The Effect of Symmetric and Asymmetric Loading of Frontal Segment with Two Curved Cantilevers: An In Vitro Study

Cantilevers: Multi-Tool in Orthodontic Treatment

This review aims to discuss and illustrate various uses of cantilevers to solve multiple clinical issues and prove their versatility. Cantilevers are commonly used in the segmented arch technique, and they can be designed to solve various clinical problems with highly predictable results. Its design and shape can modify the various combinations of vertical and horizontal forces. The novel trend is to combine cantilevers with skeletal anchorage. Cantilevers offer a very simple and statically determined force system. The advantage is the control over side effects, which normally occur on the anchor teeth and the occlusion. The disadvantages include possible side effects on the anchorage unit, when the anchorage is poorly controlled. The review highlights the clear benefits of cantilever use in complex corrections of single teeth, segments, and entire arch with a diminished effect on the dentition, also with the use of skeletal anchorage. With their simple and easily tailored design, these springs can be called an orthodontic multi-tool.

Force Systems Produced by Different Cantilever Configurations during Deactivation

Intrusion with a three-piece arch is routinely achieved during orthodontic treatment. This study aimed to experimentally determine how the cantilever design influences the generated force system. Both straight and arch-formed cantilever designs: tip-back (TB), flat curve (FC) deep curve (DC), and 3 mm and 6 mm high utility arch (UA3; UA6) were activated for 5 mm and 10 mm. Force systems were determined by a hexapod. Typodonts simulating a three piece-intrusion arch were scanned using an intraoral scanner (3Shape, TRIOS, Denmark) before (T0) and after (T1) the experiment and superimposed with Mimics software (Materialise, Leuven, Belgium). Data were analyzed. All straight designs displayed an extrusive force in the vertical plane, and all arch-formed an intrusive force. DC and TB showed a retrusive force in the sagittal plane and UA6 a protrusive. For the medial/lateral forces, DC and TB displayed a medial, and UA6 a lateral force. Configurations can be distinctively ranked from DC, FC, TB to UA3, and UA6 according to the increasing protrusive nature of the generated sagittal forces. A DC or TB configuration should be used for intrusion and retraction, while for an intrusion and a protrusion, a UA6 configuration. All straight configurations showed a higher force level than the arch-formed configurations.