Effect of archwire cross-section changes on force levels during complex tooth alignment with conventional and self-ligating brackets

Comparison of alignment efficiency of different sizes of superelastic nickel-titanium archwires in the initial phase of fixed orthodontic treatment: A single-center, double-blind randomized clinical trial

INTRODUCTION

This 3-arm parallel, double-blind study aimed to evaluate the alignment efficiency of 3 different diameters of superelastic nickel-titanium (NiTi) archwires during the initial phase of orthodontic treatment.

METHODS

Ninety-three patients with nonextraction treatment in the mandibular arch (using 0.022-in Roth prescription brackets) were randomly allocated into 3 groups: 0.012-in NiTi (group 1), 0.014-in NiTi (group 2), and 0.016-in NiTi (group 3). The alignment change was measured using the modified Little's irregularity index before archwire placement and every 4 weeks. The alignment efficiency of the 3 groups was analyzed.

RESULTS

Ninety patients were analyzed (group 1: n = 29, group 2: n = 31, and group 3: n = 30; overall mean age, 16.6 years). The overall Wald test analysis revealed that wire type was not statistically significant (P = 0.91), whereas time exhibited significance as expected (P <0.001). Furthermore, the interaction between wire type and time was not significant (P = 0.93). The time-adjusted estimated difference between 0.014-in and 0.012-in was -0.49 (95% confidence interval, -2.83 to 1.85; P = 0.68). The time-adjusted estimated difference between 0.016-in and 0.012-in was -0.45 (95% confidence interval, -2.95 to 2.05; P = 0.72). No harm was observed.

CONCLUSIONS

The clinical performance of 3 different sizes of NiTi archwires was similar. In addition, 0.014-in and 0.016-in NiTi archwires demonstrated better performances in aligning any irregularities because of a greater number of wire deformations in the 0.012-in group.

REGISTRATION

IR.TBZMED.REC.1395.1039.

PROTOCOL

The protocol was not published before trial commencement.

FUNDING

None.

Dentists' Perception of Mysmartalign Clear Aligner Treatment

Aim and Objective

To assess the dentist perception of efficiency, treatment outcome, and stability of the tooth movement treated with mysmartalign clear aligner therapy (MSA CAT).

Materials and Method

A cross-sectional web-based questionnaire survey was carried out to evaluate the dentist perception of MYSMARTALIGN (MSA). To determine the sample size, a pilot study has been carried out and the final sample arrived was 4990 subjects. The current study's inclusion criteria took into account those who had finished their BDS and MDS as well as dentists and orthodontists who had been using the MSA CAT system on their patients for the previous 7 years.

Results

The result of the study showed that most research participants (3650) used MSA to treat mild to moderate malocclusion, and 3996 participants said that initial digital treatment plans have been authorised with no revisions. In view of efficiency, 3894 doctors were satisfied with the final outcome.

Conclusions

Finally concluded that recent survey showed that dentists were very satisfied with the effectiveness and treatment results of the MSA clear aligner procedure.

Multidisciplinary approach to restore esthetics and function in a young patient with three consecutive impacted teeth: a case report with 18-month follow-up

This case report describes the orthodontic treatment of an 11-year-old patient with three maxillary impacted teeth on the right side. Cone-beam computed tomography showed that these teeth were close together, with the lateral incisor in a lower position, followed by the central incisor, and the canine in a more apical position. Treatment included applying traction to these teeth. A transpalatal arch was used as an anchorage device, and surgical exposure of the lateral incisor was performed for traction with an elastic chain toward the hook welded to the 0.017 × 0.025-inch steel segmented arch. Subsequently, the central incisor was surgically exposed, elastic chains were used, along with a 0.016-inch steel arch with a box loop for correcting the tooth position. The canine spontaneously began to erupt, and a 0.017 × 0.025-inch TMA segmented arch with boot loop was used to control rotation and torque of the canine during its distalization. Once these three teeth were in the arch, treatment was finished in the usual manner. For esthetic improvement, gingivoplasty was performed in the maxillary arch. Eighteen-month follow-up showed that orthodontic treatment allowed preservation of the natural teeth, the contour of gingival support, and avoidance of prosthetic rehabilitation, reestablishing the patient's esthetics and function, with satisfactory stability.

influence of inter-bracket distance on load deflection characteristics of nickel-titanium wires

