Palato-labial Tooth Movement

Z spring
It is palatally situated active component of removable appliance similar to letter Z in
shape. It is used to move one anterior tooth from the lingual to the labial direction.

Uses:

1- The main use is the correction of an anterior cross bite of one tooth.
2- Correction of rotated incisor of less than 90o together with a Hawley arch.
Components:

1- Three equal arms: the first arm is the active arm and has a non-traumatic end in the
shape of a small coil directed away from the gingiva. This arm is directed to the mesial
side unless the tooth is rotated, so it is directed to the site of
rotation.
2- Two coils: both are 2 mm in internal diameter. The first coil is
wound incisally while the second coil is wound gingivally to keep
the spring in one plane. The coils are wound one opposite the
other, they are made to increase the length of the wire and so
increase the flexibility and decrease the force transmitted by the
wire.
3- Retentive arm (tag): it is zigzag in shape and it extends from the third arm for 10-12 mm
parallel to the palatal midline and embedded in the acrylic base plate retaining the
spring in the base plate ending by 0.5 mm bend at right angle to the palate .

Properties:

1- It is constructed from 0.5 mm hard stainless steel wire for incisors and 0.6 mm stainless
steel wire for canines.
2- Its width is equal to the mesio-distal width of the tooth from the contact areas.
3- The active arm sits on the cingulum and the level of the coils with the arms should be
perpendicular on the long axis of the tooth to prevent slippage of the spring.
4- The spring is covered by a thin layer of acrylic extending from the base plate to prevent
food stagnation in the area during eating, deformation of the spring from the bite of the
lower incisors, slippage of the spring in an incisal direction and trauma.

Activation:

It is done by opening the coils so that the distance between the active arm and the third
arm increases by 2 mm, or so that the active arm just crosses the incisal edge (in case of
rotation, one of the coils is opened only). This gives a small force for tooth movement that lasts
for a relatively long duration (2-3 weeks). When activating the spring, the active arm is pulled
by Angle's pliers’ forwards and upwards away from the base plate in a 45 o so the spring does
not interfere with the path of insertion.
Anterior Retention:

The force of activation is applied on a 60 o inclined palatal

surface. This force is analyzed into two components; vertical and
horizontal. The vertical component tends to dislodge the
appliance incisally making the spring inactive. Therefore, it is
important to put additional retentive clasps on the anterior
teeth, preferably as anterior as possible to be more effective.
Such additional anterior retention means may be:

a- Adams clasp on the adjacent incisor.

b- Adams clasps on 4 4 or D D.
c- C clasps on c c.
d- Least preferably double Adams clasps on 6E E6 or 65 56 with a Hawley arch anteriorly.

Design of a removable appliance:

1- Active components: Z spring on 1.

2- Retentive component: Adams clasps on 64 46 or 61 6.
3- Acrylic component: base plate with posterior bite plane in case of anterior crossbite.
4- Extra component: Hawley arch in case of rotated incisors.

Alternatives: screw
Modifications: the modified Z spring has a non-traumatic end extending on the labial surface of
the incisor to permit slight mesio-distal movement in addition to the palato-labial movement.