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Berger 2008
Berger 2008
The SPEED appliance (Strite Industries Ltd., 298 Shepherd Ave., Cambridge,
Ontario, N3C 1V1 Canada), invented by Dr. G. Herbert Hanson in the early
1970s, is a miniaturized self-ligating bracket with an active spring clip. This
fully preadjusted edgewise appliance, which is available in both 0.018ⴖ and
0.022ⴖ slot size, has been in clinical use since 1977 and commercially avail-
able since 1980. During the past 25 years, the SPEED design has been highly
refined. Refinements include the incorporation of a superelastic nickel tita-
nium spring clip for greater precision of tooth movement throughout treat-
ment, a “labial window” that enhances ease of opening the spring clip, and
a horizontal auxiliary slot in the bracket body that facilitates segmental
archwire mechanics. Although the SPEED bracket is compatible with virtu-
ally any archwire selection, specific archwires have been designed to fully
exploit SPEED’s inherent benefits. These include Supercable (Strite Indus-
tries Ltd.), a seven-stranded coaxial nickel titanium archwire, Hills Dual-
Geometry archwire (Strite Industries Ltd.), and SPEED archwires. Whether
traditional or specialty archwires are used, SPEED, with its highly flexible
spring clip, creates a unique mechanical system that is ideally suited for
ultra-precise orthodontic tooth movement. (Semin Orthod 2008;14:
54-63.) © 2008 Elsevier Inc. All rights reserved.
Figure 3. The component parts of the SPEED appliance consist of a microretentive mesh bonding pad, an in-out
adapter, a bracket body that contains both an auxiliary slot for a 0.016⬙ ⫻ 0.016⬙ wire and a main edgewise
archwire slot, a superelastic nickel titanium spring clip, and a miniaturized integral mushroom hook for the use
of elastics. (Color version of figure is available online.)
The SPEED Appliance 57
Figure 5. (A) Supercable consists of seven strands of superelastic nickel titanium wire in a coaxial form. It is
available in 0.016⬙, 0.018⬙, and 0.020⬙ dimensions. It is impossible to permanently deform Supercable regardless
of the malalignment of the dentition. (B) The combined effect of the initial light multistrand Supercable
archwire, the wide interbracket span between the narrow SPEED brackets, and the energy storing capability of
the spring clip greatly increases the range of appliance activation. (Color version of figure is available online.)
58 J.L. Berger
Figure 6. The Hills Dual-Geometry wire features a square anterior portion for torque control and a rounded
polished posterior to enhance sliding mechanics. (Color version of figure is available online.)
● Correct tooth rotations to ideal alignment with- large so as to complicate the simplicity of the
out any overcorrection and rely on interproxi- desired mechanics. With SPEED, one can work
mal reshaping and circumferential supra-crestal within the physiologic limits of the supporting
fiberotomies to enhance retention; and tissues.11,12 Further, by giving adequate time for
● Overcorrect Class II or Class III buccal seg- each archwire to fully express itself, the role of
ment relationships where a strong relapse ten- anchorage in the treatment mechanics is sig-
dency is expected. nificantly reduced. As a result, it is considered
It has already been stated that the SPEED appli- that there is less need for an extraction pat-
ance is most responsive to very light forces. The tern in patients treated with SPEED brackets
use of light forces is both biologically and me- relative to twin brackets. Exceptions include
chanically advantageous. From a biological extremely crowded cases or where other miti-
standpoint light force application decreases the gating circumstances, such as soft tissue pro-
risk of occurrence of such undesirable phenom- file or incisor angulation, mandate otherwise.
ena as root resorption.10 From a mechanical Not only is this nonextraction approach ad-
standpoint, light force application reduces un- vantageous for the patient, but the orthodon-
desirable reaction forces, which can become so tist benefits by having to spend less time man-
Figure 7. The SPEED finishing archwire has a quarter round shape, which facilitates archwire insertion, spring
closure, and is highly effective in torque control. (Color version of figure is available online.)
The SPEED Appliance 59
aging the compensatory extraction mechanics rather than to continually compensate with
and more time managing the more predict- bends in the archwires;
able reaction to light forces. ● A meticulous bonding technique will pay worth-
while dividends later in terms of efficiency and
Clinical Guidelines to Using SPEED quality of treatment;
● Use very light forces and go easy on overcor-
As outlined originally by Dr. Hanson (Woodside rection. The customary anti-tip and anti-spin
DG and coworkers,1 Hanson GH,9 and Hanson provisions in conventional edgewise appli-
GH, personal communications), the following ances would be excessive if incorporated
clinical guidelines are recommended: into the SPEED technique;
● Take great care to position the brackets and ● Because of the small area of bracket-arch con-
tubes as accurately as possible during initial tact and the concentration of rotational con-
bonding; trol, it is easy to underestimate the effective-
● If significant bracket placement errors be- ness of the appliance at first; and
come apparent during the course of treat- ● Use a light touch in manipulating the appli-
ment, it is better to rectify them by rebonding ance and avoid “forcing” any component.
Figure 8. (A-D) Space closure using maxillary 0.021⬙ ⫻ 0.021⬙ ⫻ 0.020⬙ and mandibular 0.018⬙ ⫻ 0.018⬙ ⫻ 0.018⬙
Hills Dual-Geometry archwires, continuous elastomeric power chain, and intermaxillary 4 mm (3/16⬙) 4 ounce
elastics. Maxillary molars bonded with SPEED ER (enhanced retention) bracket. (E-H) Significant space closure
following 4 months of sliding mechanics. The dual arch dimension of the Hills wire greatly enhances posterior
space closure while maintaining anterior torque control. (Color version of figure is available online.)
60 J.L. Berger
Figure 9. Clinical Case with the SPEED Appliance. Non-extraction treatment of a 12y 7m old patient with a Class
III skeletal open-bite pattern, a steep mandibular plane angle and maxillary crowding (A-I). Initial bonding (J-N)
and placement of .016 maxillary and .018 mandibular Supercable arch wires. Arch alignment and maxillary
molar distalization mechanics (O1, P1) on .018 D-wire and addition of anterior compressed coil springs (O2,
P2). Segmental .016 Supercable arch wire to engage lateral incisor brackets (O3, P3) prior to alignment with
main arch wire (P4). Final detailing and torque control with .019 ⫻ .025 Force 9 arch wire (P5) before
completion of treatment (Q-Y). This case clearly illustrates how the SPEED appliance, with its precise 3-dimen-
sional control, may be utilized to effectively manage complex cases such as that of a growing patient with an
adverse skeletal growth pattern. (Color version of figure is available online.)
The SPEED Appliance 61
Figure 9. Continued.
62 J.L. Berger