Indications for Use:

An upper utility arch is, in effect, using the upper incisor teeth as the anchorage unit in maintaining the distalized molar position. It is the archwire of choice for several reasons. (1) The utility arch can be placed without full eruption of the buccal segment teeth, a quite common situation due to treatment timing. (2) The vertical step on the utility arch places an automatic stop at the molar. (3) There is no loss of anchorage caused by archwire friction when retracting the buccal segments. These teeth can be free-floated back into a Class I relationship when using a utility arch. (4) In Cl II, D 2 cases, the reciprocal force of incisor advancement is utilized to hold the upper molars back. (5) There is immediate torque control in the upper incisors using a square or rectangular archwire that is not achieved with a round leveling archwire. (6) If Cl II elastics are going to be one of the anchorage sources , the utility arch acts as the forward purchase point for the elastics.

Figure 16. Upper utility arch in place following overcorrection of upper molars (note position of upper cuspid). The buccal segments are being "floated" back into a Class I relationship. A Quick-Nance appliance is also being used for concert anchorage.

Technique:

The upper utility arch is fabricated from either .016 x .016 Azurloy (TM) or .017 x .017 TMA ® . The molar tipback should generally just accommodate the molar’s tipping, as attempting to intrude the upper incisors at this time only serves to further tip the molars.

Considerations:

Rebound at the molar region will result in upper incisor flaring and possibly an open bite. The upper utility arch is best used in deep bite patterns where the reciprocal response of incisor advancement is desirable. The upper buccal segment teeth can be free-floated distally using a light elastomeric chain attached to the molar hook. If the space between the second bicuspid and molar is large, skip one of the elastomeric links.