Dimensional accuracy of ceramic self-ligating brackets and estimates of theoretical torsional play

Objective:To ascertain the dimensional accuracies of some commonly used ceramic self-ligation brackets and the amount of torsional play in various bracket–archwire combinations.Materials and Methods:Four types of 0.022-inch slot ceramic self-ligating brackets (upper right central incisor), three types of 0.018-inch ceramic self-ligating brackets (upper right central incisor), and three types of rectangular archwires (0.016 × 0.022-inch beta-titanium [TMA] (Ormco, Orange, Calif), 0.016 × 0.022-inch stainless steel [SS] (Ortho Technology, Tampa, Fla), and 0.019 × 0.025-inch SS (Ortho Technology)) were measured using a stereomicroscope to determine slot widths and wire cross-sectional dimensions. The mean acquired dimensions of the brackets and wires were applied to an equation devised by Meling to estimate torsional play angle (γ).Results:In all bracket systems, the slot tops were significantly wider than the slot bases (P < .001), yielding a divergent slot profile. Clarity-SLs (3M Unitek, Monrovia, Calif) showed the greatest divergence among the 0.022-inch brackets, and Clippy-Cs (Tomy, Futaba, Fukushima, Japan) among the 0.018-inch brackets. The Damon Clear (Ormco) bracket had the smallest dimensional error (0.542%), whereas the 0.022-inch Empower Clear (American Orthodontics, Sheboygan, Wis) bracket had the largest (3.585%).Conclusions:The largest amount of theoretical play is observed using the Empower Clear (American Orthodontics) 0.022-inch bracket combined with the 0.016 × 0.022-inch TMA wire (Ormco), whereas the least amount occurs using the 0.018 Clippy-C (Tomy) combined with 0.016 × 0.022-inch SS wire (Ortho Technology).     

A new elastic slot system and V-wire mechanics

Objective:To biomechanically test a new elastic slot system and V-wire mechanics.Materials and Methods:Conventional twin and self-ligating brackets and the new elastodynamic bracket were biomechanically tested. The conventional brackets had a rectangular 0.022′′ slot and the new elastodynamic bracket had a V-slot, a new slot geometry. Torque measurements were performed with 0.018′′ × 0.025′′ and 0.019′′ × 0.025′′ stainless steel (ss) archwires. A nickel-titanium V wire was used for the biomechanical measurements on the elastodynamic bracket. The measurements were done with the aid of a six-component measuring sensor.Results:The results of the biomechanical testing revealed play in the brackets with rectangular slot geometry. The V slot in the elastodynamic bracket assured that the wire fit perfectly in the slot. Dynamic moments of 5 to 10 Nmm were transmitted without any play. No permanent deformation of the slot occurred in the new elastodynamic bracket because of the elastic slot.Conclusion:Control of torque for three-dimensional positioning of the teeth in the dental arch with rectangular slot geometry as used in straight-wire therapy is difficult. If torque is bent into the wire, because of the play there is a high risk that either too much, too little, or no moment is transmitted to the teeth. The V-slot archwire/bracket geometry in conjunction with nickel titanium composition has no play and allows a reduction of forces and moments with direct and continuous transmission of torque in the bracket. Because of the elasticity of the bracket, there is an upper limit to the moment possible.     

Evaluation of torque moment in esthetic brackets from bendable alloy wires

ObjectivesTo examine the torque moment that occurs between esthetic brackets and bendable alloy (stainless steel [SS], titanium-molybdenum [Ti-Mo], and titanium-niobium [Ti-Nb]) wires.Materials and MethodsThis study examined ceramic (CR), zirconium oxide (ZC), polycarbonate (PC), and conventional metallic brackets (MT) (upper, 0.018-inch and 0.022-inch slots) combined with SS, Ti-Mo, and Ti-Nb wires using elastic module ligation. The torque moments delivered by various wire and bracket combinations were measured using a torque gauge apparatus. The wire torque angles at 5–40° were examined.ResultsThe torque value increased in the order of CR, ZC, MT, and PC brackets for both 0.018-inch and 0.022-inch slots. The fracture points of the CR and ZC brackets combined with SS and Ti-Mo wires were approximately more than 30° and 35°, respectively. No fracture points were detected in the combination of ZC brackets and Ti-Nb wires.ConclusionsThe current study identified the material characteristics of CR, ZR, and PC brackets during torque tooth movements. The present results demonstrate a characteristic combined effect between different esthetic brackets and bendable alloy wires.     

