Biomechanical design and clinical evaluation of a new canine-retraction spring

Use of the sectional arch technique facilitates the creation of an optimal force system fulfilling the biomechanical requirements imperative for planned tooth movements. Controlled canine retraction, usually in extraction cases, requires the creation of a biomechanical system to deliver a predetermined force and a relatively constant moment-to-force ratio in order to avoid distal tipping and rotation. The responsive couple delivered to the anchorage unit should be adjusted in such a way that no single tooth is subjected to unwanted side effects and that undesirable changes in the occlusal plane are avoided. On the basis of a series of theoretical considerations described in the present report, a canine-retraction spring was constructed from 0.016 X 0.022 inch stainless steel wire, the principal element being a double ovoid loop 10 mm in height. A "sweep" bend was incorporated to avoid unwanted side effects at the second premolar. Load deflection and moment/force curves were derived experimentally and demonstrate the ability of the spring to generate and maintain biomechanical conditions necessary for optimal canine retraction (that is, load deflection = 45 gm per millimeter of activation, antitip moment/force ratio of approximately 11:1, and antirotation moment/force ratio of approximately 7:1). The clinical applicability of the spring is demonstrated in the present report by the presentation of two treated cases.     

双槽沟托槽滑动阻力的实验研究

目的 评价模拟尖牙滑动时双槽沟托槽的滑动阻力,探讨临床应用双槽沟托槽的合适牵引力.方法 将粘有托槽的人工尖牙置于硅胶槽内,分别在10g、15g和20g力牵引下沿弓丝滑动.双槽沟托槽组中人工尖牙在双圆丝(直径0.016英寸和0.018英寸)支撑下移动.对照组为常规方丝托槽和方丝(0.016英寸×0.022英寸)组合.通过激光测距仪及相连计算机得到的牙齿移动速率,分析牙齿滑动时所受阻力的大小.结果 牵引力为10g力和15g力时,双槽沟托槽组平均移动速率较小.当牵引力增加到20g力,双槽沟托槽组平均速率大于常规托槽组.结论 在足够牵引力的作用下,双槽沟托槽配合双圆丝(直径0.016英寸和0.018英寸)组合的滑动阻力并不比常规托槽和0.016英寸×0.022英寸方丝组合大.     

Cephalometric evaluation of open bite treatment with NiTi arch wires and anterior elastics.

The aim of this study was to evaluate cephalometrically the effects of open bite treatment with NiTi arch wires and anterior elastics. The study group comprised of 17 patients who displayed a high angle skeletal pattern, along with an anterior open bite. After initial leveling, 0.016 x 0.022 inch upper accentuated-curve and lower reverse-curve arch wires were placed, with anterior elastics applied in the canine regions. Cephalometric assessment was carried out on lateral head films taken at the beginning of treatment and on average 2.8 months after open bite closure was obtained. The results of this study indicated that open bite closure had been achieved mainly by extrusion of the lower incisors and uprighting of the upper incisors. The functional occlusal plane was leveled by extrusion of lower premolars and uprighting of lower molars. Lateral cephalograms obtained from 10 patients who had been available after 1 year postretention were used to evaluate relapse changes. During the follow-up period, position of the upper and lower incisors and the inclination of the occlusal plane were maintained. However, extrusion of upper and lower molar teeth resulted in a reduction in overbite.     

Intrabracket space and interbracket distance: critical factors in clinical orthodontics