Aim: Aim of this study was to compare and evaluate load deflection characteristic of NiTi wires of different cross-section between labial and lingual straight wire system in aligned and crowded condition. Materials & Methods:  The study was divided into two parts one with the aligned teeth and in other part typodont set was manipulated to simulate the crowded arch. Crowding was created in the anterior region by displacing one central incisor and one lateral incisor 2 mm palataly and canine were rotated in mesio-buccal direction. Typodont was sent to laboratory for lingual setup and CAD-CAM based Avant grade laser sintered 3D lingual brackets were and bonded using Cyanoacrylate by the laboratory. A modified three point bending test simulating the clinical conditions was carried out to investigate load deflection characteristics of Cu-NiTi arch-wires using Instron Universal Testing Machine. Results: Shapiro-wilk test and Kolmogorov-Smirnov test were used to check the normality of the sample and values. Intergroup comparison of LDR of wires between labial and lingual group in aligned and crowded condition showed that LDR of wires in the lingual bracket system was significantly higher as compared to labial bracket system. 

Super-elasticity in vitro assessment of CuNiTi wires according to their Austenite finish temperature and the imposed displacement

OBJECTIVES

To assess the super-elasticity of CuNiTi wires (Ormco, Glendora, Calif) according to their Austenite finish temperature (Af) and to the imposed displacement. The secondary objective was to compare the wire dimensions with the stated measurements and to study interbatch variability.

MATERIALS AND METHODS

10 types of CuNiTi wires (Ormco, Glendora, Calif) (n = 350) were investigated at 36 ± 1°C, with conventional brackets (Victory Series, 3M Unitek, Monrovia, Calif). Tensile test with coronoapical displacement ranging from 1 to 5 mm of the canine bracket was imposed. The wire dimensions were initially measured from two batches (n = 10).

RESULTS

Dimensional heterogeneity varied by ± 2.00% compared to the manufacturer's data, and even up to 5.54% for 0.014-inch CuNiTi (P = .00069). However, all unloading forces were reproducible. In decreasing order, the forces delivered by a CuNiTi 27 were greater than those with CuNiTi 35 and 40. The super-elasticity was expressed only for displacements of 1 to 2 mm, at best up to 3 mm for 0.014-inch CuNiTi 27.

CONCLUSIONS

The value of Af as well as the amount of imposed displacement seem to influence the expression of the super-elasticity of CuNiTi wires and the amount of corrected malocclusion. Among the tested wires, under these experimental conditions, 0.014-inch wire could be suitable as a first archwire. CuNiTi 35, therefore, seems to offer the best compromise among the force level, the expression of super-elasticity and the amount of malocclusion correction.

Biomechanics of clear aligners: hidden truths & first principles

Over the past two decades clear aligner-based treatment has received remarkableattention from the orthodontic profession and more so from general practitioners.Different companies have emerged using vigorous advertisement to promote theirproducts mainly to patients and clinicians through social media. A variety of concepts,methods, and adjuncts have been introduced to enhance the efficacy andeffectiveness of clear aligners. However, the accuracy of tooth movement (vspredicted) with aligners still hovers around 50%. Fixed appliances fare much better onaccuracy and predictability of treatment. Why is there a discrepancy betweenexpected and actual outcomes? This paper utilizes 'first principles' and the existingevidence to unravel some of the key drawbacks of aligner-based therapy. Severalshortcomings in the biomechanical properties of aligner material (thermoplastics) thataffect clinical performance are discussed. Based on the first principles of alignerbiomechanics, this paper provides clinical insights for improving predictability and effectiveness of aligner therapy.

The cross-sectional effects of ribbon arch wires on Class II malocclusion intermaxillary traction: a three-dimensional finite element analysis

BACKGROUND

The application of intermaxillary traction is often accompanied by the unexpected movement of dentition, especially anchorage teeth. The aim of this study was to comprehensively compare the influence of cross-sectional shape of ribbon arch wires with edgewise and round wires on intermaxillary traction in Class II malocclusion treatment using FEA simulation.

METHODS

The dentofacial structure was simulated in finite element software. A retraction force of 1.5 N was applied to different cross-sectional orthodontic arch wires: a ribbon wire (0.025 × 0.017-in. and 0.025 × 0.019-in.), a rectangular wire (0.017 × 0.025-in. and 0.019 × 0.025-in.) and a round wire (Φ 0.018-in. and Φ 0.020-in.).

