Orthodontic Folds and Handles: Why So Important?

Before talking about the orthodontic folds and braces, the plans of implementation and their importance, it is essential to reflect. Do you remember your first restoration, your first endodontic opening or even your first cavity preparation?

His first dental procedures have evolved over the years, and so have the folds! This will make it easier and easier with time, training and repetition. Nothing like good teaching to make the Folds and Handles more plausible. In addition, time is of the essence in improving manual skill.

Folding plans

There are three different plans for performing the Folds. The first is the horizontal plane and constitutes the 1st order folds. These folds are performed in the horizontal plane and promote buccolingual / palatine movement of the wire.

The second is the vertical plane and constitutes the 2nd Order Folds. These folds are performed in the vertical plane and promote cervical-incisal / olclusal movement of the wire.

The third and final folding plan promotes a twist of the wire, called torque. The torque promotes an inclination of the buccal crown and, consequently, a lingual / palatine root inclination. The teeth have a center of resistance and every tilt (torque) movement of the crown in one direction promotes a tilt (torque) in the opposite direction.

Do you know how the handles act on your patient’s teeth?

The loops are made by folding the orthodontic wires, added to wire segments that will conform to specific designs. These drawings can be defined as follows:
- T-handle;
- L-handle;
- U-handle;
- Retraction handle;
- Box handle.

Thus, the handles are responsible for increasing the amount of wire within the distance between one bracket and another. This increases flexibility in releasing force in orthodontic movement.

The Importance of Making Folds and Handles

Some people believe in the age of straight bows and that bending of wires is no longer necessary. However, the Straight Wire technique, in which an elastic wire is inserted and replaced monthly, does not allow adjustments according to the individual skeletal morphology, dentition, age, gender and personal wishes of the patient.

If these adjustments were not necessary, the treatment results should be the same in all cases, but this is not the reality. Each patient needs different treatment according to their characteristics and needs and not according to the industry that develops predetermined arch shapes and preset prescriptions.

It is a fact that advances in wire properties have changed clinical techniques. In addition, the development of high resilience yarns has reduced (but not eliminated) the need for folds and loops. Another consideration is the bracket design. The force of the wire is transmitted to the periodontal tissue and alveolar bone via brackets glued to the teeth as their morphology and size differ according to the development of each technique / prescription and between manufacturers.

Although each preset bracket has torque, angulation, in / off-set and morphology based on its original design, it is strange that in the vast majority of cases the same bracket type and prescription will be used without change for the unique needs and needs. individual patients.

This is the main reason for the real need for individualization with information (folds) in the wires for each specific patient. Therefore, if the same prescriptions and industry standard yarns are used, all patients will be standardized. Above all, one must consider that each case is a case!

I missed the collage, now what?!

Good bonding of the orthodontic appliance is essential for a good finalization and conduction of the case. However, it is inherent in the profession, especially in the beginning, some bracket positioning errors.

In addition to all these indications described above, the folds allow the professional to adjust small gluing errors, because making mistakes is human. Many will say, "But if I stuck it wrong, just replace the bracket." Who guarantees that when the bracket is replaced, since the positioning error has already occurred, it will be returned to the exact and correct position?

Nothing more practical than bending the orthodontic wire to compensate for and adjust bracket positioning errors. In other words, the folds allow to manage lower intensities and to increase gradually as the need of each case and thus "correcting gradually".

Performing orthodontic folds and loops frees the specialist from essentially theoretical concepts and miraculous results from certain techniques (prescriptions).

The theory that is reflected in skill in orthodontics, results in safe professionals in the individualization of clinical cases with excellence, conducting treatments and finishing with the best smiles.

It is well known to many of the difficulties in making the folds and loops, but nothing better than the reflection at the beginning of this post: “Do you remember the first restoration when you were still in the fifth period of graduation?” Nothing like a good didactic, a Good teacher who will take your hand and lead you to the best finishes with the individualization that the folds and handles allow for each patient.

Source: Blog Dental Cremer. Available at: https://blog.dentalcremer.com.br/dobras-e-alcas-ortodonticas-porque-tao-importantes/. Access on: 11/26/2019.