Torque Expression in Stainless Steel Orthodontic Brackets: A Systematic Review

Objective:To evaluate the quantitative effects on torque expression of varying the slot size of stainless steel orthodontic brackets and the dimension of stainless steel wire, and to analyze the limitations of the experimental methods used.Materials and Methods:In vitro studies measuring torque expression in conventional and self-ligating stainless steel brackets with a torque-measuring device, with the use of straight stainless steel orthodontic wire without second-order mechanics and without loops, coils, or auxiliary wires, were sought through a systematic review process.Results:Eleven articles were selected. Direct comparison of different studies was limited by differences in the measuring devices used and in the parameters measured. On the basis of the selected studies, in a 0.018 inch stainless steel bracket slot, the engagement angle ranges from 31 degrees with a 0.016 × 0.016 inch stainless steel archwire to 4.6 degrees with a 0.018 × 0.025 inch stainless steel archwire. In a 0.022 inch stainless steel bracket slot, the engagement angle ranges from 18 degrees with a 0.018 × 0.025 inch stainless steel archwire to 6 degrees with a 0.021 × 0.025 inch stainless steel archwire. Active stainless steel self-ligating brackets demonstrate an engagement angle of approximately 7.5 degrees, whereas passive stainless steel self-ligating brackets show an engagement angle of approximately 14 degrees with 0.019 × 0.025 inch stainless steel wire in a 0.022 inch slot.Conclusions:The engagement angle depends on archwire dimension and edge shape, as well as on bracket slot dimension, and is variable and larger than published theoretical values. Clinically effective torque can be achieved in a 0.022 inch bracket slot with archwire torsion of 15 to 31 degrees for active self-ligating brackets and of 23 to 35 degrees for passive self-ligating brackets with a 0.019 × 0.025 inch stainless steel wire.     

Debris,Roughness and Friction of Stainless Steel Archwires Following Clinical Use

Objective:To investigate the degree of debris, roughness, and friction of stainless steel orthodontic archwires before and after clinical use.Materials and Methods:For eight individuals, two sets of three brackets (n  =  16) each were bonded from the first molar to the first premolar. A passive segment of 0.019- × 0.025-inch stainless steel archwire was inserted into the brackets and tied by elastomeric ligature. Debris level (via scanning electron microscopy), roughness, and frictional force were evaluated as-received and after 8 weeks of intraoral exposure. Mann-Whitney, Wilcoxon signed-rank, and Spearman correlation tests were used for statistical analysis at the .05 level of significance.Results:There were significant increases in the level of debris (P  =  .0004), roughness of orthodontic wires (P  =  .002), and friction (P  =  .0001) after intraoral exposure. Significant positive correlations (P < .05) were observed between these three variables.Conclusion:Stainless steel rectangular wires, when exposed to the intraoral environment for 8 weeks, showed a significant increase in the degree of debris and surface roughness, causing an increase in friction between the wire and bracket during the mechanics of sliding.     

