THE

DENTAL COSMOS
VOL. LVIII.
OJ<LGINAL COMMUNICATIONS
Some New Forms of Orthodontic Mechanism. and the Reasons
for Their Introduction.
By EDWARD H ANCLE. M.D., D.D.S., Sc. D.
(l( ... before tbe .4.10,,,,.' of the Anglo Scbool of Orth<>dontiA, New London,
C"'ln., July 11, 1916. )
A
T the illSt three meetings of t.hiB
!!OCiety 1 h .. by mean. of locture8
and clinics, carefully described iWd
the use of certain lonna af
ortl,od"ntic mochaniom which are nnw
known ill; the "pin and tube" appliance.
'1' he description and di.scw;sion of the.e
appliance. arc recorded in the D ENTAl.
COSMOS for Mar<:h 1910, August 1912,
and January 1913. Complete familiar.
ity with t hese artidetl i ! ebsolutely es-
sential to a prOpl'r undcrf;tanding of
what r shan today for your con aid-
eration.
THt PI/< ANt> TUDE APPLIANCE, AND
WOR'fHLB83 :MODU'ICJoTIO!lS.
The introduction of the pin and tube
appliance nru:lonbtedly marl.:OO a great
step for ward in orthooontic t reaime-nt ,
for with it W!l.S gai nee. not only bettel'
control of force for the crown. move-

men/s of teeth, but aLe.o it was tho first
practical mechanism for \.he proper con
trol and distribution of force for the
mowment of roots of teeth, siuII!Y Ilr
collectively, and simultaueously ,,") U, Ilr
independently of their crown move-
ments. And, what is of still greater im_
witlt this the foeee
for tile mOV'!1nent of ei\l'er crowllJl or
roots can be appliee. and controlled in a
manner that far more m:srly in accord
with the requirements of ilic physiology
of the ti'lllues involoee. in t.ootll mOve-
ment than with any other previonsly em-
ployed. It is well known iliat more
narly ide&! re.ults in occlusion and in
ooue development, as well as in facia l
development, have been gained by its use
than W/Ill ever possible before.
Its use hl1$ become sbmdard with the
bett orthodontists of thia snd other coun-
tries, and it is of COUrM very gratifying
1("1 me te know that my predictions N-
."
TIU DENTAL C08MOS.
its have verifie<! _ Yet
It a humi hating fact that many who
al"'l attempt ing the practIce of ortho-
dontia _'" to ]x, eo la<:king iu judg-
ment and in wchll1cal skill as to be
unable to gain anything uearly like the
",eru;ure of &"cce68 t hat i5 iX"l"ible in the
usc of thi" mwhanisrn, of to
tile fact tllat fonns and propor_
tions and proper material for the con
st.uction of the various paris, wiUI
accuracy and of workmaruhip
in manufadure, are esseutial to its proper
efficiency. The principal difficulty wilh
most of these iCCmi to be inability to
properly locate the and attach them
to til e meta! aud many indeed have
the modifications of the
and the devised in order to
overcome this to them insurmountable
difficulty, and to obviat e the necessity for
acqui ring wchnical flkill and accnracy.
In all insiances delic&Cy and simplicity,
sod te> a large eIteut efficiency, ha,e
been .acrificed. Indeed., some of the
product ions are 8() crude and clumsy as
10 be
Realizing how apparently hopeleSli to
many ill the lUaa\ery of the i<lchnique of
thi5 appliance, I hue, stter many
months of careful thought snd
mentatiou, sucee6ded in producing an-
type of me<:haniJ;m_that which I
am about to do?SCribe, and which, while
retaining much, if not all, of the force
control of the pin and tu]x, appliance,
r.
sses- other advantag<l$, besides being
at easier to a
pP
? operate. In fact
it so think you will ogre<)
with me tJld there i8 now no neces.sity
whatever for change of principle or moo_
incatiou of iorm, even by the habItual
"modifier," that well known type of
practition", whose greatest h.ppiness
to cousist in modificatiou of me",
detai l, in llle<:haoiSOI- nearly to
ti' e detriment of the mecllaniam_
In this uell' mechaoiBDl 1
fully realize lhe moral reEpon!.lbility I
must assume or that anyone must as-
sume when Mkmpb to add Ruything
. s.. II.".. Of I"' ...... '. Jun. and
l>""!Q! ... rv. Moy
to ilie already vel)" larg<l number and
,ariety of orthodontic aPflianOO>. If
the add<'d device be not tru i" useful and
an advance beyond what hn already
produced, better by far it should
De,er a.ppear, fQr it will not only
unneesary inconvenience and di.ap'
poiniment to many patienh and orlhe-
donti&ts, aud further add to cou-
fnsion of our hwrdure aud to tbe per_
pk'lity of ilie ever-i ncreasing number
who revie.' it, but it .. ill confi_
dence in its author. The U8nal crude
modificat.ion or mel"'! difference withQut
distinction in principle i8 more often a
step backward than forwud, but there
BI"'! reaSOn. why, at this timt, there
ahould be addit.ion8 to our orthodontic
addit iotl. that Me rell im.
pl"O;emenbl, real inventions, the wonder
fu l adVllnee3 that ha,e been made in the
'lCience of orthodontia in the pa.t very
few yeQ", having made necessary the re-
arrang<>ment of our entire plan of treat-
ment, and demanding ]x,tter-
ment ill orthodontic mcehani6Dl.
INJUDICIOUS I':XTR.\Cl"ION.
.A1! you know, it was formerly the
practice to extract one Or mOI"'l of the
teeth thd were moat mi<!placed, hence
most difficult to correct, or-\Ollat wa"
often worse in elIect-to extrad
usualiy two or mote premolars, to "make
room" for Ihe malposed teeth. The
crowns only of those that were
then "pu!led into alignment" wlthout
rega.rd to "hat "hould be the true po-
of either t heir roots or thcIT
crown. in the typal archii<lctural line of
the arch-tho Jine of occlmion--or of
(heir relatioM to the skull. The in
eviiable result of ouch radically wrong
was to considerably dimioiejl
!izes of the denial thereby
corre;;pondingly impairing the function
and leMening the efficiency of the den-
tUFt, and renderio" deBcient the growill
and fn nction of the as&ICiatcd paJU----
t hat of the alveolar process, the n(>l!e,
throot, tongue, lip5, ek-llIld marring
the f&cial hM$ to an nwnt always
noticeable and u&uaUy mco;i unpleMing.
J..vor..--1lOltv. .'fIlW FOUtS OP )(.cnJ.l<lS)(' 971
plan of lr-ea.tment 10 obviouly il
Iogiet.l alld thould h&oe ....
Ions been '0110"'00 without quedion no.
&eetltl llIott .urpril;ing, for. IIMlnge u it
may appear to ruany, it ia in mOIl!
CMe. far ea.ier ro establi. b tho non,,"1
in ocelUlion than to temporiz.e in treat-
ment, a. to take the IUppoeed ahort cut
by UK mutil.tion route, which call newer
be followed by satisfaeto.y be-
eouae it ia contrary to D.Ill1te.
".CIIIIIIITT O. BSTARLISfUYO YOIUIJ.L
rUIfOTlol< 01 DBNTAL ANa COHU
LAT1:u PARTS.
The duty of the orthodontiat i. not
merely to "straighten teeth," but to .....
ltote the ia.t function aT to e!t.bli.h lhe
normal 'unetion of the denture and aU
ita parts. Thi. means not
only thlt normal relatio ... Ihall be u-
tabli.hed bet ..... n the inclined planf. of
tllf CI'OWIlJI of an the teeth .hich D.Iture
hu decreed lhall be but lilat
their 1II11st aho be gi.en nO'lIlIi
position., with the n\l(;0I$l'Y
ment of the a1veol 8r p'<)<)eS8 fOT thelf
. uppo.!. For be it c.nphuiud that 0"
1M OOTted pooition. of the roots of the
u.eth depend. to a very large deS:TM the
permaneuce of the nom,.1 relatlOna of
tbtlr em.lII. there IUnat be
eltlbliabed nonnal funct ionl or
toague, 1lOIf, and thro.t, for from th_
intimately related and highly interde-
pendent tiRlne. IUId .trudul'fll coma the
focool wbieh inUit abo be en
li8ted for the nltimate 81lpport of the
koeUI ;n their corrected pC>@i tionl. Th_
fOreel art the penn.nent retaincn whirh
"m hold the teeth in normal occlu.ion
H normal, and in malocdullon if .hno.
mal. in lhtir ful\ctiolla-
Furthermore, it "folio .... II tIM nigb!
the day" that only in proportion u tbe
furcea of lTQwth, denlopment, nd func-
tion of 1M denture and ill oorrelaw:t
tore nonnalUed "ill there result
true h.lan<le, beanty, and harmo"y of
Ihe in accordance with it. type.
On U,;I bui. only orthodontic
t .. \.mtn! be pennllDenUy Mneflcial and
t ruly IItio/actory, for Incb ollly i. in
aerordaooe with natnre. And thit. i. the
true meaning of orthodontia.
INIIICATIONS TOR UR1.T TIt&<TNnNT.
Another important point shOUld
he ..... again M empbuired, namely, thlt
childrf n ... ith deweloping malocclulion,
which ;. al ... ". progrllli$i"e, lhould not
ho- pnt of[ on one preteI! Or another until
they h .. e reached the 'I\" of fifteen
y"'!'3, or until and .nalde-
welopment shall hue about reached their
mllimum, but !bAt t re.tment ahould be
bl>gun promptly u early al! it is mini.
festly required, even in the
lor .t thi. early period ie un
douhtedly our greatll.t opportu
nity for the ul timate eiUblilhment of
normal aDd function of the
pennaneol denture IUd all ito a""""'"ted
parts. Yet I would the same time
.110 emphuiae that the nHillesa inter.
ference ", ith child denwMI, HOW 10
often done, Clnnot M too strongly con
demned. ,
From the foregoing it will be eetll
t hat iICOpo of oTthodont.1l. lin been
greatly .. i<!enell, and that the demand
for the brOf.der, dfeper nudy of both the
theory and practice of the leieuce 3 im
penthe.
TKB rnT810LOO.e J.PPL1{' .'TIOY or
I'OIIC8.
we heve the rtoration of the
denture to normal fnndiou demaud. not
only the crown movement, but
qntntly the bodily movement of teeth.
Tooth mooement .I",av, involve. bone
dlAlurhBnce-oone-<iel!tNdiou and bone-
growth-and theee on tile fune-
tioll;"g of bone-co!lll, their .eti.ity re-
sulting from stimnl_in
orthodOntic treatment from tloe Ilimulu.
of mechanical force front the Ippliancea.
We are, Ihere'ore, ... holly dependent on
the and ",teoblestl in OUT ef
fom at i-ooth movt,nent. A. D . Fred
erick B. Noyeo! hu well said, are
the true orthodonlilli!; we but thelt di.
