Fig. 15 Fig. 17 Fig. 16 The TPB has many capabilities: 4 b Torque b Intrusion or extrusion b Expansion b Rotation b Distalization b Molar uprighting b Reinforcement of anchorage How do I prepare the mesial loop (Palatal Arch Bar) to be added prior to activation and determine which size to use? The mesial loop PAB’s come in eleven sizes starting with 35mm and increasing in 2mm increments up to 55mm. Measure in the mouth or on a stone model from the lingual tissue to tooth junction of one maxil-lary first molar adapting the plastic measuring device to the curvature of the palate to the lingual tissue tooth junction of the other maxillary first molar (Fig. 13B). In this example a 47mm mesial loop PAB was selected. With the Adam’s plier bend one terminal loop 30° (Fig. 18 Fall 2014 JAOS Fig. 18 14A.) Repeat on the other side and view laterally to make sure that the bends are symmetrical. In the middle of one straight wire portion of the PAB place a 30° bend (Fig 14B). Repeat on the other side and view laterally to make sure that the bends are symmetrical. Making the bends in the middle of the straight wire portion of the PAB allows for proper adaptation to the curvature of the palate. At the junction of the straight wire portion and central loop place a 30° bend (Fig. 14C). Repeat on the other side and view laterally to make sure that the bends are symmetrical. Figs. 14D and 14E demonstrate a passive PAB prior to activation. A multitude of actions may be programmed into the TPB, far too many to cover in this article. I will focus on bilateral expansion, buccal root torque, distobuccal rotation, and distalization of maxillary first molars -the main issues encountered in constricted Class II cases. Only two activations should be performed at the same time. Excessive multi-directional activations can compromise results and lengthen treatment time. I link bilateral expansion and bilateral buccal root torque of 6 | 6 and perform these activations first. To program bilateral buccal root torque into the appliance bend the terminal loop on one side several degrees to
Journal of the American Orthodontic Society Fall 2014: Page 18
