Numeric modeling of torque capabilities of self-ligating and conventional brackets

Tip efficiency of a customized lingual appliance: Performance of wires with two different ligatures

Tip control in lingual orthodontics may be challenging because of the presence of a vertical slot and the particular configuration of the customized appliances. The aim of this in vitro experimental study was to investigate the role of the ligature-wire-slot system in achieving better tip control. A set of customized lingual brackets was obtained for a dedicated typodont made of extracted human teeth. A compression/traction machine tested two types of ligatures in combination with seven different wires, and the tipping angle of each configuration was derived. A statistically significant difference was found between ligatures when the complete set of data was tested. In addition, differences between ligatures were found when testing each wire separately. A statistically significant difference was found among all wires. Full-size wires showed the smallest angles, which correspond to the greatest efficiency of the slot-archwire-ligation system in terms of tip control, and this efficiency appeared to be ligature-related. The role played by the type of ligature was more relevant for undersized wires.

Comparative study of torque expression and its biomechanical effects: spherical self-ligating bracket with lock-hook system versus passive self-ligating bracket and conventional bracket

BACKGROUND

Proper torque control is crucial to the outcome of orthodontic treatment. This study aimed to employ finite element analysis to compare the torque capabilities of a novel spherical self-ligating bracket with a lock-hook system against those of commonly used passive self-ligating and conventional bracket systems, as well as to reveal the biomechanical changes in the periodontal ligament (PDL) during torque expression.

METHODS

A maxillary right central incisor, along with its PDL and alveolar bone, were modeled. Three types of brackets were selected: a spherical self-ligating bracket with a lock-hook system, a passive self-ligating bracket (Damon), and a conventional bracket (Discovery). Each bracket was equipped with a 0.022-inch slot and a 0.019 × 0.025-inch stainless steel archwire. A palatal root torque of 20° was applied. The torque moment, as well as the von Mises stress and strain in the PDL, were calculated. A clinical case involving the lingual inclination of the upper anterior teeth was utilized to assess the feasibility of using the spherical self-ligating bracket with the lock-hook system to express torque.

RESULTS

At a twist angle of 20°, the maximum torque generated by the spherical self-ligating bracket with a lock-hook system (27.8 N·mm) was approximately 1.6 times greater than that of the Damon bracket (17.5 N·mm) and the Discovery bracket (17.3 N·mm). As the twist angle increased, both the von Mises stress and the strain in the PDL also increased. When the maximum PDL stress was less than 0.026 MPa and the percentage of the PDL good strain area (defined as the area with PDL strain ≥ 0.3%) exceeded 50%, the torque range for the maxillary incisor was between 10.2 and 17.5 N·mm. The clinical case demonstrated that the use of the spherical self-ligating bracket with the lock-hook system effectively corrected the unfavorable linguoclination of the maxillary incisors.

CONCLUSIONS

The spherical self-ligating bracket with a lock-hook system can significantly enhance torque expression. The optimal torque range for the maxillary incisor is between 10.2 and 17.5 N·mm.

Exploring bracket torque expression: A comparative in vitro study of new self-ligating bracket designs and archwire geometries

OBJECTIVE

This in vitro study aimed to evaluate the torque expression efficiency when it is integrated into the bracket slot versus the bracket base. Additionally, the impact of archwire geometry (rectangular vs. rhomboid) on torque expression has been examined.

MATERIAL AND METHODS

The torque expression was evaluated in a full arch printed maxillary model, focusing on tooth #11, which was positioned within an alveolus filled with Typodont wax. Three different types of brackets were utilized: conventional metallic bracket (Minidiamond™), self-ligating bracket with torque in base (Damon Q2™), and a new self-ligating bracket design with torque in slot (Damon Ultima™). Two variations of archwires were used: rectangular and rhomboid stainless steel, measuring 0.019×0.025 inches and 0.019×0.0275 inches, respectively, from ORMCO™. The study included seven groups: six experimental groups and a control group, with 15 measurements in each group, totaling 105 torque measurements. Optical impressions were taken of the tooth's original position and its final position after torque expression. STL files were superimposed using GEOMAGIC software to calculate the percentage of torque expression.

RESULTS

The self-ligating bracket with torque in slot (Damon Ultima™) shows significantly higher torque expression than the self-ligating bracket with torque in base (Damon Q2™) with a rectangular stainless steel archwire (P=0.00015). The Ultima™ bracket also demonstrates higher torque expression than both the Q2™ and conventional 22° brackets with a rhomboid stainless steel archwire (P<0.003). No significant difference in torque expression was found between the rectangular and rhomboid stainless steel archwires for any bracket group (P>0.05).

CONCLUSIONS

The self-ligating bracket with torque in slot shows comparable torque expression effectiveness to the conventional bracket, outperforming the self-ligating bracket with torque in base. Archwire geometry does not significantly impact torque expression.

Extended finite element analysis for the 2nd and 3rd metatarsals stress fracture during push-off

Metatarsal stress fractures (MSF), particularly the 2nd and 3rd MSF, are common injuries among athletes. Although there are several practices to reduce foot and ankle injuries, there is no injury prevention program specifically designed to minimize MSF. This is mainly due to the lack of information about the loadings/postures that cause MSF. Therefore, this study aimed to investigate dangerous loadings/postures potentially causing MSF during push-off (PO). The analysis was conducted with Finite Element Modelling (FEM), calibrated with the three-point bending test, and validated with peak plantar pressure (PPP) and fracture force measurement. Extended Finite Element Method was used for MSF simulation such that ten different foot and ankle configurations were designed, with five for each of the 2nd and 3rd MSF under pure vertical loadings. A more complex loading, ankle eversion/inversion during PO, was also examined for the MSF. The average error percentage for the calibration of the model with the three-point bending test was 3.05%. The average error percentages for the validation of the model with PPP and fracture force measurements were 18% and 30%, respectively. The outcomes of pure vertical loadings indicated the higher potential for the 2nd and 3rd MSF at 30% PO and 70% PO, respectively. The results of ankle eversion/inversion loadings represented that the most dangerous posture for MSF was 30° ankle eversion for the 3rd metatarsal at 70% PO. These results provide a guide, including what postures to avoid for the 2nd and 3rd MSF among people who are at high risk of MSF.

Comparison of torque expression among passive self-ligating brackets with different slot depths: An in vitro study

INTRODUCTION

The aim of this study was to assess the interaction between a 0.019×0.025-inch (″) stainless steel archwire and two types of passive self-ligating brackets with the same slot height (0.022″) and different slot depths (0.028″ and 0.026″, and to measure the archwire/slot play as well as to compare the torque expression with archwire torsions of 12°, 24°, and 36°.

MATERIAL AND METHODS

An experimental device was developed along with a universal testing machine to measure torque expression in two types of brackets with 0.028″ and 0.026″ slot depths. Analysis of variance (ANOVA) and Tukey's test were performed to identify the differences between groups.

RESULTS

The 0.026″ slot bracket presented greater archwire/slot play when compared to the 0.028″ bracket. Torque expression with torsions of 24° and 36° were significantly higher in the 0.028″ depth brackets when compared to the 0.026″ depth brackets.

CONCLUSION

The 0.022″×0.026″ passive self-ligating brackets attached with a 0.019″×0.025″ stainless steel archwire provided no greater torque control when compared to 0.022″×0.028″ passive self-ligating brackets.