N!<:ton.
H tIIit. of tM demandl
of DatUIl! in ttet.tment i8 wrrect, more
",l ion.! mctl: .... d. and lno", appropriate
lIlecilauLmt than hue been em-
ployed are certainly needed, that we may
hue perfect control of the for
sary in the nI'lI:Jumied stimulus we are
to.> give in her effortl at remodd
ing the
Or. ALliin Oppenheim of Vienn., <me
of my former student., in hi, muterly,
.paper on his uperimenu.
on tooth rnOVllliIcnt in given hefon
Ihil aociety in Ihis cit y in 19 li: hall
pro1'ed OOIldOllli1'ely Wi gentle force
oontiDuGlliIly applied .-ill not only move
far more rapidly than grut toroe,
but that great foroe CI1l6tll eongl"tiou
and often .. holly ntllrds the functional
""Ii"ity of the cella for min, houri to-
gether. Thi. being true, how utumely
impomn\ doe. it beoome that forw
from ol"thooonUc IPIIi,nee tOlr Itim-
ulating the ad;y; t,. 0 tho! ooll\!...,.,ll.
.hall aceoro ..-ilh the phy,iologicN need.
of the <;til_that iI, that olian not 00
too grut nor too little in amGuot, th.t
it lhall be [me from interrurtiOIll lind
and !lull it wa!
dilltributed and colltinuomly .pplied
in 1M rig!., dirfGtibn,o Force
.-roogly applied, such .. n.pid and he-
,<"ent changes in BDlount and direction,
alway, inevitable in the liM! of faulty
me(hanism, gTeatil. diaturbo the
adivi ty or Ihe cel, and IIOreneM,
paint inll.mmalion, and fK)ffinimN Uen
the duth of the pulp, OOaidN, pouibly,
iPjury to the hone and peri,
dental membrane. On the other hand,
fol'C1! applied il attnded
by the painle!!8 movement of teeth .nd
nonnll reconstruction of lbe t;..uN_
or 10-)1 lDlUL API'LUNCH.
It mUlt therefore be apparent that in
onler to be trul)' lueft&6fl,l! in meeting
the p.-nent dem.nds of t .... tment, ortho-
dontic mecitanism mUll peTreclly ""n-
trol the Amount, direction, and didri.
bulion of force fOT ,It nO!<'!eS'lary looth
PlIbliohNi iD U .. .1 _"". 0.' ........ 1101,
1'11.
movement, Ind at the wne time that it
nnllt be of the (TUle8t po.oible .im.
plicit), . nd deliCS<!)'. The ideal appij
.nee would gi.e gentle, COD&tant foro!! in
the de6ired direcl.ionl only. With it
boll, the root and of a single
tooth, nr of &11 the teeth in the dentun!
thd require mnlement, could be mnTed
in the .. me ditee1inn or in oppooite di
re<:t.ion. , and, if need be, .lmnll.alle<)lllL!,.
11u)0)0 movements, l nrthotmo"", ...-ould
be painleu, !et II rapid II il conoident
"lth the phy.iologiCA! functioning of the
ctI!. of the aheOhr p-. peridental
men,brUJe, aud go'n'_ The ideal .ppli
ance would reduce to the minimum the
incon"enience to the .. well u
the time required for it. lint adjnslment
and for making the n_ry
changes. It would .lso teeth in
,"ch .trict with the 1 .-,
governing ho"e,boorption Iud bone--
growth that thm! .. ould be if IU,I'
neecl for apph.
11l<:N, for by the time the teeth bad at
tained theiT IIOrmai pooitiollf. the 001>6
would be nOTTnl in an",,,"t and ,true--
lure. Hence it would be .mple for the
eupport of the terlh atter the ortho'
dontie IpplilooelL had been removed,
r.
rolided of cou ..... that lucb correbted
01'Ol!l &I! were lUo pte'l' iouII, abnormll
had muntime hew. wnnalil\!Ol-that iI,
for_ from improper habits of lips,
tongue, ""pin.tion, - fOT I
tblt, without the norm,llupporl and co-
ol"'ratioD of these there can be no 183\11"
anoe of pennanenne in the pooitione of
the teeth that han hoon corrected. In
word, m..,hDo .. "", rhould
... IU'ctml and .. ",b"'rN,,1
10 III pk,Noal and rl1'"'"
mt .. ta- of
THB I<!W
1'he fonnl of mecN.uism 1 .hall now
delCribe, il Dot ,trieUy in aceonI. " ith
,It the ideala ut forth, .nil, [ belie""
upon a.nalJ@;' by
judgee, at 1.,,,,1 be found to be meMUr
.bly neaN!r th_ ideal.r. than any ()f the
fonu. hitherto employed. They baft not
been hlltil)' but IN the ",",ult
ANOLB.-SOMB NIIW roR)(Jl 01' OR'l' HOOOIi1'IC lISCIU.SISM. 973
of close and careful oil.
MrvatlOn, and clO8<'St consideration
(>[ eYery detail as to the material of which
they are wmp<llle<.l , their form&,
proportions and of pam, the
FIO. 1

M
,
.n<!Chanical principles on which thoy are
to operate, and the phymcd and physio-
laws that are to their use_
At same time the object has be<m
to produce an appliance which will
to aud 0() "-'i to
",dUe<! to ihe minimum ihe difficul
t ies and exactions of the t<cl!nique of
ooth its adjuatment and operatio,, _ Thi.
m<l<;haniBJIl i. of course b_d on that
main prweiple of the expansion
arch given to n. ](mg ago by thnt great
Froncilman, Fauehard, whom e$pe<:ially
811 orthodontid6 are honored in honoring.
Some of the de vices life but modified
forms of my own former, well knowu
appliancea; othera atO ro.dically new All
are harmoniously proportioued, ",fined,
and very
BIU.CJ[>;J".
A, F jg, I, ahows a delicate block of
metal, or bra<;ket, actual sioe, and B 8nd
c, Fig. 1, show it enJarged to facilitate
deecription_ An are shown amelled to
band material. The outer edge of the
brackd i8 ronnded, "-Ii are alIw ita coruers
and its two end., its 8ides being straight
and paraJlel. Inwardly, a deep tl1lns-
.erse slot extends downward in the
bl1lcket onehalf the length of the
bra<; ket , terminating in conce.ve fl oor,
The walls of this are parallel, one
of them bcing formed by the band
material anrl the other by the iIlj!ide
of ihe bracket proper. In the center
of vIe latter w.ll ia a delicate square
perpendicular groove wh ich passea down-
"'ard alld , through the l100r of the
bracket. In use will be considered later.
'fhe band material to the bracket
iJ! I!Oldeffil. alId "'hieh forms th6 inner
wall of the slot ihicl<ened at point,
whiclt is very import8.nt, in order to give
,t the neoo;sary dreogth. Fig. 2 sho"',
""veral bracketed bands Stted and ceo
9" "fHt; COSMOS,
menwd to tloe erowllS of the inc;wra of
an upper dental arch lypical of il,OOI!,
in ela."" I, in which tI,e W<llh
are crowded and Um dental arches pro-
portionately dimini,hed in ai'A), It will
(.022") in tbiCknC8S and thirtysix
thousandlh$ of an inch (.036') in width.
Its ends are also flat, but threaded, Bud
are provided with my well.known fric-
t ion lock DUU.. which ha.e been
Flc. 3.
be specially noted t hat the seam. of the
hands hoe been fonued on the lingual
surfaces of the teeth. Bnd that the
bra(kets are located d the Ct"tor of their
labial surfaces.
"HIDBO"''' EXPAl<SIQ" Anell.
Fig. 3 shows, in actual size, a very
dehcde, flat continuous, Or non_sectional,
expansion with rmrallel sidea and
edgea. It has, therefo..." the
{(lrm (If a ribbon, and in order W du o
tinguish it from the other forma of my
archei, I ha.e called it the
" ribbon" expansion arch. It iB but
twenty-two thonsandtru. of an ineh
reduced in diameter in order that they
may confonn to the ddiea!e proP'WtiOlU
of \his arch, which ;6 11S00 ;n connection
with the \l!llaJ clamp bands, the
of whieh ate all!() reduced m
di.merer and other novel featn]".
which will be described later. They 8re
OIl the teeth in Fig. 2. A trons-
vet":le of the ribb<.>n areh, enlarged,
is slso shown in Fig. 3.
0' IIIBBON ARCH.
In order to place the ribbon arch in
position on the teeth, aB shown in .Figs.
2 8nd 4, one of its scre'" enda i. inlleTte<!
A:<OL8.-80XE NEW FOII)'[S OF OR'fHOJ)(lNTIC MECHA.'<ISII.
in the sheath of the auchor bQnd on
one of the fitst molars, and the f riction
lock nut is seated The is then
with the fiuge,.. into the .lots
in the ... it s('Curately tits,
begiuniug with the one nearest to the
fitst auehor hand alld in
tegular order until the anchor band on
the opposite molar is reached, when the
nut is adjusted to appro:>:imately
iho proper po6jtion on the sreh, bnt
neither the end of the arch nor the fric
tion portion of the Dut are at time
placed within the sheath of the anchor
band. The arch is theu disengaged from
all the brackets, but not from the .heath
of the first anchor Now the screw
of the )006 end of the arch is slipped
into il.8 on the anchor
band, and the nllt WIlted. Then, begin-
ning as before, the arch is roplaced in
the bl"l!.cketa in ita former rela-
tions, the lut etep being the proper ,;eat
ing and accnrate adjulmenl of tile sec
ond nut ;n it! author "heath. Means for
preyenting the accidental displacement of
the arch from the will be con_
eiderod lAter.
RJ.N(l 0" OP THE RIDSON
ARCH.
By studying the engraving, 1-'ig. 2, it
will be """y W undeJ""!tand the manner in
.... hid, the force is applied to <llIch of the
mslposed teeth in order W effect not only
their individual. but ali(> their coll('Ctive
mo\emenu, . 1'he eluticity of the lIr<!h,
in thill 6pecia) case, operates constautly
for tM labial movement of the laterals,
the torsional movement of the centrals,
Il,e bu('Cal of the fird pre-
molars, and the lingual mMement of the
canines. And, as t hero i. no WMW of
power throngh Ille "lipping of
ments, the movement of the teeth must
continue nntil the force from the elastic
ity of the arch u then btnt has become
emausted, and the arch pass)'e. Force
is renewed by removing the an;h and
bending it to more nearl y ideal fonn,
when it is again sprung into place in
the brad.els lind sheaths. By this mean.
the teeth lire movo>d continuously, until
lillally the ribbon arch boon given
the exaet fonn desired for the den-
t.l arch, aud the teeth, through their
br&Cket have boon made to
coDform perfectly to it . As the metal of
which the an;h 16 made '" very elastic,
8nd u the r ibbon fOTm permits much
greater range of elasticity than does a
r<Jund arch, the force will be contiuued
iN a oorresponrlingly longer p;lriod be-
fore it is neces.sary to remove the arch
and modify i\.5 fonn _ JJ)deerl, but two
Or three modificatioIll dnring the whole
CQUI"!Ie of tretotment would probably be
enough in most ca&e6. The force is
and almost oontinuouily operative
in exactly the right direction, wi thout
the of cell func-
tion which must follow the use of Bny
that requires f requent re-
rooval
FlO, 5.
