The cuspid or bicuspid bond is loose.
The molar assembly tube or the plunger assembly has been crimped, preventing complete sliding.
The damaged part must be replaced.
There is inadequate stabilization of the ram at the elbow making it easier for the plunger assembly to rotate occlusally.
Should this occur, the maxillary cuspid or bicuspid can hit the plunger assembly causing bond failure.
Tissue tenderness distal to the maxillary molar or along the buccal vestibule with class II.
Reduce the amount of posterior extension to the molar assembly by pulling the attachment wire anteriorly.
If this is not an option because of the need for sufficient distance, instruct the patient to place a
finger on the distal end of the molar assembly and push it down and in.
This will move the molar assembly out of the buccal vestibule.
Tissue tenderness at the corner of the mouth with class II.
Change sleeping positions or suggest sleeping without hand or arm under cheek.
Use a shorter Eureka Spring and attach distal of the bicuspid.
If using the Classic, retie the tie-down ligature wire so that the elbow of the ram is held gingivally.
If using the Quick-Connect, replace with a Classic.
Tissue tenderness in the molar region with class III.
If there is excessive free distance, rebend the attachment wire at the mesial of the molar tube thereby increasing the force.
If no extra free distance exists, remove the arch wire and rebend the attachment wire so that the molar assembly is more lingue–occlusal,
and parallel to the occlusal plane. Finally, rebend the attachment wire mesial of the molar tube occluso-lingually and replace the arch wire.
Now the arch wire will be buccal to the attachment wire and thus prevent the attachment wire from moving buccally.
Cheek tenderness has not been a significant problem. Sometimes the patient will go asymptomatic for several months and then suddenly
develop irritation that necessitates removal for a few weeks. This is frequently exacerbated by sleeping on the affected side and
often can be resolved nearly by having the patient sleep on their backs, or not placing the hand or arm under the cheek.
After functioning well for several months, the plunger assembly suddenly comes apart from the molar assembly.
The internal spring driving the ram has broken and is beginning to wind into itself. This will be clinically observable by
grasping the plunger assembly with a plier and with the patient’s mouth in the open position, slide the plunger arterially and
slowly release. Check to see if the plunger springs completely back. If it doesn’t spring back completely, replace the plunger assembly.
Disengagement of the two assemblies can also be caused by class II correction excessive buccal crown torque, or intrusion of the
maxillary molars and mandibular incisors. If disengagement occurs for any of these reasons correct as necessary with a new plunger,
a new tie-down to decrease the excessive free distance, readjust the molar assembly by bringing it in more mesially through the molar
tube, or place the ram distal of the bicuspid.
The ram can no longer slide within the plunger cylinder.
The most likely cause is occlusal interferences, which have crimped the plunger cylinder.
After replacing the plunger assembly, stabilize it at the ram elbow by the tie-down mentioned previously.
The plunger assembly no longer slides completely within the molar assembly.
The plunger assembly tubing has been bent and replace the plunger assembly.
The molar assembly wall, as it rubs against the maxillary molar tube, has collapsed.
Replace the molar assembly.
The tie-down wire is broken.
Replace with a new .014 ligature wire. If this recurs, consider using .016 ligature wire.
Breakage of the ligature wire can also result from wear with normal function of the ram against it.
To prevent this wear, it is helpful to leave a slight distance at the mesial of the ram created by
inserting the tip of a scaler to tie the pigtail against.
The mandibular cuspid has rotated mesiolingually
The ligature tie wire has broken or the cuspid bond is loose.
Make repairs or stop the Eureka Spring and insert a fast acting titanium arch wire.
In 3-6 weeks replace the Eureka Spring and the rectangular arch wire.
An open bite is developing in the cuspid-bicuspid region
Continue treatment and correct after Eureka Spring therapy is completed, or place an up-and-down elastic.
If considerably more movement is needed, remove the arch wire and place a reverse curve of Spee on the affected side.
Perhaps a larger rectangular arch wire should be considered.
The ball joint pulls out of the molar assembly or the attachment wire breaks distal of the molar tube.
This only occurs for two reasons: First, the molar assembly has not been rotated sufficiently to the buccal and
occlusal interferences can occur. With some cases, in order to clear the occlusal interferences, an increased offset of
the molar assembly attachment wire can be made. Second, 2mm of free distance should always be present distal
of the molar tube. If the attachment wire is pulled snug against the molar tube, breakage in this region will be greatly increased.
The ram comes out of the plunger assembly cylinder.
The necked-down end of the plunger assembly cylinder has opened up thereby permitting the ram to escape from the plunger assembly.
The most common cause of this is insufficient free distance.
As the patient’s chewing stroke extends further laterally, this constricted portion is forced against the ram elbow and eventually widens.
To prevent this, increase the free distance and use of a ligature cutter to re-crimp the constricted collar. First, compress the plunger assembly.
Next, place the ligature cutter 1mm from the original constricted collar and crimp the plunger assembly in two locations.
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