Orthodontic Coil spring

Orthodontic coil spring, types, uses, clinical tips, activation and deactivation.

3. Under Supervision of: Prof. Dr. Maher A. Foud

Prepared By: Yasmine M. Hammad

Gap Wh In
i III) un

4. Coil Springs

Coil springs were introduced in orthodontics as early as 1931, they are
active (force generating) component of the fixed appliance along
side with archwires and elastics.

= Orthodontic tooth movement requires the application of force
4 delivering system that should - ideally- provide optimal and continuous |

- force to achieve the desired results.

RAMANA

_ Accordingly, coil springs may be: Open Coil

Open Coil /or Closed Coil
both of which differ not only in
design but also in their clinical

application.

5. AAAAAAARAAARAARARAN

Open Coil

ES SS EN SE TE N SS EZ EEE SE SE EZ ES SEI EI ES STETS II III

Closed Coil

6. À
OPEN COIL SPRINGS

are compressed between two teeth or a group of teeth.
the deactivation force is transmitted to the teeth equally on
both sides from center of compressed coil via brackets,
hence moving dental units apart and opening spaces.

* FEATURES

Wire size : made of 0.010"
Lumen diameter: 0.035"
Material: SS, CoCrNi and NiTi
These three variables
determine the force produced
by an open-coil spring.

133952 E E
A . ms

8. Open Coil Springs
SS coil springs are usually compressed to
60% of their initial length {e.g: from 15mm to “en x
6mm}, they only produce initial forces of E

high magnitude that quickly dissipate even
with small deactivations.

‘The open coll spring

A study by Von Fraunhofer El al ob
the forces generated by he t
N (Sentalloy, GAC

International, NY) and stainless steel
(3M Unitek, Calif) open-coil springs.
The Sentalloy produced forces of *
55 to 70 g with 9 mm of activation, =
whereas the SS springs produced =~

forces of 200 g when activated by
just 1 mm. AAA

tin
forces over a large range
of activation for a long
time, which limited the use
of stainless steel coll

Bourke et al;Force charac of nickel-titani 1-coil springs. American Journé thodo

9. Pr LL

ph HhAAAAA 4 44

Ay Mae,
af

e
“yt,
5 E ; ey
After the invention of Nickel ye,
Titanium alloy in the 1970s, CS
NiTi open coil springs were Ce
introduced as they can E
produce light, continuous =
forces over a large range >
of activation for a long =

vy
di

time, which limited the use
of stainless steel coil

Y
FAS
3

10. =

activation
LOADING FORCES

— ee
NN
vor wvwvvvv

eee

UNLOADING (TOOTH-MOVING) FORCES
deactivation

Open Coil Spring

The open coil spring
is a wound spring
which is activated
by compression to
exert a net
“pushing” force in
two directions

away from its
center.

11. eRe IT

Es

The larger the lumen size and the smaller the
wire cross-section, the lighter the force produced,
for the same activation. Another important physical
parameter of open-coil springs is the winding pitch.

2 types of Open coil springs:

t ft 1 AND MANN
onatoy Stop Wound Open PO ANNAN
Aste pich
cranare |
incorporated p
into the wire is
Therelore
ony wc
coils (small
ae
EES

5
4
|
pe Ë

Fig 1. The 2 types of opea-coll springs tested: stop-
‘wound top) and undormiy wound (bottom.

12. Pitch is
the distance
between
individual
coils in the
spring.

13. As the pitch

, the
amount of wire
incorporated
into the wire is
increased.
Therefore,

coils (small
pitch) generally
produce

14. Fig 1. The 2 types of open-coil springs tested: stop-
wound (top) and uniformly wound (bottom).

15. À sj DIN pa
gor e

aes? se

Aria

Uprighting of teeth

16. NiTi open coil springs are available at the force range of 50,
100, 150 and 200 gm.
And are usually compressed to the 1/3rd of their initial effective
length. The initial free length of the open coil spring is 15 mm.
According to the manufacturer(s), this spring when compressed
by 12 mm, reaching 3 mm and deactivated delivers an almost
constant force upto 9 mm of deactivation beyond which force

initial length

will a za | ts ise ES
van PANA
Epi Rae C— _ tivation
vvvvvvv RM mm

NOTE: Several studies have found that
the effective force values are EE “
somewhat lower as compared to the deactivation ---9MM---
¿1 manufactures claims. ¢
“Orthodontics: Diagnosis and management of malocclusion and dentofacial deformities. Section Ill: Components of contemporary fixed orthodontic appliance, pg:236",
illinois

17. niti en nn.