The engineers who designed the Houston Astrodome, Walter Moore and Associates, were engaged to study the effect that different edgewise appliances have on the function of orthodontic beams or wires. They were supplied with tooth width, bracket width, wire size, slot size information, and stainless steel wire specifications. With these data their computer was programmed to model each appliance as a simple beam reflecting its different support conditions. In the study the 0.018, 0.022, and 0.016-inch traditionally slotted appliances were tested in single and twin brackets. In addition the 0.016-inch bimetric appliance (0.016 inch on anterior teeth, 0.022 inch on posterior teeth) was tested. The following wires were used for testing: 0.016 x 0.022 inch, 0.017 x 0.022 inch, 0.018 x 0.025 inch (0.018 inch); 0.018 x 0.025 inch, 0.019 x 0.025 inch, 0.022 x 0.028 inch (0.022 inch); 0.014 x 0.018 inch, 0.015 x 0.019 inch, 0.016 x 0.022 inch (0.016 inch and bimetric). The results as stated in the conclusion statement by Rick Horn, PhD, of Walter Moore and Associates, are (1) for a given appliance and wire size, the amount of deflection allowable at permanent set decreases with decreasing size of teeth; (2) for a given appliance and wire size, the force imparted to the teeth at permanent set increases with decreasing size of teeth; (3) for a given appliance, the amount of deflection at permanent set decreases with increasing wire size; (4) for a given appliance, the force imparted to the teeth at permanent set increases with increasing wire size; (5) the amount of deflection allowable at permanent set is larger for single brackets than double brackets and larger for bimetric brackets than single brackets; (6) the force imparted to the teeth at permanent set is smaller for single brackets than double brackets and smaller for bimetric brackets than single brackets; and (7) of the six types of appliances examined, the bimetric appliance is the most flexible, allowing the most deflection at permanent set with the smallest force imparted to the teeth. This study supports the following thesis: the only way to take advantage of smaller wires and thereby have an appliance deliver maximum resiliency with lighter forces and not loose control is through differential slot sizing.     

外展曲与支抗磨牙所受舌向力的关系

目的　观察拉尖牙向远中移动时 ,在不同规格的弓丝作用下 ,牵引力对支抗磨牙所产生的舌向分力的大小以及在不同磨牙外展曲宽度下该牵引力舌向分力的大小。方法　利用与北京大学力学系合作研制的力测量仪在Typodont专用蜡上测量使用不同规格、不同刚度的弓丝 [0 4 0mm、0 4 5mm的不锈钢圆丝 ,0 4 0mm、0 4 5mm的澳丝以及 0 4 1mm× 0 5 6mm (0 0 16英寸× 0 0 2 2英寸 )、0 4 6mm× 0 6 3mm(0 0 17英寸× 0 0 2 5英寸 )的不锈钢方丝 ],分别在不同的磨牙外展曲宽度 (1mm、2mm、3mm)下 ,支抗磨牙受到的 15 0 g沿磨牙颊面管牵引钩至尖牙托槽远中翼中点方向的拉尖牙向远中移动力所产生的舌向分力。结果　 (1) 15 0 g拉尖牙向远中移动力会使支抗磨牙受到舌向分力。 (2 )支抗磨牙受到的牵引力的舌向分力随弓丝粗度和刚度的增加而减少 ,弓丝抵抗磨牙所受到的舌侧力作用与弓丝的刚度、粗度成正比。 (3)支抗磨牙受到的牵引力的舌向分力随磨牙外展曲宽度的增加而减少且二者间呈线性关系。结论　拉尖牙向远中移动时支抗磨牙受到舌向分力 ,为避免磨牙向舌侧移动 ,应选择较大刚度且较粗的弓丝或适当加大磨牙外展曲。     

Early detection and prevention of mandibular tooth transposition

Distal migration of the mandibular permanent lateral incisor happens rarely and it can be discovered radiographically in the early mixed dentition. If unattended, the tooth may erupt ectopically, usually distal to its normal anatomical position and occlusal to the developing first premolar, and it can become transposed with the permanent canine. Early detection and immediate interceptive removal of the retained deciduous lateral incisor and canine, followed by uprighting the ectopic lateral incisor to its normal anatomical position in the arch, will intercept the problem and prevent the developing transposition.     

Finite element analysis of stresses on adjacent teeth during the traction of palatally impacted canines

