ORTHODONTICSDOR- 221 DDB

LOWER LINGUAL HOLDING ARCH

(LLHA)Quinto, Jasmine

Regalado, Liel MarieSalazar, Stefanie

Vasquez, Czarina Alyssa

LOWER LINGUAL HOLDING ARCH(LLHA)

DESCRIPTION:

a space maintaining applianceis comprised of stainless steel rings (bands) around posterior teeth (usually molars)a stainless steel wire that passively contacts the lingual surfaces of the teeth.is designed to maintain the position of the lower molars as the baby teeth are lost.

PURPOSEto prevent your lower molars from moving. used to preserve and create space in the mandibular arch and to aid in uprighting of the molarsdesigned for space management and rotation of molars if needed.

Lower Lingual Holding Arch Procedure

• Place seperators for sufficient time• Band 26,36• Weld lingual sheaths Lingualy.• Take impressions with bands in place.• Transfer the band to the impression.• Pour cast and send it to the lab.• When lower lingual holding Arch is used as a space

maintainer the entire assembly can be fabricated in the lab itself. Only a clean stone impression is needed. But when it is used along with fixed appliance systems the procedure mentioned earlier important.

Fabrication(a laboratory processed appliance

soldered to a molar band that requires two visits by the patient)

• Bands are adapted to the most posterior tooth remaining on the arch (first permanent molar or second primary molar)

• A pick up alginate impression is taken.

Fabrication• The appliance is fabricated in

a laboratory. A 0.036” stainless steel wire is soldered to the bands. This wire must be 1.5 mm away from the soft tissues for gingival health. This wire should rest on the cingula of the incisors.

• Cementation with appropriate cements (described earlier).

Indications:• Loss of second primary molar in

the mandible • Bilateral loss of primary teeth in

the mandibular arch during transitional dentition.

• � Maintenance of arch perimeter and incisor positions.

• Contraindicated in primary �dentition.

• Modification of LLA with omega loops.

• Activation of loops �help flare anteriors with some distalising of permanent molars.

Contraindications• Permanent mandibular incisors not yet erupted.

How Do We Fit The Lingual Arch?

1. If required, separators are placed between your back teeth to create space for the bands

2. The separators are removed approximately one week later or at the band fitting appointment.

3. Bands are chosen to specifically fit your teeth

How Do We Fit The Lingual Arch?

5. Once the bands have been fitted, an impression is taken to have the lingual arch constructed

6. Once the lingual arch has been constructed, an appointment will be scheduled to have the lingual arch inserted into your mouth

How Do I Clean My Lingual Arch?

How Do I Clean My Lingual Arch?

If food is not effectively removed from the lingual arch, it can cause dental decay and gum problems

Tilt your toothbrush on a 45 angle on the gum line, underneath the bands on your lower first molar teeth

Rotate your toothbrush ten times on both the left and right sides, inside and outside of the bands

A dental floss threader will be provided so that you are able to floss around the lingual arch

Instructions:• No hard or sticky foods (corn

chips, hard candy, caramel, gum, taffy, peanuts, etc.)

• 3-4 carbonated drinks (coke, root beer, 7-up etc.) per week

• monitor highly sweetened foods (cake, pie, ice cream, cookies) brush after or rinse with water.

Proper Care• Brush teeth at least 3 times daily. • Use a water pick or floss, to remove food

caught underneath the appliance. • Watch diet and contact office if bands

come loose or anything breaks or wire gets bent.

• Warm salt water rinses for sores. • 'Rescue' wax for bands until cheeks get

used to new appliance

Advantages:

• Maintains the tooth space and the leeway space 

• to prevent your lower molars from moving

Disadvantages:

• First permanent molars may be susceptible to decalcification

• may be prone to breakage unless the patient is well-informed on maintenance 

PricesAs of June 1, 2012 by Ortho Dent Laboratory Inc.LLHA - 1361.26PhpLLHA with loops - 1536.06Php

Sources

• http://www.prescottortho.com/Treatment/Appliances.aspx• http://www.youtube.com/watch?v=JJTk5k8A3dY• http://www.bronskyorthodontics.com/assets/LLHA.pdf