Influence of bracket-slot design on the forces released by superelastic nickel-titanium alignment wires in different deflection configurations

Objective:To evaluate how different bracket-slot design characteristics affect the forces released by superelastic nickel-titanium (NiTi) alignment wires at different amounts of wire deflection.Materials and Methods:A three-bracket bending and a classic-three point bending testing apparatus were used to investigate the load-deflection properties of one superelastic 0.014-inch NiTi alignment wire in different experimental conditions. The selected NiTi archwire was tested in association with three bracket systems: (1) conventional twin brackets with a 0.018-inch slot, (2) a self-ligating bracket with a 0.018-inch slot, and (3) a self-ligating bracket with a 0.022-inch slot. Wire specimens were deflected at 2 mm and 4 mm.Results:Use of a 0.018-inch slot bracket system, in comparison with use of a 0.022-inch system, increases the force exerted by the superelastic NiTi wires at a 2-mm deflection. Use of a self-ligating bracket system increases the force released by NiTi wires in comparison with the conventional ligated bracket system. NiTi wires deflected to a different maximum deflection (2 mm and 4 mm) release different forces at the same unloading data point (1.5 mm).Conclusion:Bracket design, type of experimental test, and amount of wire deflection significantly affected the amount of forces released by superelastic NiTi wires (P < .05). This phenomenon offers clinicians the possibility to manipulate the wire''s load during alignment.     

Effects of bracket design on critical contact angle

Objective:To explore how the position of the bracket slots relative to the archwire influences the friction between them, and how bracket design affects the critical contact angle (θc).Materials and Methods:Two kinds of stainless steel archwires (0.016 and 0.019 × 0.025-inch) were tested against four kinds of brackets (Transmission Straight Archwire bracket, Domestic MBT bracket, Tip-Edge Plus bracket, and BioQuick self-ligation bracket) in the dry state. Resistance to sliding (RS) was measured as an increase in contact angle (θ). The value of θc was calculated by two linear regression lines.Results:Friction remained stable when θ < θc, then increased linearly when θ > θc. The θc values of the Tip-Edge Plus bracket and Transmission Straight Archwire bracket were significantly larger than those for the Domestic MBT bracket and BioQuick self-ligation bracket.Conclusions:The relationship between the archwire and bracket slot significantly affects the resistance to sliding. The “edge-off” structure of the Tip-Edge Plus bracket and Transmission Straight Archwire bracket could help to increase the θc value, and to expand the passive configuration range.     

The effect of water storage on the bending properties of esthetic,fiber-reinforced composite orthodontic archwires

Objective:To study the effect of water storage on the bending properties of fiber-reinforced composite archwires and compare it to nickel-titanium (NiTi), stainless steel (SS), and beta-titanium archwires.Materials and Methods:Align A, B, and C and TorQ A and B composite wires from BioMers Products, 0.014-, 0.016, and 0.018-inch, and 0.019 × 0.025-inch NiTi, 0.016-inch SS, and 0.019 × 0.025-inch beta-titanium archwires were tested (n  =  10/type/size/condition). A 20-mm segment was cut from each end of the archwire; one end was then stored in water at 37°C for 30 days, while the other was stored dry. The segments were tested using three-point bending to a maximum deflection of 3.1 mm with force monitored during loading (activation) and unloading (deactivation). Statistical analysis was completed via two-way analysis of variance with wire and condition (dry and water-stored) as factors.Results:In terms of stiffness and force delivery during activation, in general: beta-titanium was > TorQ B > TorQ A > 0.019 × 0.025-inch NiTi and 0.016-inch SS > Align C > 0.018-inch NiTi > Align B > 0.016-inch NiTi > Align A > 0.014-inch NiTi. Water exposure was detrimental to the larger translucent wires (Align B and C, TorQ A and B) because they were more likely to craze during bending, resulting in decreased forces applied at a given deflection. Align A and the alloy wires were not significantly (P > .05) affected by water storage. Overall, the alloy wires possessed more consistent force values compared to the composite wires.Conclusion:Environmental conditions are more likely to affect fiber-reinforced composite archwires compared to alloy wires.     

