Orthodontic removable appliances components, design, advantages, disadvantages

1. ‫الرحيم‬‫الرحمن‬‫هللا‬ ‫بسم‬
Mohanad Elsherif
BDS (U of K), MFD RCSI, MFDS RCPS(Glasg), MSc (Orthodontics), M.Orth. RCSEd

2. They are devices that can be inserted into
and removed from the oral cavity by the
patient as well.

3. 1. Ability of the patient to maintain good oral hygiene.
2. They are fabricated in the lab so less chair side time
in the clinic.
3. Less force are used so less strain to the anchor
teeth.
4. Less complex than fixed appliances so it Can be
used by general practitioner who received adequate
training.
5. Simple to fabricate.
6. More aesthetic than fixed appliances.
7. Cheap.

4. 1. Patient cooperation is essential.
2. They are only capable of tipping movement.
3. Multiple tooth movement is not possible so
treatment is prolonged in complex cases.
4. Frequent insertion and removal of appliance
makes it more prone to fracture.

6. ARAB
1. Active component.
2. Retentive component.
3. Anchorage.
4. Base plate.

7. These are the component that used to produce
various tooth movement these are:
BRSS
1. Bows.
2. Retractors.
3. Springs.
4. Screws.

8.  Type of wire: 0.7mm stainless steel wire.
 Components: labial arch, 2 U loops, 2 retentive
arms and 2 tags.
 Indications: incisor retraction (i.e. overjet
reduction), anterior space closure, and for post
treatment retention.
 Activation: compression of the U loops to move
the bow 1mm palataly.

11. • Used to move the canine distally.
• Made of 0.7 round stainless steel wire.
• Constructed from active arm, coil or loop,
and retentive arm.
• Activated by closing the “U” loop or the
coil.

12. U- loop canine Retractor Buccal canine Retractor

14. • Active component used to produce various
teeth movement.

15. to adjust.
to clean.
to fit in the available space without
discomfort to the patient.
adapted without slopping over the tooth
Surface.
to fabricate. Easy
 Easy
 Easy
 Easily
 Easy

16. • Type of wire: 0.6 or 0.5 mm SS.
• Component: active arm( 12-15mm), Helix (coil) (3mm
internal diameter), retentive arm (4-5mm) and tag.
• Indication: to move the tooth mesialy or distally.
• Activation: move the active arm toward the tooth to be
moved by 3mm with 0.5mm and 1.5mm with 0.6mm (or
half the tooth width). It should be done as close to the coil
as possible.

19.  Type of wire: mainly 0.5 and sometimes 0.6mm SS.
 Component: proximal arm, proximal coil, distal arm,
distal coil, retentive arm (10- 12 mm in diameter)
and tag.
 Indication: labial movement of incisors, it can also
produce minor rotation when 1 coil is opened.
 Activation: pulling the spring by 1-2mm or opening
both coil by 2-3mm.

21.  Type of wire: mainly 0.5 and sometimes 0.6 SS.
 Component: 2 T shape arms with loops
incorporated in both arms, 2 retentive arms and
tags.
 Indications: buccal movement of premolars and
sometimes canines and molars.
 Activation: by pulling the free end of “T” toward the
intended direction of tooth movement.

23.  Type of wire: 0.6 or 0.7 SS wire.
 Component: active arm (mesialy) , U loop and
Retentive arm( distally), and tag.
 Indication: to move the canine distally.
 Activation: by closing the loop by 1-2mm.

25.  Type of wire: 1.25mm SS.
 Component: omega shape wire with 2 retentive
arm impeded in the acryl.
 Indications: arch expansion.
 Activation: manually by holding both ends at the
region of the clasp and pulling them apart about
1-2mm.

27.  They are active component that can be incorporated in
the removable appliance in order to produce several
tooth movement.
 Removable appliances that have an expansion screw
usually consist of split acryl and Adam clasps on the
molars and expansion screw between the 2 parts of the
acryl.
 The screw usually supplied with special key used to
activate it in regular interval by the patient.

28.  According to the position of the screw we can make:
1. Expansion of the arch.
2. Movement of one or teeth in mesial or distal
direction.
3. Movement of one or more teeth in labial or buccal
direction.

33.  These are components that used to keep the
appliance in its place.
 How?
 By engaging certain under cuts in the teeth these are:
a. Buccal and lingual cervical undercuts (e.g.
C clasp).
a. Mesial and distal proximal undercuts ( e.g. Adam
clasp).