Comparing Torque Transmission of Different Bracket Systems in Combination with Various Archwires Considering Play in the Bracket Slot: An In Vitro Study

This study aims to examine the play between various archwires and bracket systems, exploring potential variations in angle values for specific torque and torque values for a given angle along different bracket systems. Therefore, seven brackets systems were evaluated in conjunction with different stainless steel archwires of varying dimensions (0.016″ × 0.022″, 0.018″ × 0.025″, and 0.019″ × 0.025″). Biomechanical behavior during torque development and transmission was assessed using a six-component force/torque sensor. Torque angles (5-45°) were specified with subsequent torque measurement, and the sequence was reversed by setting the torque (5-30 Nmm) and measuring the angle. A reference measurement with 0 Nmm torque served to evaluate bracket slot play. Bracket play (0 Nmm) during palatal load ranged between 20.06° and 32.50° for 0.016″ × 0.022″ wire, 12.83° and 21.11° for 0.018″ × 0.025″ wire, and 8.39° and 18.73° for 0.019″ × 0.025″ wire. The BioQuick® bracket exhibited the highest play, while Wave SL® and Damon® Q brackets demonstrated the lowest play (p < 0.001). Significant differences (p < 0.001) between the brackets were observed in the torque angles required to achieve torques of 5-20 Nmm. In summary, each bracket system has a different torque transmission, which is of great clinical importance in order to achieve correct torque transmission and avoid complications such as root resorption.

Incisor torque expression characteristics in two passive self-ligating brackets placed at different heights. A finite element investigation

Objective

This study investigated torque expression in maxillary incisors using two passive self-ligating bracket types (Damon Q and Pitts 21) placed at different heights using the Finite element method.

Materials and methods

Two passive self-ligating brackets, Damon Q (Ormco, USA) and Pitts 21 (OC Orthodontics, USA) were 3D modeled using micro-computed tomography. Damon Q (0.022ˮ x 0.028″ slot size) and Pitts 21 (0.021ˮ x 0.021″ slot size) brackets were placed on a maxillary central incisor at predetermined vertical heights. Arch wires of size 0.019ˮ x 0.025″ stainless steel (Damon Q) and 0.020ˮ x 0.020" Titanium Molybdenum (Pitts 21) were placed in the bracket slots.

Results

Pitts 21 brackets showed higher torquing moments at all bonding heights as compared to Damon Q brackets. The minimum torquing moment was 9.03Nmm at 5 mm for Damon Q and the maximum torquing moment was 14.92Nmm for Pitts 21 at a bracket bonding height of 8 mm. Total deformation for Pitts 21 at a height of 5 mm from the incisal edge was 0.61 × 10-6mm as compared to that of Damon Q which was 0.41 × 10-6mm. Lowest Von Mises stress values were at 27.07 MPa in Damon Q brackets at a bracket height of 5 mm from the incisal edge. Highest Von Mises stress values were 36.80 MPa for Pitts 21 brackets at a bracket height of 8 mm from the incisal edge.

Conclusion

Pitts 21 brackets exhibited superior torquing characteristics compared to Damon Q. Total deformation in Pitts 21 was higher than Damon Q at all tested bracket bonding heights.

In silico approach towards neuro-occlusal rehabilitation for the early correction of asymmetrical development in a unilateral crossbite patient

Neuro-occlusal rehabilitation (N.O.R.) is a discipline of the stomatognathic medicine that defends early treatments of functional malocclusions, such as unilateral crossbite, for the correction of craniofacial development, avoiding surgical procedures later in life. Nevertheless, N.O.R.'s advances have not been proved analytically yet due to the difficulties of evaluate the mechanical response after the treatment. This study aims to evaluate computationally the effect of N.O.R.'s treatments during childhood. Therefore, bilateral chewing and maximum intercuspation occlusion were modelled through a detailed finite element model of a paediatric craniofacial complex, before and after different selective grinding-alternatives. This model was subjected to the muscular forces derived from a musculoskeletal model and was validated by the occlusal contacts recorded experimentally. This approach yielded errors below 2% and reproduced successfully the occlusal, muscular, functional and mechanical imbalance before the therapies. Treatment strategies balanced the occlusal plane and reduced the periodontal overpressure (>4.7 kPa) and the mandibular over deformation (>0.002 ε) on the crossed side. Based on the principles of the mechanostat theory of bone remodelling and the pressure-tension theory of tooth movement, these findings could also demonstrate how N.O.R.'s treatments correct the malocclusion and the asymmetrical development of the craniofacial complex. Besides, N.O.R.'s treatments slightly modified the stress state and functions of the temporomandibular joints, facilitating the chewing by the unaccustomed side. These findings provide important biomechanical insights into the use of N.O.R.'s treatments for the correction of unilateral crossbite, but also encourage the application of computing methods in biomedical research and clinical practise.

Clinical implementation of axial angulation of incisors in the course of routine fixed appliance treatment - a retrospective cohort study

PURPOSE

To identify clinically relevant factors for changes in axial angulation of incisors during routine fixed appliance orthodontic treatment.

METHODS

A total of 106 patients (grades 1-2 of IOTN, 64 females, 42 males; mean age: 15.5 years) from a private practice and treated with metal or ceramic brackets were included in this retrospective cohort study. The axial angulation of the upper and lower incisors was measured on lateral cephalograms before insertion of the first rectangular 0.016 × 0.022-in NiTi archwire (T0) and at the end of treatment about 8 weeks after insertion of the working 0.019 × 0.025-in stainless steel archwire (T1). Treatment-related changes according to bracket type, initial situation, premolar extraction, angle class, and skeletal vertical configuration were analyzed.

RESULTS

Although statistically significant treatment-related changes were seen for both the upper incisors (+ 1.3°) and the lower incisors (- 5.2°), only in ten patients (9.4%) was the prescribed torque value of 17° for the upper incisors and in no patient for the lower incisors achieved. A negative association between the induced change of axial angulation of incisors and the initial values was detected for the upper incisors as well as for the lower incisors. A comparison of the angle classes revealed significant differences in incisor changes. At the end of therapy, only a slight change for the upper central incisors in patients in angle class I cases and a significantly greater change in patients with angle class II/2 was observed. Cases with premolar extraction ended with lower axial angulation of the incisor than cases without extraction. The individual analysis of possible influencing factors also revealed an association with the vertical skeletal configuration.

CONCLUSIONS

For the first time, the presented data show clinically relevant influencing factors for incisor axial angulation changes of the upper and lower incisors in relation to the torque value of the applied brackets in the course of routine clinical practice. For the orthodontist, it remains mandatory to decide whether a customized system must be individualized in order to achieve individual therapy goals.

Effects of Rigid and Nonrigid Connections between the Miniscrew and Anchorage Tooth on Dynamics, Efficacy, and Adverse Effects of Maxillary Second Molar Protraction: A Finite Element Analysis

Introduction

Direct, rigid indirect, and nonrigid indirect absolute anchorages using temporary anchorage devices (TADs, mini-implants/miniscrews) can provide promising opportunities for challenging, yet common, orthodontic tooth movements such as molar protraction. Rigid rectangular wire and ligature wire are the most common methods of attaching a tooth to a miniscrew in indirect anchorages. We aimed to provide a comparison of the rigidity of the connecting wire in terms of stress on the miniscrew, the anchorage loss, and the risk of root resorption using finite element analysis (FEA).

Methods

The maxillary right second molar was protracted into the proximal space at a 150 g load (1) using direct absolute anchorage with a tapered miniscrew implanted between the premolar roots and using indirect absolute anchorage with the second premolar reinforced by the miniscrew through (2) a rigid stainless steel (SS) wire or (3) a nonrigid SS ligature wire (4) at different elastic moduli. Stresses and displacements of 4 models' elements were measured. The risk of external root resorption was evaluated.