Role of lubricants on friction between self-ligating brackets and archwires

Objective:To evaluate the effect of different lubricants on friction between orthodontic brackets and archwires.Materials and Methods:Active (Quick, Forestadent) and passive (Damon 3MX, Ormco) self-ligating brackets underwent friction tests in the presence of mucin- and carboxymethylcellulose (CMC)–based artificial saliva, distilled water, and whole human saliva (positive control). Dry friction (no lubricant) was used as the negative control. Bracket/wire samples (0.014 × 0.025 inch, CuNiTi, SDS Ormco) underwent friction tests eight times in a universal testing machine.Results:Two-way analysis of variance showed no significant interaction between bracket type and lubricant (P  =  .324). Friction force obtained with passive self-ligating brackets was lower than that for active brackets (P < .001). Friction observed in the presence of artificial saliva did not differ from that generated under lubrication with natural human saliva, as shown by Tukey test. Higher friction forces were found with the use of distilled water or when the test was performed under dry condition (ie, with no lubricant).Conclusion:Lubrication plays a role in friction forces between self-ligating brackets and CuNiTi wires, with mucin- and CMC-based artificial saliva providing a reliable alternative to human natural saliva.     

Finite element study of controlling factors of anterior intrusion and torque during Temporary Skeletal Anchorage Device (TSAD) dependent en masse retraction without posterior appliances: Biocreative hybrid retractor (CH-retractor)

Objectives:To evaluate, using the finite element method (FEM), the factors that allow control of the anterior teeth during en masse retraction with the Biocreative hybrid retractor (CH-retractor) using different sizes of nickel-titanium (NiTi) archwires and various gable bends on the stainless-steel (SS) archwires.Materials and Methods:Using FEM, the anterior archwire section, engaged on the anterior dentition, was modeled in NiTi, and another assembly, the posterior guiding archwire, was modeled in SS. Two dimensions (0.016 × 0.022- and 0.017 × 0.025-inch NiTi) of the anterior archwires and different degrees (0°, 15°, 30°, 45°, and 60°) of the gable bends on the guiding wire were applied to the CH-retractor on the anterior segment to evaluate torque and intrusion with 100-g retraction force to TSADs. Finite element analysis permitted sophisticated analysis of anterior tooth displacement.Results:With a 0° gable bend all anterior teeth experienced extrusion. The canines showed a larger amount of extrusion than did the central and lateral incisors. With a gable bend of >15°, all anterior teeth exhibited intrusion. Bodily movement of the central incisor required a 30°∼45° gable bend when using anterior segments of 0.016 × 0.022-inch NiTi and 15°∼30° gable bend with the 0.017 × 0.025-inch NiTi.Conclusions:With the CH-retractor, varying the size of the NiTi archwire and/or varying the amount of gable bend on the SS archwire affects control of the anterior teeth during en masse retraction without a posterior appliance.     

Torque expression of self-ligating brackets compared with conventional metallic, ceramic, and plastic brackets

The purpose of this research was to investigate the torque capacity of active and passive self-ligating brackets compared with metallic, ceramic, and polycarbonate edgewise brackets. Six types of orthodontic brackets were included in the study: the self-ligating Speed and Damon2, the stainless steel (SS), Ultratrimm and Discovery, the ceramic bracket, Fascination 2, and the polycarbonate bracket, Brillant. All brackets had a 0.022-inch slot size and were torqued with 0.019 x 0.025-inch SS archwires. For this purpose, the labial crown torque of an upper central incisor was measured in a simulated intraoral clinical situation using the orthodontic measurement and simulation system (OMSS). A torque of 20 degrees was applied and the correction of the misalignement was simulated experimentally with the OMSS. Each bracket/wire combination was measured five times. Maximum torquing moments and torque loss were determined. The results were analysed with one-way analysis of variance, with the bracket serving as the sole discriminating variable, and the Tukey test at the 0.05 level of significance. The ceramic bracket (Fascination 2) presented the highest torquing moment (35 Nmm) and, together with a SS bracket, the lowest torque loss (4.6 degrees). Self-ligating, polycarbonate, and selective metallic brackets demonstrated almost a 7-fold decreased moment developed during insertion of a 0.019 x 0.022-inch SS wire into a 0.022-inch slot and a 100 per cent increase in loss.     

