Prevent Incisor Flaring in Fixed Functional Appliance

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Clinical Pearl

Easy and effective technique of preventing incisor


flaring during Forsus treatment

Siddharth Shashidhar
Abstract
Revankar, Vikram Pai,
Chetan Shankar1 Lower incisor flaring is often encountered during Forsus treatment. To prevent this,
consolidating the entire mandibular arch by ligature wire and cinching back the
Departments of Orthodontics and
mandibular archwire has been recommended. However, lower incisor flaring might still
Dentofacial Orthopedics, Maratha
Mandal’s NGH Institute of Dental
occur due to ligature breakage from friction of the push rods and also cinching back the
Sciences, Belgaum, 1College of Dental mandibular archwire might not be possible in few cases due to anatomic limitations.
Sciences, Davangere, Karnataka, India The following article describes an innovative technique to prevent any chances of
lower incisor flaring during Forsus treatment in cases where cinching the archwire is
not possible due to anatomic limitations. This method is simple, inexpensive, less time
consuming and comfortable for the patient.
Key words: Crimpable stops, Forsus appliance, lower incisor flaring

INTRODUCTION flaring in such cases where cinching the archwire is


not possible due to anatomic limitations.
Forsus appliance has been popularly used in the
correction of Class II malocclusions. As the appliance
exerts strong forces on the lower arch, in order to PROCEDURE
prevent lower incisor flaring, mandibular archwire distal
to the second molars is cinched back.[1,2] However, this 1. After engaging the mandibular archwire, two crimpable
might not be possible in few cases due to anatomic stops or crimpable hooks with the hook component
limitations [Figure 1]. cut-off (leaving behind only the crimpable portion)
[Figure 3] are crimped immediately distal to the first
In such cases, consolidating the entire mandibular arch molar tube [Figure 4].
from second molar to second molar by ligature wire
serves as a good alternative. Despite these efforts,
lower incisor flaring might still occur due to ligature
breakage from friction of the push rod [Figure 2].
This could lead to increased treatment time, as Forsus
treatment would have to be discontinued, until the
spaces are closed back. We have devised an innovative
technique to prevent any chances of lower incisor

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DOI:
10.4103/2321-1407.139511
Figure 1: Cinching the mandibular archwire not possible due to
anatomic limitations

Address for Correspondence:


Dr. Siddharth Shashidhar Revankar, 1379/1A, Plot No 8, Sadashivnagar, Belgaum - 590 001, Karnataka, India. E-mail: drsiddharthsr@gmail.com

144 APOS Trends in Orthodontics | September 2014 | Vol 4 | Issue 5


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Revankar, et al.: PrevenƟng incisor flaring during forsus treatment

Figure 3: Crimpable hooks with the hook component cut off


Figure 2: Lower incisor flaring occurring due to ligature breakage from
friction of the push rod

Figure 5: Forsus appliance is now inserted

Figure 4: Crimped immediately distal to the first molar tube advantages of this method are: It is simple, inexpensive,
less time consuming, comfortable to the patient and more
2. A laceback is placed, tying the first and second molars practical for use in day-to-day orthodontic practice.
together.
3. The Forsus appliance is now inserted [Figure 5]. REFERENCES
1. Vogt W. The Forsus fatigue resistant device. J Clin Orthod
CONCLUSION 2006;40:368-77.
2. Rizwan M, Hemanth M, Patil GS. Preventing delays in Forsus
treatment a er canine bracket failure. J Clin Orthod 2013;47:108.
The crimpable stops crimped distal to the first molar tubes
act as stops preventing the archwire from sliding anteriorly, How to cite this article: Revankar SS, Pai V, Shankar C. Easy and
thus prevents flaring of the lower incisors. As the lacebacks effective technique of preventing incisor flaring during Forsus treatment.
APOS Trends Orthod 2014;4:144-5.
hold the first and second molars together, the chances of
any space opening distal to first molars is avoided. The Source of Support: Nil. Conflict of Interest: None declared.

APOS Trends in Orthodontics | September 2014 | Vol 4 | Issue 5 145

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