Orthodontic Tips September 26, 2015

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How can we place a permanent lingual wire that is less likely to break and lets us floss between the teeth?

Use a looped lingual wire.

This adult case originally presented with upper and lower anterior spacing because of a strong tongue thrust.

Her braces closed the spacing and then double retainers were placed. First, straight lingual wires were bonded behind the anterior teeth in both the maxilla and mandible. Second, for night time, upper and lower full coverage open bite TMJ splints were made to hold the teeth in place and provide space for the tongue to come forward for breathing.

Unfortunately, during the day, the tongue habit was so strong that the upper lingual wire broke.

I replaced the straight lingual wire with this looped one. The advantages are as follows:

  • The loops provide some flexibility for the teeth to do micro-movements during eating without causing the metal or plastic to fatigue which results in failure.
  • This wire can be placed closer to the gingiva without interfering with the gums. That is particularly good in deep bite situations (which this is not).
  • The patient can floss her teeth.

The disadvantages are that is takes a lot more effort to make and place. That makes it more expensive.

Stan

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