Torsional strength of computer-aided design/computer-aided manufacturing–fabricated esthetic orthodontic brackets

Objective:To fabricate orthodontic brackets from esthetic materials and determine their fracture resistance during archwire torsion.Materials and Methods:Computer-aided design/computer-aided manufacturing technology (Cerec inLab, Sirona) was used to mill brackets with a 0.018 × 0.025-inch slot. Materials used were Paradigm MZ100 and Lava Ultimate resin composite (3M ESPE), Mark II feldspathic porcelain (Vita Zahnfabrik), and In-Ceram YZ zirconia (Vita Zahnfabrik). Ten brackets of each material were subjected to torque by a 0.018 × 0.025-inch stainless steel archwire (G&H) using a specially designed apparatus. The average moments and degrees of torsion necessary to fracture the brackets were determined and compared with those of commercially available alumina brackets, Mystique MB (Dentsply GAC).Results:The YZ brackets were statistically significantly stronger than any other tested material in their resistance to torsion (P < .05). The mean torques at failure ranged from 3467 g.mm for Mark II to 11,902 g.mm for YZ. The mean torsion angles at failure ranged from 15.3° to 40.9°.Conclusion:Zirconia had the highest torsional strength among the tested esthetic brackets. Resistance of MZ100 and Lava Ultimate composite resin brackets to archwire torsion was comparable to commercially available alumina ceramic brackets.     

Self-Ligation Esthetic Brackets with Low Frictional Resistance

Objective:To test the frictional resistance forces (FRS) generated between several archwires and (1) interactive self-ligating (ISL) brackets and (2) conventionally ligated (CL) brackets.Materials and Methods:Frictional forces produced between three different archwire combinations and self-ligating (SL) brackets (ceramic and metal-slot or all-metal) and CL brackets (metal or ceramic) were evaluated in a dry environment. The three ISL brackets tested were In-Ovation-C, In-Ovation-R, and Damon 3. The three CL brackets were Mystique with Neo Clip, Clarity, and Ovation. Each bracket was tested with 0.020″ SS, 0.019″ × 0.025″ SS and 0.018″ × 0.018″ coated SS.Results:The ISL brackets generally exhibited the lowest frictional forces irrespective of the bracket material and the wire size, and CL brackets exhibited consistently higher frictional forces. Mystique with Neo Clip produced the lowest frictional resistance of all brackets. The In-Ovation-C brackets demonstrated significantly lower frictional resistance than the SL brackets In-Ovation-R and Damon 3 as well as the CL brackets Clarity and Ovation.Conclusions:The ISL ceramic brackets produced the lowest frictional resistance of all the self-ligating brackets. The CL ceramic brackets produced the greatest friction.     

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

Objective:To investigate the influence of a rotational second-order bracket-archwire misalignment on the loads generated during third-order torque procedures. Specifically, torque in the second- and third-order directions was considered.Materials and Methods:An orthodontic torque simulator (OTS) was used to simulate the third-order torque between Damon Q brackets and 0.019 × 0.025-inch stainless steel archwires. Second-order misalignments were introduced in 0.5° increments from a neutral position, 0.0°, up to 3.0° of misalignment. A sample size of 30 brackets was used for each misalignment. The archwire was then rotated in the OTS from its neutral position up to 30° in 3° increments and then unloaded in the same increments. At each position, all forces and torques were recorded. Repeated-measures analysis of variance was used to determine if the second-order misalignments significantly affected torque values in the second- and third-order directions.Results:From statistical analysis of the experimental data, it was found that the only statistically significant differences in third-order torque between a misaligned state and the neutral position occurred for 2.5° and 3.0° of misalignment, with mean differences of 2.54 Nmm and 2.33 Nmm, respectively. In addition, in pairwise comparisons of second-order torque for each misalignment increment, statistical differences were observed in all comparisons except for 0.0° vs 0.5° and 1.5° vs 2.0°.Conclusion:The introduction of a second-order misalignment during third-order torque simulation resulted in statistically significant differences in both second- and third-order torque response; however, the former is arguably clinically insignificant.     

