Lec-8- 15-11-2013

Palato – labial Tooth Movement

Z-spring
It is palatally situated active component of removable appliance similar to letter Z
in shape. It is used to move one anterior tooth from the lingual to the labial direction.

Uses:

1- The main use is the correction of an anterior crossbite of one tooth.

2- Correction of rotated incisor of less than 90o together with a Hawley arch.

Properties:

1- It is constructed from 0.5 mm hard stainless steel wire for incisors and 0.6 mm
stainless steel wire for canines.
2- Its width is equal to the mesio-distal width of the tooth from the contact areas.
3- The active arm sits on the cingulum and the level of the coils with the arms
should be perpendicular on the long axis of the tooth to prevent slippage of the
spring.
4- The spring is covered by a thin layer of acrylic extending from the base plate to
prevent food stagnation in the area during eating, deformation of the spring from
the bite of the lower incisors, slippage of the spring in an incisal direction and
trauma.

Activation:

It is done by opening the coils so that the distance between the active arm and
the third arm increases by 2 mm, or so that the active arm just crosses the incisal edge
(in case of rotation, one of the coils is opened only). This gives a small force for tooth
movement that lasts for a relatively long duration (2-3 weeks). When activating the

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spring, the active arm is pulled by Angle’s pliers forwards and upwards away from the
base plate in a 45o so the spring does not interfere with the path of insertion.

Anterior Retention:

The force of activation is applied on a 60 o inclined palatal

surface. This force is analyzed into two components; vertical and
horizontal. The vertical component tends to dislodge the
appliance incisally making the spring inactive. Therefore, it is
important to put additional retentive clasps on the anterior
teeth, preferably as anterior as possible to be more effective.
Such additional anterior retention means may be:

a- Adams clasp on the adjacent incisor.

b- Adams clasps on 4 │ 4 or D│ D.
c- C clasps on c │ c.
d- Least preferably double adams clasps on 6E E6 or 65 56 with a Hawley arch
anteriorly.

Design of a removable appliance:

1- Active components: Z spring on 1.

2- Retentive component: Adams clasps on 64 46 or 61 6.
3- Acrylic component: base plate with posterior bite plane in case of anterior
crossbite.
4- Extra component: Hawley arch in case of rotated incisors.

Alternatives: screw

Modifications: the modified Z spring has a non-traumatic end extending on the labial
surface of the incisor to permit slight mesio-distal movement in addition to the =alate-
labial movement.

Double Z spring

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 Basically it is a combination of two Z springs joined anteriorly at the active arm
forming one major active arm.

Uses:

1- Correction of more than one incisor in

crossbite.
2- Correction of mild rotations and
irregularities of more than one incisor
together with a Hawley arch.

Components:

1- One large active arm.

2- Four small connecting arms.
3- Four equal coils of 2 mm internal diameter.
4- Two retentive tags.

Properties:

1- Constructed from 0.5 mm stainless steel wire.

2- Its width is equal to the collected mesio-distal widths of the incisors to be
moved.
3- The level of the coils with the arms should be perpendicular on the long axis of
the teeth.
4- The spring is covered by a thin layer of acrylic.
5- The outer coils are directed upwards and the inner coils are directed downwards
to keep the spring in one plane.
6- The inner coils are separated by 0.5 – 1 mm.

The activation and anterior retention are similar to the Z spring.

Design of a removable appliance:

1- Active components: double Z spring.

2- Retentive component: Adams clasps on 64 46.
3- Acrylic component: base plate with posterior bite plane in
case of anterior crossbite.
4- Extra component: Hawley arch in case of rotated incisors.

T – SPRING
It is a palatally situated active component of removable appliance. It consists of a
T shaped arm whose ends are embedded in acrylic. It is used for buccal movement of

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upper premolars and molars. It is constructed from 0.5 mm stainless steel wire. It works
effectively on a tooth with a rather vertical palatal surface.

If we need to move a premolar or a canine buccally the patient may find it

difficult to insert the appliance if a Z – spring is used. So the T – spring can be much
simpler to manage.

Note: the T spring should be away from the palate by 1 – 2 mm, and touches the cast only at two
points; the active arm and the retentive tag to allow for activation of the spring without
impinging the gingiva and to ensure that it does not impinge the gingiva as the tooth moves.

Activation:

It is activated by pulling it away from the acrylic base plate in the direction of
tooth movement. After the tooth had moved some distance, it is necessary to elongate
the spring at the adjustment loops.