Indications for Use:

The most effective way to retract the upper buccal segments without forward movement of the molars is with a push coil between the lateral incisors and first bicuspids. It is ideally utilized when: (1) The upper cuspids lack enough space for eruption. (2) The upper incisors can afford to be flared to clear the lower arch for bonding.

Figure 17. Push coils in the cuspid region designed to advance the upper incisors, clear the lower arch for bonding and move the upper bicuspids distally. Note that the upper cuspids are blocked. A bent-in omega stop is also utilized at the molars.

Figure 18. Push coil springs at the cuspid region when the Pendex Appliance is still in place – commonly used to prevent excessive forward movement of the bicuspids into the erupting cuspids. It is important to bond the upper arch early whenever the upper cuspids are not in place.

Technique:

An upper continuous (usually reverse curve Ni-Ti) archwire is placed with Ni-Ti push coil in the cuspid regions. A pinch-on stop at the molars prevents their forward movement along the archwire. The archwire is not cinched or tied back.

Considerations:

If the upper incisors are already flared (Cl II, D I), this technique will increase the overjet. It is ideally utilized in the Cl II, D II malocclusion where it is beneficial to advance the incisors, round out the anterior arch form and create room for blocked-out cuspids.