In vitro evaluation of frictional force of a novel elastic bendable orthodontic wire

Objectives:To determine the frictional force (FF) of the novel, elastic, bendable titanium-niobium (Ti-Nb) alloy orthodontic wire in stainless steel (SS) brackets and to compare it with those of titanium-nickel (Ti-Ni) and titanium-molybdenum (Ti-Mo) alloy wires.Materials and Methods:Three sizes of Ti-Nb, Ti-Ni, and Ti-Mo alloy wires were ligated with elastic modules to 0.018-inch and 0.022-inch SS brackets. The dynamic FFs between the orthodontic wires and SS brackets were measured at three bracket-wire angles (0°, 5°, and 10°) with an Instron 5567 loading apparatus (Canton, Mass).Results:FFs increased gradually with the angle and wire size. In the 0.018-inch-slot bracket, the dynamic FFs of Ti-Nb and Ti-Ni alloy wires were almost the same, and those of the Ti-Mo alloy wire were significantly greater (P<0.05). FF values were 1.5–2 times greater in the 0.022-inch-slot bracket than in the 0.018-inch-slot bracket, regardless of alloy wire type, and the Ti-Mo alloy wire showed the greatest FF. Scanning electric microscopic images showed that the surface of the Ti-Mo alloy wire was much rougher than that of the Ti-Ni and Ti-Nb alloy wires.Conclusion:These findings demonstrate that the Ti-Nb alloy wire has almost the same frictional resistance as the Ti-Ni alloy wire, although it has a higher elastic modulus.     

Active and passive self-ligation—a myth?

Objective:To compare the frictional behavior of several self-ligating brackets with that of normal brackets both with and without tipping force-moments and in combination with different archwire dimensions.Materials and Methods:The resistance to sliding (RS) of seven self-ligating brackets, a conventional bracket, and a ceramic bracket with a low-friction clip were evaluated in combination with three different archwires and tipping force-moments of 0 and 10 Nmm. The center of rotation for the measurements was set within the center of the bracket or with a 10-mm offset. Resistance to sliding was measured using an Instron 3344 at a cross-head speed of 10 mm/min at a temperature of 36°C.Results:Without a tipping moment, RS increased with the active self-ligating brackets with increasing archwire size. No RS was found for any of the passive self-ligating brackets. The 10-Nmm tipping moment resulted in more RS and was similar for all bracket and archwire combinations. RS was approximately doubled when the center of rotation was located at the bracket rather than with a 10-mm offset.Conclusions:RS between brackets and archwires is highly dependent on the experimental setup. Different setups can result in contradictory results. Almost 1 N of traction force is lost in RS when a moment of 10 Nmm is placed at a rotational center 10 mm from the bracket.     

Factors affecting friction in the pre-adjusted appliance

A jig was constructed to measure the frictional forces created by various tip and torque values in association with two types of straightwire bracket moving along tainless steel (SS) archwires. Forces were measured during translation of the bracket using an Instron machine. Steel and cobalt chromium brackets were tested in association with 0.019 x 0.025 and 0.021 x 0.025 inch steel archwires at tips from 0 to 3 degrees and torque values in 2 degree increments from 0 to 6 degrees.The mean values for static (2.2 N) and kinetic (2.1 N) friction were very similar (P = 0.71), as were the overall friction values for stainless steel (2.1 N) and chromium cobalt (2.2 N) brackets of similar dimensions (P = 0.44). Use of 0.021 x 0.025 inch wire produced three times as much friction as 0.019 x 0.025 inch wire, 3.0 N against 1.2 N (P < 0.01). Increased tip and torque were associated with highly significant increases in friction (P < 0.01). Every degree of tip produced approximately twice as much friction as comparable torque. The main conclusion of the study was that space closure should be completed on a 0.019 x 0.025 inch archwire before a 0.021 x 0.025 inch wire is used to complete tooth alignment.