See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/328518687

Tricks of the trade: molar distalization with double loop archwire distalizer

Article in Orthodontic Update · October 2018

DOI: 10.12968/ortu.2018.11.4.155

CITATIONS READS

0 440

3 authors, including:

Sivakumar Arunachalam Jitendra Sharan

International Medical University (IMU) All India Institute of Medical Sciences Bhubaneswar
85 PUBLICATIONS 214 CITATIONS 60 PUBLICATIONS 262 CITATIONS

SEE PROFILE SEE PROFILE

Some of the authors of this publication are also working on these related projects:

local population study View project

Sealing efficacy of over-the-counter desensitizing dentifrices on dentinal tubules: An in-vitro comparative study. View project

All content following this page was uploaded by Jitendra Sharan on 06 June 2020.

The user has requested enhancement of the downloaded file.

October 2018 Orthodontics 155

Tricks of the Trade: Molar

Distalization with Double
Loop Archwire Distalizer
Loops are an integral part of
orthodontic mechanotherapy. They
deliver a predictable force system
for an efficient tooth movement in
the required direction. A simple, yet
effective double loop archwire distalizer
has been developed for molar distal
movement. It can be used for bilateral or
unilateral distalization in the maxillary
or mandibular arch. This appliance has
been found to be very useful, simple
to apply, and easy to handle at the
chairside.
Molar distalization for gaining
space in the dental arch is a popular
strategy among orthodontists. A number
of clinical and research reports have
demonstrated the efficiency of intra-oral
molar distalizing appliances supported
with miniscrews in the contemporary
practice.1-3 This article showcases a
Figure 1. Basic design of double loop distalizer. L2 should be longer than L1 by at least 2 mm to permit
simple tactic utilizing archwire loops for effective activation.
maxillary second molar distal movement.
After a preliminary alignment and
levelling, a continuous archwire set-up
is designed with double loop archwire
wire, which has excellent resilience and  Form a 20° bend down at the distal
distalizer. When the double loop
resistance to permanent deformation. leg of the open vertical loop (Figure
archwire distalizer is used to move the
The double loop assembly consists of 2b).
molar tooth distally, the activity of the
an open vertical loop (4−5 mm wide  Activate the set up by engaging
loops invites anchorage loss in the
and 6−7 mm high) and a short omega the omega loop to the second molar
mesial direction too. To prevent this, a
loop (Figure 1). tube (Figures 2c and 3a−c). The force
miniscrew could be inserted buccally
 Make the mesial leg of the open delivered by the activated loop moves
between the second premolar and first
vertical loop flush with the distal the maxillary second molar distally
molar, although other sites may be
aspect of the convertible first molar (Figures 2d and 3d−f ).
appropriate.
tube. Continue the distal leg to form  If additional tooth movement is
a short omega loop that is bent at a desired, reactivate the ‘double loop’
Fabrication distance of about 2 mm beyond the by opening the omega loop with a
 Fabricate double loop archwire mesial end of the second molar tube bird beak plier at the subsequent
distalizer from 0.020” special+ Australian (Figures 1 and 2a). appointment (Figure 4).

Arunachalam Sivakumar, BDS, MDS(Manipal, India), MOrth RCS(Edin), FDS RCS(Edin), MFDT(Edin), Associate Professor, Orthodontics and
Dentofacial Orthopedics, Division of Children and Community Oral Health, School of Dentistry, International Medical University, Malaysia,
Jitendra Sharan, MDS, PhD, Department of Orthodontics, All India Institute of Medical Sciences, Bhubaneswar, India. New Delhi and
Vanishri S Nayak, MSc Senior Grade Lecturer, Kasturba Medical College, Manipal, India.
 156 Orthodontics October 2018

a a

c d

Figure 3. (a−c) At the start of distalization (main

buccal tube on the first molar is of open type to
Figure 2. Schematic representation of activation of double loop distalizer. (a) Initial position of double receive the archwire and is secured with steel
loop distalizer in maxillary arch. (b) Distal leg of open vertical loop bent down 20°. (c) Activation of ligature). (d−f) After 3 months of treatment with
double loop distalizer generating moment and force. (d) Space opening from initial activation. a double loop distalizer.
 October 2018 Orthodontics 157

a the open vertical loop would place

it further at an angle that in itself
generates an activation moment in
the desired direction. Thus the molar
undergoes a translatory movement
instead of tipping (Figures 2c, d).
Further, the activation of the double
loop archwire distalizer conforms to the
biomechanical principle, as outlined
by the Bauschinger effect, which states
that the range of activation of a loop is
always greatest in the direction of the
last bend.4 Furthermore, a double loop
archwire distalizer is a fail-safe design.

References
1. Kuroda S, Yamada K, Deguchi T,
Kyung HM, Takano-Yamamoto T.
b Class II malocclusion treated with
miniscrew anchorage: comparison
with traditional orthodontic
mechanics outcomes. Am J Orthod
Dentofacial Orthop 2009; 135:
302−309.
2. Yamada K, Kuroda S, Deguchi T,
Takano-Yamamoto T, Yamashiro
T. Distal movement of maxillary
molars using miniscrew anchorage
in the buccal interradicular region.
Angle Orthod 2009; 79: 78−84.
3. Lim SM, Hong RK. Distal
movement of maxillary molars
using a lever-arm and miniimplant
system. Angle Orthod 2008; 78:
167−175.
4. Graber TM, Vanarsdall RL.
c Orthodontics: Current Principles
and Techniques 3rd edn. St Louis:
Mosby, 2000: pp259−292.

CPD Answers for

July 2018
1. C
2. D
Figure 4. (a, b) Opening the short omega loop activates the open vertical loop. (c) Completion of 3. C
distalization of maxillary second molar.
4. B
Discussion of the open loop distally drives the 5. B
The engagement of the second molar. The 20° bend produces
omega loop into the tube of the a moment that counteracts the 6. C
second molar compresses the open tipping movement created by the
vertical loop, and so the deactivation force of the appliance, and closing 7. D

View publication stats