ON

-3 mm-

> activation
AAA ANA] A )-=

deactivation ———

18. Close Coil Spring

The SS closed coil springs have vanished in use since
the introduction of NiTi close coil springs.
USES

1-Retraction of the maxillary canines into the
extraction spaces.

LOADING FORCES

A>

—
| ne onone clootnovne) FORCES

Closed Coil Spring

\
2- Very useful for en-mass MAY N (eng)
SS Ë ps A AT
retraction of the anteriors Vals FA Om)

especially in the upper arch.

3- Orthodontic alignment of the ran

impacted teeth. Authors have >
particularly foundthese useful =
in cases with palatally impacted
canines.

19. o

USES

1-Retraction of the maxillary canines into the
extraction spaces.

2- Very useful for en-mass “AN y UN
retraction of the anteriors rs ee” à
especially in the upper arch.

3- Orthodontic alignment of the ran

impacted teeth. Authors have
particularly foundthese useful ETES
in cases with palatally impacted 4
canines. Me

20. The close coil springs are available in 50, 100, 150 and

200 gm.
The spring’s effective initial length is 3 mm. The springs

are activated to the length of 15 mm, i.e. 5 times the
initial length. The spring deactivation force is close to the
values of spring until 0.5 mm of its activation hereafter it

gradually falls. som
.-3mm-, --- 12mm---
CLMMZ®) activation >

ne
Ses) Fe

EVE TS EE JU
"eumelanin pan
Ce er KA RASO

lance. pg 236"

1 orhadonis: Diagnosis and management of mlocelusion and dentofacial deformes. Secbn I: Components of contemporary xed othodontc appl

21. .-- 3mm--, --- 12mm---

activation D

22. Closed Coil Spring

ss 4

100 gm coil 150 gm coil

+ Sentalloy closed coil springs of 0.010" diameter and 0.035" lumen

- 3 mm initial effective length require about - 3 mm initial effective length and temper,

110 gm to activate it by 12 mm displacement À require about 178 gm to activate it by 12 mm

to a length of 15 mm. displacement to a length of 15 mm.
- À constant deactivation force of - A constant deactivation force of 121.38
84.66 + 15.3 gm is produced until +21.52 gm is produced until about 0.5mm|
about 0.5 mm displacement displacement

+ 0.5 mm displacement hereafter it dips to O gm at original length.
+ No permanent deformation was noted in the coil springs.

“Orthodontics: Diagnosis and management of malocclusion and dentotacial deformities, Section it: Components of contempor

23. Ms pone

#3.A von Fraunhofer: Force Generation by Orthodontic coil springs. The Angle Orthodontist. Vol.63 No.2 1993.
‚eiiStorey E.. the nature of tooth movement.

24. The recommended forces for dental movement,

Upper central incisor
Upper lateral incisor
Upper canine

Upper first premolar

Upper second premolar

Upper first molar

Upper second molar
Lower central incisor
Lower

Lower canine

Lower first premolar
Inferior second premolar
Lower first molar

Lower second molar

according to Ricketts, are:

Ricketts’ Table

Anteroposterior se Intrusive and extrusive
movements. s moveme:

"1.001 Tips for Orthodontics and Its Secrets" Esequiel Eduardo, pı

26. Orthodontic Coil

Springs

28. rezi

“The maximum force generated by springs isan
impor drague is deinen ast
Produced when to Sega ae compressed

Open col sings weve sy
thet labeled value, but Faros were
signa higher No mantacturers included

| any information with hair products warming

the clinician ofthe possible maxim
‘magnitudes produced by the spring

29. Clinical implications of Coil-springs:

The maximum force generated by springs is an
important characteristic ,it is defined as the force
produced when the springs are compressed

to 50% of their resting length.

