November’s Tip

Why do I have to learn artistic wire bends? Shouldn’t Straight Wire Appliance finish my case perfectly?

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

November 2020

   

My answer to the question in the title above is – very seldom.  We, the orthodontic practitioners, are striving for perfection (as faultless as possible). However, because of numerous setbacks (patient cooperation, oral hygiene, time constraints, difficulty of the case etc.) we are quite happy to deliver optimal (best or most favorable) finished result.

I listened to an interesting speaker few years ago where he declared, “We should not beat our heads against the wall to achieve perfection, if we are able to obtain improvement (enhancement of the value) it would suffice.”  However, this is not the philosophy of the author and Rondeau Seminars. We suggest that our students aim for perfection, and if even with the ultimate effort, this is not attainable, at least try to achieve the optimal result.

Why do I have to learn Artistic Wire Bends?

            Pre-adjusted (pre-programmed) SWA brackets are constructed for an average tooth with average crown surface.  Many teeth display irregular crown surfaces; they are microdonts, they have large restoration, crowns, transposed teeth, etc.  In these cases, the bracket does not fit well on the coronal portion of the tooth and numerous re-bracketing do not remedy this situation.  Furthermore, the tooth color brackets are difficult to bond and difficult to remove; if the placement is not optimal, the artistic wire bends are the answer. Finally, when the patient is in the final arch wire and small

localized misalignment is noticed, rather than re-bracketing and stepping back to the leveling arch wire, the artistic wire bend may resolve this problem.

Technique for holding pliers

            The pliers should be held firmly in the dominant hand without any movement.  The position of the pliers is altered only for Helical running loop. The clinician has sight on the pliers and the arch wire all the time. The artistic wire bends are executed only with the thumb (bend-in and bend-down, PUSH) and the index finger (bend-out and bend-up PULL).

References

  1. Nakajima E., Manual of Wire bending Techniques; 8
  2. Rondeau Seminars “Case Finishing” manual; 63