Arch bars are preferred:

 For temporary fragment

stabilization in emergency cases before definitive treatment  As a tension band in combination with rigid internal fixation  For long-term fixation in conservative treatment  For fixation of avulsed teeth and alveolar crest fractures

The occlusion must be checked. In the case of jaw malformations, such as a deep bite deformity, it may be impossible to use arch bars. There should be calculable tension forces on both bars, so the hooks should be symmetrically positioned in the upper and lower jaw. This symmetry is essential for functional training with elastics. One pitfall when using arch bars is the risk of contamination of bloodborne infection from patients. Passing the wires to secure the arch bar can result in a puncture or tear in the surgeon s glove and the possibility of disease transmission to the surgeon.

Check occlusion Before inserting the arch bars, check the occlusion. There should be full interdigitation of the teeth with regular contacts. Determine if the patient has a normal occlusion or a preexisting malocclusion.

Adjusting the shape The prefabricated arch bar must be adjusted in shape and length according to the individual situation. The arch bar should not damage the gingiva. Firstly, the bar is adapted closely to the dental arch. The bar should be placed between the dental equator and the gingiva.

Trimming the bar The bar should be trimmed to allow ligation to as many teeth as possible. The bar should not extend past the most distal tooth or protrude into the gingiva as this will be an irritation to the patient.

Cut the bar to correct size by placing the bar on half of the arch and counting numbers of the hooks, then cut twice the number of hooks to cover the entire arch The posterior position of the bar should be bent inward to avoid unnecessary injury to the mucosa

Symmetric bar position To achieve calculable tension forces on both bars, the hooks must be positioned symmetrically in the upper and lower jaw. This symmetry is essential for functional training with elastics.

Ligature preparation To fix the arch bar in place, prepare a ligature in the premolar region of each side. The wire ends should not damage the surrounding soft tissues.

Attaching the bar Position the arch bar and fix it using the wire twister. In the premolar and molar regions one end of the wire is above the arch bar and the other end below it.

Arch bar can be applied first to either upper or lower jaw Initially affix to the first premolar tooth

Pass a six inch length gauge 25/26 stainless steel wire above the bar and between the teeth in the interdental space to the lingual space Then feed the wire back between the teeth exiting below the bar on the buccal surface

Twist the wire down across the bar and tooth in a clockwise diagonal fashion and secured as high as possible on the crown All wires should be pulled while twisting in the same direction affixed to the first molar in the opposite side Secure the bars to the other molars and canine teeth

Wire end Cut the wire with the cutter and turn the ends away from the gingiva to prevent damage.

Make sure the wire rosettes do not protrude away from the arch bar as this will be an irritation to the patient.

arch bars applied to mandible and maxilla

Special technique is used in the canine tooth: 1. Wire should be passed above the arch bar toward the lingual surface and returned around the tooth above the bar to the buccal or lateral surface 2. One end is looped around the bar and the ends are twisted horizontally around the tooth

Thank You