Broussard system
It consists of a continuous archwire used for intrusion of the incisors
with simultaneous anterior space closure, when a deep bite exists because of
upper incisors extrusion. It enables all the desirable movements in space
closure including forces to actively torque, intrude and retract the anterior
teeth to take place simultaneously. In addition this archwire extrudes and
seats the buccal segments.
The Broussard system uses a combination closing and bite-opening
loop that creates a step between the anterior and posterior segments.(Fig-
83)This acknowledges that with brackets placed at the same relative height
on all the teeth, a stepup is required between the cuspids and the incisors if
the buccal segments are to be properly seated in a Class I relationship and
the incisors placed in an overcorrected, end-to-end overbite during the
finishing phase.
Fig 83:Broussard combination closing and biteopening loop with step between
anterior and posterior segments.
The stainless steel Broussard archwire allows the horizontal loop to
be compressed by the step between the anterior and posterior segments, and
the vertical loop to be activated to retract the upper incisors. The system
works quite well, but it is mechanically inefficient because the vertical loop
is being opened.
Hilgers modification:
Hilger modified the Broussard arch wire and made the vertical
component into a crossed "T", allowing a smaller loop size and greater
mechanical efficiency, since the vertical portion is closed on activation (Fig
84 ).
Fig. 84: Hilgers modification with reduced loop size for patient comfort and
crossed "T" for greater mechanical efficiency.
Disadvantages
Both archwires take time to bend and are cumbersome in the mouth,
often compromising patient comfort and hygiene.
In addition, stainless steel wire does not have the working range required
for either loop design to work optimally.
Asymmetrical “T” arch wire
Asymmet T archwire developed by James J. Hilgers as an adjunct to
Bioprogressive therapy and has been proved to be effective in achieving the
same tooth movements produced by the Broussard system.
Fig. 85: Asymmet "T" archwire made of TMA wire, with 5mm vertical step, 2mm
anterior loop, and 5mm posterior loop.
Wire size and material
It can be fabricated from 0.016× 0.022 TMA ( for 0.018 slot brackets ) or
0.019× 0.025 TMA ( 0.022 slot brackets ).
Appliance design
This asymmet T archwire has a loop that is placed distal to the upper
lateral incisors . The vertical portion of the loop should be 5mm, the anterior
loop 2mm, and the posterior loop 5mm. The archwire should have an
exaggerated reverse curve of Spee and strong distal molar rotation. Bend the
loop slightly inward to prevent irritation of the cheek, and curve the distal
ends of the archwire outward to allow easy insertion into a pre-rotated molar
tube (Fig 86). Trim off the curved ends after final placement and activation
of the wire.
Fig. 86 A. Reverse curve of Spee accentuated
with Hollowshop arch-contouring plier. B. Distal
end curved outward to allow easy insertion into
prerotated molar tubes. C. Final contour of
archwire before preactivation.
Fabrication
To bend the loop into a preformed TMA archwire, use the rounded tip
of either a small, tapered bird-beak plier or a small optical plier. The optical
plier produces a more compact loop (Fig. 6). Using the rounded tip prevents
nicking the wire, which with TMA can result in fracture. TMA is resilient
enough that it will not twist even when bending a rectangular wire around
the conical plier tip. Exaggerated reverse curve of spee is accentuated with
hollowshop arch contouring plier.
Preactivation
Because of the resiliency of the TMA wire, the shorter, mesial portion
of the loop can be closed and the longer, distal portion opened to create a
step between anterior and posterior segments that allows simultaneous bite
opening and anterior space closure.
Fig 87: Preactivation of Asymmet "T"
loop. A. Short mesial loop compressed.
B. Long distal loop opened. C. Loop after
preactivation.
Intraoral activation
Once the continuous Asymmet "T" archwire has been placed, it can be
activated intraorally to advance the upper incisors during the initial
phase of treatment, or to increase torque during retraction. The shape
memory of the wire and the loop configuration make this a multipurpose
system that can be incorporated into a continuous arch wire.
In the initial phase of Class II, division 2 treatment, where the upper
incisors are extruded and in linguoversion, the loop acts to advance the
upper incisors and to add to the torque that is already incorporated in the
incisor brackets. The reverse curve of Spee accentuates the leveling
process and creates overjet, making the lower incisors accessible for
bracketing.
This advancing/torquing moment can be achieved by pinching a small,
inverted gable bend at the top of the closing loop with a tapered optical or
three-loop tier plier (Fig 88).
Fig. 88: Intraoral activation made with inverted optical
plier at top of loop. Gable bend opens loop at base and
adds torque, thus advancing and intruding incisors.
The intraoral activation opens the loop at its base, which tends to advance
the upper incisors; it also adds lingual root torque through the upward
gable bend, which enhances bite opening .
A gable bend is not appropriate when closing anterior space, because
opening the loop at its base detracts from the activation space needed to
retract the anterior teeth. If increased torque is desired during space
closure, use the optical plier to place a small gable bend or "V" in the
mesial vertical step of the closing loop (Fig. 89). This affords almost full
space closure by not opening the loop at the base.
Fig.89: Intraoral activation placed in mesial vertical
step. Base of loop is still relatively closed, allowing
addition of torque without affecting space closure.
The ability to add torque while the archwire is fully engaged to be
particularly helpful when using ceramic brackets. Lingual root torque can
be placed without having to deflect the wire into the slot, which can
fracture a fragile ceramic bracket.
