I. Johnson technique of anterior and molar band making

JOHNSON

TWIN-WIRE

ARCH

PROGRESSIVE

CLINIC

I. JOHNSON

TECHNIQUE OF ANTERIOR AND MOLAR BAND MAKING (DEMONSTRATED ON MANIKIN). HENRY U. BARBER, JR., D.D.S. II. ADJUSTMENT OF MOLAR BUCCAL TUBES FOR THE JOHNSON TWINWIRE MECHANISM. JOSEPH D. EBY, D.D.S. III. JOHNSON TWIN-ARCH TECHNIQUE AND SPECIAL ARCH PULLING VISE. LOWRIE J. PORTER, D.D.S. IV. COIL SPRING ATTACHMENT TO JOHNSON TWIN-WIRE APPLIANCE. CLARE K. MADDEN, D.D.S.

This progressive clinic consisted of four technical clinics given in compliment to Dr. Joseph E. Johnson of Louisville, KY., who, in the opinions of the clinicians, has made a most worthy cont,ribution to the progress and science of orthodontics. Following the technical clinics Dr. Johnson gave a color’lantern slide lecture on the use of the twin arch in the treatment of various types of cases. He also showed the method of seating and unseating the twin-arch locks and the adjustment of the arch with and without coil springs. Dr. Johnson’s lectures were fully described and illustrated in three publications of the AMERICAN JOURNAL OF ORTHODONTICS AKD ORAL SURGERY (Volume 27-April, June, and July, 1941) and, consequently, are not repeated in this progressive clinic report. The aim of the clinicians of this group was based on a desire to assist in the teachings of the technique of Dr. Johnson, not with the idea of creating any new devices or technique, but rather to so coordinate the various progressive steps in the Johnson technique that it could be readily followed by those who might not have had the opportunity of studying directly under the teachings of Dr. Johnson. Although no changes were made in the twin-arch technique, the clinicians demonstrated some such auxiliaries as had proved of value in simplification or in speed of construction in the various steps or procedures of the twin-arch technique. I. JOHNSON

TECHNIQUE HENRY

OF ANTERIOR

AND MOLAR

BAND

MAKING

U. BARBER, JR., D.D.S., NEW YORK, N. Y.

In demonstrating the positioning and adaptation of the Johnson twin-wire mechanism, this section of the progressive clinic deals with : 1. The allocation of anterior and posterior bands. 2. The method of adapting them and instruments used. It is an accepted fact that any appliance, in order to reach its maximum efficiency, must be placed on the teeth in a precise predetermined position. Bearing this in mind we wilt proceed with the adaptation of the anterior bands. Presented before the First Inter-American Orthodontic ciation of Orthodontists. New Orleans, La.. March, 1942. 340

Congress and the American

Asso-

CLINIC

ON

TWIN-WIRE

ARCH

341

Ranging from No. 1, small, to No, 4, large, these bands are 3/32 inch wide and 0.005 inch in thickness. To those of you who have used wider bands, these will appear very narrow, but you may rest assured they are most efficient. Beginning with a maxillary central incisor, select a band, usually No. 4, and before placing it on the tooth, crimp both incisal and gingival edges with, preferably a No. 136 S. S. W. plier as shown in Fig. 1. This step will procure a snugly fitting band at the edges. Place on the tooth so that it is adjacent to but not impinging on the septal tissues, adjusting it so that the lock is at right angles to the long axis of the tooth and in the center of the tooth mesiodistally. On a rotated tooth, place the lock in such a position that it is fart,her away from the arch when the arch is in position. Locks with rotating holes can be bought for this purpose. Placing the thumbnail in the lock as a means of holding the band in its correct position, as in Fig. 2, insert the Johnson modified rubber dam clamp forcep so that the short beak rests against the lingual incisal surface of the

Fig.

1.

tooth and the long hooked beak into the loop in the band. Compress the handles until the band fits snugly around the tooth and a loop forms on the lingual surface. Remove the forming plier and with a Howe plier, pinch this loop tightly together (Fig. 3). Burnish the band to the lingual surface with the plier or suitable burnisher and before removing, measure the distance between the incisal aspect of the band and the incisal of the tooth, as in Fig. 4. Transfer this measurement to the opposite central incisor and mark with a fine-pointed, hard lead pencil. When banding the maxillary lateral incisors, decrease this measurement one millimeter and mark these teeth a.s before. This will assure proper relationship and alignment of all four teeth at completion. One must. make sure that ample separation of the teeth has been accomplished prior to the fitting of all bands. The Johnson molar loop band is made of 0.008 material and is 0.1’8 inch wide. By using this width material it is seldom necessary to festoon the.band

342

HENRY

U.

BARBER,

JR.

when adapting to the tooth. These bands are already annealed when they come to you and are made in four convenient sizes. When banding a molar tooth, select a band which will have to be opened slightly to slip over the tooth. This opening can be accomplished readily with the fingers. Place the band on the tooth” so that the loop is in the center of the mesiobuccal cusp and the gingival edge is about one milIimeter under the margin of the gum. (See Fig. 5.) With

Fig.

2.

Fig.

a band adapter or similar instrument, press the band into all embrasures around the occlusal edge of the band. Now with the Johnson loop band pinching pliercurved beak for the upper and straight beak for the lower-pinch the loop tightly together, thus adapting the band snugly around the tooth. This is shown in Fig. 6.

Fig.

Fig.

We ai now ready for the next step in the technique before ren nov.ing the ban .a,ar Ia his will be demonstrated in the clinic to follow. 6 EI

WI i7m

ST~ET