34.  Should offer an adequate retention.
 Can be used in both partially and fully erupted tooth.
 Should not apply any active force to the tooth.
 Should be easy to fabricate.
 Should not imping on soft tissue.
 Should not interfere with normal occlusion.

35.  Unercuts engaged: Designed to engage the bucco-cervical
undercuts.
 Type of wire: 0.7 mm SS wire.
 Component: Consist of C shape clasp and retentive arm.
 Advantages: simple in design and fabrication.
 Disadvantages: cannot be used in partially erupted tooth.

37. Robert’s Retractor Mill’s Retractor

38. Quad helix Hyrax appliance

39.  Unercuts engaged: Designed to engage the mesial
and distal proximal undercuts.
 Type of wire: Constructed of 0.7mm SS wire.
However when adam clasp is used on anterior teeth,
premolars or deciduous molars it is usually
constructed from 0.6 mm SS wire
 Components: Consist of 2 arrow head (that engage
the undercuts, a bridge (which is 45 degree to the
long axis of the tooth in the middle third of the crown)
and 2 retentive arms.

43. 1. Can be used in both deciduous and permanent teeth.
2. Can be used in both fully and partially erupted teeth.
3. Can be used in both anterior and posterior teeth.
4. Can be modified in a number of ways.
5. Rigid and offer excellent retention.
6. No specialized instrument needed for its fabrication.

46. Southend clasp Ball end clasp

47. • Clasp more teeth.
• Occlusal capping.
• Split the load.(2 URA’s rather than 1).
• Split the activation (move teeth on one side only).
• Add extra-oral device.

48.  The bulk of the removable appliance is made of acryl.
 It can be made of self-cure or heat cure acrylic resin.
 Thickness is usually about 1.5-2mm.
 Maxillary baseplate cover the entire palate distal to 6 for
strength while mandibular baseplate is U shape and
shallow to avoid irritation to the lingual sulcus.

49.  Unites all the component of the appliance into one unit.
 Helps in anchoring the appliance in place.
 Provides support for the wire component.
 Helps in distrusting the forces to a large area.
 Can act as an active component ( e.g. bite planes to treat
deep bite).

51. Declaration
 The author wish to declare that; these presentations are his original
work, all materials and pictures collection, typing and slide design
has been done by the author.
 Most of these materials has been done for undergraduate students,
although postgraduate students may find some useful basic and
advanced information.
 The universities title at the front page indicate where the lecture was
first presented. The author was working as a lecturer of orthodontics
at Ibn Sina University, Sudan International University, and as a
Master student in Orthodontics at University of Khartoum.
 The author declare that all materials and photos in these
presentations has been collected from different textbooks, papers
and online websites. These pictures are presented here for education
and demonstration purposes only. The author are not attempting to
plagiarize or reproduced unauthorized material, and the intellectual
properties of these photos belong to their original authors.

52. Declaration
 As the authors reviews several textbooks, papers and other
references during preparation of these materials, it was
impossible to cite every textbook and journal article, the main
textbooks that has been reviewed during preparation of these
presentations were:
 Contemporary Orthodontics 5th edition; Proffit, William R, Henry
W. Fields, and David M. Sarver.
 Handbook of Orthodontics. 1st edition; Cobourne, Martyn T, and
Andrew T. DiBiase.
 Essentials of orthodontics: Diagnosis and Treatment; Robert N.
Staley, Neil T. Reske
 Orthodontics: Current Principles & Techniques 5th edition;
Graber, Lee W, Robert L. Vanarsdall, and Katherine W. L. Vig
 Orthodontics: The Art and Science. 3rd Edition. Bhalajhi, S.I.

53. Declaration
 For the purposes of dissemination and sharing of
knowledge, these lectures were given to several
colleagues and students. It were also uploaded to
SlideShare website by the author. Colleagues and
students may download, use, and modify these
materials as they see fit for non-profit purposes. The
author retain the copyright of the original work.
 The author wish to thank his family, teachers,
colleagues and students for their love and support
throughout his career. I also wish to express my
sincere gratitude to all orthodontic pillars for their
tremendous contribution to our specialty.
 Finally, the author welcome any advices and enquires
through his email address: Mohanad-07@hotmail.com