Open coils need to be compressed more than
one-third of their original length to produce the
forces labeled by manufacturers, though it was
found that the average force magnitudes
produced by some commercially available NiTi
open coil springs were significantly lower than
their labeled values, but the maximum forces were
significantly higher.No manufacturers included
any information with their products warning Very important note:

the clinician of the possible maximum force Sentalloy open-coil springs with a suggested force

delivery of 150 g actually produced 300 g of force
magnitudes produced by the springs.* when compressed to 80% of their original length.

Based on the ability of the heavier springs to
produce forces as high as 527 g, the clinician must
+ Bourke et alForce characteristics of nickel-itanium open-col springs. American Jounal USE Caution, especially when activating heavier
of Orthodontics and Dentofacial Onhopedics. August 2010.Volume 138, Number 2 springs.

30. oi Me: |
Clinical implications of Coil-springs: |

OPEN COIL SPRINGS:

23 NiTi open-coil springs available in the
markets were subjected to measuring
force level in compression testing.

The open coil-springs with initial 15mm
length were evaluated at 25%
compression and 50% compression.

Only 4 out of 23 NiTi open coil springs
(GAC light, medium, heavy and RMO 12 x
45) showed well-defined plateaus
indicating their superelastic properties. It
was recommended that these particular
springs should be cut to a length of 200%
of the interbracket distance as they
| require a preactivation of 50% of their

initial length to take full advantage of the
» superelastic properties, that is, constant
==) forces over long deactivations.**

31. 250 CAME
External

diameter Force [N], Force [N], Ratio,

Company Coil spring RefNo. Lot No. mm) sD SD" significance
3M Unitek, St Paul, Minn Light 45-10 29885-15 135 025,002 06,00 065%
Medium 35-20 32380-38 125 062,004 1.30,0.08 0.70, ***
Hey 35-275 3139-28 14 081,008 19,00 063"
‘American Orthodontics, 0.091 855-171 9101 141 037,002 091,004 064"
Sheboygen, Wis
0.076 855-170 9101 124 060,009 12,00 074%
Dentaurum, Ispringen, — Rematitan lite, 758-360-00 5840 125 055,013 12,02 072
Germany light
Rematitan Ike, 758-36100 59027 134 100,011 22,007 074%
medium
Rematitan lite, 758-362-00 597 162 120,013 049 290,005 067,
strong
Forestadent, Pforzheim, Medium 311-2001 0684024 151 110,008 An 210010 076,"
(Germany
Distalizing spring 311-2020 O48 168 043,092 05° 0.0.00 065"
GAC, Bohemia, NY Light! 10-00-09 A476 136 067,095 072,ctL 080006 120, ct
Medium 10-00-08 A486 139 110,004 QTIım 15,00 Lin
Heavy 10-00-07 MSG 143 130,013 065,m 18000 1.00, ns
Ormco, Orange, Calif "Light 221-5510 07M23 126 045.002 056” 0.6.03 071,”
Medium 22-5512 07M2 136 110,007 055%" 240009 075,"
Heavy 221-5514 07194 162 100.009 048" 24.017 064"
OnthoOrganizers, Molar 100-647 415437808167 043,002 059," 09,003 065,"
Carlsbad, Calif
10 X 36 100-644 412814007 143 036.006 0437 0.6.0.6 069,
10 x 30 100-643 — 41G487A08 122 052,006 QS2** 120,006 070%
14% 37 100-642 34375403159 120,017 050” 2,017 067,”
RMO, Denver, Co 10% 30 FOOT 12245 126 055,003 052%" 10,00 074
12x45 Fou02 028510 173 052.008 054 1.00,0.15 085
12x30 Fom03 12487 136 100,097 053°" 22,00 072%"

‘Significance is indicated at 3 evel (P=0.05[*), P=0.01 ["*], P=.001 [**]) in comparison ta the col spring with the best ratio of variance (GAC

rauchli et al:Force levels of 23 nickel-titanium open-coil springs in compression testing.American
‘Orthodontics and Dentofacial Orthopedics.May 2011, Vol 139, Issue 5.

32. Clinical implications of Coil-springs:

e Stop wound vs Uniform wound.

