Different Positions for the ALF Body Wire
Hello, fellow ALFers 😃
I am so grateful that Dr. Darick Nordstrom has been sharing his ALF designs with us! One thing that intrigues me about the basic ALF design is that it tickles our imagination and creativity to come up with variations and innovations of lightwire designs.
When I took my first ALF course in 2003, I thought the design I was taught was written in stone. In hindsight, this was helpful to prevent a complete information overload as cranial osteopathy, myofunctional therapy, and ALF all came flying at me like a tornado.
Fast forwarding to today, there is nothing written in stone in the lightwire world for me anymore. What intrigues me now is how the highly complex ALF approach could be developed into something less technique sensitive and more affordable while honoring the principle “do no harm”.
That being said, I would like to elaborate on the position of the ALF body wire in the anterior section:
I learned that
- the body wire should rest on the cingulae of the six anterior teeth, see IMAGE 1
- The adjustment should be such that after opening the upper midline loop, the loop should be about 1 mm wider. IMAGE 2
IMAGE 1: body wire resting on cingulae
IMAGE 2: The red line shows where to measure how much the midline loop was opened.
(The appliance is aligned with a photocopy that was taken before the adjustment).
This worked very well, particularly if the incisors were reclined. I never observed the body wire cutting into the gum in the anterior arch.
One day, I worked with a mandibular design with the body wire positioned further apical …. but initially, I didn’t notice. This was no problem on insertion, yet after the first adjustment for sagittal arch development, the body wire started cutting into the papillae. For future cases, I always requested the body wire to be positioned incisal to the tip of the papillae.
Recently, I had the pleasure of having several participants of Dr. Jim Bronson’s course in my ALF 101 Intensive course. When I mentioned an adjustment of 1 mm opening of the loop, there was a shriek of horror going through the group (okay, I am exaggerating, but Halloween is around the corner). Then I learned something that I very much appreciate: if we keep the body wire at the gingival margin and open the midline loop only 1/4 mm, we can minimize the mechanical effect and maximize the osteopathic impact. See IMAGE 3
IMAGE 3: body wire at the gingival margin/CEJ
Since I don’t run my practice anymore, I won’t have a chance to gather direct experience with this utmost subtle approach, but I can see that both options have their place. Considering a case carefully will help to place the body wire in the position that is most beneficial for the patient.
My preference would be:
- If there is a need for significant proclination of the incisors > body wire resting on cingulae
- If there is a team approach in place, and there are significant cranial issue > body wire at the gingival margin
IMAGE 4: blue line - body wire closer to incisal edges > more mechanical > more proclination
violet line: body wire at the gingival margin > maximizes cranial effect > minimal proclination
Choose what works in your hands and come up with your own designs. While we stand on the shoulders of giants, we shouldn't stop there. Going forward with new ideas is how we will create new horizons.
Warm personal regards and happy ALFing,
You probably know about "ALF Therapy and Cranial Osteopathy 101" (available online and live). But there is more:
- ALF 101 Intensive - LIVE (limited to four participants)
- ALF Beyond the Basics - ONLINE
- ALF Mentoring - ONLINE and LIVE
- Study Clubs - ONLINE