Results

Connecting the tooth to the miniscrew using rigid full-size wire (model 2) compared to ligature (model 3) can give better control of the anchorage (using the ligature wire, the anchorage loss is 1.5 times larger than the rectangular wire) and may reduce the risk of root resorption of the anchorage unit. However, the risk of miniscrew failure increases with a rigid connection, although it is still lower than with direct anchorage. The miniscrew stress when using a ligature is approximately 30% of the rigid model using the rectangular wire. The miniscrew stress using the rectangular wire is approximately 82.4% of the miniscrew stress in the direct model. Parametric analysis shows that the higher the elastic modulus of the miniscrew-tooth connecting wire in the indirect anchorage, the less the anchorage loss/palatal rotation of the premolars/and the risk of root resorption of the anchorage teeth and instead the stress on the miniscrew increases.

Conclusions

Direct anchorage (followed by rigid indirect anchorage but not nonrigid) might be recommended when the premolars should not be moved or premolar root resorption is a concern. Miniscrew loosening risk might be the highest in direct anchorage and lowest in nonrigid indirect anchorage (which might be recommended for poor bone densities).

Finite element analysis of tie wings rotation: A new phenomenon in orthodontic bracket-archwire contact assembly during simulated torque

In orthodontics, the torque generated forces from the rectangular archwires refine the teeth position. Literature shows only linear deformation in brackets during torqueing. The objective of this study was to evaluate a new phenomenon of tie wings rotation, an angular deformation in Stainless Steel (SS) brackets with SS and Beta-Titanium (β-Ti) archwires at various angles of twist. Maxillary central incisor SS 0.457 mm × 0.635 mm and 0.558 mm × 0.711 mm brackets, SS and β-Ti archwires of 0.431 mm × 0.635 mm and 0.533 mm × 0.635 mm sizes were used. Finite element analysis was performed in various bracket-archwire assemblies for simulated torque. Palatal root torque was applied and the gingival tie wings rotation was measured at selected points, from 5° to 30° angles of twist. The tie wings rotation for 30° twist with SS 0.533 mm × 0.635 mm archwire in 0.558 mm bracket ranged from 1.32° to 2.55° and with SS 0.431 mm × 0.635 mm archwire in 0.457 mm bracket from 0.71° to 1.73°. Similarly, with β-Ti 0.533 mm × 0.635 mm archwire in 0.558 mm bracket and β-Ti 0.431 mm × 0.635 mm archwire in 0.457 mm bracket, the tie wings rotation ranged from 0.73° to 1.38° and 0.39° to 0.93° respectively. The tie wings rotation were present in all the FE models. Higher archwire size, stiffness, and angles of twist showed increased rotation. Thus, clinicians should be aware of this tie wings rotation during torqueing as an additional factor for torque loss.

A Comparison of the Ligation Torque Expression of a Ribbonwise Bracket-Archwire Combination and a Conventional Combination: A Primary Study

OBJECTIVE

To assess the effect of the third-order mechanics of a new ribbonwise bracket-archwire combination using an orthodontic torque simulator. Material and Methods. An orthodontic torque simulator was used to measure the third-order moment of a maxillary central incisor as it changed from a neutral position to a 40° rotation in 1° increment. A new ribbonwise bracket (Xinya, China) was compared with a conventional ligation bracket (American Orthodontic, U.S.A.). The effects of different archwire sizes (i.e., 0.017″ × 0.025″ and 0.019″ × 0.025″) and materials (i.e., nickel-titanium, titanium-molybdenum alloy, and stainless steel) were analyzed. Paired sample t-tests were conducted to compare the moments between the two bracket types corresponding to each of the archwires. The effects of the stiffness of the bracket-archwire complexes were also assessed.

RESULTS

Statistically significant differences (P=0.05) between the moments from the two brackets were found. The ribbonwise bracket-archwire complex generated larger moments when the rotation angle was lower than 30°. The ribbonwise brackets produced moments that could reach a threshold of 5 Nmm more quickly as the angle was increased. The higher the stiffness of the complex, the larger the moment.

CONCLUSION

The ribbonwise bracket-archwire complex reached the moment threshold limits earlier than the conventional complex. When the rotation angle is less than 30°, the ribbonwise bracket-archwire complex generated a greater torque moment in comparison with the conventional complex.

Torque Comparison Between Two Passive Self-Ligating Brackets with Respect to Interbracket Wire Dimensions and Types: A Finite Element Analysis

Objective:

This study aimed to analyze the expression of torque between 2 passive self-ligating brackets by simulating different clinical situations using finite element analysis.

Material and Methods:

Two passive self-ligating brackets, that is, Damon Q (Ormco, Glendora, California) and Smart Clip (3M Unitek, Monrovia, California), were 3D modeled using micro-computed tomography. ANSYS V14.5 software was used for analysis. Archwire and bracket interactions were simulated to measure torque expression by changing wire alloys (stainless steel [SS] and titanium molybdenum [TMA]) and interbracket dimensions.

Results:

Damon Q brackets generated higher torque values compared to Smart Clip brackets with both SS and TMA wires. Damon Q brackets generated the highest torquing moment of 25.72 Nmm and 7.45 Nmm, while Smart Clip brackets generated 22.25 Nmm and 7.31 Nmm with 0.019 × 0.025″ SS and TMA wires, respectively, at an interbracket distance of 12 mm. Torquing moments decreased for Damon Q and Smart Clip brackets when wire length increased from 12 mm to 16 mm.

Conclusion:

Damon Q with 0.019 × 0.025″wires exhibited superior torquing characteristics as compared to Smart Clip brackets with similar archwires.

Comparative analysis of passive play and torque expression in self-ligating and traditional lingual brackets

INTRODUCTION

The aim of this study was to determine and compare the play and torque expression of self-ligating and conventionally ligated lingual brackets, with square and rectangular slots, when engaged with archwires of different size, cross section and material.

METHODS

Passive play and torque expression of 3 types of archwires and 5 types of brackets from four different manufacturers were measured and compared using a dynamometer. Each archwire was tested five times in each bracket; passive play was compared to ideal values, while torque expression was tested at 5, 10 and 20 Nmm as clinically efficacious values.

RESULTS

Regarding full thickness stainless steel archwires, the lowest passive play was found in STb brackets (2.66 ± 0.89°, Ormco, Glendora, CA, USA), which was statistically significantly lower than for ALIAS brackets (4.44 ± 0.75°, Ormco), In-Ovation L brackets (6.14 ± 3.22°, Dentsply GAC, Bohemia, NY, USA), Harmony brackets (7.76 ± 2.94°, American Orthodontics, Sheboygan, WI, USA) and eBrace brackets (9.46 ± 3.94°, Riton Biomaterial, Guangzhou, China). Increasing the torsional load to the greatest torsional load clinically applicable, there were no statistically significant differences between STb, ALIAS, In-Ovation L and Harmony brackets.

CONCLUSIONS

STb and ALIAS brackets generated the lowest passive play; STb and In-Ovation L brackets showed the lowest angle of play at the greatest torque expression. These measurements allow to understand the accuracy of lingual systems and at the same time the amount of overcorrections to be applied in the setup in order to obtain high quality orthodontic treatments.

Finite element analysis of torque induced orthodontic bracket slot deformation in various bracket-archwire contact assembly

BACKGROUND AND OBJECTIVES

Orthodontic fixed appliance therapy involves alignment of teeth through the bracket and archwires. The archwire twist (torque) imparts significant forces inside the bracket slot in refining the teeth position at the end of treatment. The objective of this in- silico study was to evaluate the torque induced bracket slot deformation in the commonly used 0.018 inch (") and 0.022" conventional Stainless Steel (SS) brackets with clinically relevant archwires during various angles of twist.

