Pacific Coast Society of Orthodontists Bulletin Summer 2020 - 72

Staff Report

▫▫ Is the wire too short? Was it cut too short?

▫▫

▫▫
▫▫
▫▫

Figure 3

Instead of placing the wire back into the slot,
evaluate to determine if a new, longer wire is
indicated. A wire too short will likely come out
again (Figure 3).
Is there a large interbracket space, for example,
teeth not bracketed or an extraction space?
Large interbracket spaces can allow a wire to
come out of the slot when a patient chews.
Determine the best practices to mitigate
these issues. Segments? Larger wire?
Is the patient biting on the wire? This can also
cause a wire to slip out of the tube. Additional
preventive measures may be required.
Can the archwire be bent back to prevent it from
sliding out of the tube? This is a technique I
have used for years to prevent issues (Figure 4).
What size and composition of archwire are
being used? Is it too small for the alignment?
Rather than always starting with the same
size and type of wire, customize wire progression for each patient and coordinate appointment intervals accordingly.

Discussion & Prevention Action Plan: _ __________
___________________________________________
___________________________________________
___________________________________________
Ligature Tie Poking
▫▫ Is the ligature tie poking because it is not fully
engaged? If the wire cannot be fully engaged
with a ligature tie, consider adding an elastic
tie (some use a figure 8 elastic tie) to prevent
the ligature tie from "loosening" as the tooth
moves into position.
▫▫ Is the tie tucked properly before the patient
leaves? It is practically impossible to have
a properly tightened and tucked tie move,
even with aggressive tooth brushing. Ending
the twist at the rotation has been proven to
prevent issues.

Figure 4

72	

Discussion & Prevention Action Plan:____________
___________________________________________
___________________________________________
___________________________________________

PCSO Bulletin    Summer 2020



Pacific Coast Society of Orthodontists Bulletin Summer 2020

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