January’s Tip

Second Order Wire Bends Step-up and Step-down Arch Wire a .016 x .022 SS

By Dr. Adrian J. Palencar, MUDr, MAGD, IBO, FADI, FPFA, FICD

January 2021

Second order artistic wire bends – refers to the tip or angulation of the teeth in vertical plane.  The tip on all teeth in nontreated ideal cases is positive. It means that the crowns are slightly mesial to the roots (Dr. Lawrence Andrews).  For simplicity, numerous instructors prefer 0° angulation on bicuspids and molars.

Ribbon arch pliers are used for the Second order artistic wire bends and the arch wire of choice is a .016 x .025 SS (1,700 gm of force).  Certain educators prefer a .019 x .025 CNA (Beta titanium) or a .019 x .025 Multibrade. However, the author found that Stainless Steel is more resilient, is better at maintaining the crisp artistic wire bends and can be retained as the final arch wire.

The orientation of the Ribbon arch pliers is parallel with the arch wire. The basic rule of Second order artistic wire bends is:

  1. If the corner of the crown of the tooth should be stepped-up – bend-down the arch wire
  2. If the corner of the crown of the tooth should be stepped-down – bend-up the arch wire
  3. All artistic wire bends are around 15°. These artistic wire bends may be accentuated on subsequent appointments.

A misaligned maxillary left lateral was attempted to correct by placing a 15° mesial step-down and the problem was resolved in two weeks. Now, there are two choices:

  1. Maintain the same arch wire for 3 months and finish the case, alternatively;
  2. Place heavier finishing SS arch wire (i.e. a .018 x .025 or a .019 x .025). However, the Second order artistic wire bend must be meticulously reproduced and held for 2 more months

References

  1. Nakajima E., Manual of Wire bending Techniques; 9 -13
  2. Rondeau Seminars “Case Finishing” manual; 95 – 103
  3. Andrews L. A.; Straight Wire the Concept and Appliance