Molar double tubes: enhancing orthodontic mechanics

In the 1960s the introduction of double tubes on molar bands popularized highly effective mechanics developed by Burstone and Ricketts.^1,2,3 The modern day pre-adjusted straight-wire operator generally favours single straight-wire molar tubes, unless an additional tube is required to accept a headgear facebow. The single straight-wire tube is less bulky than its double or triple counterpart but this advantage can be overshadowed when an additional tube is required to execute certain mechanics. This article presents rationale to stock upper and lower molar bands or bonds incorporating multiple tubes.

The stabilization arch is constructed in 0.016″ or 0.018″ round stainless steel wire. Posteriorly it passes through the accessory tubes and anteriorly it overlies the incisor brackets and is secured in place by the base archwire. The stabilization arch has multiple uses. As nickel titanium archwires can easily be distorted with the use of intermaxillary elastics, a popular use of the stabilization arch is to allow for the early use of Class II elastics whilst still in nickel titanium archwires (Figure 1). The anchorage bends mesial to the molar tubes and facilitates overbite reduction as well as assisting in reinforcing posterior anchorage. This technique enables the overbite and overjet to be addressed earlier in treatment thus decreasing the overall treatment time. Stabilization arches may also be used to maintain bite opening mechanics until a rigid base archwire may be used. Case 1 demonstrates the use of the stabilizer arch in the treatment of a Class II division II case with a deep overbite.