Objective:To evaluate stresses on maxillary teeth during alignment of a palatally impacted canine (PIC) under different loading conditions with forces applied in vertical and buccal directions.Materials and Methods:A three-dimensional finite element model of the maxilla was developed from a cone beam computed tomographic scan of a patient with a left PIC. Traction was simulated under different setups: (1) palatal spring extending from a transpalatal bar (TPB) anchored on the first molars (M1) and alternatively combined with different archwires (0.016 × 0.022-inch; 0.018 × 0.025-inch) with and without engaging second molars and (2) a buccal force against 0.018-inch, 0.016 × 0.022-inch, and 0.018 × 0.025-inch archwires with and without engaging the left lateral incisor (I2).Results:Without fixed appliances, stresses were assumed by M1; with fixed appliances, stresses were distributed on all teeth, decreasing mesially toward the midline. Direct buccal pull exerted most stress on neighboring I2 (19–20% with different wire sizes) and first premolar (12–17%), decreasing distally, along a similar pattern with different archwire sizes. When I2 was bypassed, stresses on adjacent teeth increased only by 3–6%. Higher stresses occurred with the lighter round wire.Conclusions:This first research on stresses on adjacent teeth during PIC traction provided needed quantitative data on the pattern of stress generation, suggesting the following clinical implications: use of distal-vertical pull from posterior anchorage (TPB) as initial movement and when using a buccal force, bypassing the lateral incisor and using heavier wires that would minimize side effects.     

Frictional changes in force values caused by saliva substitution

The objective of this study was to determine the magnitude of frictional force changes between several sizes of stainless steel orthodontic wires (0.018 inch round, 0.020 inch round, and 0.018 X 0.025 inch rectangular) and an edgewise bracket (0.022 X 0.028 inch slot) when an artificial saliva medium was introduced. The wires were secured in the bracket slots with a 0.010 inch polyurethane ligatures. The force values in the saliva substitute medium were compared with those produced in a dry control and in glycerin. Clinically significant differences among the environmental conditions and among the wire sizes were found. The introduction of saliva substitute provides a significant reduction in force values.     

Mechanical properties of several nickel-titanium alloy wires in three-point bending tests.

The purpose of this study was to clarify the mechanical properties of 42 brands of nickel-titanium alloy orthodontic wires from 9 manufacturers by conducting three-point bending tests under uniform testing conditions. Manufacturers included A-Company, Hoya Medical, Lancer, Ormco, Rocky Mountain, Sankin, Tomy (GAC), TP, and 3M/Unitek. Cobalt-chrome, and titanium-molybdenum alloy wires were also tested as a reference for comparison of force levels. All reported data were recorded during the unloading process to simulate the force that a wire exerts on a tooth as it is moved into the dental arch from a position of malocclusion. The following results were obtained for the nickel-titanium wires tested. (1) Among the 0.016 inch round wires tested under a maximum deflection of 1.5 mm, the difference between the smallest (Copper nickel-titanium 35) and the largest (Aline) load values was 136 g. For the 0.016 x 0.022 inch rectangular wires tested, the difference between the smallest (Copper nickel-titanium 40) and the largest (Aline) load values was 337 g. (2) The change in load between 1.5 and 0.5 mm of deflection was examined to clarify the superelastic properties of the wires tested. For the 0.016 inch wires, 17 wire brands produced a load difference of less than 100 g, and two brands produced a difference of at least 100 g (Aline and Titanal = 100 g). For the 0.016 x 0.022 inch wires, 15 brands produced a load difference of less than 100 g, and eight brands produced a difference of over 100 g. The smallest and largest load differences were 3 g (Copper nickel-titanium 35) and 200 g (Aline). (3) The majority of the samples with a smaller load difference between deflections of 1.5 mm and 0.5 mm in the unloading process were found among super-elastic wires, while samples with a larger load difference were predominantly found among work-hardened wires. Compared with cobalt-chrome and TMA wires, nickel-titanium alloy wires exert significantly less force. However, the amount of force varies greatly from brand to brand. Consequently, when using nickel-titanium alloy wires, brands must be selected carefully by taking into consideration the severity of the malocclusion and the stage of orthodontic treatment in each case. It is the intent of this study to offer clinicians an unbiased guide for the selection of appropriate nickel-titanium alloy wires.     