17
' -.
-. :
\ ....
\ !
'. '"
\. ;"
Anothe,- point which .8Cmi of great
to me is that the force
distributed to the ]fl(><ing teeth auwmat_
receiving ita proportionate
share both in BUlount and in di rection.
To this point : The pecuUarity
of the b!"acket attachlnent is such that
teo:th may slide freely in a lateral
direction upon ij-,e ribbon areh. like
beads upon /I ... ire, as shown in Fig. 5,
f,(> that "a.;h moves along tl,e line of least
realslance toward its nonnal position and
automatiClllly _i$1.8 di=Uy and indi-
recuy in plncing all thc other teeth. In
no other orthodontic !D('Chani.m is sneh
wmpJete J1!Ciprocility of movement pos.
sible_
Sometimes, however, it is desirable to
prevent Qne or mor of th" teeth f rom
on the arch. 'f bis i. dOM hy
soldenng a veri delicote ,pur upon me
Oilier .urfaN 0 the ribbon arch close to
'"
Tlrll: DENTAL COSIII08.
the bracket in such rw:-itiOIl II tQ pre-
vent the sliding of the tootll.
AI the teeth may llide freely on
arch, the c\Ol!lng of 'pace between &uy
1"0 teeth, u for example two cent""l
(aee }<'ijl;. 6) may 00 effected by
mUll' of a metal ligature made to em
the braeketa upon the t ... o teeth and
OC<'UionaUy rene.ed or ti!htened. (The
two utreme aid .. of the ipture , Iululd
be behind the metal arch, not in front of
it, u IhOWIl;n th8 engraving.) If it ia
de5!red to move one of the teeth on11,
the movement of the other may be pre-
Yeated by the means aboye deacribN.
Another point w be emphasi:&ed in
the 115<1 of this mechanism is that Ute
fo ree ia elerted upon the tooth wholly
PI4 ..
through the bracket .lId not by '-ring
apillilt any other portiou of tooth or
NDd. T hIS accurale mechanical .ttach.
ment Dot only penuill the fret'r no.nge
of eJuliei!y from the metal ,reb and
oonacqllenUy m(lte dialribul>on of
the foree, but pre.eut. any pouible un-
(. v"uble int\uen(e upon the teeth that
aN! being Thi, il because
the fiat parallel walll of the metal
bllck"et fit the panlltl sidea ot U,e rib-
bon .reh $0 accnnleiy that teeth bl-ing
moved outw.rd, II the lateral illcison!
in . 'ig. 2, Cllllnot be rol1led uof .. orahly
by contact with adjoioing teeth. Alllo,
whto rotation iA daired, the force is
through the bracht and not by
prying 00 a 0011l6r of tooth. AI the
arch Issume'! perfe-ct fonn, the de-
,iled movcmcnu of the teeth take place
ill accordance therewith through the QC-
w,o/& rdiltio .... ,
F'lge. 7 and 8. Heretofore rotatiOIl hu
U!ually I"t'gIIrded as U,e mQ&t diffi
cult of all tooth movemenbl to looom-
plilh. TIli, i, becaose romplete force
control h .. impossible with the
mechAoi em previou5ly at Ollr dilpo&a]..
With the mechslIiam here c-oueiderM,
the force may be 110 continuou, "nd
eyenly diltributed thAt rotAtion beooml!ll
no more difl\cult than anJ other tooth
lUoyemeol The principle employed i.e
that ot the double lever-two elutic
leYen! operating with equal foroe in op-
polite .....
PI ... 7.
0' QRQW>( .,10 ROOT XOVl\
)1fi>(T.
To uoid confulion iu diJcuuinj!: this
mechanism, we have"" far oolUlldered
only tll8 erofl'll moyementll of teeth, but
the diatribution I.Dd control of force for
root mO'l'ement i.e equally feuible with
it, either simultaneously "ith ennm
movement Ind in the ... me or in oppot.ite
direetiolil, or independe!.Uy of eroW1l
mOO'ement. The force from the elutic
arch i.e di.etribut.ed to the mob throuj(}!
the yi.e-like g .... p of the arch by tlie
hraehta. (Tbe direction of force upon
the root deJl!'ude upon the anfle of in-
dinatioll glytU to the .l"'ra.lle ,idei of
the metal .reb, ""fore It i.e sprung into
AYGLE.,-SOllE NlIW J"<)B){S 01' OR1'IIOO(lN1'IO )( I\CIU NIS>I . 977
tho If the crown and root
movements to be equal and in the
direction, ae in A., Fif. 9, where
bQth are to be mo\"oo labial y, (It in B,
Fig. 9, where both are to be moved
li ngually, the ... alls of the ribOOn arch
mU8t be perpendicular before t he arch is
sprung into the bracket, &0 that the force
will be dilrtributed equally and in the
Mme direction to hoJth root II1Id crown.
If the labial movement of a root only is
taining we ribbon arch within ilia slut
of the brad:et. Unless the a.reh be f ree
from the danger of accidental diepla.ce-
ment and firmly maintained in the
hrMket slot to its full depth, iliere is a
probability of lou of po1DM' and the lack
of its pcrfut CQntrol. These two fea-
tnl"<'s ate &0 ,ery essential in ort.hodontk
that their importance i3 at
last being keenly recugnized by om best
orthodontists, and the many crude appli-
F lO.

"
. , .
, '
! n N'U\ !
; "" ... ' \
I :
i .

requiJW., the ribbon atch is bent in the
region of the bracket &0 that it ... ill flare
outwardly at the gin!;ival border, and
when sprung into pOI!itlOn in the bracht
.... ill bind alld exert force in a labial di
rection on the root of the tooth, M in c.
l 'ig. 9. By flaring it inwa.lly, to that
it will bind in the oppoolite direction
when into the bracket, the toot
of the tooth will be moved in a ling>lal
direction, as in n, 9. So it i. eMily
JXlS!ible to mOve either root Or crown to
any dfgroo, according to the fonn giwn
the ribbon arch and the angle at which
it is indined ill iIB bracket relations.
" KRFJrCT CONTROL BY >lEANS OF LOCK
PIN.
.Before considuing othfr movements
frequMtly nece88llty, as elevation or
depression of t.eeth in their .....:kets, the
tipping of mol,," or othe-r teeth to up-
right pc>sitionB, or the bodily movement
of Weth meeiaily or distally in line
of occlusion, let u.a couOiider another im
portant f""ture of the mechaniJ!m,
namely, the meanS of ett(')ciually main-
\
t: \
,
,
ances in which a large p!lrt of Ole JXlwer
is .. .sted or mischicyously di rected are
rapidly losing fa"Of.
After much carefnl thought and I-
peri mentation in which probably moat,
if not all;of t he poesjble IUeaM of main_
tainillg proper arch and bracket relationa
rIG 10.

considered, II method was finally
which seemed (Iecidedly more
effident, simple, lind pradkable thall
any uf the others. It consists ill locking
ilie arch in th'" bracket. by metw.8 of a
lock pin, shown in actual site at A, k'ig.
10, and greatly enla'"l"'d at II, Fig. 10.
lt is very delicate- bnt ten thousandth.
of an inch (.OION) square- and pointed
'1'111 DBNUL COSMOS.
at one the other end h1"ing .. he.d
.. h;ch prnjecte to one . ide. In Ih,pe it
do .... l,. NlIHnble. the ordinary railroad
epLke, a.nd !I proport.ioned to give the
gffatt deheacy COIll15tent .,ith .U De.
oeM&ry.strongth. The .rcb being firmly
llelted III the bnr.ckH, the point of the
locI: pin ;. inaerted in tbe .perture of
the of the br..:ket, puehed
dO .. D until it can be gruped .,ith I
p"ir of Ho., pliers, .nd dl"l""ll through
until ilA ht"&d ;0 firm contact
with the edge of the ,lbooo areh ..
Fig. 11. It fib the grooTe Tery
rlLtely. The poiut i, now p1.Llled and bent

fO ..... Ard And upwud and clipped oft ,
thul firmly clinching it in poIition, U
.hown in H, Fig. 11. 1'he roughened
end is then smoothed and hurnished 110
lhlt it .,ill not interfere .... ith the lip.
I n th;' limple manner the Irch i.
securely hcld, yet the lock pin iJ 10 del.
icate thAt, when it ill in poolition, it ill
h.rdly nouttable Utepl npoD e\oee in.
lipootion. By .traightcning it. bent end
by rn"""",, of. delia.te ehi .... l or the blade
of .. Iman knife, the lock pi n ma, be
readily removed .. itll the Irch II the
I.tter il lifted out of ita IIOCket conDee-
tion.
CORRECTION 0' II'PR.< "11"0 8u n ..
OCCLU6ION.
1'eeth that in infra-clnlion rnl,
be elev.ted lor I prinf!:ing the .rch giagi
Illl, . nd keyI ng i t mto ill b ... eket nil'
tioPJ! by meam of the lock piDs, u in
Fig. 12, the Tlpidity _LId extent of the
movemeut bfing under the (uil eontrol
of the orthodontist.
B, r .... the dirretion of the force
teeth in eupraoociusion may bf dep..-.i
Fl. ... 12.
in thei r .ockeb, all in Fig. 13, . nd this,
too, limultanOOU!ly .,ith other mon ..
that rna, he for
rw. 13 .
ULeir crowPJ! Or rOQU, .,. alreldy
described.
TIPPINO :UIrl"H 1'0 Ur lHaUT POSITION.
Tloe demands of treatment .180 often
necessitate tipping of one Or more Qf the
buccal teeth to uptight poIitioo, which
;. "sill ItCI."OIDplished after the
shown Ln Fig. H. Camul stud, of the
device iUUltnted in thi. engl"l1"ing will
ahow hOlT perlecUy the force i. und ....
control for the fo ...... nit ip-
ping movement of the premola .... I . the
ANGLE.-SO:llE NBW FORMS OF ORTHOOOl<'flC >!EOIIAN'S)! . 919
nut tightened, the delicate spur at-
tached to the Quter surface Qf the arch
bearing the dist.tl aurfae<! Qf tile
bracket, a, while ti,e anchor tooth Qffers
full, even, and ..qUAl t"e$isUu'e<! through
Qut the: tntire .Ioeollr connedion with
Qut the poosibility Qf it.. being tipped Qr
the <hrectlQn of [orca upon it being
changl!d (stationary anchQrage) ,
It iii Qften deairable to tip the mQlar
disWly to an upright positiQn at the
same time that the premolar is being
tipped mesially (see Fig. U} - in Qrtho-
dontic pradice to regain lQst by
mutilatiQn Qr the non-eruption of teeth,
!<lld in dental pr.dice lor the beiter re-
lation of hridge
be done quite eR.ily hy combining
from the elasticity of t he rI bbon
f19. 15.
