The Correction of the Curve of Spee
in the Treatment of Malocclusion
For the last 100 years we have been discussing different methods of correcting the occlusal curve of the mandibular arch. There are very important principles and concepts, which must be observed in the correction of this curve. If these principles are ignored, the result is sure to be a relapse of overbite and crowding of the lower incisors. The tendency toward crowding is already within the tissues, and it needs no further encouragement by the orthodontist. Potential crowding of the lower incisors post treatment is a scourge of the orthodontic profession.
In the November 1999 issue of the AJODO, Abdulaziz et al published an article designed to determine whether leveling with a rectangular wire would prevent the lingual movement of the incisor apices, which is always observed when leveling with a round wire.
In our first published article, in the Angle Orthodontist, in 1963 we discussed the principles involved with leveling the lower arch. In this article it was made abundantly clear that we cannot level with a round wire without moving the apices lingually. To try to level with a rectangular wire with considerable play between the wire and bracket is about the same as leveling with a round wire. To prevent the apices from moving lingually there must be a rather close fit between bracket and wire by reason of labial root torque or reverse torque built in the brackets.
The very most desirable technique is to use a .016 x .022 wire in a .016 bracket. Before retiring I used such an arrangement for 20 years, and almost never moved the incisor apices lingually. These principles seem so simple that a person without formal education should readily grasp them. It is such a pity that some orthodontists do not understand these simple principles.
The research project was conducted at a school; and the professor should not have allowed the student to waste his time on such a project, and never learn anything of a basic nature. Orthodontists should know the answers before conducting such research.
In the 1963 article mentioned above it was stated that, "Labial root torque on the mandibular incisors accompanied by Class III elastics, usually at night only while leveling the mandibular arch, will prevent the apices from moving lingually....The labial root torque is not for the purpose of moving the roots labially, but to prevent their lingual movement."
Having understood these principles so thoroughly, and having practiced so successfully, it seems a pity that all orthodontists do not understand, and that this is not a part of their heart and soul.
If one expects to ever produce stable results, he or she must never move the apices of lower incisors lingually. Stable treatment is difficult enough, without this glaring mistake. As would be expected, sure enough the rectangular wire, used incorrectly, did not prevent the apices from moving lingually. The final conclusion was that a rectangular wire did not prevent the apices from moving lingually. This should have been known before the worthless research. Sadly, the researchers did not have an answer for the solution to the problem!!
The reader is admonished to get help if he or she does not have a routine technique to solve this problem.
Bibliography
Abdulaziz, Kh. Olgabandi, BDS, MS,a Cherill Sandowsky, BDS, MS,b and Ellen A. BeGole, PhD,c Chicago, Ill.
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