bends close to the canine brackets T h e Mcs at the canine and m o l a r brackets will
result primarily in molar expansion with little or no both be in the same direction with respect to
molar rotation. The smaller Mc at the molars will each o t h e r and their associated e q u i l i b r i u m
either slightly enhance or attenuate the net expan- forces will always be additive (Fig 10). Locating
sive equilibrium forces at the molar brackets. the bends progressively closer to the brackets
will result in g r e a t e r angles of wire entry at the
brackets and g r e a t e r Mcs p r e s e n t on insertion.
This in turn, will lead to associated equilibrium
Mc forces o f g r e a t e r m a g n i t u d e .
Mc
:5
_5
Me Me
Figure 10, A 2 x 6 arch wire with step bends will
have angles of wire entry and resultant couples that Figure 11. Toe-outs at the canines and toe-ins at the
are similarly oriented. The magnitudes of the Mcs molars result primarily in M-out molar rotations
do not have to be equal, but their associated equi- with enhanced expansive equilibrium forces at the
librium forces will always be additive. molars.
Transverse Arch Wire Activatior~ 43
Clinical U s e s
This activation o f the 2 x 6 arch wire is useful
J,.,, w h e n m o l a r M - o u t r o t a t i o n s are r e q u i r e d
along with greater molar expansive forces than
can be obtained with asymmetrical V-bends.
References
1. Ricketts RM. Bioprogressive therapy as an answer to
orthodontic needs. Part II. Am J Orthod 1976;70:
Mc 241-268.
2. Ricketts RM, Bench RW, Gugino CF, et al. Biopro-
Figure 12. T o e - i n s at the c a n i n e s a n d t o e - o u t s at the gressive Therapy. Book 1. Denver, CO: Rocky Moun-
molars result p r i m a r i l y in M-in m o l a r r o t a t i o n s with tain Orthodontics, 1979:93-126.
e n h a n c e d constrictive e q u i l i b r i u m forces at the mo- 3. Isaacson RJ, l.indauer SJ, Rubenstein LK. Activating a
lars. 2 x 4 appliance. Angle Orthod 1993;63:17-24.
4. Burstone cJ. Rationale of the segmented arch. Am J
Orthod i9(52;48:805-822.
5. Burstone CJ. The mechanics of the segmented arch
Step Bend for Molar Expansion techniques. Angle Orthod t 966;3:99-120.
6. Burstone CJ, Koenig HA. Force systems from an ideal
arch. Ant.] Orthod I974;65:270-289.
Bilateral toe-outs closer to the canines with toe- 7. Burstone cJ. Precision lingual arches--Active applica-
ins closer to the molars results in a step b e n d tions. J Clin Orthod I989;23:101-I09.
activation o f the 2 × 6 arch wire and the ca- 8. Demange C. Equilibrium situations in bend force sys
nines a n d molars will b o t h feel M-out Mcs terns. A m ] Orthod Dentofacial Orthop 1990;98:333-
339.
(Fig 1 1). T h e i r associated equilibrium forces
9. Smith RJ, Burstone CJ. Mechanics of tooth move-
will b o t h be facially d i r e c t e d at the m o l a r ment. Ant J Orthod i984;85:294-307.
bracket a n d lingually directed at the canine 10. Yoshikawa DK. Biomechanical principles of tooth
bracket. movement. Dent CIin North Am i981;25:19-26.