C. '
arch with from tbe IICre ,,- , 'I'he
anchor band is adjusted on the molar
that the .heat h will lin(! below the bAnd
upon the prelnolll r, Fig. I:;. After the
arch in the 8he..th, it
is sprung upward into ita J"<l -
latiQo, thus a constant pry up
wl\rd Qn tbe snwrior root and dQwnward
on the posterior root of the mQbr, plus
the fQrce in a direction gained by
tighteuing the nuL The lONe is th\l&
ideally direcood Rnd p<lrfed con
trol, and will he found very ellective.
NQtwithstanding the great I1lnge in
the elasticity Qf the ribbon when w
employed, wme of this elasticity WQuid
he lost in springing the areh up over the
Quter wall Qf the bracket Qf the band on
the pNmQlIl r, espedally when the le<lth
cloaer to.l(ether than.is showlI in the
engravlUg. Thi. possible lou of spring
may be completely Qbvi ated by reversing
the of the slot in the bnlcket
when the balld is formed about the pre-
mQlar- that is, by placing the opelling
Qf the slQt $inginlly instead of Qeel".
aUy. In tllle the downward spring
Qf the arch would 00 bornc hy the lock
pin, which if properly !pphed would
amply support it. 'fhe addit ional mQH
ment of rotation Qf eiiber Qf thcec teeib
may be accomplished simultaneo'lsly by
bending the ribbon arch 80 that it will
bind within the bracket Qr sheath, Bnd
rotatory force in the desired direc-
tiQn.
CHATS mmp A. rrA.C1!)U!NT.
If the bodily movement Qf ally Qr the
buccal teeth ie required, t ho
is chenged to a rigid attach-
ment, If, l'ig. 16, which will render
tipping of the tooth irnpo&lible. 'l' hi3
rigidity i3 gained by two del-
icate square ball! of mdal (see (Z, Fjg.
IS) to the M'th, these barE
or cleat.. being parallel and in contact
wiih the m(>S;a l and distal surfaC<'ll Qf
the brae"e!. The rigid attachment of
the cleat. to the nch and their close
grasp Qf the sides of tho bracket ellectu-
ally the t ipping of the tooth, alld
iu bodily mQnment 3.'j tht
nut in ftollt Qf th anchQr sheath oc-
cuiQnally a\i.l(htly tightened. Althoull:h
simple and ellectiYe, the efficiency Qf the
de'"ice depends wholly upon the accuracv
with wbid. the clcau fit ti,e brocket. -
PACILITATINO Til l!: Qf CI,u'TS.
The ooldering of tl<"Q delicate bk" Qf
metal traru;wrsely to the arch 60 tbat
tbey will be exactl y parallel and at the
'"
THE DENT'\L COSMOS.
same time aepa.n>.ted only the exact width
of the " racket is a feat in soldering that
would tax the most skilful. After much
thQllght and a plan Wali
hit upon which not only in$ures &C<,lurncy
but the & very easy one.
'The deal\! are sLunped from a ahed of
metal so tI,at ilia two ue counected at
one eno, and they are seps ..... \.e<.I by ex-
actly the desiroo distance (see A, Fig.
I'l). This U torm oJ metal ;$ then easiTy
SoOlde",d at any point on the fiat areh.
aa at B, Fig. 17. The 8urplOQ portion
oJ the U is then off, leaving the
deats at C 81ld D, Fig. 17, ill mt"Chan-
iCIIUy correct l'<Jlationa. I n order to still
further the operation it i! hoped
FlO. 11.

that, in manufacturing. the solder may
be rolled upou one of the metal
before t he U'5 are stamped. This would
obviously be of great advantage, 8./1 it
would then (>Dly to apply the
proper flUI and heat in te attach
them and would insure the proper qUill"
ity quantity of IIOlder andyreyent ihl
acddenu.l di"l' la.ccment durmg IIOlder.
ing. Until this done, .ery minute
pjecoo n! aolder only JOust be employed,
as any surplus solder will prevent the
wBting of the arch in the slot in the
hracket.
VA&10U8 APPLICATIONS or CLEAT5.
Agllju referring to /I., Fig. 16, it will
readily be undeTlltood that the root move
ment of the premolar may be ea..ily ac
celerated or retarded b)' bending the
ribbon arch alighlly upward or down
wart! just posterior to thc dee.t IItt..ch
ment , thUB causi n/ol' tJ,e clefl.u, to bind
npon the bracket as the arch ] $ spruog
into poi!ition. Or the &ame mault will
follow if the deab are originally sol.
dered at a shghtl) different angle on the
arch fron' that at Which the brn.::ket i.
stu.ched to th ... band.
In order to ruxomplil;h the bodily
movement of incisors in a mesial or
distal as for in F ig.
6, the crown movemena of which have
already bMn dillussed, it only n<lCe:t-
!,lIry to apply the dee.ta to the ucb 110
that t hey "' ill engage the mesial Iud
dislal wall, of both brackeu upon the
teeth. The force is then applied. by the
gradual formation of a loop or crimp
betw""n the two teeth, letting the crimp
into the embra!ial epace between
them-not fonni ng a vertical loop, the
bandulne'lll of which I eloall later point
""'
Another way of acoomplil;hing the6C
results would be to occaaion&\Iy cnt very
short from the areh in tllia
region, and then to reunite the
end. with Th,,* twO methoos
combined might of teo be desirable. Or,
by meaM of .. ligature, the crown may
.5J'\1t be movoo, QS in Fig. 6, and then
the root., by the addition of the cleat
attachmenb to the arch. For this ih.
cluts would 00 00 attached QS to bind
On the bl1l.ckets, thus cOllctlntTliling the
foree upon the roots in a mesi .. ] direc
tion.
POINTS OF I>' SlI"PII<(I TnE
IU BBON Alleli .
T he should be 110 shaped
that it wi ll exert lull fOml by ib t"",
eiuticity through the bracket connro
nons alone, as I have already poiuted
out, without touching the teeth, as in
}'ig. . 2, 7, and 8, and with as little in
terference with the lip!! lUI possible. In
ca_ where the malarrangement of the
tooth not great., 0Ji in fi$"' 2, the rihon
arch, will,out any prehml.nary bendlDg,
It will or <lOU'" be rU'p""sible t o
haying ribbon aroh \.to"
. ening but .hi be don.
eye' ..... ouch <lO.t..et inkrf.,.", .. ;th
the It .. I tle;" of the .,."h, .. nd eo_
quenUy with I,,, .. lnt,ol.
A/fOLK.-80ME NEW FORMS Oil" ORTHOOONT((; MJ!lCH4N"ISM. 981
may elIsily aprung into pooIition in the
bmci<et.!; with thefingeMl &lone. But
where V,e teeth aro in pronounced mal-
ocdusion, the arch must first be most
carefully shaped out.!;ide of the mouth,
wholly independent of the bracke\.'!, by
meana of pliers, in accord alice with the
poaiiiona of t.l,e teeth ILJl shown by the
plaster To bend it iJl..5ide the
mouth, assiated by the brackets on the
bands alone, would require snch I".'
fo= that the would o;<lrtain y be
;trained and r uined, Or the connection
between b.nd aud lOOill would be broken.
This will apply equally to the finer . hap-.
ing of tlJ.e arch in order to CauS<! it to
bind within ille bmckets 90 thet power
may be applied in p.t:rti<:uler dire<:tion.
to individUILI teeth, as for rotation, or
for root or bodily movement. Therefol"C,
would emphasi,e the fact that we
arch mmt be so perfectly formed jnde-
pendently of the bracket ill all
thet it may be .... ily seated with the
fingers, or OIith IS piece of wood
held lD the fingers, to aV(>1d the danger
of straining the bracket. Thll.!! the per-
led rot between brocket IIud srcl" so \"Cry
necessary for perfect control and
!lO carefully worked out in
mlly be preserve<.!.
Anot1:ter point of importance in
the shaping of the arch is to Qooid bend-
ing or marring it !j() a. to change iill
fonn in the least at the points where it
is to be engllgOO in \.he brackets. Any
hange would render it difficult or im
poesible to scat it " ithollt siraiuing
bracket.
flESDISG PLIERS.
So importaut is the proper bending of
the arch thet it hM made Ue<:ellllary the
special fOml of pIiC!"!l shown in Fig. 18.
Round-be>lke<.! pllers must not be used,
b"t we nell' plief6 illustrated are ideal
for the purpoo;e. The dimeusions of the.
trans.erse slot (S<!en nCar the end of on(>
of the beaks) exactly to thoae
of the in the bracket, Whe'l tlLe
erth is placed in thi$ .Iot, and the beab
are cla.sed, it is held iu the Mme maUner
thllt it would 00 in the bracket on \.be
band, but. more rigidly. It may now be
bent a.. deeired wttJLOut marring it in any
way and without changing the form of
that pat!. of it which the bracket
ylot, go that, when it ia replaced, it will
fi t. very ac<:nrately. No other method of
shaping the Brch insures such accuracy
Fla. 18.
of fi t between atch and slot, and this is
always of the importance. In
shaping the arch _t specific poin\.$ for
accelera.ting Or retarding root-mo\"ement,
or for rotation, as in Figs. 8 lind 9,
theoe aTe indispeMable. 'fhis
firm grMp of the arch and its .teadv
support are abo necewLry while bending
982
THE DMJ<TAL
it edgewise upnrd or downw'rd at
might he r<!<:!u;roo in cases to
those shown in 12 a.nd 13, but for
mtn, rtalOWl bendt in the
ardl, "peeiatty aharp bend., mould al_
ways he avo,aed.
'l'he cunes in tho! rib-
bon II'ch between the attachmentl rna,
be made w'lh the Or with the
round portinn of the beak of the&/! plien.
'l'h.e proper ."d uniform I.n.Oealing Qf
rI bbon ;. qlli" .. importut aI
that (If the dolicate round areb. of the
pin an,1 I ud in no other
... y \"ell be .to Ic.::om-
pliehed ... by the of Ihe
clecuic .nneale .
Alto, in order that tile", nay be per_
fect oolltrol 15 to the amonnt and direc.
ti'ln of the foT<'<! in the UJf! of the ribbon
&,h, it ;. hight;r imP'>rta.Qt that each
In<l ,II modiftcationa in the form oJ tile
In;)b ,luring treatment be made in accor.
dance the archograph, lUI pointo!d
out by Dr. String in ronn"",tion Tith
the of the pin and tub<! appliaDa'.