METHODS

SS maxillary central incisor brackets of 0.018" width × 0.022" depth (0.457 mm × 0.558 mm) and 0.022" width × 0.028" depth (0.558 mm × 0.711 mm) were used. The SS archwires of 0.016" width × 0.022" depth (0.406 mm × 0.558 mm), 0.017" width × 0.025" depth (0.431 mm × 0.635 mm), 0.019" width × 0.025" depth (0.482 mm × 0.635 mm) and 0.021" width × 0.025" depth (0.533 mm × 0.635 mm) were engaged in the respective bracket slots. The assembled bracket-archwire Finite Element (FE) models were constructed. The archwire torque, the top, middle and bottom slot deformations (TSD, MSD, BSD) were obtained for the bracket-archwire combinations for various angles of archwire twist using FE Analysis (FEA).

RESULTS

The torque, TSD, MSD and BSD for 30^o twist of 0.016" × 0.022" archwire in 0.018" slot were 28.13 Nmm, 35.71 µm, 21.51 µm and 15.67 µm respectively, and for 0.017" × 0.025" archwire were 50.18 Nmm, 54.52 µm, 32.47 µm and 19.11 µm respectively. Similarly for 0.019" × 0.025" archwire in 0.022" slot and 0.021" × 0.025" archwire in 0.022" slot they were 38.82 Nmm, 50.78 µm, 31.47 µm and 16.82 µm, and 60.22 Nmm, 65.22 µm, 36.44 µm and 22.68 µm respectively.

CONCLUSIONS

The slot deformation was present in both 0.018" and 0.022" brackets which increased as the angle of twist increased. The TSD were higher than the MSD and BSD in all the bracket-archwire combinations. We conclude that there is only elastic deformation of bracket slots upto 30^o angle of twist and clinicians could maintain within this torque limits to avoid plastic deformation leading to improper teeth position.

EFFECTS OF THE INSERTION OF AN ARCHWIRE THIN-WALLED SLEEVE IN ACCELERATING THE CANINE’S TRANSLATION

In sliding mechanics, resistance to sliding (RS), including friction, binding, and notching, generated at a wire-bracket interface has a bearing on the force transmitted to the teeth and further influences the biomechanical behavior associated with tooth movement efficiency. Objective: This study aimed to propose and verify the insertion of a rectangular thin-walled sleeve between an archwire and a bracket to minimize the resistance effect on the biomechanical behavior of tooth movement by using the finite element (FE) method. Material and methods: A 3D FE solid model was constructed and composed of mandibular dentitions, including the surrounding tooth-supporting structures and fixed self-ligating appliances. The translation of the left mandibular canine was simulated (0.1[Formula: see text]mm and 0.3[Formula: see text]mm) from the labial side to the lingual side with or without the thin-walled sleeve by using eight kinds of archwires with various dimensions and cross-sections by FE methods. Results: FE analysis indicated that the canine’s maximum initial displacement and the highest periodontal ligament (PDL) von Mises stress were mainly influenced by the orthodontic wire and the insertion of the thin-walled sleeve. Without the thin-walled sleeve, rectangular archwires could initiate a more optimal tissue response than round archwires. However, the insertion of the thin-walled sleeve between the small round archwire and the bracket significantly presented the most optimal biological responses in all of the cases. Conclusion: FE results revealed that the insertion of a thin-walled sleeve in a small round archwire and a bracket could have a positive influence on final tooth movement.

Buccolingual Inclination Effects of Self-Ligating and Conventional Premolar Brackets: A Cone Beam Computed Tomography Study

Objective

This study aimed to compare the effects of passive self-ligating (PSL) and conventional ligating (CL) of brackets on the buccolingual inclination (BLINC) of the maxillary premolars.

Methods

This in vitro study included a PSL bracket group and a CL bracket group. Acrylic teeth on typodonts were aligned using 0.014-inch heat-activated nickel titanium (HANT) (T1) and 0.019×0.025-inch HANT (T2) and 0.021×0.025-inch stainless steel (SS) (T3) archwires in a sequence. Standardized cone beam computed tomography (CBCT) images were taken immediately after each archwire stage. The differences of premolar teeth BLINC values in the 0.019×0.025-inch and 0.014-inch HANT archwires (T2-T1) and 0.021×0.025-inch SS and 0.019×0.025-inch HANT archwires (T3-T2) were compared between PSL and CL groups. The value of p < 0.05 was considered statistically significant.

Results

The BLINC change of the second premolar (SPM) showed a statistically significant difference (p=0.008), but the BLINC change of the first premolar (FPM) (p=0.056) between the groups showed no statistically significant difference during the T2-T1 stage. However, there were statistically significant differences between two groups in the BLINC of the FPM (p=0.032) and SPM (p=0.032) in the T3-T2 stage. The angular changes in the buccal direction in the PSL group were higher than those in the CL group.

Conclusion

The PSL upper premolar brackets used with the 0.021×0.025-inch SS archwire produced more buccal crown movement of the upper PM teeth compared with that of the CL brackets.

Impact of passive self-ligation and conventional elastic ligation on orthodontic force in the simulation of a mandibular lateral incisor linguoversion

INTRODUCTION

This study compared three-dimensional forces delivered to the displaced tooth and its adjacent teeth between passive self-ligation (PSL) and conventional elastic ligation (CL) in simulation of mandibular lateral incisor linguoversions.

METHODS

A multisensor system was used to measure three-dimensional forces delivered to brackets attached to the mandibular left central incisor, lateral incisor, and canine (FDI tooth numbers 31, 32, and 33, respectively). Two ligation methods (PSL and CL), 3 nickel-titanium (0.014-inch) archwires similar to the arch form of normal occlusion, and 2 displacements (1 and 4 mm) were tested.

RESULTS

In 1-mm displacement, forces were significantly smaller in CL than in PSL at 32 in the labial direction and larger at 31 in the mesial direction for all 3 types of archwires (P <0.01 for both). For 2 of 3 archwires, forces were larger in CL than in PSL at 33 in the lingual direction (P <0.01). In 4-mm displacement, forces were significantly larger in CL than in PSL at 31 in the mesial direction and significantly smaller in CL than in PSL at 33 in the distal direction for all 3 archwires (P <0.05 and P <0.01, respectively). Mean forces in the vertical direction were small, ranging from -0.05 to 0.05 N.

CONCLUSIONS

Under a small amount of displacement, force magnitude in PSL was smaller than that in CL at the displaced tooth in labial-lingual directions. Under a large amount of displacement, a more "open coil spring effect" was significantly obtained in CL than PSL at both adjacent teeth of the displaced tooth.

Torque efficiency of a customized lingual appliance : Performance of wires with three different ligature systems

PURPOSE

Torque control in lingual orthodontics is key to obtain optimal esthetic results. The aim of this in vitro experimental study was to verify the efficiency of the ligature-archwire-slot system in torque control using a customized lingual appliance.

METHODS

An idealized cast with eight extracted human teeth was created and a set of customized lingual brackets was obtained. Tests were performed with the following wires: 0.016″ × 0.022″ nickel-titanium (NiTi), 0.016″ × 0.024″ stainless steel (SS), 0.017″ × 0.025″ βIII titanium (βIIITi), 0.0182″ × 0.0182″ βIIITi, 0.018″ × 0.025″ SS, 0.018″ × 0.025″ NiTi, 0.018″ × 0.025″ βIIITi, and three types of ligatures were tested using a universal testing machine to calculate the efficiency in torque control. A blind statistical analysis was performed.

