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October's Tip: Gaining Space and Creating a Class 1 Molar Relationship

By: Dr. Rick Grant

Have you ever had a case in which you are close to a molar class 1 but not quite there? Or perhaps you needed a little more posterior space but for some reason you could not gain in the molar areas? One way to do this is using the flat on flat plier as a vise (Figure 1) .

You may want to look at the rotation of your upper molars and in particular the first molars. Ideally the tip of the distobuccal cusp and the tip of the mesiobuccal cusp should line up with the center of the cuspid on the opposite of the arch (Figure 2). Make a mark on the wire just mesial to the molar tube.

Place the tip of a flat on flat plier on the mark. Hold the plier as a vise. With you thumb, bend th portion of the wire mesial to the mark out. Then without moving the pliers as a vise bend the distal portion of the wire in. The amount of tow in on the distal bend will be determined by the amount of rotation that is needed (Figure 3). 
The bend is then towed in to create the rotation. The severity of the rotation will dictate the amount of tow in bend (Figure 4). It is important to make sure that the wire extends completely through the molar tube. If it is short it will not rotate the tooth fully. Of course, if it is too long it will irritate the patient's cheek.

Th rotation of the molar will ensure a better molar Class one relationship and help you to gain space (Figure 5).