Only >n tillS ,. . ,. ca.n /l'ueNing be elimi.
rlated and aC<lu racy gained
in the mtrol of the foree th.t il t.:. be
Ili ,lrilll'ted to the moving U!etb.
0 1' TilE A.l'rLlA.1<CI::6.
It is highly delii rable U,.l the bracl:eu
]x. u delicate Ai po8Ilible comialeut "ith
the strtngth, and much care hu
gr.-en to their form and proportiom
and to the materilll o( "'hiclt they are
con8uucted. I hue ()lind, ... a roault
ot mall)' e:rperiIDelllS, that the metal 0(
which the round ,...;tional . reh or the
pill lIJ1d tube appliQuee and the new rib
bon !In:h are made giVei tmm gre.Wr
strength than !lny otller mown prllCti.
cable (onn of metal, IlId, more Impor.
tant .WI, of thi. metal
i, not impttired "1 the beat neee&Mr)'
ill soldering lorS(ket. t.:. the blind.
Sinee much &("(:" r80y And akiU are reo
10 properly attach Ihe brackets t.:.
the bands, Ind as it is never ntoe.ary
to chan,l(l! their poaitioru On the band.,
they will only be l upplie(\ by the manu-
facture .. already Ittached to sect.ions of
the reiutorced ""lid material.
/'lEW OONITIlUCTJOIi or BUIDII.
The balld nraieriRI furni.hed in
both precious Ind I>On-pucionl metaia,
Ind in t ... o dil'/erent lellgtM, tor large
and small t<!Eth. The Itr"in UpOIi tlie
band laterally ill rotat ion, Ind perpendic_
ularl), in root-movement, ia!iO great thst
it the ordinary band ot
unl lonn thickneu. 'l'hi. haa been over.
come by thickening, hence strengthening,
the band in the l'I!gioll oJ the IU&cl:tment
of the bracket where the It ... in is COIl-
and making it thinner whert
the slrain is dill'nsed, Ia Mt,Wtell the
'ppro:ri",atillg ludlDl!t of the teeth.
Thi . i8 an important iml;lrovement in
band-mlJr.ing, and In time ,t will donbt.
1_ be employed to advantage ill the
con.lntdion o( nl09t orthodontic bands.
Band-holdin!1 plw-I. The prwent
standard method of making plain b4ndl ,
especially of nonpreeiowl metal., to
u..., a piece 01 band material long
'" that ilJi two end. may be fi rmly
gruped by one I'and Ind drawn tightly
aboot th tooth, wbile it is pinched lI'ith
my blnd-fonn;ng plien held in the
other hind. But the erpeuse of
cionl metaia, eapeciall, of a\kl,. which
contain platinum, renden highl), desir-
able the use of dripll of baud muerial of
lhe 8hortest practicable length., Tlt i.
haa n_itated .orne fonn of in,d.rumen\
to take the pll\Ce of the ti nge.. for
holding the 01 the pie-cea. Dr.
Grunberg ho.. IUggetlted BOldering Ihe
end, of each piolo;:oo 10sMher Ind U
eJ'nng on the loop so l ormed
by meaDS of right-augle ball-end
burni.oher. Th, plan it a good one,
but il requireo. e:rtra t in' e Ind t rouble to
unite the cnds. To avoid this ne!tity,
Dr. F rederick B. No}" ... luggeeted 10 me
the poeeibi lity of lUling lOme form of
plie." for g ... oping the ununited t nd. of
thu banol malnill, sud woweol III! a
pair of obtUAe-aJlgle !low plien lI'hich
b ..... IIling-for that purpoee with llOlJIe
degree of SUCCell. Ad;ng on Dr. Noyes's
luggedion, I hue, afwr wuch upor;-
menlillg. produced a pair of plien whieb.
I think, fully meet the requiI1'menta, Illd
"'hieh are at the same time very limple
in design and Ipplicable to either the
lingual or labial of the teeth of
NEW FORMS 0' ORTHODONTIC MECH .. D IS).I . 083
either arch. 1'he beaks of the pliers are
flat, and stanrl at an
angle to t he hM.dlcs lIig. 19).
jaw is provided with a
s!ot for the reo;eption of the two thick-
nesses of band material. A piece of band
mawrial of the proper length iij bent
sharply right angles near both end!,
FIG. 19.
ILS in Fig. 20 These heods be9t
formed in the slot with ,..hkh one of \he
hndles pro, ided, thus insuring uni-
formitv in V,e;r \eo/(th. The band
material is then fonneJ into a loop, B,
Fig. 20, \he enda are see.wd in t he
slot in one of the oo..ks, and the haodles
d06ed, 0, Fig. 20, thus giviog the finn
ed grip to the bent ends of the
material and the firmest 5"pport to the
band. The loop is U,en worked over the
Crown of the tooth to the desirOO posi-
tion, the sen-ing a.s a most ron-
venient handle for this purpose, a5 well
ay for fi rmly drawing it about tile tooth
it is heiDg pinched by my band-
pliers (see F,gs. 21 and 22).
FlO. 20.
,
A
,
It is thus possible 10 employ piee<>s of
band materia! of the minimum length-
00 ohort that they CQuid not he held with
the :fingers. Tbe imuument i! very
1atJdactory. Of 00<')1\=, loog pi<lCeS of
band material may aloo be used with it,
FIG. 21. Fl . 2l!.
the surplus Inaterisl p3S-lillg out hetwoon
tI)e beab of the pliers.
A fe w words here as to the positions
the plain bam\s should occupy 00 in.
and will not be amifjil as
to my nO definite
for these banda has eVfr been indicated
by any author, the being a ouy
of u:"romuty 'u the placing
of bands m IndlVld1l81 mouths, and thi s
'"
I'I'IIuh. not .(mly in of .U.ch-
ment, but III II. prollQulloedly in .. t irlic
.ppeafllnce. In fact, there ill but Qlle
eorrect po;!!it ioll for ... haud W <x:cupy Oil
tach lud,,'idual tooth, because only in
1h;$ positIon can It afrom tho greatest
firnmee8 and au.bi1ity of .Uaduuent.
'l'llia poeition ;8 t r.".,.ereely to the crown
of the tooth, and the band Ihollid be ""
"laCfll as i(I embT&Cto equaUy Ule mesial
and dillta] .... 1'.'11. of the C!'OW'II in an tIC-
dUAl and gingi"11 di!'tct.ioll. The IUt.t-
u .. l 1,lna] 8wcll of the CroWD of the
tooth will prevent the lliding of the
hllDd either gingiv.lly or oedUMU)', if
it il _\:Cur, lely fitted and properly 00-
,nented, And thi. poeitlou should be
Itrictly adhered to in the cate of each
tooth, regudlOOI of it. poIi ti()1l or G!
that of Iny other tooth eJOIIpt .1_ in
complele eruption of the tooth mak\'!ll the
correct placing of the b.od temporarily
ilUp0e8ible.
Abo, ... hentv"r poaaible the hruket
. honld Il )lOIIitioll in tI,e
of the labia SUd8ct! 01 the band on a
line with We nil. of the tooth.
baud and bracket being Ull" ()()rreo;tly
pla06d mecllanically, they '<rill al!l(l be
mo.t nearly in a<:<:Ord .. ith the require
menta of art-for, all the teeth are moved
iulo harmonious relationa, the band. and
brackeu will ..",.,rd in b.l. o.ce and bar-
mOlly. Thil. " ill be brite. undenrt.ood
by referrin/( to Fig. 4 ... bere it .. ill be
that the ",idth of enamel margins
above and below t he banda harmoni:res
in the case of the two lawral lnd abo
of the two but tl,at betWl>eJ>
tlH! lawrala aud COlntral& th_
"ary proportioll&tely to the variati ou in
aize of the t",o kinds or teeth.
The inariiAtic effect of placing the
bracket in the wrong poIition ;. Itrik
ingly Mown on the left eeulnol inci!l(lr,
FiA:' 4, is an error in the
ing. Had it .been placed in the center of
the band. as shown t(I hue been prop--
erl y done in the case of the otl,er COlnt.al
Ina Ixlth l.terals, the brackeu and inter-
venin "paces on t he banda would have
been In hannony Ind b. lauCOl and wonld
h .. e been far more pleuing in appeot..-
anee Ulan;' now the cue. T he inartistic
nnougtmen!, as 5ho",0, il the IIIme IS
"'()nld ",olt wure four picturel hung in
u n,.uy upon a wan, one ()f the
pict uffil being wrongly pi&ced to ita
space.
Fin.<>lIy, the fonujng of lIe.ml in
labially il 80 manifestly out of koop
ing witli correct and 10 pro-
nouncedl), inartidic io appeanonce that
only the mOlt ... and doyen!)' aper-
atora ('(InUnO! to make banda In this
wa!;,.protJe(/. u.ea.tk of th gncltor c/4 ... ?
The improvemente in the .tte.th
Fm. U
n . 24.

III the clamp baud M()Wn in Fig.
23, and A, Fig. 24, are astollow.: Fino!,
the uniform diltribution of metal of the
the wallo being af the WIle lbiek
ness in ita anterill' pari ... here it inclOleOl
the CJlindriCl.! p:lItian of the f riclian
I<lcl< nnl, and where it il .ubject to the
J"":tat itnw and 1iAbili t::r til injur}, ..
,n that prort which inc10ge1 the thrtaded
I'Ortion of the orch. This giyea the "me
dOle adaptation to the arch II to the
cylindrical portion of the nnl, and re-
duce. the bulk of the ijheath to the min-
imum. Second, the main bOOy of the
aI,eath h .. been uniformly bent til f()rnl
the arc of a circle.
Adrontag4 gf ""noili..ur .hea.tk.
'I'lIi, .hee,th h .. many decided ,dUll'
AIiOLH.--&).lIJ: NJ:W FORKS Qr GBTJ.lQOONTJe IUlC1L .. ,H$1.. 986
ta.tet the Itr&ight eh8th, "hicb
will bo! readily Ipprecillfld by both ortbQ.
(loQtilbi and patienf&.
i'il'lt, the diital end 01 the Iheath lies
much dour to the di.to-bue<:al f.llgle of
the tooth (oee A, Fig. 21), tIlua avoiding
III interference ",th U>e cheeh. The
llreight oheatho formerly Ileefllary fn)
quently ueed Ibl'laio", Qf the cOOeka,
eepeewly "hen emplQyed on the IeOOnd
deciduoul mQlar befQre Ihe t fllplion Qf
lhe first permanent molar, or upon the
fll'lt petmlIU'nt molar before the eruptiQn
Qf the I8COlld. ThiA advantage "in bo!