An in vitro investigation of the influence of self-ligating brackets, low friction ligatures, and archwire on frictional resistance

This study, performed using a specially designed apparatus that included 10 aligned brackets, evaluated the frictional resistance generated by conventional stainless steel (SS) brackets (Victory Series), self-ligating Damon SL II brackets, Time Plus brackets, and low-friction ligatures (Slide) coupled with various SS, nickel-titanium (NiTi), and beta-titanium (TMA) archwires. All brackets had a 0.022-inch slot and the orthodontic wire alloys were 0.016, 0.016 x 0.022, and 0.019 x 0.025 inch NiTi, 0.017 x 0.025 inch TMA, and 0.019 x 0.025 inch SS. Each bracket-archwire combination was tested 10 times. Coupled with 0.016 inch NiTi, Victory brackets generated the most friction and Damon SL II the least (P < 0.001); with 0.016 x 0.022 inch NiTi, the self-ligating brackets (Time and Damon SL II) generated significantly lower friction (P < 0.001) than Victory Series and Slide ligatures; with 0.019 x 0.025 inch SS or 0.019 x 0.025 inch NiTi, Slide ligatures generated significantly lower friction than all other groups. No difference was observed among the four groups when used with a 0.017 x 0.025-inch TMA archwire. These findings suggest that the use of an in vitro testing model that includes 10 brackets provides information about the frictional force of the various bracket-archwire combinations.     

Frictional forces between bracket and arch wire

Guiding a tooth along an arch wire results in a counteracting frictional force. Clinically, a mesiodistally applied force must exceed the frictional force to produce a tooth movement. A friction-testing assembly simulating three-dimensional tooth rotations was constructed to study factors affecting friction magnitude. Five wire alloys (standard stainless steel, Hi-T stainless steel, Elgiloy blue, nitinol, and TMA) in five wire sizes (0.016, 0.016 x 0.022, 0.017 x 0.025, 0.018, and 0.018 x 0.025 inch) were examined with respect to three bracket widths (2.2, 3.3, and 4.2 mm) at four levels of retarding force (0, 1, 2, and 3 N). The following factors affected friction in decreasing order: retarding force (biologic resistance), surface roughness of wire, wire size (vertical dimension), bracket width, and elastic properties of wire. The study recommends the application of 0.016 x 0.022 inch stainless steel wire combined with a medium (3.3 mm) or wide (4.2 mm) bracket for an arch-guided mechanism with an 0.018 inch slot. The effective force of this arrangement has to increase twofold to overcome the friction. For TMA wire, however, the effective force must increase sixfold, resulting in a hazardous overload of the anchorage units.     

Experimental force definition system for a new orthodontic retraction spring

A new geometry of orthodontic retraction spring was experimentally studied through an electronic device (platform for measuring forces), using strain gauges that were adapted to cantilever beams. The sample consisted of 36 titanium-molybdenum springs, divided into three groups of 12 springs each. The springs were produced with different cross sections of 0.016 x 0.022 inch and 0.017 x 0.025 inch and with different angles between the extremities (120 degrees and 130 degrees). The springs were adapted to the platform in three different positions so that the force system developed by them could be known (horizontal forces, vertical forces, alpha-beta moments, and moment-to-force ratio M:F). The analysis of factorial variance and the Tukey honestly significant difference test were applied to verify the differences between the averages caused by three possible variation sources and the interactions between them. Regression analysis was also performed to obtain the spring rate. The results show the interactions between the three geometric variables, force magnitudes, and also the spring rates, which are compatible with the ones mentioned in the literature related to the subject. The spring rate was within the levels that are appropriate for clinical use (varying from beta = 33.1 gf/mm to beta = 43.9 gf/mm).     

Expanding the horizons of the edgewise arch wire slot

The purpose of this article is to introduce an edgewise-type bracket that permits both initial Begg tooth movement and final edgewise torque and tip control with straight arch wires. Analysis of individual tooth movements during treatment of all types of malocclusions with the Begg technique shows that all teeth tend to tip distally or toward extraction sites if present. Given this tendency, it is possible through precise removal of diagonally opposed corners of conventional edgewise slots to permit desired initial free crown tipping yet provide predetermined secondary control of root uprighting as required for each tooth. Treatment can be carried out with four straight arch wires, two 0.016 inch (0.406 mm) and two 0.020 inch (0.508 mm), in conjunction with selective applications of 2 ounce (57 g) forces. Mesiodistal root uprighting and labiolingual torque are achieved with uprighting springs and torquing auxiliaries. Special elastomeric ties and torquing flaps in conjunction with the unique brackets and round molar tubes provide the final option to capture all preangulations (tip and torque) from two full-sized, highly resilient rectangular arch wires.     

