Quadhelix for easy derotation of molars

Rotated first molars are a common problem, affecting upper molars in half of Class II and III orthodontic patients.¹ Effective correction of molar rotations can lead to gain of arch space, which is important both in non-extraction cases,^{2, 3} and in extraction cases where anchorage is at a premium. Derotating molars provides a clinical conundrum, and there are many options available to clinicians to achieve this movement.

Previously described techniques to overcome this problem include compound palatal arches⁴ and transpalatal arches,⁵ which are reputedly for bilateral molar derotation. Other suggestions have included constructing complex archwires using cantilever mechanics⁶ or building a horseshoe molar derotator.⁷ Both of these techniques have proved to work; however, they may add to treatment times and cause unnecessary stress to the operator, as they require somewhat complicated wirebending techniques that may be unfamiliar to the treating clinicians.