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10.5005/jp-journals-10021-1094
CLINICAL INNOVATION
PG Makhija et al
MAK Bends and MAK Stops: An Innovative
Way to put Bends and Stops in NiTi Archwires
1
PG Makhija, 2Abhishek Gupta, 3Kamna Jain, 4Virag Bhatia, 5Madhur Navlani
ABSTRACT
Introduction: It is difficult to bend NiTi wire because of its shape memory properties. Although prefabricated NiTi archwires, such as the
Connecticut Intrusion Arch or utility archwire are available, there is no simple, economic method available to incorporate first or second order
bends in NiTi wires. Similarly there is no simple, economic and reliable method available to place stops in NiTi archwires. A simple creative
method of using sterile disposable surgical needle segments as archwire stops (Makhija, Abhishek, Kamna or MAK stops) and archwire bends
(MAK bends) is demonstrated. These may be adapted as custom stops and bends in NiTi archwires for fabricating intrusion, extrusion,
expansion and distalization archwires.
Materials and methods: Fresh unused, sterile, disposable,18 to 23 gauge surgical needles are segmented using a diamond cutting disk to use
as crimpable stops (MAK stops), stops of varying length may also be bent with optical pliers to incorporate bends in NiTi wires (MAK bends).
Conclusion: MAK stops and MAK bends are simple, easy and an economical chairside method to incorporate a range of applications which,
overcome some of issues with formability of NiTi wires.
Keywords: Molar stops, NiTi wires, Anchor bend.
How to cite this article: Makhija PG, Gupta A, Jain K, Bhatia V, Navlani M. MAK Bends and MAK Stops: An Innovative Way to put Bends and
Stops in NiTi Archwires. J Ind Orthod Soc 2012;46(4):228-231.
INTRODUCTION
Nitinol wires have limited formability, which contraindicates
their use for situations where bends with a small radius are
required.1
Nitinol wires are associated with advantages, such as fewer
archwire changes, less chairside time, reduction in time
required to accomplish rotations and leveling and less patient
discomfort. However, several other properties of nitinol
impose limitations on its use. The poor formability of these
wires challenges the clinician to incorporate first-, secondand third-order bends. Nitinol fractures readily when bent over
a sharp edge.
Several attempts were made to bend NiTi wires and
simultaneously keep their superelastic properties. Miura et al2
proposed the direct electric resistance heat treatment method
1
Professor and Head, 2,5Senior Lecturer, 3Private Practice, 4Reader
1,4,5
Department of Orthodontics, Modern Dental College and Research
Centre, Indore, Madhya Pradesh, India
2
Department of Orthodontics, Hitkarni Dental College and Hospital
Jabalpur, Madhya Pradesh, India
3
Department of Orthodontics, Kolkata, West Bengal, India
Corresponding Author: PG Makhija, Professor and Head, Department
of Orthodontics, Modern Dental College and Research Centre, Indore
Madhya Pradesh, India, e-mail: [email protected]
Received on: 4/4/12
Accepted after Revision: 26/5/12
228
which was used to develop the first machine known as
Archmate by Gac, but it was not popular.3
Since hooks cannot be bent or attached to nitinol,
crimpable hooks and stops have been recommended for use.
Cinch-backs distal to molar buccal tubes can be obtained by
placing crimpable archwire stops,4 preformed archwire stops,
Gurin locks, crimpable hooks have been used for a variety of
applications which include molar distalization. 5 The
Connecticut Intrusion Arch is a multifunctional wire that is
preformed from nickel-titanium and provides the high
performance and mechanical advantages of these alloys.
