“The new Preattached Cantilever Bite-Jumper ™ (CBJ) is as strong, easily delivered and foolproof as could be designed and engineered. It can be delivered less expensively than by having a commercial lab fabricate the appliance. It can reduce the number of patient visits, while improving net profit during the correction of Class II malocclusions.
“The CBJ features .022 tubes attached occlusal to the axles on the cantilever arms. This provides three distinct advantages:

1. If minor lower anterior crowding is present, it can be corrected while wearing the CBJ.
2. The tube allows the appliance to be adapted to Dr. Terry Dischinger's Edgewise Bioprogressive Herbst Technique.
3. If the tube is not needed, it can be ground away or ignored, and it will have not effect on therapy.

We have found the single-appointment CBJ to be a boon to our treatment. Patients and parents don’t have to make repeated trips to the office. Also, we can enroll patients into active treatment more easily and start them faster. In this manner, we routinely deliver a CBJ in 45-60 minutes.”


– Joe H. Mayes, D.D.S., M.S.D. From “The Single-Appointment Preattached Cantilever Bite-Jumper,” Clinical Impressions, Vol. 5, Number 2, 1996.The CBJ…Armed For Efficiency

---

Implementing the Cantilever Bite-Jumper

---


The 20-patient CBJ Kit provides the essential components for the single-appointment Cantilever Bite Jumper. ™ A com-plete size range of laser-marked first molar crowns (seven per quadrant) is provided – 80 crowns distributed according to popular usage. Upper crowns are supplied complete with nickel-brazed axles, while all lower crowns come with nick-el- brazed cantilever arms that are specifically designed for maximum strength and optimum patient comfort. Each cantilever arm has an axle with a .022 tube occlusal to it for use with bonded cases. All necessary components for 20 cases are also supplied, including rods, sleeves, Hex-Head screws and a Hex-Head Allen wrench. Hex-Head screws are used for all appliances to increase accessibility and improve performance over conventional slot-head screws. The CBJ saves the expense of additional chair time, doctor time and staff time, and costs significantly less than using a commercial lab.


The CBJ Fit-Kit ™ provides one loose crown in each of the 28 sizes for trial fitting in order to avoid having to trial fit (and possibly deform) the more expensive crowns with attachments. Prewelded Precision ™ Lingual Hinge Caps are an option for the lower arch (and upper as well when TPAs or other auxiliaries are planned) to eliminate all soldering and lab work except for pouring models. If Hinge Caps are used, Snug Fit .032 x .032 wire (available in straight lengths or preformed lingual arches) is recom-mended for achieving an ideal fit with lingual or transpalatal arches. Peerless ® M/P .022 buccal tubes are also available nickel-brazed to upper molar crowns for use in bonded cases.



---

Lingual Arch

Using an impression of the lower arch, prefabricate a lower lingual arch (.032 x .032 Snug Fit is recommended) to fit precision lingual hinge caps or solder directly to the stainless steel crowns.



An extra model is made when the patient is ready for the Cantilever Bite-Jumping Appliance.



Extra model with adjusted .032 x .032 Snug Fit wire.

---

Sizing Crowns

The CBJ Crown Fit Kit contains loose stainless steel crowns for trial sizing, each crown has a permanent laser mark and can be reused after sterilization. The CBJ Crown Fit Kit protects the more expensive components.



Loose stainless steel crowns are fitted in the mouth for size.

---


Preparing Lingual Arch

Using the original plaster model, trim around the lower first molar using a bur. This will allow the crowns to be fitted to the model; any up-down, in-out, or torque corrections to the cantilever arm should be made at this time. If using Precision Lingual Hinge caps, place the lower lingual arch, mark and make bayonet bends both mesially and distally to the hinge caps to prevent the lingual bar from moving in an anterior-posterior direc-tion. Keep the anterior portion of the lower lingual bar on the cingulums of the lower anterior teeth and not on the soft tissue. Note: The lower lingual bar should be totally passive at this time; if not, make any necessary adjustments. To test, lay the arch in place with the hinge caps open.





---

Trial Fit

Once the appropriate size has been determined, trial fit all crowns. Measure the interaxial distance from the mesial of the upper casing to the distal edge of the lower on both left and right sides. These interoral measurements determine the distance the lower jaw will be moved forward.



---

Cut to Length

The untrimmed interaxial distance is 31mm, so the difference between the measured interaxial distance and this figure should be cut away. For example: interoral measurement = 27mm,cut away 4mm. A separate disk can be used to cut both rod and tube; remove any sharp edges with a rubber wheel. The tube should be routed at the opening so the rod doesn’t have any restrictions and slides freely. To avoid soft tissue impingement, the rod should extend no more than 2- 3mm past the axle on the upper crown. There may be a trade off as the rod should be as long as possible to prevent it coming out of the tube when opening wide, but short enough not to affect the cheek.



Cut rods and tubes with a separating disc.



Round and smooth the cuts with a rubber wheel.



Route the opening of the tube for free movement of the rod.

---

Fitting Crowns

Crimp both mesial and distal crown walls prior to cementation. Glass ionomer band cement (Protech) is recommended. Check the length of the precut rods and make corrections using shims on either or both sides




Crimp the mesial and distal of the crowns before cementation.



Shims of different sizes can be added to correct the midlines or advance either or both sides.

---

Recommendations

Do not trim crowns unless absolutely necessary. To prevent screws from coming loose, Ceka Bond* should be applied directly to the screws when fitted.


*Ceka Bond is a registered trademark of Preatt Corporation

---

---

Summary of Benefits
1. Herbst therapy made easy
2. Reduced breakage
3. Single appointment fittings save time, making the whoe procedure more efficient
4. All crowns are laser-marked and micro-etched for maximum retention virtually eliminating emergency visits caused by loose crowns
5. Breakage is now a thing of the past...All components are nickel-brazed for maximum strength
6. Arms and castings have been specially designed for comfort, strength and durability
7. Custom options are available to cate for differing preferences and needs

Ormco
a subsidiary of
Sybron, Dental Specialties, Inc.
1717 West Collins
Orange, CA 92667

(800) 854-1741

Copyright 1996 Ormco Corporation

---

[Return to Spotlight]

[Mail]	Send EMail to The OrthodonticCYBERjournal
[Search]	Search The OrthodonticCYBERjournal