RESULTS

Based on post hoc multiple comparisons, differences were found for two of the three ligatures when using the 0.016″ × 0.022″ NiTi wires (p < 0.001 for both ligatures). When considering all ligatures, 0.018″ × 0.025″ SS and 0.018″ × 0.025″ βIIITi were significantly different from all other wires (p < 0.001 in all cases). With a moment of 5 Nmm, the 0.016″ × 0.022″ NiTi wire developed median angles of 26.7, 29.8, and 38.7° with the three ligatures, respectively, while the 0.018″ × 0.025″ SS developed median angles of 12.9, 10.7, and 12.7°, respectively.

CONCLUSIONS

The ligature type and geometry did not affect the efficiency of torque control, except for the 0.016″ × 0.022″ NiTi wire. The wires generating the greatest moments were the 0.018″ × 0.025″ SS and 0.018″ × 0.025″ βIIITi.

Simulation of orthodontic force of archwire applied to full dentition using virtual bracket displacement method

OBJECTIVE

Orthodontic force simulation of tooth provides important guidance for clinical orthodontic treatment. However, previous studies did not involve the simulation of orthodontic force of archwire applied to full dentition. This study aimed to develop a method to simulate orthodontic force of tooth produced by loading a continuous archwire to full dentition using finite element method.

METHOD

A three-dimensional tooth-periodontal ligament-bone complex model of mandible was reconstructed from computed tomography images, and models of brackets and archwire were built. The simulation was completed through two steps. First, node displacements of archwire before and after loading were estimated through moving virtual brackets to drive archwire deformation. Second, the obtained node displacements were loaded to implement the loading of archwire, and orthodontic force was calculated. An orthodontic force tester (OFT) was used to measure orthodontic force in vitro for the validation.

RESULTS

After the simulation convergence, archwire was successfully loaded to brackets, and orthodontic force of teeth was obtained. Compared with the measured orthodontic force using the OFT, the absolute difference of the simulation results ranged from 0.5 to 22.7 cN for force component and ranged from 2.2 to 80.0 cN•mm for moment component, respectively. The relative difference of the simulation results ranged from 2.5% to 11.0% for force component, and ranged from 0.6% to 14.7% for moment component, respectively.

CONCLUSIONS

The developed orthodontic force simulation method based on virtual bracket displacement can be used to simulate orthodontic force provided by the archwire applied to full dentition.

Failure patterns of different bracket systems and their influence on treatment duration: A retrospective cohort study

OBJECTIVES

To compare the failure pattern of four different bracket types and to assess its effect on treatment duration.

MATERIALS AND METHODS

A total of 78 white patients (28 male, 50 female) with a mean age of 12.6 years were included in this retrospective cohort study and treated for a mean period of 30.6 months. The patients were treated in a private practice with stainless steel conventionally ligated brackets, ceramic conventionally ligated brackets, stainless steel self-ligating brackets, or nickel-free self-ligating brackets. The loss of at least one bracket during the course of treatment was analyzed with Cox proportional hazards survival analyses and generalized linear regression.

RESULTS

The overall bracket failure rate at the tooth level was 14.1% (217 brackets), with significant differences according to tooth type (between 8.0%-23.4%) and bracket type (between 11.2%-20.0%). After taking confounders into account, patients treated with ceramic brackets lost more brackets (hazard ratio = 1.62; 95% confidence interval = 1.14-2.29; P = .007) than patients with stainless steel brackets. On average, treatment time increased by 0.6 months (95% confidence interval = 0.21-1.05; P = .004) for each additional failed bracket.

CONCLUSIONS

Bracket failure was more often observed with ceramic brackets and was associated with increased treatment duration.

Coordinating bracket torque and incisor inclination : Part 3: Validity of bracket torque values in achieving norm inclinations

PURPOSE

To analyze common values of bracket torque (Andrews, Roth, MBT, Ricketts) for their validity in achieving incisor inclinations that are considered normal by different cephalometric standards.

METHODS

Using the equations developed in part 1 (eU1_(BOP) = 90° - BT_(U1) - TCA_(U1) + α₁ - α₂ and eL1_(BOP) = 90° - BT_(L1) - TCA_(L1) + β₁ - β₂) (abbreviations see part 1) and the mean values (± SD) obtained as statistical measures in parts 1 and 2 of the study (α₁ and β₁ [1.7° ± 0.7°], α₂ [3.6° ± 0.3°], β₂ [3.2° ± 0.4°], TCA_(U1) [24.6° ± 3.6°] and TCA_(L1) [22.9° ± 4.3°]) expected (= theoretically anticipated) values were calculated for upper and lower incisors (U1 and L1) and compared to targeted (= cephalometric norm) values.

RESULTS

For U1, there was no overlapping between the ranges of expected and targeted values, as the lowest targeted value of (58.3°; Ricketts) was higher than the highest expected value (56.5°; Andrews) relative to the bisected occlusal plane (BOP). Thus all of these torque systems will aim for flatter inclinations than prescribed by any of the norm values. Depending on target values, the various bracket systems fell short by 1.8-5.5° (Andrews), 6.8-10.5° (Roth), 11.8-15.5° (MBT), or 16.8-20.5° (Ricketts). For L1, there was good agreement of the MBT system with the Ricketts and Björk target values (Δ0.1° and Δ-0.8°, respectively), and both the Roth and Ricketts systems came close to the Bergen target value (both Δ2.3°). Depending on target values, the ranges of deviation for L1 were 6.3-13.2° for Andrews (Class II prescription), 2.3°-9.2° for Roth, -3.7 to -3.2° for MBT, and 2.3-9.2° for Ricketts.

CONCLUSIONS

Common values of upper incisor bracket torque do not have acceptable validity in achieving normal incisor inclinations. A careful selection of lower bracket torque may provide satisfactory matching with some of the targeted norm values.

Comparative study of torque expression among active and passive self-ligating and conventional brackets

OBJECTIVE

The aim of this study was to compare torque expression in active and passive self-ligating and conventional brackets.

METHODS

A total of 300 segments of stainless steel wire 0.019 x 0.025-in and six different brands of brackets (Damon 3MX, Portia, In-Ovation R, Bioquick, Roth SLI and Roth Max) were used. Torque moments were measured at 12°, 24°, 36° and 48°, using a wire torsion device associated with a universal testing machine. The data obtained were compared by analysis of variance followed by Tukey test for multiple comparisons. Regression analysis was performed by the least-squares method to generate the mathematical equation of the optimal curve for each brand of bracket.

RESULTS

Statistically significant differences were observed in the expression of torque among all evaluated bracket brands in all evaluated torsions (p < 0.05). It was found that Bioquick presented the lowest torque expression in all tested torsions; in contrast, Damon 3MX bracket presented the highest torque expression up to 36° torsion.

CONCLUSIONS

The connection system between wire/bracket (active, passive self-ligating or conventional with elastic ligature) seems not to interfere in the final torque expression, the latter being probably dependent on the interaction between the wire and the bracket chosen for orthodontic mechanics.

Torque differences according to tooth morphology and bracket placement: a finite element study

Introduction

Torque of the maxillary incisors is essential in esthetics and proper occlusion, while torque expression is influenced by many factors. The aim of this finite element study was to assess the relative effect of tooth morphology, bracket prescription, and bracket positioning on tooth displacement and developed stresses/strains after torque application.