For the force to remain near constant despite tooth movement, the MAAIAATA
load deflection ratio must be relatively low. 1 1 1

Significant differences were found between the 2 spring designs. The stop-

wound coils produced higher average forces, maximum forces, and load

deflection ratios. The lower load-deflection ratio of the uniformly wound

coil could be considered more clinically appropriate, the stop-wound coil ae
has a mechanical disadvantage compared with a uniformly wound coil of ARE av
the same length. The winding configuration of the stop-wound coil consists
of areas of open and closed coil. Therefore, there is a smaller potential
range of compression with increased stress created in the active portions
of the coil during compression compared with the uniformly wound coil.
The characteristics of the stop-wound coil would be comparable with those

of a uniformly wound coil with a length equal to the sum of the uniformly AVIV
wound (active) portions of the original stop-wound coil. This explains the À

higher average and maximum forces created during decompression. uniformly wound

stop-wound

Bourke et al:Force characteristics of nickel-titanium open-coil springs.American Journal of Orthodontics and Dentofacial Orthopedics. August
> 2010.Volume 138, Number 2

33. Clinical implications of Coil-springs:

CLOSED COIL SPRING

As in Open coil springs, 22 NiTi closed-coil springs 'CCS' of 8.5-mm (10-
mm-long advertised length) were subjected to tensile mechanical testing
on activations in a temperature simulating that of the body temperature
varying from 3.2 to 16.0 mm (500% of 3.2 mm) before and after 6 months
of clinical use. It was found that permanent deformation became
greater as the amount of activation increased especially at the activations
normally used (12.8 and 16 mm) which are more practical because they
correspond approximately to the distance between the first molars
and the canines.

The long-term use or recycling of nickel-titanium CCSs was found to be
inadvisable because of their degradations in superelastic properties,
changes in force, and decreased elastic recovery. Clinically, nickel-
titanium CCSs should NOT be reused because they lose the ability to
return to their original shape. Clinicians should understand the limitations
of these materials and modify their expectations by monitoring the
progress of treatment accordingly.*

The 3M Unitek springs produced the most constant forces throughout an
activation range of 13 mm and, therefore, were considered the most ideal
for clinical tooth movement.** Faure 2. Poprosa nikal ant done ot wpe,

Zum sm

+ Magno et al: Effect of clinical use of nickel-itanium springs American Journal of Orthodontics and Dentofacial Orthopedics July 2015, Vol 148 . Issue 1
* Bourke et al Force characteristics of nickel-ttanium open-cail springs. American Journal of Orthodontics and Dentofacial Orthopedics. August 2010 Volume 138, Number 2

34. in/sever, lliterátures, à
Was found that uring

deactivation, NiTi open
and closed e

deliver alload less thal

the | f

35. Clinical implications of Coil-springs:

CLOSED COIL SPRING:
How to Use??

First: measure the area between
components used for closure or traction.
Second: when choosing the proper NiTi
CCS notice that 2 types are available : with
and without stainless steel eyelets.

Third: The length of inactive closed coil is 3
mm ( the eyelets not included) and can be

stretched up to 15 mm without deformation
or force change, so,eyelets should be
subtracted from the coil length as they are
not extensible.

NOTE:
Various eyelet diameters are available in
_ the markets, the eyelets are soldered to
… the coil with laser and this makes placement
f= on tubes, loops, brace hooks, TAD heads

36. i
la
ji
3
il
H

a
i
i
af

NiTi Preformed Springs

Heavy 2509

db orthodontics

37. Sentalloy Closed Coil Springs

Closing spaces with closed Sentalloy coil springs brings unprecedented results. TITAN™ Coil Springs
Two designs are available: CL AU EXTENSION QE

sh NICKEL TITANIUM - EXTENSION
1. Two eyelets: The initial length is 3 mm. unactivated (this does not include the eyelet

lengths). These can be activated to 15 mm. without any deformation or change in force. No ALL SPRINGS ARE NOT CREATED EQUAL!
change in force will be seen as the coil contracts, reducing the space. To en- / Absolute consistency that works all the way through.
‘Gage, slide over a molar hook and slowly stretch to the post on the cuspid

bracket ora siding hook on the arch wire. Use a locking Mathieu plior AL Onho Species nickel titanium col springs have variable or
on the widened platform of the eyelet. Hi you do not use the cuspid — intl force a ful extension to overcome the moment of inertia
post, tie the arch wire to the tooth you wish to move, slide on Des

the sliding hook, then tie in the balance of the wire. Now en- x + Cutus
gage the spring as above. L