.till more Qn oompt.rillg the
cuned Iheath with that Qf tht Oettin
gH type of hand .hOWD at ft, Fig. 24:
"hich, in order that it may be re. ohed
ill clal>lpin.g,. nl<.lui ..... a oery lI.rge Ind
neoeaurily Itreight ll heath. The fact
th.t the .l>H.th iI CUrled migbt
t.o lOme thu it would be dil!\cult Qr lm-
to paM the ribbon .reh through
It, but the elasticity ot W, arch illueh
that the ClIne offen no appreciablt dif!i.
culty.
SetQnd, another advaotage which all
" ill appreciate i. that if. belore it. in.
lenion, that portion of the areh which
i. to lie within the "Math be bent to the
Ire of "",aller eirele thin th.t o( the
cu ... ilineo.. oheath, the t8ult Qf the elas-
ticity 10 gained win be DQt (01)' to pre-
the nul {rom WQrking out, but to
un ... both lIut .... d uch to wQrl< dillaUy
aud to hold them in elote appooIitiQIl to
the sheath, t.hu. rendering \lie aeo:;iden-
tal dilpla<:emenl Qf the nut illlpooleiblc.
Keeping thooght in !nind while
carefully . tudying 2, Qne will ",,"l-
in how important thil U in ketping the
.reh and nuto in proper rel.tiQIlI with the
anchQr teeth 80 that the fQrmer will nQt
work {Q,.....rd and po.aibly permit Ipao!lI
to 'pp"r between the !.eetII durillg
ment. Thil is an .... DQTance which ,11
hIVe uperienood in the 'UN Qf .n Qther
orthodontic mechaoi!ml with "h'oh we
lore (&mili.r, &lid which hu Qtten made
nocetMry ti,. use 01 edr. ligduree or
othe. attl.l;hmento to p.event the RTch
from l lidin/( forward .
Third, tlLe enrrilineo.r sheath giya !.he
beot collt..,1 Qyer the directiQn Qf IQree
fQ. mQYing the roob Qf the ."chor teeth
either buceally Qr linguall)" in connec-
tion with Qr independently Qf tlle; .
crown movementa. 'fhe curved IheaU>
effectllblly preyenbl the Inrni!l4" of the
ribbon 81Ch .ithin it, thuo inaunnl{ oom-
plde oontrol olver the force IOOOrthng to
the degt"!l Qf perpendicularity Qf the
...u. Qf the ribbon .n:h befQre !.he .reh
!F
<: ' W
ia shd into the !heath. TlliA make.
wholly uuueoes&ary any of the numeroUI
e<;>mpho.ted Ut6Chmcnbl (see Fig.
which have been advoca.ted from time to
time in oonnectiQn with the expaWJiQn
areh IlId Itraight &beau.., to dect U,e
buccal Qr lingnl.l mOY\'Dlent Qf the root.
QI teeth.
VQurth, .ith the cunilinelr ohe.th a
an:h can be used than with
.t. aight "'eath. The ends QI the an:h
olay p!ll$ through it an eighth Qf an
mw 0. mQre, (or they are &0 ddicete
and lie 10 claM to the adjoining teeth
b .. d "U ;n .... l4d bJ D<. \let- Pull.,., JoII_'. "()pt."'-;'"
tI ..... , or loI'-ll, Jol on....... pqe 6$1.
t ....... Lntl._l
,so
TilE DENTAL 0(8),10$,
that cause IlO interference with the

Occasionally, also, advantag>! may be
taken of this elndic projecting Md of
thll to apply pressure upon the dis-
tally adjoiMog looU, for itt lingual
movement, or W assi.t in the bnoxal
mo.ement nf anehor tooth.
I:ST"BLlS1U [ENT OF NORMAL }1ESIO-DlS-
TAt. RELATIONS OF TERTI[ OF OPPOSING
ARCHES.
After the foregoiug description of the
manner of applying and operating the
FIG. 28.
mecj' anwu for ac<:omphtiliing both
and root mo,ements either .iugly or col-
/ediveJy in either or both dental arches,
it should be caey t.o understand how it
may also be applied lind opel'lOted, in
addition to lOud simultaooouely with
these in order to el;tablish
the normal mesio-di.tal rcbtions of te<Jth
()f opposing denbl arch"" in the >cry
distinct types of msloo::iuslon oolonging
to ClaSi>'lS II aDd 111, and ilIu!tl1lted in
26 and 27.
The ,",-,,!ui!"<'nlenb of treatment of in-
dividn81 caso:'s of thee" typea of malpcclu_
sinn vary ennslder ably, dependmg npon
ihe extent of th\l deforn'ity, the 8g<l of
the patient, arreflt or modification of
bone-development, etc. Yet in nne re-
t.hey are alwal' Ihe eame, namely.
that proper fnrm must be gireu to eMh
dental and that any existent mal
poSltion of individual teeth mnst be cor-
rected. Then, when the mesio-dislal re.-
lations of the dental sTeh"" have been
corrected, the arches will hsrmoni.J:e tIS
to site, f()rm, and other reiatiOD1l, aud
the teeth ()( t.wo archea wlll ooclude
normally. Of COUrsf-, all these '-ariouo
may be bronght about .in",l
tliDeously, but in thew cUes there are
two classes of movements, and
thi s fact Mould be kept dearly in mind
througbout the entire COlirse of treat-
mcnt, "ith efforts logically directed I.e-
oordingly.
or TNTM:UAXILW-IiY
l:USTTO LlO.4TUIUl8.
'I'he normal mellio-distal relations of
the dental arch,," be established by
chAnging either the forms 01 tl'e jaw.,
of the mandibl&, Or tbe rela
tion3 of the crnlVns of the teeth (by
t ippillg or by bodily movement), or boUt.
The are effecW
largely througb the fotee from inter
IDaxii18ry ellUlue ligatures used in oon
nection with the we are ber<!
considering.
In cases belonging in n, the in
Nhw HlhMS or OWrIlOOOl!TIO ... XISld.
:rmaxillary ligRture!l engtoge the di.tIII
enda of the sh"",th. of t he bands 011 the
lo .... u first molars and hoo\:6 at-
tached to the lower margin of the upper
ribbon arch, "-'l indicated by the dotted
lints in Fig. 26. I II CIMII II I (see Fig.
27), the J.IOO itiona of the ela'!tic ligatures
are, of course, re.erwd, and engtoge the
distal ends of the oh.eath of ihe upper
anchor bauds and hooks att.ached W the
upper margin of the ribbon arch.
Of oourO(>, the inwrmaxillary force as
here used is the same A$ that which we
have long employed iu cOlloeciio" with
the expansion arch E.
In treating the maloccluaion of typo
ical cue belo"ging to division 1, Cill.2s
II, a. illu5trated in Fig. 26, the fin;t
of the operatiou, M ,,'e 88id,
;, to eorred the form of deotal areh
snd the malpositiollll of the individual
Weth ; the secvud. w establish the uom'al
mesiodiatal relatio"s of the t wo arch .. !.
'I'he geoerbl form of the lower dental
arch in th_ cases ia Ul;ua.ily quite nor
mal, ' but the upper arch is commonly
narrowed antnioriy, with characteristic
protrusiou of the inei""rs. 'fhi. nooe>J-
litat.es its being in the region
of the callines aud aud short-
ened by tippillg the incisors lingually.
The latter .. holild be nnder
ta\:"" first, and by keeping UIO nuts in
front of the upper anchor teeth t urned
for,,"srd ",bout half th" length of the
friction sIMOes, the free of
the arch dil;tally throogh the sheatru is
permitted, and all or tI'e fo= of Ille
inronuu illary elastica is concentrated
"pon the incisQrs.
Considerable force for the disW mo>e
ment of the ribbon Ircb through
anchor WeitthB, in addition to thut fron,
iIle int.:rmuillary elaatics, ia w IJ.e de-
rived from the elastici ty of the &rch by
re&80n of the curves in the sheath., !IS
already d=ribed in connection ",iill this
pe<;ulillt fonn of "hcath. fore\'
shonld be kept active by c>ccasionally
be"dio", w their proper forms tll_ por_
t iOM 01 the r ibbon .. reh which lie "'ithin
tha sheaths.
,\ $ the ineiBon tipp-ed linguall;>.
they will tend w w..oge the canine!! and
premolurs ootward, Oms widening the
anterior pari of the dental arch, and in
many instanC<lS it will thus be sufficiently
Howe"cr, if ,noTe dired fo=
be required, the elastic ribb<>n arch may
be used with bl1lcket.ed band$ on theS\'
if.'<lth, as in simi lar mo.cmcniil already
deMribed, and illu$trated iu },'ig. 2.
When tl,e work of reshaping the den.
tal arches is well under way, attention
DISy be $pe<; ially directed toward el!UW-
lishing their normal mesi<>-distal ,...,la-
tion$." This i8 efl'ected by intermaxillary
foret!, changing the rel atinIl8 of the np
pOlling teeth either by tipping t heir
CrowlUI or by mOYing them budi ly. Also,
in either caS\' t he forms of the jan,
especially of the mandible, are probably
. hiays favorably modified to a g",ater
or lesser deg'"*, as a result of t he stim-
ulua of the rorce upon tne b<>ues
through the roots of the teeth. The ex-
tent of the change in the form of the
grellUy on the age
of Ute patieut, the amoont of
fo=, the length of time it operative,
and the ma nner of il$ didribution to
the boM8 through t he attachments of
the mechanism on the teeth. That is,
if the attacbmente are tuch a8 to ravor
the tipping of the crowm of upper
teeth distally and those of the lower
teeth meaially, tile;r norn, al ",csio-distal
rel.iion. IllIly be '" speedily areompl;'hed
thbt probably but little change will ' e/lult
in the forms of the bonel!. If, howe"er,
the attachments are mch 11.2 to prevent
the t ipping of the CT'OWD8, but
bodily Ino.emeut if moved at all,
the opern!ion will necessarily reqoire a
p"riod of The force wm
also be more favOr&bll dietribnted to
stimulate the growth 0 tne bones, Witll
coDS'XJuent greater morQ
I" f .. ,o",bl . . . ... of young p .. t i. nt o
",h.,. In .. ;. ,_nt oric;n.
"'""dib\< h ... l>eeo",e Hu,n
. inly in form "" W .. ;n hu.
mony ..nth tho mal""du';on, the " ,"pIe trui ug
of tbe ueb , rondoring and ' . 'Y tho
d ooing of tbe ju .. wit h t b. Itb in 00,
"",t ru<o ;o.JilItol i. ' h< only tr .. t-
ment "<'< _ _ I")", hu t tb, P'>",.ntogo "I ,"on
cd ... i mall.
""
tH'>: CQS. lQS.
modification of t heir forma. Thi. is
highly dl'Si rable, as in the
shapes of the bones in the." deformities
should 00 one of the Hry importa.nt ob-
j ects of treatment., when the
mandible is f)f abnormal form, M it
poorly alwaya is in typical, well-devel -
oped Ca_.
rUPIN(l OP U1'PI.R TEETH DISTA.LLY .. I<D
W WEl! T&lITIl ME$1ALLY.