Methods

A three-dimensional upper right central incisor with its periodontal ligament (PDL) and alveolus was modelled. The tooth varied in the crown-root angle (CRA) between 156°, 170°, and 184°. An 0.018-inch slot discovery® (Dentaurum, Ispringen, Germany) bracket with a rectangular 0.018 × 0.025-inch β-titanium wire was modelled. Bracket torque prescription varied between 0°, 12°, and 22°, with bracket placement at the centre of the middle, gingival or incisal third of the crown. A total of 27 models were generated and a buccal root torque of 30° was applied. Afterwards, crown and apex displacement, strains in the PDL, and stresses in the bracket were calculated and analysed statistically.

Results

The palatal crown displacement was significantly affected by bracket positioning (up to 94 per cent), while the buccal apex displacement was significantly affected by bracket prescription (up to 42 per cent) and bracket positioning (up to 23 per cent). Strains in the PDL were affected mainly by CRA (up to 54 per cent), followed by bracket positioning (up to 45 per cent). Finally, bracket prescription considerably affected the stresses in the bracket (up to 144 per cent).

Limitations

These in silico results need to be validated in vivo before they can be clinically extrapolated.

Conclusion

Tooth anatomy and the characteristics of the orthodontic appliance should be considered during torque application.

Torque differences due to the material variation of the orthodontic appliance: a finite element study

Background

Torque of the maxillary incisors is crucial to occlusal relationship and esthetics and can be influenced by many factors. The aim of this study was to assess the relative influence of the material of the orthodontic appliance (adhesive, bracket, ligature, and wire) on tooth displacements and developed stresses/strains after torque application.

Methods

A three-dimensional upper right central incisor with its periodontal ligament (PDL) and alveolus was modeled. A 0.018-in. slot discovery® (Dentaurum, Ispringen, Germany) bracket with a rectangular 0.018 x 0.025-in. wire was generated. The orthodontic appliance varied in the material of its components: adhesive (composite resin or resin-modified glass ionomer cement), bracket (titanium, steel, or ceramic), wire (beta-titanium or steel), and ligature (elastomeric or steel). A total of 24 models were generated, and a palatal root torque of 5° was applied. Afterwards, crown and apex displacement, strains in the PDL, and stresses in the bracket were calculated and analyzed.

Results

The labial crown displacement and the palatal root displacement of the tooth were mainly influenced by the material of the wire (up to 150% variation), followed by the material of the bracket (up to 19% variation). The magnitude of strains developed in the PDL was primarily influenced by the material of the wire (up to 127% variation), followed by the material of the bracket (up to 30% variation) and the ligature (up to 13% variation). Finally, stresses developed at the bracket were mainly influenced by the material of the wire (up to 118% variation) and the bracket (up to 59% variation).

Conclusions

The material properties of the orthodontic appliance and all its components should be considered during torque application. However, these in silico results need to be validated in vivo before they can be clinically extrapolated.

Electronic supplementary material

The online version of this article (doi:10.1186/s40510-017-0161-5) contains supplementary material, which is available to authorized users.

Torque expression in self-ligating orthodontic brackets and conventionally ligated brackets: A systematic review

Background

To evaluate the torque expression of self ligating (SL) orthodontic brackets and conventionally ligated brackets and the torque expression in active and passive SL brackets.

Material and Methods

Our systematic search included MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus, and key journals and review articles; the date of the last search was April 4th 2016. We graded the methodological quality of the studies by means of the Quality Assessment Tool for Quantitative Studies, developed for the Effective Public Health Practice Project (EPHPP).

Results

In total, 87 studies were identified for screening, and 9 studies were eligible. The quality assessment rated one of the study as being of strong quality, 7 (77.78%) of these studies as being of moderate quality. Three out of 7 studies which compared SL and conventionally ligated brackets showed, conventionally ligated brackets with highest torque expression compared to SL brackets. Badawi showed active SL brackets with highest torque expression compared to passive SL brackets. Major and Brauchli showed no significant differences in torque expression of active and passive SL brackets.

Conclusions

Conventionally ligated brackets presented with highest torque expression compared to SL brackets. Minor difference was recorded in a torque expression of active and passive SL brackets.

Key words:Systematic review, self ligation, torque expression, conventional ligation.

Torque efficiency of square and rectangular archwires into 0.018 and 0.022 in. conventional brackets

BACKGROUND

The aim of this study was to compare the torque efficacy of square and rectangular wires in 0.018- and 0.022-in. conventionally ligated brackets.

METHODS

Brackets of the same prescription were evaluated in both slot dimensions. Identical acrylic resin models of the maxilla were bonded with the brackets and mounted on the Orthodontic Measurement and Simulation System. Ten 0.018 × 0.018 in., 0.018 × 0.022 in., and 0.018 × 0.025 in. stainless steel wires were evaluated in the 0.018-in. brackets and ten 0.019 × 0.019 in., 0.019 × 0.025 in., and 0.019 × 0.026 in. stainless steel wires were evaluated in the 0.022-in. brackets. A 15° buccal root torque was gradually applied to the right central incisor bracket, and the moments were recorded at this position. One-way ANOVA was applied for both bracket slot sizes along with post hoc analysis for the various archwire sizes.

RESULTS

The mean measured moments varied between 10.78 and 30.60 Nmm among the assessed wire-and-bracket combinations. Both square and rectangular archwires in the 0.018-in. bracket system exerted statistically significantly higher moments in comparison with their counterparts in the 0.022-in. bracket system. Rectangular archwires exerted statistically significantly higher moments than square archwires, both for the 0.018- and the 0.022-in. bracket system.

CONCLUSIONS

Rectangular archwires seem to be more efficient in torque exertion, especially in 0.018-in. brackets.

In vitro biomechanical analysis of torque capabilities of various 0.018″ lingual bracket-wire systems: total torque play and slot size

OBJECTIVES

To determine the total torque play of various rectangular titanium molybdenum alloy (TMA)/stainless steel (SS) wires in various 0.018″ upper incisor lingual brackets and slot size measurements.

METHODS

TMA (0.0175″ × 0.0175″, 0.0170″ × 0.025″, 0.0182″ × 0.0182″, 0.0182″ × 0.025″) and SS wires (0.016″ × 0.022″, 0.016″ × 0.024″, 0.018″ × 0.025″) were twisted in standard (Hiro, Incognito™, Joy®, Kurz 7th generation, STb™: fixation with elastic modules) and self-ligating brackets (Evolution SLT®, In-Ovation® L MTM: closed ligation mechanism) from -20 degrees to +20 degrees with a custom-made machine. The total torque play was calculated by extrapolating the linear portion of the twist/moment curves to the x-axis and adding the absolute negative and positive angle values at the intercepts. The bracket slot height was measured before and after the experiments with a series of pin gauges with round profile.

RESULTS

Brackets in ascending order for total torque play with the most slot-filling wire TMA 0.0182″ × 0.025″: Evolution SLT® (0 degree ± 0 degree), Incognito™ (2.2 degrees ±1.1 degrees), Hiro (5.1 degrees ±3.0 degrees), In-Ovation® L MTM (6.3 degrees ±2.2 degrees), STb™ (6.6 degrees ±1.8 degrees), Kurz 7th generation (7.1 degrees ±0.8 degrees), and Joy® (12.0 degrees ±0.8 degrees). Wires in ascending order for total torque play with the most precise slot Incognito™: TMA 0.0182″ × 0.025″ (2.2 degrees ±1.1 degrees), TMA 0.0182″ × 0.0182″ (2.4 degrees ±0.9 degrees), SS 0.018″ × 0.025″ (5.5 degrees ±1.0 degrees), TMA 0.0170″ × 0.025″ (9.4 degrees ±1.8 degrees), TMA 0.0175″ × 0.0175″ (13.0 degrees ±1.5 degrees), SS 0.016″ × 0.024″ (16.1 degrees ±1.4 degrees), SS 0.016″ × 0.022″ (17.8 degrees ±1.0 degrees); differences between some of the experimental groups were not statistically significant. Bracket slot dimensions in ascending order: Evolution SLT® (less than 0.452mm), Incognito™ (0.460mm ±0.002mm), In-Ovation® L MTM (0.469mm ±0.001mm), Hiro (0.469mm ±0.010mm), STb™ (0.471mm ±0.002mm), Kurz 7th generation (0.473mm ±0.002mm), and Joy® (greater than 0.498mm).