2. For an eyelet with ligature wire, you

have the option of hooking the eyelet

on the molar, then activating the spring A
and tying it tothe cuspid bracket with h

the 008” ligature wire. Should you wish t

to span an area greater than 15 mm., e

measure the span frst. Then place the ee

coil on the molar hook and activate the
coil 10 mm. Tie the ligature wire to the bracket. Force Loves are dependent upon 1) Total mm of extension and 2) Your

Color
Purple CHOOSE THE DESIRED GRAM FORCE AND LI
109 Blue Gram Forces: Ma
Yellow
Red
Green
White

38. ™ Coil Y n

Are TITAN” Coil Springs FE

NICKEL TITANIUM - EXTENSION 3
fin oes wich include the epale ave ii
formation of change in force. No ALL SPRINGS ARE NOT CREATED EQUAL! La El
Sr nn if
so on the cuspid
Mathieu pli Al Oro Species cietttaniu col singe have arabe fore’ repartee. Spaces, the singe provide sigh higher
Pepsi Inseln oc ih onen nr Ele ds cea ce per fe
“= Ed .

ay + Cut using automated equipment ensuring consistent spring
h

ins
A a

+ Eyelets are machine wound onto the spring for highly accurate
levels offorce

Mamenfecmmended censor: Virm Maimun fconmerded Dn Matrumfecrmenied tenon: nm
[e e o Mnmanfwesmmensedtserson Iimm Mima faconmandeatatrasr. m

C2 3
ze una

CE

Recommended Range otActwaton: bm Recommended ange ct tation: 9mm Recommended Rangect Activation: 12m.

“SALE amo] pue sadn URBANA 940 PEUT JON “une

2
tit
8
z
Hu
ipl
‘Force Loves ar dependent upon 1) Total mm of extension and 2) Your choice of ight, mechum orheavy spring. te
Caer HE EN
que {€ CHOOSETHE DESIRED GRAM FORCE AND LENGTH. E al !
Blue Gram Forces: Maximum/Average gt
Yellow e258 j El:
= HER
White Sm | TAD, Tight spaces 200/310 30090 - = | 6mm i E
SI a | mn | du |
= 12 mm | Extended Class 1 Retraction 160/260 207390 390/880 om [12mm is E35 1
ER 15mm ión - wen | wu | oo [5m] © FEBRES
= 3

39. Force Levels are dependent upon 1.) Total mm of extension and 2) Your choice of light, medium or heavy spring.

CHOOSE THE DESIRED GRAM FORCE AND LENGTH...

Gram Forces: Maximum/Average

TAD, Tight Spaces
Standard Class Il Retraction
Extended Class II Retraction
Intra-Arch
designed

two times their original length. The higher rate reflects maximum extension; the average rate of force you can

40. Nitinol Coil Springs

Nitinol Open Coil Springs
Length 7° (175 mm)
Packaged 3 per tube
Available in three forces

Nitinol Closed Coil Springs
Length 9 mm and 12 mm lengths,
8 Dimension, inner diameter (arbor)
0.030" (0.76 mm). Packaged 10 per
box. Each available in three forces.

Min.

Order No. Inner Diam. (Arbor)
345-100 0.030" (0.76 mm)
345-200 0.030" (0.76 mm)
345-275 0.033" (0.84 mm)

Force (9) €
Description 9mm 12 mm Ext.
Ught 344-150 1509
Medium 344-200 2009
Heavy 344-250 209

Opening
Force (9) 25 mm (1")
Length Compressed
Desc. 1019 mm (0.75")
Light 1009
‘Medium 2009
Heavy 2759
Force (9) €
2mm 24 mm Ext.
346-150 1509
346-200 200 9
346-250 2509

Important: Do not expand 9 mm coil to more than 22 mm total length from
eyelet to eyelet or do not twist more than 180° (half a turn) to avoid deformation
or significant change in force. A 12 mm coil spring is recommended for cases
which require the spring to be expanded to 22-36 mm from eyelet to eyelet.