When the normal mesio-diml rela_
t ions of the dental .",hell are to be ell-
chiefly through thetippin9 of
I". lett" of the upper jaw dl$ially and
those of the lower jaw meeially (in ClaM
Ill, Ul" ribbon arches must be gi'en
such [om, in lJ.oe' r bracket and B"chor
slwMh relations will pennit o' faoor
this HlO'-ement, 8l\d not bind in thei r
.tLwhmenls and prevent it. This nooe.-
. itate.! that the !heaths on the "pper
aucho. teeth should $Iign, not horirop-
tali" as wown in Fig. 26, but olightly
obhqnely, ",jth We meoial end the higher,
6() that, when the upp<lr ribbon arch is
place<.! in JIO"ition in the sMaths, and
before it engages the bl'1ldebl, itl! ante,
r ior part will lie high or higher than
the Illargin of the ginglYB, requinng it
to be sprung downward to engage the
brn<;kem, Th result will be to pry down,
wftrd on the meei.l end. of tile anchor
sheaths e.nd upwBrd on the diml end.!,
thus contributing mCAAlI ""bly to the
from the intenn""illaty elast" ... to t iP
the anchor teeth distally, At the ... mc
time the force eJ[elUd by the anterior
pa rt of the ribbon areh in an upward
will tend to compress the In-
ciwrs in their wckets. often
desirable, e6pe<:ially when, through lack
of proper funct ion, theoo tooth Art
in supra-ocduaion, a$ thoy nsually are to
a f1:reater or less delfTOO in these "",res.
1'h'. prying for<:e of the arch may be
n\aintai"e<.! , when requi,.w by the distal
t ipping of the t.eeth, by slightly
it upward at POints oome",hat anterlor to
the friction lock outs.
Of couroo it is quiw for
the upper buccal teetll anterior to the
"ncbor teeth also to be tIpped distany.
This i6 done by plating bracketed bfI.n<h
upoo the clUlines, the lmlCkc!.6 engaging
tbe ribbon arch, while delkall! ,PUt., at-
tached to the ouwr of ti,e arch,
beM agaillllt tbe of the
brac.ketJo, after the manner already de
ocribed, and shown at <1, Pig. 14. Tbe
res ult of U,i.! opnt and attach
ment to the canines, with the Duta 00 the
arch acting again.t the aochor sheaths,
is to dilltribuw the fotce equally aDd
di rectly to tip didally the aud
anchor tooth, and indirectly, through
contact, the inte1'\'eoin$ prenloll<N.
Tbe SIlme ,. applied fot the
tipping of the lower teeth, bnt
the direction of force through the pry
of the lower ribbon arch it reverned by
$ligni!lg the ohcath. On the lower anchor
bao& 110 that the anterior put of the
arch will li ne higher than the ONlu-
... 1 edges of tiw incisors before it ia
"pnmg downward and locked within the
braok'ete. lIowe,tr, it it now my opinion
that we lower teeth in tileS<! rarely,
i f ever, rjuire tipping. hut, Oil the con-
kary, that wis ahonld nearly alway!! be
prevented from tile beginning.
OOTT,Y l!onW':NT OP T8m'J! ONI< OR
BOTII ARCHES.
When 11", bodi ly mo.ement 01 the
t""th of ooe or both arch.,. i. to be
complillhed in order to estab!i.o;h the !lOr-
mal mesio-diBtal relatio". of lhe opposiog
t""tlt {Clua ll), their attachment to the
metal ar<:hes mmt be rigid to pr,-vent
tipping. Thi! is made by bl"llcket
And band attacbmenta, 8.8 w own 00 tile
lowu incisora in Fig. 26, with addit ional
band, and cleQt attachmenta 00
the eanillei, and, usually, Oil fi rat
premolal1l, after the manner .hown io
]i"4;. 16. 'fhe ribbon Hch mu.t then be
given such form in im relation to these
attachmcou 8.8 to bind &nd prevent the
tipping of the t<Jeth. A. the de6Cription
of thew bas already been
giV<!n in conoection wiUt Fig.. 15,
and 16, its repetition here unnec .. -
w,
Similar may be attached to
the teeth of upper oteh, \>ut in . uch
AN"(lU.- SQl\E Ntw FOR>!S 0>' lIBOIIAl<18X. 989
maUner that the direction of from
the binding of the arch in ill; attach
menta will be rever&e<l , thus distributing
the intermlUillary force distally to the
roou of ih" upper and mesi.l1y to ih06lO
of the lower teeth.
Another N)l;ult of application of
force is, as we .aid, to modify the
fOmlll of tlle j&WS, espeeililly of the
angles and rami of the mandible, which
baa l:>ecn prove(J to have been done in
nnmeroUJI .;age. reported.
The same principle of attachment iUld
of force eontrol will IIpply for
the crown or root movements, or bone
changes in manJible, in the treat-
ment of CaotS belonging to III.
aU.BURY 01 ADVANT.,<lIsS 01 T HE
NEW D!VICI:t'3.
From tho foregoi ng it will be apparent
tllat the force may be 80 eontroHed as
to pennit or to prevent the tipping of
any woth or teetll to /lny e:rtent, or to
compel the bodily movement of any
tooth or teeth in either or both arehel!.
It will ha,-e l:>ecn noted that this mech_
.ni!!m is of the greatellt simplicity, of
the maxiroum delicacy of parts, Rnd
with all nnMCI;Sary material elimilliltOO..
Hence it jg of IJle leru;t inconvenience to
patients and the eaaieat to keep clean&ed.
It wonld .e.lm that the mechanism ill
nearly ideal, not only for aecuring the
necel!SSry ststic fon:e for snchorage and
of dynsmie fOr<:<! for tooth mO"omcut,
but for directing <:ontrolling this
force l!O tht cellular attend-
ant on tooth movement roMt nea,rly
cordJJ with the law. of physiology. It i.
$1&0 gTal!efu\ in its and uot
unpleallin$" in appearance . . In a word,
the prinCIples of mechamcs, art, and
do not confli ct, bot are made
II> harmonize beautifully and M w QS
never poosible in orthodontic meehani"",
before. Tt i& eo and eaoy to ap-
ply ... greatly to lessen the usual work
of tile orthodontiat and the nlna! nmn_
b<cr of vi.its of palicnt!_ It is not ex-
pecWd tllat it will wholly superwle the
pin lnd tube rooohani,ro, neither will it
wholly supplant ihe expan5ion arch in
ill; round form with ligature atw:h-
roeuu. In fact, the ligature attachment
will be found to be of advantage in con-
"ootion with ti,e ribbon areh in the move-
ment of premolera and of other te<lth
that may be so pronouncedly misplaced
"" to render the bending
of the ribbon ardl to gain bracket at-
taehment with them until after they
haye first been moved into more fa""r.
ahle pooitiollJ! by means of ligatnre .
But in the great majority of cases the
mechanism herein shown will be found
to )lOW!1!S such obvious adviUltages in
force control and in CRee of
and Op<lraiion, that I believe it "ill find
place in orthodontia.
In concluding the description of \lJ i9
mechllnism, let me say that I have giyen
Sncil c10ae thought snd care to perfecting
it in all it. details, and have bee" ro
ably supponed by the manufacturers.
IJlst I snre it c ... nnot be improved
by modification. Or sdditions, 8t lesst
not until yon it years of thought
and study, as I h""e. Therefore let me
earnestly advise tJlat, indead of attempt-
ing to modify it, yon devote your ener-
gies to llllderstandlllg It and it! poBal-
bilities, a'ld to perfect;"g your skill
in the technique of il.o. application
and op<lraUon. In Ulis way your oppor-
tunities for ... If-improvement will be
greatest, and you .. ill be able to confer
tb. greatest amount or good on your
patients. Apt in this connection i. the
remark of the great IlUrge.;>n, Hamilton:
"It i6 not in IJle di'lCOvery and multipli-
cation of mechanical that the
,UJ'goon of this day declares hi uper:or_
ity, to much Min lJ,e skil ful and judi-
cious of those which ar<>
al ready inwnted."
OP c.oSES TQMTRD WITH TJlR
l<RW ){EClU.>lISM.
RecwUy I have treated wi th thee
mechanis,o a typical case to
CIa&; II, division 1, the charactertatiCli of
which were similar to those illns-
trated in Fig. except that IJle "over-
bi te" was greater. nuring this treatment
r belie,-. I have made a vsluable dill-
,,,
THI> DENTAL
,'O'-cr)', and which shoul d henceforth
greatly lessen one of Ihe an!loying diffi.
culties which we frequently eneOlUlter
in the t reatment of theoe
in wcuring and maintaining the proper
height or "bite" of the teeth. 1 am au'"
it is the common experiente of all of
you that in typiesl, ca&e8
belonging to tl"s you frequentl y
find what i8 apparently inf rs-occlusion
of the molua and of the
incisors, both upper and lower, !<) th"t
the cutting oogeli of the lowe r indsol'!!
are often in contact with the mucous
membrane of the li ngual gingiva of the
upJ"lr anterior teeth, or even will, that
of the hard palate. And this impmper
height of the teeth remaina tQ a greater
Or less degree after the cor,...,c! me.io-
distal relations of t he teeth have bo;,ell
establish'd, "bite bands" Or
''bite pla.tl<!' or oilier to 00 worn
for long pel'ioda, to effect the
of the incirors and lengt.hening of the
molarll.
I n the trEat.ment of the in <J"-
lion I gave plcnty of ipring in a gingi .. !
direction to the anwrior part 01 the CIt..
bon arch,.. for both npper and lo ... er
dental arches, so that when they were
engaged in U,e br a>:k:ebl on the inciwrs
there WM a conatant teM,on npward on
the npper inciaon; and downward on the
lower on,... The reIlult has been not
only thu of the indson, but
a compensating lengthening of the
lars, in obedienC<' to the law of ph)'llCl!
!hl adion and reaction are equal and
opposite. I n other ,,"ora.,
operated to> compre!lS the me"!ors
within their sockets acted to an equal
in the opposite di rection (or :r<!-
ciprocaJly) for the elevation of the mo-
lal"1' , and simultaneously WIth tho
mesio-distal of the teeth of
the two arch.... I even carried U)l!
a li t tle farther than normal,
a prn.ctiC'l I hal'e long followed in t.he
movement of all teeth. th". allowing for
their possible slight the
fi nal remonl of t he appliances, which
io this case will of eonroe be worn pa.
ai "ely for retfution. for aome tilne .,et.
featu l'e in connection with
this case, which will surpri& Inan)" of
J o)u who consume an inordinate amount
of time in the treat.ment of cases, is that
the entire operation of treatment wM
acromplished practically withiu eight
weeb. I wish, however, to that
1 wag testing the control of the mechan
iam iu thie cue rather tI,n aiming to
amply strictly with the requirement.. of
physiology, which woulcl logically nec<.'&-
sitate a IIOmewhat longer period for
treatment. I have, however, ohilerved no
undue SOrCnCM of the tkssuee. In fad,
ne>"er before have I treated a case "'ith
apparently 110 hille nnfa" orable dinurb
Bnce of the tisEme .
