Clinical Techniques Annals and Essences of Dentistry Vol. - III Issue 1 Jan – Mar 2011 60 doi:10.5368/aedj.2011.3.1.2.5 UTILITY ARCHES IN ORTHODONTICS – CASE REPORTS 1 Rakesh A 1 Senior lecturer 2 Vijay Reddy G 2 Professor 3 Deepthi Reddy V 3 Professor 1,2,3 Orthodontics and Dentofacial Orthopedics, Sri Sai College Of Dental Surgery, Vikarabad, Andhra Pradesh. ABSTRACT Utility arches, originally designed by Ricketts as a part of his Bioprogressive therapy, are one of the most versatile auxiliary arch wires. They can be used for a wide variety of orthodontic tooth movements including protraction, retraction, intrusion and to hold teeth passively. They are also called as 2 x 4 appliances and can be used in both permanent and mixed dentitions. Their construction and applications are well illustrated with case reports. KEY WORDS: Auxiliary, Bioprogressive Therapy, Protraction, Intrusion, Utility Arches. . INTRODUCTION The utility arch is one of the most versatile auxiliary arch wires that can be used in various stages of orthodontic treatment in either mixed or permanent dentition. It was originally developed to provide a method of leveling the curve of spee in the mandible, according to the biomechanical principles described by Burstone. 1,2 Later, it has been adapted to perform many more functions and as a major component of Bioprogressive Therapy. 3,4 Construction The utility arch is a continuous archwire that extends across both buccal segments, but made of different wires for different uses and also based on which arch it is used in. It encompasses only six teeth viz., the two first permanent molars and the four incisors. Hence, it is also called as the 2 x 4 appliance. With a .018" appliance, the recommended wire for the mandibular arch is .016" × .016" or .016" × .022" Blue Elgiloy. For most maxillary arches, .016" × .022" Blue Elgiloy is recommended. With a .022" appliance, .019" × .019" Blue Elgiloy can be used in either arch. 4 When using utility arches in combination with full arch appliances, it is necessary to have auxiliary tubes in a gingival position on the first molar bands. In a pre- orthopedic phase of treatment when the buccal segments are not banded, the main buccal tube or bracket on the first molar can be used to anchor the utility arch posteriorly. 5 Case Reports Case 1: Passive Utility Arch Any irregularities in the position of the anterior teeth are usually corrected with a sectional leveling arch before a utility arch is placed. The passive utility arch can be used for stabilization or space maintenance in either the mixed or permanent dentition. It is ideal in the mixed dentition, when it permits eruption of the canines and premolars. It allows maintaining arch length during the transition of dentition. It is also used in permanent dentition, primarily for the maintenance of anchorage. A passive utility arch by definition is not activated and should not move teeth in any direction. A posterior vertical step, usually 3-4mm long is formed connecting the horizontal or vestibular segment. The anterior vertical step measures 5- 8mm. 4 A 10 year old male patient S.K. reported with the chief complaint of forwardly placed upper front teeth. His hand wrist radiographs showed he still had lots of growth left (stage 2 according to Julian Singer) (Fig. 1). Hence, it was decided to give a holding utility arch to hold the dentition of the upper arch anticipating the mandibular growth to catch up. An initial phase