•  The 2×4 partial fixed appliance is a therapeutic solution applied in the early orthodontic treatment to prevent improper tooth positions from affecting the facial growth and dentition which includes:
  • Spacing and diastemas, minor rotations, reclined or proclined teeth, anterior crossbites may be corrected. It offers an opportunity to regain space for permanent teeth – in case of premature milk tooth loss the space for permanent tooth might be closed by neighbouring growing teeth. It also acts as a firm construction to guide an impacted tooth to the dental arch. 
  • It aims to correct the position of the front teeth (aesthetic role) or correct more complex malocclusion, which requires two-stage orthodontic intervention. 
  • Generally, this appliance allows you to effectively correct the alignment of teeth through the control of three dimensional tooth movement. Removable appliances do not provide such a possibility. 

Which teeth are involved in 2×4 appliance ?

  •  Central Incisors , Lateral incisors , 1st Molars 

Why is it okay to put braces at a young age ?

  •  The 3 teeth involved are completely erupted by the following age . 

 Therefore are ideal to be treated at the particular age .

Tooth Eruption age 
Central incisor7-8 yrs
Lateral incisor8-9 yrs
1st molar6-7 yrs


The basic 2×4 appliance design is as follows:

  •  Bands cemented on both upper/lower first permanent molars.
  •  Brackets bonded onto the erupted maxillary incisors.
  • Continuous archwires to provide/maintain good arch-form, as well as control of anterior teeth.
  • Supporting stainless steel tubing placed in the long archwire spans between the molars and incisors.


  • Treatment may start as soon as sufficient permanent teeth have erupted and it is felt that the child is co-operative enough to have separators placed, bands cemented and brackets bonded.
  • Treatment carried out in this mixed dentition stage may take as little as a couple of weeks, but in the more difficult cases can take few months.
  • In the majority of cases, however, the end result can be more effectively and efficiently achieved than if a removable appliance was used.
  • Definitive treatment will probably still be necessary in the permanent dentition, but the complexity and duration of this may be significantly reduced. 

Interceptive Orthodontics - Fresh SmileFresh Smile

How to Effectively Use a 2×4 Appliance | Semantic Scholar

JaypeeDigital | eBook ReaderOn the 13th month: A) upper right central incisor in the dental arch, B) radiographic evaluation where a bony defect was observed around the upper right central incisor and the root dilacerations on the central and lateral incisors. The root of the upper right canine is almost completely formed and with a tendency towards impaction.

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  • Minimal discomfort , Reduces need for patient co-operation 
  • Psychological benefits
  • Habit correction
  • Better hygiene maintenance
  • Increase control of tooth movements 
  • Movement possible in all three planes of space 


  • Appliance rarely worn full time 
  • Appliance damage/lost appliances 
  • Difficulty in speech/eating 
  • Gagging 
  • Decalcification/caries, Gingivitis/palatal hyperplasia/fungal infections 
  • Incorrect activation produces unhelpful changes  

For more details about 2/4 Appliance and Ortho Treatment in Bangalore visit our website http://www.chiseldental.co.in