Using Hawley Retainers for Minor Adjustments
Robert von Wendt, DDS, DMD • Los Angeles
As a practicing general dentist, I realized early in my career that I had a flair for aesthetics. While my colleagues began specializing in endodontics and periodontics, I always saw the beauty of the tooth structure—even where it didn’t exist, there was always the potential and the possibility of what could be.
While I do not attempt to make major changes in alignment as an orthodontist might, I do very much enjoy the minor adjustments I am able to achieve for my patients, creating symmetry where there is none or better occlusion where the bite is misaligned. Small changes to the anterior dentition leave my patients smiling and grateful that they don’t have to face years’ worth of treatment with braces, when all they really need is just a little “tweaking.” In my more than 15 years of practice with almost 100 Hawley retainers fabricated, this has been, and continues to be, a most rewarding experience.
The basic design of my active Hawley appliance consists of a labial bow wire and various lingual mattress springs placed at strategic points. The canines are considered “anchor teeth.” They are difficult to move, but serve as great abutments. On the other hand, the incisors can be tipped, tilted, and even rotated within limits. Slight interproximal reduction is often involved, generally using diamond strips and, on occasion, fine diamond burs to facilitate ease of tooth movement. The use of retainers can be beneficial in minor malalignment situations, exclusively involving incisors.
Weekly or biweekly appointments for adjustments are imperative during the 2- to 3-month procedure. This is a requirement in order to achieve proper and timely results. Cooperation on the patient’s part is also vital, as the strategy and goal of the treatment must be understood. Daily wear of the retainer is critical for a successful outcome. Continuous wear is ideal. However, the optimum wear can be 16 to 18 hours per day.
I have found the Hawley retainer to be quite effective, safe, and predictable. Of course, age can be a factor, and slight bone and soft-tissue recession may occur temporarily as a consequence. Your patients will appreciate the alternative to doing nothing by “living with” slightly crooked teeth; undergoing major restorative procedures involving radical reduction of the natural teeth; or long and costly treatments, such as braces, which patients do not always want.
Using the V-bend Technique to Intrude Anterior Teeth
Suhail A. Khouri, DDS • Manchester, Mo
Intrusion of anterior teeth has been one of the most challenging tooth movements that orthodontists face. After I invented and developed the Bendistal Pliers to bend distal ends of all kinds of superelastic wires without annealing, I started to use this tool to intraorally place permanent V-bends on tied superelastic archwires in order to activate those wires for much more difficult tasks. Such permanent V-bends did not only intrude anterior teeth efficiently, but they did it with a 1-second intraoral squeeze of tied archwires. It turns out that this technique, called the V-bend technique, has revolutionized orthodontic practice and shows clinical evidence in correcting deep skeletal and dental overbites, as well as Class III malocclusions, without surgery.
I currently use this technique routinely in my office and have collected clinical data showing its validity in dealing with stubborn orthodontic problems and other clinical situations, such as easy molar tip backs. I have lectured on this topic and am ready to offer extensive courses about this technique in order to share my experiences with my orthodontic colleagues around the world.
For more information, visit www.bendistalpliers.com.
Correction: In the March 2008 department “Focus on Brackets,” the description of Fairfield Orthodontics’ brackets contained two errors. First, the sentence “The company introduces its ‘Cannon Ultra II’ line of brackets, in composite with metal inserts,” omitted the fact that Cannon Ultra II brackets are also available in metal.
Second, the sentence “Low- and high-friction brackets are available in different colors” was incorrect. The sentence should have read “Cannon Ultra II, easy to ligate with only two tie-wings, allows patients to choose colors and orthodontists to choose between low and high friction.”
Orthodontic Products regrets the errors. For more information on Fairfield Orthodontics’ products, visit www.fairfieldorthodontics.com.
