Proper Use of Intra-oral Finishing pliers

It took me 2 years of development for the intra-oral finishing pliers (1 prototype plier cost me $1100 and I did not use the design...too complicated for the user). The intent was to allow placement of "finishing bends" in archwires WITHOUT first removing them. I want you to know how to properly use this important product.

Here are some basic concepts to intra-oral wire bending:
1. Since you are making bends with the archwire already tied to the brackets, you need to know exactly what the bend is and that it is what you intended, WITHOUT removing the archwire to check. During my testing period, this is what I had to do...make a bend, remove the archwire to see if it was what I wanted, then retie the archwire. With this in mind:
***ONLY use the pliers on archwires with a MAXIMUM dimension of .018. That would include 018ss, 016ss, the 18 side of 18x25 (up or down only).
*** 18x25 NITIE should be in the mouth for at least 2 months before using these pliers. The properties of the archwire changes to accept the bend.
*** if you try bending an archwire larger than 018 (eg. 020 or 019), then the resulting bend will be at an angle...not on the same plane as the wire entering the bend.

2. Interbracket distance will determine the size of the INITIAL bend that is possible without stressing the bracket bonding.
*** suggested maximum size of the bend between lower incisors is 1/4mm at each visit
*** suggested maximum size between 3-4-5-6 is 1/2 mm at each visit
*** suggested maximum size between 6-7 is 3/4mm at the first visit

3. The 1mm plier was added a few years after initial development ONLY as a "reforming" plier. Use this to reform a 1/2mm bend to 1mm. This has the advantage of conserving inter-bracket distance for bends at a future visit....instead of placing successive bends "side-by-side" in the limited interbracket distance.
** slide the plier over the wire with an existing bend until you can FEEL the first bend....then squeeze the plier to reform.
** there is no way to "reduce" the size of a bend by reforming an existing bend. This requires you make another bend, adjacent to the first one, assuming there is available interbracket distance.

4. NO second order bends: These pliers are NOT intended to make second order bends. If you try, the bend will likely NOT be what you intended. Use the pliers ONLY for step "in" and "out", "up" and "down". For second order bends, mark the archwire, remove it, make the bend and replace it.

5. When squeezing the plier, be sure to first look on the end of the plier pointing towards you (vs. torwards the tooth) to confirm the step is what you intend...THEN push the plier towards the tooth until it stops...THEN squeeze the plier ALL THE WAY DOWN without twisting the plier. Flip the plier to the other side for the bend on the other side of the tooth.
** if the bend is wrong, you will have to remove the plier and correct the bend in your hands. ughh
** if you bend the wire on the very tip of the plier, the weakest point, the plier will eventually break, usually at the weld of the insert
** if you do NOT squeeze all the way down, the bend will NOT be what you intend...it will be at an angle.
** if you twist the plier as you squeeze, brackets will debond.

6. As you add bends, the archwire gets shorter and the previous bends move "anterior". When placing initial bends, place them off-center TO THE DISTAL in the interbracket space.

7. reappoint your patient 4-weeks later to make adjustments to the bends you made today. Enlarge or reduce.

Fortunately, the use of IP brackets with the proper diagnosis has dramatically reduced our job of finishing. these pliers are still needed for making bends in finishing wires without removing the archwire...step up or down is the most common.

Hope this helps your understanding of this rather complicated plier. don