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目的采用三维有限元法模拟不同方向牵引力内收上前牙,分析前牙位移趋势及应力分布,为临床治疗提供指导。方法研究于2012年在福建医科大学进行。建立唇侧直丝弓矫治器、6个上前牙及其牙周膜和前颌骨的三维有限元模型。模拟在0.48 mm×0.64 mm英寸主弓丝上,以种植钉为支抗、1.47 N矫治力整体内收上前牙,设定前牙区牵引钩为0-6 mm、后牙区种植钉高度分别为8和14 mm。加载后求解,计算出各前牙的位移及牙周膜第一主应力。结果滑动法整体内收上前牙时,牵引钩长度主要影响前牙的矢状向位移方式：牵引钩长度增加至6 mm的过程中,侧切牙在唇舌向上由舌向倾斜运动变为舌向整体平移和舌向控根运动外,中切牙和尖牙的三维位移只有数量的增大,趋势基本保持不变。支抗种植钉高度主要影响前牙垂直向位移：种植钉位置越高,侧切牙的压低位移增大,尖牙的伸长位移减小,即前牙整体压低的趋势更明显。结论种植支抗整体内收前牙时,单纯调整牵引钩长度和支抗种植钉高度难以实现前牙段的整体内收,有必要对前牙段增加适当的垂直向压低力量。     

不同陶瓷托槽与金属弓丝间摩擦力的研究

目的 研究不同类型陶瓷托槽与金属弓丝间的摩擦力,为临床应用及研制摩擦性能优良的陶瓷托槽提供参考.方法 选取正畸临床上常用的三种陶瓷托槽作为研究对象,一种金属托槽作为对照组.利用MTSTytron250微力实验机检测托槽与三种金属弓丝在不锈钢丝结扎下的最大静摩擦力和平均动摩擦力.结果 金属托槽与不锈钢圆丝间的最大静摩...     

Application of the orthodontic measurement and simulation system (OMSS) in orthodontics

An orthodontic measurement and simulation system (OMSS) is introduced. The major component of the system consists of two force-moment sensors capable of measuring forces and moments in all three planes of space simultaneously. The two sensors are mounted on motor-driven positioning tables with full three-dimensional mobility. All mechanical components are built in a temperature-controlled chamber. A control programme executed by a personal computer performs various types of measurement which can be classified as absolute measurements (e.g. force-deflection diagrams) and simulations of orthodontic tooth movement. By using the OMSS any orthodontic problem at the level of a two-tooth model can be analysed statically and dynamically. Besides other applications, the study evaluates three mechanical systems available for uprighting molars, namely a straight wire, a conventional uprighting spring, and a modified Burstone uprighting spring. It was found that the force systems produced by the straight wire and by the conventional uprighting spring showed a severe extrusive force component which may lead to occlusal trauma. The uprighting performance of the straight wire was inadequate. The conventional uprighting spring produced a large uprighting moment (17.8 Nmm), but also a strong lingual tipping moment (1.5 Nmm). The modified Burstone loop showed the best static and dynamic performance. It produced a force system with substantial uprighting moments in both the sagittal (11.6 Nmm) and frontal plane (4.2 Nmm). A slight intrusive force (0.09 N) might prevent the development of occlusal trauma during treatment. However, concern should be addressed to the fact that intra-oral adjustment of this uprighting spring is difficult because of its high susceptibility to minor modifications of its geometry.     

利用压低辅弓增加后牙支抗的生物力学研究

目的确定远中移动尖牙时,使用压低辅弓增加后牙支抗的最适后倾弯角度。方法按照Burstone方法弯制0．017×0．025英寸（1英寸-2．54cm）伊钛丝（TMA）的压低辅弓,主弓丝采用0．016×0．016英寸不锈钢丝,拉尖牙远中移动的拉簧为150g力。设计后倾弯分别为20°、30°、40°,采用口外正畸模拟生物力学检测系统（OrthodonticMeasurementandSimulationSystem,（）Mss）模拟临床加力,分别测量三维状态下切牙段、尖牙段和后牙段受力和力矩情况。结果尖牙远移过程中,无压低辅弓时,尖牙远中移动并倾斜,磨牙近中倾斜10°;压低辅弓的后倾弯为20°时,尖牙远中移动并倾斜,磨牙近中倾斜5°;后倾弯为30°时,尖牙远中移动基本保持直立,磨牙远中倾斜5°;后倾弯为10。时,尖牙远中移动有压低倾向,磨牙远中倾斜超过10°。结论尖牙远中移动时,弯制有30。后倾弯的乐低辅弓既能够增加后牙专精．又不影响前牙的覆[牙合]覆盖。     