RESULTS

Among the three groups, ribbon wire (0.025 × 0.017-in. and 0.025 × 0.019-in.) exhibited the lowest displacement in the X-axis (12.61 μm and 12.77 μm, respectively) and Z-axis (8.99 μm and 9.06 μm, respectively). However, the 0.025 × 0.017-in. ribbon wire showed the highest Y-axis displacement. In the round wire group, Φ 0.020-in. wire displayed less rotation than Φ 0.018-in. wire, where the sagittal, frontal and occlusal rotation of Φ 0.020-in. wire was almost half of that of Φ 0.018-in. wire. The movement of the first molar region was intermediate between the ribbon arch group and the round wire group. Notably, the values of the 0.025 × 0.017-in. arch wire displacement, which were higher than those of any other group, peaked at 0.019 mm in the central incisor region with a spike-like shape. The deformation range of the Φ 0.018-in. wire group was the largest in this study.

CONCLUSIONS

The cross-section of the arch wire influenced force delivery in Class II intermaxillary traction. With the same shape, a larger cross-sectional area led to less mandibular dentition movement. For the rectangular arch wire and ribbon arch wire groups, since the height and width were inverted, the vertical displacement of anchorage teeth in the ribbon wire group was reduced, but the possibility of buccal tipping in mandibular anterior teeth also increased.

Stress distribution and deformation in six tie wings Orthodontic bracket during simulated tipping - A finite element analysis

BACKGROUND AND OBJECTIVES

Four tie wings brackets are widely used in orthodontics, while the Six Tie Wings Brackets (STWB) are recently emerging in fixed orthodontic appliances due to their claim for less friction and thus faster teeth movement. The aim of this work was to evaluate the stress distribution and deformation during simulated mesio-distal tipping forces in Stainless Steel (SS) six tie wings orthodontic bracket using Finite Element Analysis (FEA).

METHODS

A six tie wings bracket (Synergy®, RMO, USA) dimensions were measured using the Vision system and a 3D model of the bracket was constructed. A Finite Element (FE) model was developed and mesio-distal tipping forces of 1.22 N to 1.96 N (125 to 200 gm) in increments were applied on the gingival and incisal slot walls. The stress distribution and deformation were recorded at specific points in the bracket and analyzed.

RESULTS

The maximum deformation and stress distribution for the mesial and distal tipping forces of 1.96 N were recorded as 0.137 µm and 10.60 MPa respectively. The stress concentration was more at the junction of the slot wall and the slot base. For mesial tipping,the deformation was more on the disto-incisal and mesio-gingival tie wings. Similarly, for distal tipping the deformation was more on the mesio-incisal and disto-gingival tie wings. The mid-tie wings showed minimal deformation during both distal and mesial tipping.

CONCLUSIONS

Our study visualized both the mesial and distal tipping forces induced stress distribution in the bracket tie wing-slot junctions. The deformation was present maximum in the mesio-incisal and disto-incisal tie wings and minimal in the mid-tie wings. Clinicians should be aware of this behavior of STWB in making decisions to alter the tipping forces in the archwire to compensate for the tie wing deformation in refining the teeth position.

Orthodontic force prediction model of T-loop closing spring based on dynamic resistance model

Malocclusion has been seriously endangering human oral function. The most effective and mature therapy is orthodontic treatment. But the relationship between the shape of the T-loop and the orthodontic force is unclear, and the precise mathematical model has not been established. In this article, the dynamic orthodontic force prediction model of the T-loop was established by analyzing the treatment process of the T-loop. The model was based on the dynamic resistance model of waxy dental jaw, the theory of beam deformation, and the deformation characteristics of the T-loop. In the experimental process, 11 kinds of orthodontic archwires were used as experimental samples, including 2 kinds of common archwire materials, 7 kinds of cross-sectional sizes, and 10 kinds of clearance distances. The T-loop was put into the extraction space and immersed in 75°C constant temperature water for 2 min. And the experimental data were measured and collected by the dynamic force measuring device. The experimental results show that the cross-sectional size and the clearance distance are positively correlated with the orthodontic force. The influence of the clearance distance on the orthodontic force is greater than that of the cross-section size. The deviation rates between the experimental values of orthodontic force and the theoretical values are between 1.10% and 9.09%, which verifies the accuracy of the dynamic orthodontic force prediction model. The model can predict the orthodontic force, improve the treatment effect, shorten the treatment cycle, and provide reference and guidance for orthodontists to carry out orthodontic treatment safely and effectively.

