Quad Helix Adjustments
By Dr. Michel Champagne, BA, DMD, MAGD, IBO, CD

In our last info-letter, we discussed the benefits of the Quad Helix appliance. In this month issue, we will describe the appliance manipulation. The clinician must try the appliance in the mouth before cementation and first make it completely passive. This applies both to a laboratory made appliance or a chairside made appliance. Once passive the appliance and the bands are removed. The mesial to molar extension arms are bent to avoid any contact with the lingual surfaces of every tooth mesial to the molar (Figure 1). This no contact zone will allow the molar to move freely during the first activation. The molars will expand and rotate mesial cusp to the buccal. This first activation is made by expanding the intermolar width by half a molar on each side (Figure 2). It is preferable to cement the bands and the appliance as a single unit. The patient will come back in 4 to 6 weeks for his control and a second activation will be made if needed. This can be done directly in the mouth (Figure 3) using an angulated double tip 3 prong plier, Orthopli 064-DA or equivalent (Figure 4), or the appliance can be removed from the mouth and adjusted in the clinician’s hands. I prefer the in the mouth option because it is faster even if it requires a special plier. The in the mouth adjustments require bending the appliance in 3 areas as shown in Figure 5, for visibility purposes the bends are shown outside of the mouth. The anterior bend will result in more transverse and the mesial to molar bends will rotate the molars buccally. Normally in a young patient with a unilateral crossbite, 2 activations will be enough. If you use the Quad Helix on a teenager or adult patient, the effect will be mostly tipping of the posterior teeth but sometimes you need tipping. For retention of the transverse gain, the appliance is left in place for 4 to 6 months. If your bands have buccal tubes, you can continue with your treatment during the retention phase. I hope you enjoy this small and very useful appliance.

Figure 1.No contact with lingual surfaces      Figre 2. Expansion and rotation                  Figure 3. In mouth second activation

Figure 4. Double 3 prong plier                     Figure 5. Points of activation