Caution: Not designed for use between upper and lower arches.

=] 3M Unitek

41. db orthodontics

NiTi Preformed Springs a

Nickel Titanium Preformed Springs close or open spaces at a level which is
unapproachable with stainless steel springs. Sold in packs of 10.

Lee = 12mm Pricefpack
Light 1509 D841-0150 D841-0151 £27.78
Medium 2009 DB41-0200 D841-0201 £27.78
Heavy 250g DB41-0250 0841-0251 £27.78

43. Singla et al, The journal of indian Orthodontic Society, Dec 2011
Open coil springs are mainly used for opening spaces to crowding, and for distalizing molars.
Insertion of open coils is a cumbersome procedure that often requires assistance to hold ends with a
tucker. Failure to ligate the teeth properly can lead to rotation of teeth.
The method presented will eliminate the need for tucker or assistance in any form:

qe

DIL

Fo. 3 Te cares at ichs tomar aca ah

44. Fig. 1: Coil spring inserted into the archwire and tooth on one side of
coil spring tied with ligature wire

45. +
“he, /

=.

Fig. 2: An elastomeric ligature engaged into the other
end of the coil spring

46. Fig. 3: The elastomeric ligature stretched toward adjacent tooth

47. Fig. 4: Elastomeric ligature engaged into the wings of the
bracket of adjacent tooth

48. Fig. 5: Tooth engaged with ligature wire

49. Fig. 6: Elastomeric ligature cut to remove it

50. Sr. *#

Fig. 7: Fully ligated bracket

51. Reactivation of Open coil Springs: A Novel Intraoral Procedure
Kumar Sahu et al: The journal of indian Orthodontic Society, Sep 2012

The use of open coil spring to create space for a blocked out tooth is common. However, the
Clinician is faced with a situation were removal of archwire is required to reactivate the spring to
regain sufficient amount of space.

In addition, once some amount of space opening is achieved, another (longer) spring is re-
inserted to produce more space. This will cause reciprocal forces on adjacent teeth resulting in
undesirable tooth movement (rotation..etc) especially if unilateral activation is required. In such
case, insertion of single or multiple crimpable hooks is done. Again this is not cost effective yet it
consumes much of the clinician time.

The following technique provide an easy cost effective method for spring activation:

53. Fig. 3: After

Fig. 2: Spring was compressed by a wire tucker toward the side of the tooth need to be moved

54. rethod for spring activation:

Fig. 3: After composite bead was made in rectangular wire and continuous bead in round wire

ES TN

| to be moved

56. Clinical pearl: a method of controlled movement of teeth using

open and closed coil sprin
N. R. Smith, Journal of Orthodontics, Vol. 34, 2007, 173-175

Teeth adjacent to the active coil spring are subjected to a force which
can result in several unwanted effects:

1- rotation;

2- tipping;

3- disengagement of the brackets off the archwire on either side of
the active coil spring;

4- increased friction.

Acommon way to lessen these unwanted effects is to tie the A
neighbouring brackets to the active coil spring tightly onto the

archwire with stainless steel ligatures. Although the rotations resulted
could be dealt with when dropping back to a flexible archwire to pick
up a displaced tooth, the increased friction slows progress.

If the ligatures fail, a tooth is pushed off the archwire resulting in
increased treatment time.

If the force could be ‘broken’ and divided between more teeth then
1. less unwanted movement might occur.
This can be achieved by using closed coil spring as a ‘brake’.

57. Figure 1 Coil spring causing unwanted reciprocal rotation

58. Figure 2 Closed coil spring inserted either side of the active coil
spring to prevent unwanted reciprocal movement

59. PURE a Cam

CONT.:Clinical pearl: a method of controlled movement of
teeth using open and closed coil spring

Each time an active coil spring is placed a segment of closed coil spring can
be inserted between the adjacent inter bracket spaces over the archwire. This
coil spring needs to fit closely to the edges of the brackets so no movement of
the two brackets on either side is possible.