A Comparative Assessment of the Efficiency of Orthodontic Treatment With and Without Photobiomodulation During Mandibular Decrowding in Young Subjects: A Single-Center, Single-Blind Randomized Controlled Trial

Objective: To assess if photobiomodulation (PBM) improves the efficiency of orthodontic treatment with fixed appliance during the alignment stage.

Methods: Eighty-nine subjects were included in this trial and randomly assigned for treatment with fixed appliance and PBM group or with fixed appliance only (control group). Inclusion criteria were as follows: (1) age between 13 and 30 years, (2) permanent dentition, (3) class I malocclusion, (4) lower 6–6 mild crowding measured on dental cast, (5) no spaces or diastema in the lower arch, (6) no ectopic teeth, (7) nonextractive treatment plan, and (8) no previous orthodontic treatment. PBM was administered in the PBM group every 14 days using the ATP38^® (Biotech Dental, Allée de Craponne, Salon de Provence, France) (72 J/cm² of fluency for each session). Dental alignment was assessed by visual inspection, and treatment time was defined in days as T2 (date of assessment of complete dental alignment)–T1 (date of brackets bonding). The number of monthly scheduled appointments was also recorded. All the data underwent statistical analysis for comparison between groups.

Results: Treatment time was significantly shorter (p < 0.001) in the PBM group (203 days) compared with the control (260 days). Consequently, control visits (p < 0.001) were lower in the PBM group (7) compared with the control group (9).

Conclusions: The present findings would confirm that PBM can be used to enhance the efficiency of orthodontic treatment during dental decrowding.

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.

Camouflage treatment of skeletal Class III malocclusion in an adult cleft-palate patient using passive self-ligating system

This case report describes the successful camouflage treatment to correct a moderate skeletal Class III malocclusion in a 19-year-old male cleft-palate patient. Early closure of the palate produced palatal scar tissue that inhibited midfacial growth, causing maxillary arch deficiency, severe maxillary crowding, and anterior and posterior crossbites. Combined surgical-orthodontic therapy would have been the preferred treatment of choice; however, the patient declined this option because of surgical risks and costs. Therefore, nonextraction camouflage treatment using a passive self-ligating bracket system was used. Treatment aims including expansion of the maxillary arch and correction of the anterior and posterior crossbites were achieved without the use of an additional maxillary arch expander or other auxiliary appliances. This treatment resulted in satisfying facial esthetics and a normal dental occlusion.

Buccolingual Inclination Control of Upper Central Incisors of Aligners: A Comparison with Conventional and Self-Ligating Brackets

Objective

The upper incisors torque expression is essential for the orthodontic treatment accuracy. Various orthodontic devices are claimed to have different inclination control capacity. The purpose of this retrospective study was to compare the radiographic buccolingual inclination of upper incisors in patients treated with three different orthodontic techniques.

Material and Methods

Conventional brackets (Victory, 3M), self-ligating appliances (Damon Q, Ormco), and aligners (Invisalign, Align Technology) were tested. Cephalometric data of 25 patients with similar skeletal and dental pretreatment parameters were collected for each technique. Position changes of upper central incisors were assessed with radiographic evaluation before and after therapy. Three different parameters were considered: 11^∧SnaSnp, 11^∧Ocl and I+ TVL. All variables were measured before (T0) and after (T1) treatment and their variation over treatment was assessed.

Results

When evaluating angular measurements, 11^∧SnaSnp and 11^∧Ocl angles showed the highest numeric variation with conventional brackets. Lowest values were reported with aligners. However, the differences among various techniques were not significant for both angles (P>0.05). Also I+ TVL linear value variation did not show significant differences among the different groups tested (P>0.05).

Conclusion

Conventional multibrackets appliance showed the highest incisal position variations over treatment, but the differences among various groups were not significantly different.

Is Low-Level Laser Therapy an Effective Method to Alleviate Pain Induced by Active Orthodontic Alignment Archwire? A Randomized Clinical Trial

OBJECTIVE

The aim of this study is to assess if low-level laser therapy (LLLT) alleviates pain after the placement of orthodontic alignment archwire and if there could be a specific indication for the usage of LLLT according to the amount of dental crowding.

