Influence of second-order bracket-archwire misalignments on loads generated during third-order archwire rotation in orthodontic treatment

Research paper: The three-dimensional mechanical response of orthodontic archwires and brackets in vitro during simulated orthodontic torque

Orthodontic archwire rotation around its long axis, known as third-order torque, is utilised to correct tooth rotational misalignments moving the tooth root closer to or away from the cheek through engagement with an orthodontic bracket. Studying the behaviour of archwire and brackets during an applied rotation can aid in better understanding and appreciating the mechanics of third-order torque, potentially allowing for more effective orthodontic treatment protocols. Mechanically characterising archwire behaviour during third-order torque application is a complex task due to their physical scale and geometries. An advanced measurement technique was needed to address these constraints. A three-dimensional (3D) non-contact optical method using a digital image correlation (DIC) system was developed. An orthodontic torque simulator (OTS) was used to apply and measure third-order torque with 0.483 × 0.635 mm (0.019″ x 0.025″) rectangular archwires in tandem with a 3D DIC system, whereby surface deformations and strains could be computed using correlation algorithms. The 3D DIC system was implemented to enable third-order torque experimentation with the OTS while imaging the archwire and bracket surfaces. The 3D DIC system's ability to measure 3D archwire deformations and strains was verified using a finite element model, where comparisons between 3D DIC measurements and calculated results from the model were made to ensure the measurement capabilities of 3D DIC in the context of third-order torque. The 3D DIC system was then used to compare archwire behaviour between stainless steel (SS) and titanium molybdenum alloy (TMA) archwires to study potential clinical differences in archwire behaviour, in which the archwires were rotated with a custom SS rigid dowel (RD) as well as commercial Damon Q orthodontic brackets. The quantification of third-order torque and archwire deformations and strains led to the conclusion that SS archwires led to larger torque magnitudes compared to TMA archwires. The RD resulted in larger archwire strains compared to Damon Q brackets. The 3D DIC system provides a non-contact measurement technique that can further be used with third-order torque experimentation with the OTS.

Torque expression by active and passive self-ligating brackets in patients with four premolar extractions: A retrospective study

OBJECTIVE

Appropriate torque expression contributes to ideal treatment outcomes both clinically and aesthetically. Whether active and passive self-ligating brackets (SLBs) have different torque-control capability in vivo has never been reported. The purpose of present study was to explore whether there was difference in torque expression in active and passive SLBs.

SETTING AND SAMPLE POPULATION

In this retrospective study, 225 patients with four first premolar extractions were enrolled. For each patient, the digital lateral cephalometric radiographs were taken before and after treatment.

MATERIALS AND METHODS

The study consisted of 2 groups: 111 subjects were treated with passive SLBs (Damon Q, Ormco) and 114 subjects with active SLBs (Empower 2, American Orthodontics). Measurements to determine skeletal changes and incisor inclination were obtained from cephalometric tracings using Dolphin software (version 11.8, USA). Comparisons in both groups and intergroups were compared using t tests and chi-square test.

RESULTS

Significant differences in the variation of U1-SN(°), U1-NA(°), L1-NB(°) and L1-FH(°) were found between two groups. More labially inclined maxillary incisors were found in active SLB group, while more labially inclined mandibular incisors were observed in passive SLB group.

CONCLUSIONS

With the present prescription set in the two brackets, active SLBs achieved more proclined maxillary incisors and retroclined mandibular incisors. Clinicians should take torque expression of brackets into consideration during orthodontic treatment.

The effect of buccal-lingual slot dimension size on third-order torque response

Introduction

The focus of the presented study was to investigate the effect of buccal-lingual (B-L) orthodontic bracket slot dimension on third-order torque mechanics.

Materials and methods

Three types of orthodontic brackets and two archwire sizes were considered. Ortho Classic H4 (0.026″ B-L slot, passive), Ormco Damon Q (0.028″ B-L slot, passive), and In-Ovation R (0.028″ slot, active) brackets were tested using 0.017″ × 0.025″ and 0.019″ × 0.025″ beta-titanium archwires. An in vitro orthodontic torque simulator (OTS) was used to rotate archwires relative to a single bracket while recording forces and moments in three directions. For each bracket-archwire combination, a total of n = 47 samples were tested. Repeated measures analysis of variance between brackets was conducted for third-order torque values at 3° increments between 9° and 30° during loading and unloading for each archwire size.

Results

Statistically significant differences between H4 and Q brackets were only found for 0.017″ × 0.025″ archwires during loading, and 0.019″ × 0.025″ archwires during unloading. Conversely, differences between H4 and R brackets were found for both archwires during loading and unloading phases. Finally, when using a 0.017″ × 0.025″ archwire the H4 brackets reached the 5 Nmm threshold before R and Q brackets; however, there was little difference found when using a 0.019″ × 0.025″ archwire.

Conclusions

The concept of using a smaller B-L bracket slot dimension in orthodontic treatment showed it may theoretically allow for more options, primarily using smaller archwires to correct third-order rotational misalignments. However, it is suspected that bracket material limitations and added loading on the door currently prevent this from being clinically applicable.