Orthodontic Appliance Wiki

⌂ IndexDictionary

Buccal tuberesearched

Quick facts

FieldValue
IDOA-0187
Typecomponent
Categorycomponent
Fixed/removablefixed (welded to band or bonded)
Primary functionterminal archwire engagement on molars
Uses TADsno

Overview

The buccal tube is a rectangular metal tube attached to the molar (and sometimes premolar) that receives the end of the archwire. It defines the terminal insertion point of the archwire. First molar tubes are double-tubed on the buccal surface: one slot for the main archwire (0.022" × 0.028"), and a separate round tube for headgear facebow insertion. Convertible tubes can be opened by removing a clip, converting the tube to a bracket slot for finishing mechanics. Bonded buccal tubes (directly bonded to the molar without a band) are used when bands are not clinically required.

Clinical & technical

Role in treatment

The buccal tube is the terminal bracket of the fixed appliance — the point where the archwire ends and is locked into position at the molar. Its precise placement determines the molar's final tip, torque, and in-out position. Errors in tube placement are fully expressed in the finished result; unlike bracket positions, molar tube placement is not easily disguised by wire bends.

Indications and selection

Buccal tubes are selected based on the bracket system (slot size — 0.018" or 0.022"), molar (upper vs. lower first or second molar), and any torque or rotation prescription the clinician builds into the tube design. Single tubes are used when no headgear or auxiliary is planned; double tubes (two slots) allow simultaneous use of an archwire and a second auxiliary wire (e.g., bite-jumping wire, utility arch). Convertible tubes open to allow easy wire threading during initial placement of severely displaced molars.

Clinical considerations

Tube slot dimensions must match the archwire system. In MBT and Roth prescriptions, upper molar tubes incorporate specific torque angles to compensate for the natural buccal crown torque of upper molars. Lower molar tubes are typically zero torque. Rotation built into the tube corrects for the natural mesiorotation of upper first molars. Bonded buccal tubes have become the standard over banded molars in many practices, but banded molars remain preferable in high-force cases (heavy Class II correction, RPE anchorage) where debonding risk is high.

Contraindications and limitations

Bonded tubes on molars with short clinical crowns, heavy occlusion, or poor moisture control are at elevated debonding risk. Second molar bonding is technically demanding due to access; banding is often more reliable. Poor initial tube position is difficult to correct without rebonding.

Lab fabrication notes

Buccal tubes are welded to bands by the lab for custom appliances. Pre-welded band-tube assemblies are also available from manufacturers.

Used in

Appliances that incorporate this component. ★ = fabricated by Clear Fusion Lab.

attachment)

Common variants & modifications

when no auxiliary tube is needed

headgear/Forsus/lip bumper tube

by removing a locking pin; used when molar needs to be engaged early

good enamel access and moisture control

Also known as

Sources

Orthodontics](https://www.americanortho.com/product-category/buccal-tubes/)

Research log