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December's Tip: Keeping Wires in Self-Litigating Brackets

Click picture to view Dr. Hughes' website

Click picture to view Dr. Hughes' website

Figure 1

Figure 1

Figure 2

Figure 2

Figure 3

Figure 3

Figure 4

Figure 4

Figure 5

Figure 5

Figure 6

Figure 6

Figure 7

Figure 7

Dr. Thomas Hughes

Today more and more practitioners are using true self-ligating brackets (brackets that have doors that don't put any pressure on the arch wires) and now need to find a way to keep the wires they use from sliding out of the brackets and pocking their patients.
I'll show you two ways to solve this problem and hopefully make using these brackets more comfortable for your patients.
The first way is to use a sliding stop on the arch wire that you crimp down tight at the midline of the wire Figures 1-3. If there is not enough space between the centrals for the stop to fit, place the stop between one of the laterals and canine. This way the wire can only slide a very small distance mesial or distal until it touches one of the brackets and then stops. You can use .018 or .022 round solid stops for doing this with the small stops used on wires smaller than .018 x .018 and use the .022 solid stops on wires up to .022 x .022.
The second way is to use tip back bends distal to both first molars or second molars if they are in the arch to keep the wire from sliding. This has to be done after you put the wires into the brackets and then you have to leave 2-4mm of wire distal to the last molar slot to put the bend in (fitting the wires) Figure 4.
For Niti wires, you will have to fit the wires first. Then take the wires out and heat the last 2-4mm of wire with a flame to allow it to be bent and hold the bend once you put the arch wire back into the mouth for bending. You can use a flat on flat or tweed pliers to make this band. It just has to be about 45 degrees so that the wire doesn't slip through the bracket slot Figures 5-7.
I hope this helps you when treating your patients with self-ligating brackets.