My patient il; wi th uS today for yonr
inspection of his teeth and of the appli-
=<le$ which aN &tili in poeit(on nvon
U,em. The modela of the caM at tIle
beginning of treatment, and !!eYerai
dudy modem during its progrwl, are
also hete fot your inijp""tion. One of
the studl modds alw the verifi
cat ion 0 my pre<liction that the spring
from the cibbon arch alone actiug .... ithin
Ille cnrviline&r sheath would carry the
ribbon arch distally. In Calle it car-
ried lhe \ "'0 upl"'r central wi th
it to a marked degree during the first
ten days of ita operation, or hefol"<.' the
application of auy intermaxillary elag
tics; e' en b.fore attachment of t he
sheath hooh. ThlB Dr. Gongh call
verify, as he Raw the at t he time
the sh<lllw hook. fo r rec<.'pt ioo of
the elastic ligat nres ",ere to
the upper ribbon a",h.
The firet two c..ses on which this
mechanism used were treated by Dr.
G. P. 01 Minneapolis, Minn.
The appliancet! were adjusted to the firn
case ().(, May 20, 1913, and to the
cru;e BOOn dter this date. The pictures
of the latl.er case I "ill here abo .... , giv.
ing but a brief of them, !ea,'-
ing the more detailed l-xount of the
The piotu,,,,, 1<0 illo,,"'ot<. this .......
too 1M" lor publie.t;Qn, but " ,11 be tho,,"n in
fo,thQoming ...,.,,,, tog<tIJ., with too .. 01
"" ... t, .. I,d ".ith Ibi. ", .. huiom br
w., .. 1f and by Dro. Slrong, Mend.H.
."d
AIIOU.-!(I)(B "",W POIt:N8 or OIl'fIlOOOJ<'fW J.lI!CIIAJ<J51r , 99]
treatment of both this and the fi!'5t calle
to Dr, Merode!J, who jt with lUI today
}' m. al).
with Ute ruodfl' of the -. and who
rill doubtlO!@ll later "lake a more ex-
tended report of them in we
The of the second cue,
fore trtatmenl, i. aha .. " in Fig. 28, and
. 31 n,
the model of the upper a.reh, after trtat-
,nent, in 29. Tl'e model of the
Frt, sa.
10,", ,reb after trtllnrent i, not 'llown,
" it "'IS rorrreled with tire pin and
tnllt I ppliRnce. Although 1l1li toot h
'"
Tfn; DIIl<T&L 00&1101.
gained compuati",iy
simple, yet the work hi. been beautifully
done. By romJll' ring the poII itiOll1 of the
toots of t eeth in the t wo rnodeil!
In Fig. 30, or the lawai.,
tapecUll!y, aM dearly show" to hue been
move;:!.
.The Ilext casc, Fig. 31, wu tn..te.d
,"}i.h thia me<:banilm by Dr. A. H.
Ktleham of the thi rd eue to
be en !.mated. FiJi!:. 33 Il10 ... the teeth
with the apptaDCfl& in por.i tioD upon
them, i.n Fig. 32 JOu will ate the
\'try gnu!yu),g in the positions
of the that &CCOmpliahed.
Dr. Ketcham;8 pn>eent will> full Aeries
of model, of thil cue. He wi!! erplaio
tilelll to you, and la.ter will probably
mike an extended report of the c ..... .
Still other C8ge1 hue been mo ...
t(!ntly treated by Dr. F. A. Gough of
Bt?Okl)'D, and Dr. R. ll. W. Str.....g of
Brldlleport, Conn. 'l'ILeIe gtnt.lemen .... ill
aplam the models of their CQeII this
afternoon t "bieh t ime we will ,110 be
gin Our in .. hic1l yoo .. ill .n.djud
the tI"" appliane.ll! to modele, in """",rd.
with the wehnique I have jU!t de-
acribe.i, in order Utat there may lawr be
no mLlunderstanding in rtgard 10 the
technique, nor blunde .. in the Il*e of the
in YDur pn.dieee.
CRITlqUJI DP LODP
VS. I'll' AND TUB
III wmpariwu ... ith the acre ... 88 &.
of applying foroe from a base of
anchorage in orthodontic treatment J
now ".i$h to) ooMidcr, in a spirit of
f riendly critieism, I very difl' erent me-
chlliell principle fDr this p"'rpoMl "'hich
has ken by n ... Rob
in.on I.Dd Young, eipecially in OOnOOO-
tion with my pin aDd tube appliUlet',
FiIi:.34.
The plan ia to uert force by rue&DI of
the elasticity of a perplllldiculsr loop, or
loop', formed in the arch, Ie in Fig. 35,
ineteao of by a scre... 1'hil loop is tem
porarily contracied, and is by
ita aquare or ellipti""l perpendleule.r at-
t.chment, within I do.ely fitting
meut of tuhillJl,' &Oldered Yer-tic.lly to
the anebor blind. il.8 accidental displ.",,
",wt beinF pl't"lenW by loek-f!lld
projectiOll ill the form of a II\O!ODd loop
which eng&jtCS the lower end of the tube.
Corce. (rom the fif'8t loop mUlt con.
tmue until th$ i. exhausted by
the movement of tbO'le u...th that are at-
tsoched 10 the arch anteriorly, or of the
anchor teeth, or both. Then the uth
l"Ja. 14.
i, the perpendicular
tube, the foop .1& .ligbUy It.r.igbuned,
agaIn Wllpon"ly oontraeted, and the
I rcl! once more sprong into poIition.
l 'hil modification of form 01 the
loop ie IHlriodically repeated nnW the
loop diaappea11l, more or 1_, through
the straighttlling of the bar of /II etal.
My cri Ucilm i, thai inllead or u....
force being delivered enmly to the anclior
tooth Rod m on. dir.ction only, ... (,
easily JlO8Sible with the acr<lW 14 ),
the dlr"eCtion cf l ome ie constantly
changed, th"., nuechievously diiturbing
the runction of the cell of the pend!n
tal membn.ne and al veolar proc:ul. And
this must be repeated with Mell clliogl'
in Ille form of the loop. The die' turb-
.. "QL ... """"OlU NEW POl)lS Qf QIITHQIIONTI(I )lilClLlNlS)I'. 993
i. lIso further by the
frequent removallIld replaeement ot the
meeh.nirm neeeu&ry in ita operation.
'rll ia continUlI pushing IIId pulling of
tile iooth b.u;h.ard and forward in its
ia in direct violation of the pllysi -
ology ot cell function, IIId must inevit-
abl, cause irritation, pain, and lbeorp-
tion ot Ulllue_ Such lIl juriou. diatllri>-
lnce ot the ti!!flUeI, "bich h .. 11 )"&
been more or less unlY<lid.ble wl100
flnlt, mechanism II .. beeD UHd, b.,.
been the chitf cause of toren_ .nd pain
in orthodontic trubnent. It ia no wOD-
der tllat the andoNlg<l become. 100I!-
ened. Neither is it \Jut, when
a loop ;1 formed farther forward. u in
r,o. 3&.
the of the canine teeth (lief! Fig.
36), ei cellli 'e ablOtption occura in the
region of the incisor mota. The ,rrect is
the u me .. on the enchor teeth_n-
fi t. nt change in the direction of faT,
with the inevitable disturbance of the
cell& of the .tveolar proeeae, from the
backward and forward displ'cetnent of
the mota of the ;pci60n. I hve had
the priyilege of aamining number of
t.lA8M treated by me&nA of th_ loojllll by
oihn orthodontil'ta in ... hieh thia N!fIult
ia eyidenl
On the One band, "ith the lie",", wf
hue a proctSll in full IICC(Ird "ith pb,..i-
ologic.1 priDCipleol, undu complete .... d
control of both ope-utor .nd pa-
ti ent by the !imple turnIng of the nut,
wiU, vower of \l%aclly the dMired ,mouot
applied . teadily in oue direction. MOn!-
over, we have a moohllli. m with the
minimum amOll.Dt of ma\trial, aud with
the leMt interference with oo:e!ulion and
inconvenience to the pa.iient.
On \.he other hand, ill the II!e o( the
loop there i. unnecessary didun:.IIlO! of
<;ell function, often oeriOI1&, noc_Tily
lroquel'\t in the appliance which
ooly the operator can make, and alllO
ao eutirely iu.dequ.te knowledge of the
amount and direction of VOlfer applied,
while the loop itlel! offen more 'nter-
ference .,ith oceiUlion, is unAta.ble, un-
... nita.ry, bnl ky, IIld inconvenient to the
,,taNf, beaides being mOllt inartiltic.
Equilly or even more ridicnloUl i. the
me of the loop in combination with the
""Ttw, I I ..tfeelted by rome writen, for
the urne evil el'rect i! prwmt, with in_
of ml<terill, and "ithout the leut
"eed for ita use. Tho!ol! wllo me a loop
P.o. 11.

It
in oonnl'Ctlon with the llerew 8ee\ll to for_
get thit the entire u pans:ion &reb is a
loop and mill! cootwue to foree
both liitiu lly .... d dynamically III 1000g
lJI there ia lenaiou on any part ot il
Now, it wrongful dilllurbauce of the
tissues il tho !'e$ult of power gained
from the perpendicular loop, t he que.-
lion will n.t" .... lly be I.'Iked by some of
y"u, Why .,ilI not the .ame resulta fol-
low the draii"telling of the Imall hori-
'Wntal bend. lP the .reb in order to
iL lrne areh form and carry the teWl
labillly, .. in Fig. Sol? The In' ''tr i,
very limple: The foree to the
in thi, y ia in the nght diMClion
for bodily labial movement, for
&II the bendl are occuionally slightly
atraightened, both the oental ar.:h Rud
the e:rp.nsiou nch are graduaUy .ad
uenly tnlargtd. Force;" thus not only
nnder proper control, but it is e.urt.ed
only in the direction nl'CellUry tor the
enlargement ot the dental areb,
'"
TUB DENTAL COSMOS.
and not. in conflicting or disturbing di-
tel.tioD.$.
Whi le there could be no objection to
this form of locking mechanism for the
ptIssive support of the end of the arch
i ll retention, and independent of all per-
pendicular loops. yet 1 am not very
proud or it, 1llIe even bere, and I now
tUle in pre.ference any ot the locking
mechanisms shown in 37, any of
"'hich aTe decidedly more Il mple, cleanI)',
Ind certainly as efficient a8 the
Young lock. I regard this mechlUliIDl
." now obaoJete.