See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/329607248

An innovative use of the K-SIR arch

Article in Indian Journal of Orthodontics and Dentofacial Research · October 2018

DOI: 10.18231/2455-6785.2018.0031

CITATIONS READS

0 2,075

3 authors, including:

Prerna Raje Batham

Govt college of dentistry indore
12 PUBLICATIONS 24 CITATIONS

SEE PROFILE

All content following this page was uploaded by Prerna Raje Batham on 28 December 2021.

The user has requested enhancement of the downloaded file.

Case Report DOI: 10.18231/2455-6785.2018.0031

An innovative use of the K-SIR arch

Ulrika Diana Pereira Kalia1, Prerna Raje Batham2,*, Bhakti Ramchandani3
1
Professor, Private Practive, 2Reader, Dept. of Orthodontics, Index Institute of Dental Science, Indore, Madhya
Pradesh, 3Senior Lecturer, Private Practive

*Corresponding Author: Prerna Raje Batham

Email: drprernaraje@gmail.com

Abstract
Segmental arch mechanics are always preferred mechanics of choice since a known force system is delivered to the teeth without
loss of force to friction. The springs available for single canine retraction are complicated in design and time consuming to fabricate.
This article presents an innovative way to use the K-SIR arch wire for single canine retraction.

Keyword: Segmental arch mechanics, Individual canine retraction, KSIR arch.

Introduction required to increase the molar anchorage and bring about

Segmented retraction using frictionless springs is a canine intrusion. This is bought about by introducing a
useful method to reduce the strain on posterior 60 degree V bend posterior to the centre of the inter
anchorage.1 We are able to utilise one couple and two bracket distance. A 20 degree anti rotation bend is then
couple systems and an approximation of both forces and given just distal to the U loop to prevent mesio lingual
moments can be made. This allows for better use of rolling of the buccal segments caused by the force of
favourable force levels and better control. The main loop activation.
advantage of frictionless mechanics is the establishment
of well defined units of anchorage and movement Activation
segments. As in K-SIR arch, stresses are built up while
In contrast, the undesirable side effects seen during bending the wire for the springs. This is released by
canine retraction while applying friction mechanics are doing a trial activation of the springs. This also reduces
tipping, binding, lack of vertical control, anchorage loss the severity of the V bends as well. The legs of each of
and incisor extrusion. the springs are extended horizontally to determine the
To address these problems frictionless mechanics neutral position and the U loop will be 3.5 mm wide in
can be used. But the main disadvantage of segmented this position. On activation of 3 mm the distance between
arch approach lies in greater complexity of the the medial and distal legs is considerably reduced. On
orthodontic appliance and increased chair side time of initial activation the retraction force creates larger
the clinician to install, adjust and maintain it. The springs tipping moments in comparison to the opposing
available for canine retraction in segmented mechanics moments generated by the V bends. This brings about a
are T loop,2 PG canine retraction spring3 and Ricketts controlled tipping of the canine into the extraction space
canine retraction spring.4 and once deactivation of the loops occur the moment to
The K-SIR or Kalra Simultaneous Intrusion and force ratio increases causing bodily movement of the
Retraction archwire when introduced, was considered to canine followed by root movement. This allows for
be a modification of the segmented loop mechanics by activation to be done after every six to eight weeks till
Burstone and Nanda. K-Sir arch consists of .019”x.025” the space is closed.
TMA archwire with closed 7mm x 2 mm U-loops at the
extraction sites.5 Case Report
A 23 year old male patient was referred to the
Spring Design Department of orthodontics and dentofacial orthopaedics
It was decided to modify this design by using it for from the Department of Prosthodontics for the
individual canine retraction rather than enmasse consolidation of spaces distal to maxillary canines. On
retraction. This was done by making individual springs clinical examination it was noted that the maxillary and
for each canine. The bends required to construct the K- mandibular incisors and maxillary right first molar were
SIR Arch were kept the same. A 90 degree V bend was missing. The maxillary canines were forwardly placed
given at level of each U loop to obtain bodily movement and extruded. For prosthetic replacement the patient
and prevent tipping of the canine into the available space. required orthodontic treatment to correct the position of
This creates two equal and opposite moments when the maxillary canines and to correct the malalignment in
centrally positioned between the molar and canine and the lower dentition. A 3M Unitek Gemini metal bracket
acts as a counter to the moments developed by activation kit with 0.022 slot was used and banding of molars was
of the closing loops. An increased clockwise moment is done using upper double and lower single 0.022” X

