Placement of Arch bar

Summary

This video explains the process of using arch bars for dental stabilization, particularly in emergency cases. The technique involves wiring around the necks of teeth, being careful to avoid gum laceration. While full tooth engagement is ideal, alternate tooth wiring may be sufficient in most cases. Special attention is given to proper wire orientation and placement around the teeth, ensuring a tight fit. Arch bars are essential for temporary stabilization in dental fractures, particularly for condylar and alveolar fractures, and are used in combination with other treatments like internal fixation for long-term care.

Takeaways

• 😀 Arch bars are used for temporary stabilization of fragments in emergency cases before definitive treatment.
• 😀 The wire in arch bar applications should pass around the neck of each tooth without lacerating the gingiva.
• 😀 Using an alternate tooth for wiring may reduce discomfort and tissue trauma during the procedure.
• 😀 More teeth should be involved in wiring if there are missing teeth, potential spaces, or compromised teeth post trauma.
• 😀 When placing arch bars, both ends of the wire should be oriented correctly, with the mesial and distal ends positioned appropriately.
• 😀 The operator should twist the wire to ensure it tightly clings around the neck of the tooth, below the cingulum.
• 😀 The arch bar needs to be held in position by the assistant while the operator twists the wires.
• 😀 Arch bars are commonly used in conjunction with internal fixation using plates for long-term fixation.
• 😀 The twisting of the wire should follow the same pattern as British wiring for consistency and effectiveness.
• 😀 Arch bars are also used in conservative treatment for inter-maxillary fixation, particularly in dental and alveolar fractures.
• 😀 These bars are also beneficial in the conservative management of condylar fractures, stabilizing fractured bones until healing is complete.

Q & A

What is the purpose of the wire in the context of dental treatment?

The wire is supposed to be inserted around the neck of each tooth, passing through the embrasure. Its purpose is to help stabilize the teeth and provide support during treatment.

What precautions should be taken when inserting the wire around the neck of the tooth?

Care needs to be taken not to lacerate the gingiva (gums) while passing the wire around the neck of the tooth.

Why can using the wire on each tooth be cumbersome or uncomfortable for the patient?

Using the wire on every tooth can be cumbersome and uncomfortable because it becomes time-consuming, may cause more tissue trauma, and is generally more invasive.

When is it sufficient to wire alternate teeth instead of all teeth?

Wiring alternate teeth is sufficient when all teeth are present and in good condition, especially in cases where full tooth involvement is not necessary.

What factors influence the decision to involve more teeth in the wiring process?

Factors like the presence of missing teeth, trauma, mobile teeth, or compromised periodontal status may require involving more teeth in the wiring process.

What is the importance of orienting the ends of the wire correctly?

It is important to orient the mesial and distal ends of the wire properly so that they align with the arch bar. This ensures effective stabilization and prevents complications.

How should the arch bar be positioned during the procedure?

Once the arch bar is in place, the assistant should hold it in position with their fingers or a periosteal elevator while the operator twists the wires.

Why is twisting the wire around the tooth necessary?

Twisting the wire around the tooth ensures that it tightly clings to the neck of the tooth below the cingulum, providing effective stabilization.

In what situations are arch bars typically used in dental treatment?

Arch bars are used for temporary fragment stabilization in emergency cases, as a tension band in combination with internal fixation, and for intermaxillary fixation in cases of dental and alveolar fractures, or condylar fractures.

What is the role of rosettes in the wiring process?

Rosettes are used to help secure the arch bar and assist in the proper alignment and stabilization of the teeth during treatment.