Although incisor intrusion is its most common application,
various other functions can easily be performed with only
minor modifications like simultaneous Class II molar
correction, incisor flaring, correction of minor open bite
(incisor extrusion) and correction of anterior occlusal cant.6
All of the aforementioned applications of preformed
archwires and auxiliary attachment, such as stops and hooks
reduce the adaptability of the wires as the clinician is limited
by its proprietary shape. Moreover, the cost of the archwires
and auxiliaries may be prohibitive in some circumstances.7
MATERIALS AND METHODS
Makhija, Abhishek and Kamna or MAK stops are fabricated
by cutting the prescribed dimension (Table 1) from sterile,
disposable, hollow surgical needles (Fig. 1) for the specific
dimension of flexible round or rectangular NiTi wire. MAK
bends are modified MAK stops which incorporate bends in
the NiTi wires for specific activities.
JAYPEE
JIOS
MAK Bends and MAK Stops: An Innovative Way to put Bends and Stops in NiTi Archwires
Table 1: Suggested gauge of surgical needles
S. no.
Dimensions of wire
(superelastic NiTi)
Gauge of needle
Clinical Uses
A simple and easy technique to fabricate a MAK stop is
described as follows:
1. A carborandum or diamond cutting disk (Fig. 2) is used to
segment the prescribed gauge needle for the particular
dimension of superelastic wire, as given in the table
(Table 1). The usual length of a segment is 2 mm for stops
and 4 mm for bends depending on the intended use. The
lumen of the segment is cleaned by wiping it with alcohol
followed by compressed air.
2. For MAK stops, needle segment is passed over the
archwire end, placed in the designated position and crimped
using Weingart pliers secure over NiTi.
3. To fabricate the MAK bends, the secured sleeve is bent
with optical pliers to fabricate intrusion, extrusion, flaring,
bite correction or distalization arches.
MAK stops and MAK bends can be a creative and cost-effective
solution in many situations with NiTi wires. A number of
applications include the following:
1. Midline stops to prevent slipping and walking or wandering
of wire particularly in self-ligating systems (SLB; Fig. 3).
2. Toe-in bends mesial to molars (Fig. 4).
3. Molar stops (Fig. 5).
4. Stops to facilitate proclination of anterior teeth (Fig. 6).
5. Tight cinching at the back of wire (MAK stops crimped
on distal ends).
6. Facilitation of single or double molar distalization (Figs
7A and 7B).
7. Placing anchor bends, toe in, toe out in flexible NiTi wires
(Fig. 8).
8. Forming Connecticut intrusion and protraction archwire
(Fig. 9).
9. Forming expansion or contraction archwires from NiTi
wires.
10. Forming a utility archwire from flexible NiTi wires
(Fig. 10).
11. Placing first- and second-order bends in flexible rectangular NiTi archwires (Fig. 11).
12. Space maintenance.
13. For space regaining when placed between adjacent teeth.
Fig. 1: Armamentarium used for fabrication of MAK stops, MAK bends
Fig. 3: Archwire stops in SLB archwires
Fig. 2: Cutting the needle for MAK stops/bends
Fig. 4: Toe-in mesial to molars with MAK bends
1.
2.
3.
4.
5.
6.
0.014" round
0.016" round
0.018" round
0.016" × 0.022" rectangular
0.019" × 0.025" rectangular
0.021" × 0.025" rectangular
23
22
21
20
18
18
Methods
The Journal of Indian Orthodontic Society, October-December 2012;46(4):228-231
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PG Makhija et al
230
Fig. 5: Bilateral MAK stops for anterior expansion
Fig. 8: Anchor bends in NiTi wire with the help of MAK bends
Fig. 6: MAK stops to procline anterior teeth
Fig. 9: MAK bends used for fabrication of intrusion arches
Fig. 7A: MAK stops for molar distalization
Fig. 10: MAK bends used for fabrication of utility arches
Fig. 7B: MAK stops for double molar distalization
Fig. 11: MAK bends for first and second order bends in NiTi wire
JAYPEE
JIOS
MAK Bends and MAK Stops: An Innovative Way to put Bends and Stops in NiTi Archwires
CONCLUSION
A creative solution has been recommended to address poor
formability issues with NiTi wires by fabricating a sleeve from
a surgical needle (MAK stops) and then bending the sleeve
itself to produce an accurate bend in a NiTi wire (MAK bend)
to increase the functionality of NiTi wires.
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