The closed coil can be offered up to the inter bracket space with serrated
college tweezers and then cut to length and threaded onto the archwire. Itis a
simple and quick procedure that could be used routinely.

Using this technique some tipping was still noted but rotation is virtually
eliminated. Teeth and brackets are more fixed in their position the archwire is left
free to slide with reduced friction.

Even if a ligature is lost on the brackets either side of the active coil spring the
closed coils usually prevent the tooth spinning off the archwire.

excluded
is completely ed

force mas

across ean
is qui oy E
space © opening proven ay ms e
ai sprint
cal 10 = from a active ©
recipre

remain in place

60. sed coil spring

d coil spring can
je archwire. This
no movement of

ith serrated
archwire. It is a

Virtually
he archwire is left

e coil spring the

A

61. Cases where a tooth is completely excluded
from the arch, greater force may be needed.
More closed coil spring brakes can then be
placed to distribute the force more evenly
across several teeth.

Space opening proceeds quickly with no
unwanted tooth movements. Teeth receiving
reciprocal force from active coil spring
remain in place

62. . “Wire. ~ LO// Sp ring

Figure 5 Three closed coil springs in place Figure 7 Aligned lower indsor

63. (a) (b)

Figure 9 (ab) Two dosed coil springs braking force from active coil in lower left second premolar region

65. Orthodontic tooth movement of total buccally blocked-out canine:
a case report

Hessa M Alkhal, Bakr Rabie: Cases Journal 2009, 2:7245

À 14 years old Chinese female came for orthodontic treatment. On diagnosis, she had a problem list as follows:
Extra-oral condition: Convex profile, acute nasolabial angle, increased lower facial height, increased mandibular plane
angle, retrusive mandible and short ramus.

Intra-oral condition

Sagittal: Molar Class III on right side and canines are unclassified on left side, decrease overjet. Crossbite tooth left
maxillary lateral incisor (22) against left mandibular lateral incisor (32).

Vertical: Increased lower facial height and decreased overbite.

Transversal: Lower and upper center lines are shifted to left side (4 mm and 3 mm respectively), upper 8.5 mm crowding,
lower 9 mm crowding, buccal displacement of left maxillary canine (23) (totally blocked out) and left mandibular canine
(33), palatal displacement of left maxillary lateral incisor (22).

| The treatment plan was:
+ + Oral hygiene instruction Figure 1. Totally blocked out 23. Palatal displaced 22 Buecally displaced 33.
+ Full mouth scaling and prophylaxis
+ Fixed orthodontic appliance with extractions of teeth right maxillary first premolar (14), left maxillary first premolar (24), left
| mandibular first premolar (34), right mandibular first premolar (44) with maximum anchorage
2: « Fixed lingual retainer right maxillary canine (13) - left maxillary canine (23) and left mandibular canine (33) - right
À

mandibular canine (43) with removable wraparound retainers
« Review third molars eruption

66. Figure 2. Upper arch: 0.017 inch x 0.025 inch stainless steel
archwire, open coil to create space for 22, 23 and to correct
midline. Lower arch: 0.014 inch NiTi archwire.

67. Figure 3. Upper arch: Extraction of 24. 23 allowed to drift
down. Lower arch: 0.017 inch * 0.025 inch stainless steel

archwire. Open coil to create space for 32, 33 and to correct
lower midline.

68. Figure 4. Upper arch: 0.018 inch stainless steel main
archwire. 0.017 inch * 0.025 inch TMA sectional wire with
closing loop for distalisation, palatal root torquing and then
extrusion of 23.

69. Figure 5. Upper arch: 0.014 inch thermal NiTi archwire to
align 23. 22 not bonded. Lower arch: 0.019 inch x 0.025 inch
stainless steel archwire. Open coil to create space for 32, 33
and to correct lower midline. Power chain to retract 43.

70. Figure 6. 22 included for alignment

71. Figure 7. Extraction of 34. 0.014 inch NiTi archwire to align
32, 33.

72. Figure 8. Lower arch: 0.016 inch stainless steel archwire.
Close spaces.

73. Figure 9. 0.019 inch * 0.025 inch stainless steel archwire for
arch coordination and space dosure.

74. Figure 10. Finished occlusion.

75. de Prezi