Dental Problems

Lingual Arch Space Maintainer

Flossing with BracesLingual arch space maintainer is made up of 2 bands. It is cemented to the six-year molars with the arch wire running from 1 band to the other band along the inside of bottom teeth.

Lingual arch space maintainer

is used for maintaining the proper space amount for the permanent teeth eruption. In this article, there is a brief discussion on the lingual arch space maintainer, removable lingual arch and its modification, fixed lingual arch and lingual arch construction. Read on to know more.

Lingual Arch Space Maintainer (Fixed, nonfunctional, passive mandibular arch appliance)

  • They belong to those group of space control appliances which not only control anteroposterior movements but also are capable of controlling and preventing an arch perimeter of distortion, by controlling the lingual collapse of single tooth or segments of the arch.
  • The lingual arch in essence consists of a round stainless steel or precious alloy wire, 0.32 to 0.40 inches in diameter closely adapted to the lingual surfaces of the teeth and anchored to bands on the first permanent molars. Rarely, second deciduous molars may also be used. The means used to anchor the arch wire to the bands will define whether the lingual arch is of a removable or fixed type.

Removable lingual arch:

  • It has precision made vertical posts soldered at right angles to distal extensions, which fit precision -made tubes on the lingual surfaces of the molar bands and are held together by means of lock wire.
  • More used for active movement when tipping of the molar is less than 5 degrees as it allows for an easy removal and adjustment.
  • Lingual tubes are placed in the center of the lingual surface of the band anterior-posteriorly and aligned with the lingual groove, such that they are parallel to the long axis of the tooth and at right angles to the occlusal margin.

Modifications of removable lingual arch:

  • a. Auxiliary springs:

    They can be incorporated to bring about minor individual tooth movements.

  • b. Loop lingual arch wire:

    They are used as 2 loops or 1 loop mesial to the first permanent molar. It is used for limited tooth movements i.e. either posteriorly or even buccal movement of the tooth.

  • c. Lingual horizontal tubes:

    This is used as the vertical tube on the unaffected side will provide a greater resistance to its movement than on the affected side.

  • d. Ellis loop lingual arch wires:

    These are preformed arch wires. Along with this, Ellis Vertical lingual tubes are used. It has the advantage that it is time saving. Since, it is performed, possible fracture points are reduced to a minimum.

Fixed lingual arch:

This is soldered or welded to the band. It is used mostly where an active tooth movement is not planned. The addition of canine ‘spurs’distal to the deciduous cuspids, is a simple modification that help to maintain a anterior-posterior length at both ends of the arch.

Lingual arch construction:

  • The wire should be made to contact the cingual of the mandibular incisors slightly above the gingival papillae. The wire should also lie in the gingival third of the primary molar, while extending posteriorly to rest passively on and parallel to the middle third of the molar bands (Kapala, 1985).
  • In case of edentulous ridge, the wire is curved down to the lingual approximately 1mm away from the soft tissue.
  • The wire should maintain a 3 -4 mm contact with the lingual surface of the band to provide for a long solder joint.
  • Konstantinos et al (1998) have suggested that in the canine region 2 omega bends need to be given. This is to prevent interference between the arch wire and the cuspids, which migrate distally into the primate spaces.
  • In the original design by Hotz, 2-inch adjustment loops are given so as to allow for some adjustment of the length. They may also be used for regaining space.

Passivation:

The lingual arch wire should be completely passive. This is done by heating the wire to a dull brownish appearance, while keeping the wire gently in place on the cingula with an old instrument.

The above article discusses about the lingual arch space maintainer.

1 response to Lingual Arch Space Maintainer

  1. this is a very good article.

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