PIN AND TUBE APPLIANCE
CONSTRUCTION”
G. VERNON FISK, D.D.S., TOROKTO: CANADA
A
S THE careful and accurate construction of the pin and tube appliance is of fundamental importance to success in treatment, the various steps in arch assemblage are shown in detail. The component parts for the constructing of the pin and tube appliance include :
1. Seamless molar bands, 0.020 by 0.006 in., in twelve graduated sizes ranging in inside circumference from 1.130 to 1.571 in. (Fig. 1). 2. Seamless anterior bands 0.18 by 0.003 in., in eighteen graduated sizes ranging in inside circumference from 0.045 to 0.097 in. (Fig. 2). Bands 0.004 in. thick are used for the maxillary centrals when carrying lingual bite planes. 3. Half-round tubes D. L. 0.15 in. for molar bands when carrying buccal planes to stimulate forward growth of the mandible. D. L. 0.10 in. for general molar use ; D. S. 0.10 in. for general anterior use ; D. S. 0.15 in. for maxillary central bands when carrying lingual planes. (Fig. 3.) 4. Half-round pin material made in two sizes, 0.021 by 0.039 in. which accurately fit a new D. S. tube; 0.023 by 0.045 in. to fit a D. S. tube stretched by continued use; two sizes of half-round posting 0.032 by 0.060 in. which fits the D. L. .July,
*A demonstration 1931.
presented
to
the
Second 281
International
Orthodontic
Congress,
London,
tube and a slightly larger size 0.034 by 0.065 in. to fit a D. L. tube stretched by continued use. Short pieces of each size are used to test which size of a half-round wire fits the tube before it is soldered to the arch wire. (Fig. 4.) 5. Gold platinum round spring arch wire of 0.028 in., 0.030 in. and 0.032 in. diameter. 6. Auxiliary springs made from wires of small diameter (0.018 in. to 0.022 in.) and soldered to the arch wire for the movement of individual teeth. (Fig. 25.) Some are provided with half-round wire for root movement, and when greater flexibility is required, a coil is made near the half-round pin. 4 7. Locks 0.018 in. of Aderer Xoxidium D. wire for anterior pin locks; 0.026 in. Sderer Koxidium I). wire for molar pin locks. (Fig. 22.) After the seamless bands have been carefully fitted to the teeth, the first step in the const,ruction of the pin and tube appliance is attaching the tubes to the
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bancls. A half-round tube is placed on the center of the band, its bore parallel to the long axis of the tooth. (Fig. 5.) It is “fluxed” and heated in the flame. A try-in test pin is placed in the half-round tube, and any deviation of the tube from the correct angle is noted. (Fig. 6.) The band is again heated in the flame and the position of the tube corrected with the tube mover. (Fig. 7.) The tube is now parallel with the long axis of the tooth and is soldered to the band. (Fig. 8.) After soldering, the test pin is again inserted in the tube to finally check the angle. (Fig. 9.) The second step in construction is aligning the tubes in the mouth. The distance that the first tube is placed from the occlusal edge of the band governs the posit,ion of the remainder of the tubes. The Hawley calipers are used to check alignment of the tubes. (Fig. 10.) The mandibular tubes must be placed far enough gingivally that the cusps of the maxillary teeth do not touch the arch when it is placed in position. (Fig. 11.)
Pits awl Tube Appliance
283
Construcfion
Making the arch is the third step in the construction of the appliance. The desired length of the arch wire is obtained by measuring the distance between the tubes on the molar teeth with a piece of ligature wire bent in the mouth to conform t,o buccal surfaces of the teeth. A piece of the gold platinum arch wire is then cut about one-half inch longer than the ligature measurement. A piece of half-round posting is then held in a pin vise and the end filed square. (Fig. 12. ) ,A groove is made in the squared end parallel with its flat surface. Fig.
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This is done with a knife-edged needle file. (Fig. 13.) The periphery of the posting is then smeared with graphite from a soft lead pencil, and a small piece of 18 K. solder is fused into the groove. (Fig. 34.) Commencing at the right, the first half-round post is soldered to the arch a quarter inch from the end. (Fig. 15.) The post is cut off to the exa.ct length of the half-round tube. (Fig. 16.) The arch is then placed in the mouth and is bent to rest squarely over the mesially a.djacent tooth. A nick is then made in the wire with a knife-edged file opposite the center
Fisk
B. Vernon
284
of the tube. (Fig. 17.) The next pin is carefully grooved, centered on the nick and soldered to the arch. (Fig. 1%) The arch is again transferred to the mouth, and the position and angulation of the second pin are checked. The space-feeler (a piece of banding filed to 0.0001 in. at the end) compares the proximity of the
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t,eeth with the arch inserted. (Fig. 19.) The desired number of pins are added until the arch is completed when the angle of all pins and posts is carefully checked. As most of the movement is accomplished by auxiliary springs, they are fitted and then soldered to the arch where required. (Fig. 20.) As anchorage must be ade-
Pin and Tube Appliance
Construction
285
yuate, too many springs should not be used at one time. An auxiliary spring attached to the arch to correct the position of a tooth badly out of alignment is shown in Fig. 21. The soft wire locks are now attached, with 14 B. solder about l/32 in. from the desired half-round posts and pins. (Fig. 22.) Figs. 23 to 27 show five views of the completed appliance fitted to casts of a distoclusion case. Note the V-shaped coiled auxiliary springs for the bodily movement posteriorly of the premolars, and the horizontal coiled auxiliary springs for the lingual tipping of thr maxillary incisors. Fig. 28 shows the finished case