LIMITATIONS

The applied method must be questioned when used with brackets with incomplete slot walls (Evolution SLT®). Slot measurement with pin gauges may not register bracket wing deformation.

CONCLUSIONS

All brackets showed a differing slot size from the nominal 0.018″ (0.457mm). Incognito™ presented the most precise and Joy® the widest slot. The main wires for the retraction phase SS 0.016″ × 0.022″/SS 0.016″ × 0.024″ showed poor torque control. Among the finishing TMA wires, TMA 0.0175″ × 0.0175″ exhibited the highest and TMA 0.0182″ × 0.0182″/TMA 0.0182″ × 0.025″ the smallest torque play.

SIGNIFICANCE

The manufacturers could profit from this investigation towards optimization of the dimensional precision of their products. The orthodontist must be aware of the torque play of the wire-bracket combinations to be able to plan and individualize the appliance by third order customization.

Effect of material variation on the biomechanical behaviour of orthodontic fixed appliances: a finite element analysis

INTRODUCTION

Biomechanical analysis of orthodontic tooth movement is complex, as many different tissues and appliance components are involved. The aim of this finite element study was to assess the relative effect of material alteration of the various components of the orthodontic appliance on the biomechanical behaviour of tooth movement.

METHODS

A three-dimensional finite element solid model was constructed. The model consisted of a canine, a first, and a second premolar, including the surrounding tooth-supporting structures and fixed appliances. The materials of the orthodontic appliances were alternated between: (1) composite resin or resin-modified glass ionomer cement for the adhesive, (2) steel, titanium, ceramic, or plastic for the bracket, and (3) β-titanium or steel for the wire. After vertical activation of the first premolar by 0.5mm in occlusal direction, stress and strain calculations were performed at the periodontal ligament and the orthodontic appliance.

RESULTS

The finite element analysis indicated that strains developed at the periodontal ligament were mainly influenced by the orthodontic wire (up to +63 per cent), followed by the bracket (up to +44 per cent) and the adhesive (up to +4 per cent). As far as developed stresses at the orthodontic appliance are concerned, wire material had the greatest influence (up to +155 per cent), followed by bracket material (up to +148 per cent) and adhesive material (up to +8 per cent).

LIMITATIONS

The results of this in silico study need to be validated by in vivo studies before they can be extrapolated to clinical practice.

CONCLUSION

According to the results of this finite element study, all components of the orthodontic fixed appliance, including wire, bracket, and adhesive, seem to influence, to some extent, the biomechanics of tooth movement.

A comparative experimental investigation of torque capabilities induced by conventional and active, passive self-ligating brackets

INTRODUCTION

A proper selected bracket-archwire combination displays a determining factor in the efficacy of torque applied to a tooth at the final stages of an orthodontic treatment. The objective of the current study was to assess the torque capabilities of various bracket systems combined with diverse archwire materials and cross-sections.

METHODS

The study comprised of four different 0.018-inch slot orthodontic brackets: the passive and the active self-ligating 1. Swiss Nonligating Bracket (SNB) and 2. SPEED and the metallic and the plastic conventional ligating 3. Mini Mono and 4. Brilliant, respectively, and four different archwire types: stainless steel and Nitinol: 0.016×0.016 inch and 0.016×0.022 inch. A 20 degrees labial crown torque (+20 degrees) and then a 20 degrees palatal crown torque (-20 degrees) were applied gradually on the upper right central incisor. Maximum torquing moments and torque play were registered.

RESULTS

Highest torquing moments were expressed by combining SPEED® with 0.016×0.022 inch stainless steel archwire. Lowest moments, but highest torque loss were registered by inserting a 0.016×0.016 inch Nitinol archwire in conventional ligating brackets.

CONCLUSIONS

Active self-ligating system manifests the best torque effectiveness. An evident dependence of the torque expression is displayed both on the type of ligation and on the material of the archwire.

Torque expression capacity of 0.018 and 0.022 bracket slots by changing archwire material and cross section

Background

The aim of this study is to calculate and compare the play and torque expression of 0.018 and 0.022 bracket slots when engaged with archwires of different size, cross section and material.

Methods

Eight orthodontic brackets, two of slot height 0.018 and six of slot height 0.022, from different manufacturers, were measured and fixed to a vertical support. Twenty-four archwires of differing size, cross section and material were selected, measured and tested in each bracket of compatible slot width. Compression testing by Instron dynamometer and geometric calculations enabled us to determine the play angle of each bracket/archwire combination, and the angle at which a clinically efficacious force couple, sufficient for dental movement, is exerted.

Results

All bracket/archwire combinations considered were found to have play angles far above the ideal. This is ascribable to the slots being oversized with respect to the manufacturers' claims. Likewise, some archwires were found to be oversized, while others undersized.

When the same archwire was tested with brackets from different manufacturers, the play and torque expression differed, despite the same nominal dimensions of the slots. When the same bracket was tested with the same size archwires, their construction material was found to influence the torque expression, due to the difference in elastic modulus, but not the wire/slot play.

Conclusions

The dimensional precision of orthodontic brackets and archwires and the rigidity of the latter have a profound influence on the torque expression of pre-angled appliances.

Analysis of the torque capacity of a completely customized lingual appliance of the next generation

Introduction

In lingual orthodontic therapy, effective torque control of the incisors is crucial due to the biomechanical particularities associated with the point of force application and the tight link between third order deviations and vertical tooth position.

Aim

The aim of the present in vitro investigation was to analyze the torque capacity of a completely customized lingual appliance of the next generation (WIN) in combination with different finishing archwire dimensions.

Methods

Using a typodont of the upper arch carrying the WIN appliance, slot filling and undersized individualized β-titanium archwires were engaged. Horizontal forces ranging from 0 to 100 cN were applied at the central incisor by means of spring gauges. The resulting angular deviations were recorded and the corresponding torque moments were calculated.

Results

For fullsize archwires (0.018”×0.018” β-titanium and 0.018”×0.025” β-titanium), an initial torque play of 0-2° had to be overcome prior to the development of an effective torque moment. Thereafter, a linear correlation between torque angle and torque moment developed for both archwire dimensions with steeper slopes calculated for the specimens with the larger dimension. A torque moment of 2 Nmm required for effective torque correction was noted after a minimum of 2-3° of twist for the 0.018”×0.018” β-titanium wires as compared to 2-4° for the 0.018”×0.025” β-titanium study sample. When undersized archwires were analyzed (0.0175”×0.0175” β-titanium), the measured torque play ranged from 5-7°. After 8-12° of torque angle, the threshold of 2 Nmm was reached. A linear relationship between twist angle and torque moment in which the steepness of the slopes was generally flatter than the ones calculated for the slot filling archwires was noted.

Conclusions

Given the high precision of the bracket slot-archwire-combination provided with the WIN appliance, an effective torque control can be clinically realized.

