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References

McLaughlin RP, Bennett JC, Trevisi HJ. Systemized Orthodontic Treatment Mechanics, 1st edn. St Louis Missouri: Mosby Company; 2001

Tricks of the trade: a new method of active tie-back for space closure

From Volume 12, Issue 4, October 2019 | Page 161

Authors

Rithesh Bangera

Postgraduate student

Department of Orthodontics and Dentofacial Orthopedics, SDM Dental College And Hospitals, Sattur, Dharwad, Karnataka, India

Articles by Rithesh Bangera

Email Rithesh Bangera

Roopak D Naik

BDS, MDS

Professor and Head, Department of Orthodontics and Dentofacial Orthopaedics, SDM College of Dental Sciences and Hospital, Sattur, Dharwad – 580 009 Karnataka, India

Articles by Roopak D Naik

Anand K Patil

BDS, MDS, MOrth RCS(Edinb)

Professor and Head, Department of Orthodontics and Dentofacial Orthopedics, SDM College of Dental Sciences, Sattur, Dharwad, Karnataka 580009, India

Articles by Anand K Patil

Kumar B Shashi

Associate Professor

Department of Orthodontics and Dentofacial Orthopedics, SDM Dental College And Hospitals, Sattur, Dharwad, Karnataka, India

Articles by Kumar B Shashi

Praveen Kumar

Assistant Professor

Department of Orthodontics and Dentofacial Orthopedics, SDM Dental College And Hospitals, Sattur, Dharwad, Karnataka, India

Articles by Praveen Kumar

Article

The usual method of space closure by sliding mechanics is by active tie-backs or elastomeric chain.1 The various drawbacks encountered with the use of active tie-backs is laceration on the buccal mucosa/inner surface of the cheek, impingement on soft tissue and gingival overgrowth, thereby often creating discomfort to patients. The following is a simple and unique method of space closure with the help of sectional 0.019” x 0.025” SS wire (Ortho organizers) and elastomeric module (Ormco).

Procedure

  • Cut a piece of 0.019” x 0.025” SS wire and fabricate hooks on either end with the help of a bird beak plier (Figure 1).
  • Depending on the requirement of force levels, there are two ways of utilizing this sectional wire (Figure 2).
  • Engage an elastomeric module on one end of the wire, which is engaged on the molar hook, and the other end of the wire is free to hook onto the crimpable hook used for retraction (Figure 3).
  • When there is a greater distance between anterior and posterior segments, engage elastomeric modules on both ends of the wire, one end secured to the molar tube and the other end to the crimpable hook delivering light continuous forces efficiently (Figure 4).
  • The length of the sectional wire can be adjusted during the course of space closure by shortening one end of the wire and fabricating a similar hook.
  • The elastomeric module can also be substituted with separator modules during higher force requirements.
    • Figure 1. Fabrication of hook on either end of the wire 0.019’’ x 0.025” SS.
    Figure 2. Variation in design for patient comfort.
    Figure 3. Placement of active tie-back (elastomeric module only on one end).
    Figure 4. Placement of active tie-back (elastomeric module on both the ends).

    Advantages

  • This technique has simplicity and efficiency, where force levels can be adjusted by placing modules on one end or both ends of the rigid sectional wire.
  • Problems encountered with active tie-back, such as frequent breakage of ligature wire or disengagement of the active tie-back, can be overcome by using stiffer wire which snugly holds the crimpable hook and does not compromise on the forces applied for space closure.
  • Level of patient comfort can be increased by contouring the sectional wire according to the arch, thus preventing impingement.
  • It is easy to fabricate and does not need special equipment. No extra material is required as the cut ends of the pre-formed rigid 0.019” x 0.025” SS wire used for space closure during sliding mechanics can be utilized to fabricate this sectional wire.
  • It can be pre-fabricated in the absence of patients on their casts. Re-activation is easy, thereby reducing the overall chairside time.