|Home | About | Journals | Submit | Contact Us | Français|
In orthodontic treatment planning, involving the key question of preservation of the anchorage, lingual arch in association with the present day labial appliances provides a viable solution to the orthodontist The continuous wire lingual arch auxiliary, addresses the important aspect of anchorage conservation by enhancing the buildup of forces in the posterior region. It also facilitates the retraction of the anterior segments and the resultant correction of the soft tissues.
The field of orthodontics has been witnessing a revolution both in availability of 3-dimensionally controllable appliance systems as well as the introduction of a host of new attachments to enhance the performance of these systems. The present day pre-adjusted edgewise appliance (PEA) system provides not only the inbuilt values of tip, torque and in-out but also numerous choices to avail of a number of auxiliaries. All these factors strive to reduce the duration of the treatment as well as crucial patient and operator time with predictably enhanced optimised treatment results. The removable continuous wire lingual arches provide an important anchorage proposition in conjunction with the labial appliances in the mandibular arch. These arches provide both enhancement and stability in anchorage .
The basic armamentarium (Fig-1) consists of preformed removable lingual arches  made of heat treatable Cobalt base alloy round wire (0.036”) in assorted sizes (48mm to 72 mm), plain lingual sheaths (2×0.9mm weldable; 3.5mm width) having horizontal slot with a notch on distal end to provide lockable housing, palatal and lingual arch placement plier having steel hardened curved beaks with a arch holding groove, universal plier for activating omega loops, three-jaw plier for removing torque, brass wire and arch gauge to measure arch length and 0.006″×0.125” molar band material or performed bands.
It involves welding of lingual sheaths onto the molar bands at the properly marked place which is kept more towards its occlusal margin. It is ensured that the notched part of the sheath is always facing the distal side. The bands are then cemented using thin paste of commercially available glass ionomer luting cement (GC Fuji Type I) after ensuring adequate dry conditions in the oral cavity.
After selecting the appropriate size of the continuous wire lingual arch, it is held by the lingual arch placement plier. First one side of the arch is inserted into the lingual sheath of corresponding side and then the procedure is repeated on the other side. Once both the tags of double back wire are inserted inside the lingual sheath, the same plier is then utilised to firmly guide these tags to inside of the lingual sheath with a click noise which is an indication of proper placement and locking of the arch. Additionally, in doubtful cases the lingual arch can be secured with the help of stainless steel ligature wires to prevent unintentional sliding out due to either loose fit or tongue pressure.
The lingual arch is checked at each recall visit for its snug fit. It can be removed and then reactivated/deactivated/readapted or replaced as per the requirement of the particular clinical situation. It is checked for any soft tissue impingement or any mucosal tissue overgrowth. This is an important criterion that the arch be kept away from the tissue area. The lingual arch is removed very easily with the aid of arch placement plier by firmly pulling the tag end of the arch of one side out of the lingual sheath and then repeating the same procedure on the other side.
Uses of the lingual arch :
Advantages of lingual arch :
Complications of lingual arch can occur due to :
Lingual arches are versatile auxiliaries for the mandibular arch. They have proved to be an important adjunct to present day preadjusted labial edgewise appliance systems. They aid in controlled tooth movements in all the three planes of space. Their usage in different clinical situations needs to be fully exploited to evaluate their anchorage enhancing potential.