Indian Journal of Orthodontics and Dentofacial Research, July-September 2018;4(3):161-163 161

Ulrika Diana Pereira Kalia et al. An innovative use of the K-SIR arch

0.028” tubes. The maxillary canines and the lower

dentition were completely bonded and 0.014” Niti was
placed for alignment of the lower arch. The Modified K-
SIR spring was placed on both the maxillary canines
(Fig. 1). Initially the springs were placed but not
activated. Activation was done after 1 month and then
subsequent activations were done every six to eight
weeks until the space distal to the canines were closed
and the canines were intruded (Fig. 2). Once the
maxillary canines were distalized the first and second
maxillary premolars were bonded and continuous wires
were placed for arch alignment and levelling. The wire
sequencing for the maxillary and the mandibular arches
were as follows- 0.014” Niti, 0.016” Niti, 0.017 X 0.025”
HANT and 0.019 X 0.025” S.S. Debonding (Fig. 3) was Fig. 2: Individual intrusion and retraction spring at
done and a functional retainer was placed with missing the end of canine retraction
teeth replaced till the department of Prosthetics was able
to deliver their prosthesis to the patient. Pre treatment
and post treatment OPGs (Fig. 4 and Fig. 5) which were
taken as a part of routine patients records showed the
position of the canine before and after the use of the
springs.

Fig 3: Post debonding

Fig. 1: Individual intrusion and retraction spring at the

start of canine retraction

Fig. 4: Pre treatment OPG

Indian Journal of Orthodontics and Dentofacial Research, July-September 2018;4(3):161-163 162

 Ulrika Diana Pereira Kalia et al. An innovative use of the K-SIR arch

Fig. 5: Post treatment OPG

3. Gjessing P. Biomechanical design and clinical evaluation
Discussion of a new canine retraction spring. Am J Orthod Dentofac
Ortho. 1987;5:353-362.
The main indication of the K-SIR arch wire was to 4. Ricketts R. Development of retraction sections.
retract the anterior teeth in a first premolar extraction Foundations of Orthodontic Research Newsletter.
patient who had deep overbite and excessive overjet and 1974;5:41-44.
would require both intrusion of the anterior teeth and 5. Kalra V. Simultaneous intrusion and retraction of the
maximum molar anchorage. The arch wire would require anterior teeth. J Clin Orthod. 1998;32:535-540.
a few modifications to be used in moderate and
minimum anchorage cases with varying degrees of
overbite. Another positive feature of the K-SIR arch was
its ease in fabrication, patient comfort and lack of tissue
impingement. The use of TMA for the construction of
this arch wire provided with sufficient strength to resist
distortion but enough stiffness to generate the required
moments. Together the K-SIR arch could provide low
forces, low load deflection rate and a range of activation
that allowed the appliance to continue closing the space.
In the case described above the maxillary canines
required intrusion and retraction to correct their position
within the arch so as to aid in prosthetic replacement of
the missing anterior teeth. By modifying the K-SIR arch
into a spring we were able to benefit from the advantages
of segmental mechanics and that of the K-SIR arch and
were able to simultaneously retract and intrude the
canines in question for successful prosthetic
replacement.

Conclusion
By converting the K-SIR arch into a spring we were
able to achieve a successful outcome by understanding
the biomechanics involved and using it to our advantage.

References
1. Proffit W.R, Fields H.W, Sarver D.M. Contemporary
Orthodontics. 4th ed. St. Louis: Mosby Co; 2007.
2. Burstone CJ, Koenig HA. Optimising anterior and canine
retraction. Am J Orthod Dentofac Orthop. 1976;70:1-19.

Indian Journal of Orthodontics and Dentofacial Research, July-September 2018;4(3):161-163 163

View publication stats