Torque efficiency of different archwires in 0.018- and 0.022-inch conventional brackets

OBJECTIVE

To compare the archwires inserted during the final stages of the orthodontic treatment with the generated moments at 0.018- and 0.022-inch brackets.

MATERIALS AND METHODS

The same bracket type, in terms of prescription, was evaluated in both slot dimensions. The brackets were bonded on two identical maxillary acrylic resin models, and each model was mounted on the orthodontic measurement and simulation system. Ten 0.017 × 0.025-inch TMA and ten 0.017 × 0.025-inch stainless steel archwires were evaluated in the 0.018-inch brackets. In the 0.022-inch brackets, ten 0.019 × 0.025-inch TMA and ten 0.019 × 0.025-inch stainless steel archwires were measured. A 15° buccal root torque (+15°) and then a 15° palatal root torque (-15°) were gradually applied to the right central incisor bracket, and the moments were recorded at these positions. A t-test was conducted to compare the generated moments between wires within the 0.018- and 0.022-inch bracket groups separately.

RESULTS

The 0.017 × 0.025-inch archwire in the 0.018-inch brackets generated mean moments of 9.25 Nmm and 14.2 Nmm for the TMA and stainless steel archwires, respectively. The measured moments in the 0.022-inch brackets with the 0.019 × 0.025-inch TMA and stainless steel archwires were 6.6 Nmm and 9.3 Nmm, respectively.

CONCLUSION

The 0.017 × 0.025-inch stainless steel and β-Ti archwires in the 0.018-inch slot generated higher moments than the 0.019 × 0.025-inch archwires because of lower torque play. This difference is exaggerated in steel archwires, in comparison with the β-Ti, because of differences in stiffness. The differences of maximum moments between the archwires of the same cross-section but different alloys were statistically significant at both slot dimensions.

Labio-lingual root control of lower anterior teeth and canines obtained by active and passive self-ligating brackets

OBJECTIVE

To investigate the torque capabilities of passive and active self-ligating (SL) brackets on mandibular incisors and canines using three-dimensional (3D) imaging analysis.

MATERIALS AND METHODS

Two types of SL bracket systems were analyzed: a passive and an active. Both brackets had a 0.022 × 0.028-inch slot size. Treatment protocol and wire sequences were followed as recommended by the manufacturers. Twenty-six patients were included in the passive group and 20 were included in the active group; all received pretreatment and posttreatment cone-beam computed tomography (CBCT) scanning. Based on the CBCT scans, a customized 3D analysis was developed to assess labiolingual inclination of the roots of mandibular canines and incisors with respect to the occlusal plane before and after treatment.

RESULTS

Following treatment, a statistically significant labiolingual proclination of the teeth was seen in both groups. Moreover, in both SL systems the roots exhibited a large variation in labiolingual inclination between adjacent teeth even after treatment.

CONCLUSIONS

A significant proclination was seen for the mandibular front teeth; the claimed third-order torque control of SL systems could not be demonstrated. Therefore, a considerable play between the wire and the brackets could be hypothesized, even more in relation to the passive than the active SL brackets.

Torque capabilities of self-ligating and conventional brackets under the effect of bracket width and free wire length

OBJECTIVES

To numerically investigate the torque capacity of conventional and self-ligating brackets under the effect of varying bracket width and free wire length.

MATERIAL AND METHODS

Finite element models of three kinds of orthodontic brackets in the 0.022-inch slot size were investigated: Discovery, Damon 3MX, Speed. Additionally, finite element (FE) models of Speed and Damon brackets were generated with the same width as the Discovery. From the left upper incisor to the right upper canine, four brackets each were modelled. The total wire length at the upper right incisor was kept constant at 12 mm for all brackets types. For the Discovery brackets, the wire length was increased from 12 to 16 mm in 2-mm steps. A torque of 20° was applied to the upper right incisor with 0.46 × 0.64 mm(2) (0.018″ × 0.025″) and 0.48 × 0.64 mm(2) (0.019″ × 0.025″) wires. Wires made of stainless steel, titanium molybdenum and nickel titanium were studied. Torque angle/moment characteristics were recorded.

RESULTS

  Wider brackets showed more torque control capability (e.g. Discovery: 10.6 Nmm, Damon: 9.2 Nmm, Speed: 4.0 Nmm for the NiTi wire). Even with the same width as the Discovery bracket, Damon and Speed brackets showed lower torque capability than the Discovery bracket. Increasing the free wire length decreased the torsional stiffness of the wire and thus decreased the torque capability.

CONCLUSION

The results showed that the bracket design has less influence on the torquing moment than other parameters, such as bracket width, free wire length, wire/slot play or misalignment.

Bidimensional techniques for stronger anterior torque control in extraction cases: a combined clinical and typodont study

OBJECTIVE

To investigate the capacity of bidimensional techniques for torque control of anterior teeth in extraction cases.

MATERIALS AND METHODS

Two different bidimensional techniques were distinguished by nomenclature as bidimensional-slot (bDS) and bidimensional-wire (bDW), respectively. (1) In the clinical study, patients were randomly assigned to three groups (ie, bDS [n  =  27], bDW [n  =  24], and control [n  =  25] groups). The major inclusion criterion was mild crowding in the upper arch, with the two upper first premolars (teeth 14 and 24) to be extracted. After space closure through standardized treatment, the torque of the upper central incisors (∠TQ _U1) was calculated using the angle formed by the base of the U1 bracket and the working archwire on cephalograms. (2) In the typodont study, a standardized setup of the upper dentition with teeth 14 and 24 extracted was established. The spaces were closed through water bath followed by elastics, using the bDW or the conventional (control) technique, respectively. In six replicate experiments, after space closure, the ∠TQ _U1 was measured on the standardized lateral photographs.

RESULTS

(1) In the clinical study, after space closure, the ∠TQ_U1 was 9.4° ± 3.4° (bDS), 8.3° ± 3.3° (bDW), and 5.8° ± 2.9° (control), respectively. The ∠TQ_U1 of bDS and bDW were both significantly (P < .05) larger than that of the control, but no statistical difference was found between them. (2) In the typodont study, after space closure, the ∠TQ_U1 of bDW (8.5° ± 0.9°) was significantly (P < .01) larger than that of the control (4.9° ± 1.0°).

CONCLUSION

The bDS and the bDW techniques may help enhance anterior torque control in extraction cases.

Mechanical effects of third-order movement in self-ligated brackets by the measurement of torque expression

INTRODUCTION

Axial rotation of orthodontic wire produces buccal or lingual root movement and is often referred to as third-order movement or "torque expression." The objective of this study was to quantify torque expression in 3 self-ligation bracket systems (Damon Q, Ormco, Orange, Calif; In-Ovation R, GAC, Bohemia, NY; and Speed, Strite Industries, Cambridge, Ontario, Canada) during loading and unloading.

METHODS

A stepper motor was used to rotate a wire in a fixed bracket slot from -15° to 63° in 3° increments, and then back to -15°. The bracket was mounted on top of a load cell that measured forces and moments in all directions.

RESULTS

Damon's and In-Ovation's maximum average torque values at 63° were 105 and 113 Nmm, respectively. Many Speed brackets experienced premature loss of torque between 48° and 63°, and the average maximum was 82 Nmm at 54°. The torque plays for Damon, In-Ovation, and Speed were 11.3°, 11.9°, and 10.8°, respectively.

CONCLUSIONS

Generally, In-Ovation expressed the most torque at a given angle of twist, followed by Damon and then Speed. However, there was no significant difference between brackets below 34 Nmm of torque. From a clinical perspective, the torque plays between brackets were virtually indistinguishable.