Initial effect of multiloop edgewise archwire on the mandibular dentition in Class III malocclusion subjects. A three-dimensional finite element study

The purpose of this study was to compare the effect of a multiloop edgewise archwire (MEAW) with a plain ideal archwire (IA) on distal en masse movement of the mandibular dentition. A three-dimensional finite element model (3D FEM) of the mandibular dentition, without third permanent molars, was constructed to include the periodontal membrane (PDM), alveolar bone, standard edgewise bracket (0.018 x 0.025 inch), stainless steel IA (0.016 x 0.022 inch), and MEAW (0.016 x 0.022 inch). Stress distribution and displacement of the mandibular dentition were analyzed when Class III intermaxillary elastics (300 g/side) and 5 degree tip-back bends from the first premolar to the second molar were applied to the IA and the MEAW for distal en masse movement of the mandibular dentition. Compared with the IA, the discrepancy in the amount of tooth displacement was less and individual tooth movement with the MEAW was more uniform and balanced. There was minimal vertical displacement or rotation of the teeth with the MEAW when compared with the IA. The MEAW seems to have advantages for distal en masse movement of the mandibular dentition.     

Forces in the presence of ceramic versus stainless steel brackets with unconventional vs conventional ligatures

OBJECTIVE: To compare the forces resulting from four types of bracket/ligature combinations: ceramic brackets and stainless steel brackets combined with unconventional elastomeric ligatures (UEL) and conventional elastomeric ligatures (CEL) during the leveling and aligning phases of orthodontic therapy. MATERIALS AND METHODS: The testing model consisted of five 0.022-inch preadjusted brackets (second premolar, first premolar, canine, lateral incisor, and central incisor) for each of the two bracket types. The canine bracket was welded to a sliding bar that allowed for different amounts of offset in the gingival direction. The forces generated by a 0.014-inch superelastic nickel titanium wire in the presence of either the UEL or CEL bracket/ligature systems at different amounts of upward canine misalignment (1.5 mm, 3 mm, 4.5 mm, and 6 mm) were recorded. RESULTS: Significant differences were found between UEL and CEL systems for all tested variables (P < .01) with the exception of the canine misalignment of 1.5 mm. The average amount of recorded force in the presence of CEL was negligible with 3.0 mm or greater of canine misalignment. On the contrary, during alignment, a force available for tooth movement was recorded in the presence of both ceramic and stainless steel brackets when associated with UEL. CONCLUSIONS: The type of ligature used influenced the actual amount of force released by the orthodontic system significantly more than the type of bracket used (stainless steel vs ceramic).     

Three-dimensional finite element analysis in distal en masse movement of the maxillary dentition with the multiloop edgewise archwire

The purpose of this study was to compare the effects of a multiloop edgewise archwire (MEAW) on distal en masse movement with a continuous plain ideal archwire (IA). Three-dimensional finite element models (FEM) of the maxillary dentition in which the second permanent molars had been extracted were constructed to include the periodontal membrane, alveolar bone, standard edgewise bracket (0.018 x 0.025 inch), stainless steel IA (0.016 x 0.022 inch), and MEAW (0.016 x 0.022 inch). The stress distribution and displacement of the maxillary dentition were analysed when Class II intermaxillary elastics (300 g/side) and 5 degree tip-back bends were applied to the IA and MEAW for distal en masse movement of the maxillary dentition. Compared with the IA, the MEAW showed that the discrepancy in the amount of tooth displacement was lower and individual tooth movement was more uniform and balanced. There was minimal vertical displacement or rotation of the teeth using the MEAW when compared with the IA. The MEAW seems to have advantages for distal en masse movement of the maxillary dentition.