MATERIALS AND METHODS

Ninety subjects were included and randomly assigned to the tested group (orthodontic treatment and LLLT), placebo group (orthodontic treatment and simulated LLLT), and control group (orthodontic treatment only). Inclusion criteria are age between 13 and 30 years, completely erupted mandibular teeth, and lower crowding of ≥3 mm. Exclusion criteria are spaces or diastema in the lower arch, ectopic teeth, treatment plan including extractions or the use of auxiliary devices, and previous orthodontic treatment. Patients reported the pain experienced by using a numeric rating scale, ranging from 0 to 10, at specific time intervals, that is, 2 hours, 6 hours, 24 hours, and from day 2 to 7. Kruskal-Wallis H Test was used to assess differences in the maximum pain and pain experienced at each time interval among the three groups and in the maximum pain reported among subjects with different degree of crowding.

RESULTS

The final sample consisted of 84 patients, 41 male and 43 female patients, with a mean age of 16.5 ± 2.8 years. The pain experienced at each time interval and the maximum pain score were significantly lower in the tested group, whereas no differences were found between control and placebo groups. Moreover, no differences were found in the pain experienced among subjects with mild, moderate, and severe incisor crowding in all groups.

CONCLUSIONS

LLLT is effective in alleviating the intensity and duration of pain experienced by patients after the engagement of alignment archwire. However, there is no specific indication for the usage of LLLT according to the amount of crowding.

Effect of the vertical position of the canine on the frictional/orthodontic force ratio of Ni-Ti archwires during the levelling phase of orthodontic treatment

This study investigated the effect of the vertical position of the canine on changes in the frictional/orthodontic (F/O) force ratio of nickel-titanium (Ni-Ti) archwires during the initial levelling phase of orthodontic treatment. Frictional and orthodontic forces were measured by using low-friction brackets and Ni-Ti archwires with three different cross-sectional sizes and force types. To simulate canine malocclusion (first premolar extraction case), the upper right canine was displaced gingivally by 1 to 3 mm and the inter-bracket distance between the upper right lateral incisor and second premolar was set at 15 mm or 20 mm. A three-point bending test was performed to measure the orthodontic force of each Ni-Ti archwire. Frictional forces were measured with a universal testing machine and dental arch models by pulling parallel to the end of the archwire at a crosshead speed of 0.5 mm/min. F/O force ratio was calculated and analysed statistically. At a displacement of 3 mm, few archwires had F/O force ratios of less than 1.0, at which orthodontic force overcame frictional force, thus ensuring extrusion of the canine. For effective tooth movement, orthodontists should use Ni-Ti archwires with an F/O force ratio of less than 1.0.

Reliability of Orthodontic Miniscrews: Bending and Maximum Load of Different Ti-6Al-4V Titanium and Stainless Steel Temporary Anchorage Devices (TADs)

Temporary anchorage devices (TADs) have been introduced into orthodontic clinical practice in order to allow tooth movements while avoiding strain on adjacent teeth. Miniscrews are available in the market with different diameters and materials. Accordingly, the purpose of the present report was to measure and compare the forces to bend and fracture different mini implants. Ti-6Al-4V titanium and stainless steel TADs of different manufacturers (Spider ScrewHDC; Mini Implants⁻Leone; Benefit⁻Orteam; Storm⁻Kristal) were evaluated. Two different diameters (1.5 mm and 2.0 mm) were tested. The sample included 10 unused specimens for each group, blocked in an Instron Universal Testing Machine, and a shear load was applied at the neck of the miniscrew. The force to bend the miniscrew was measured at 0.1 mm and 0.2 mm deflections. Also, the maximum force before screw fracture was recorded. Data were submitted for statistical analysis. Results showed significantly higher forces for 2.0 mm than 1.5 mm screws, both at 0.1 mm and 0.2 mm deflections and at maximum load. Moreover, no significant differences were reported between titanium and stainless steel miniscrews of equal diameters.

Reliability of Orthodontic Miniscrews: Bending and Maximum Load of Different Ti-6Al-4V Titanium and Stainless Steel Temporary Anchorage Devices (TADs)

Temporary anchorage devices (TADs) have been introduced into orthodontic clinical practice in order to allow tooth movements while avoiding strain on adjacent teeth. Miniscrews are available in the market with different diameters and materials. Accordingly, the purpose of the present report was to measure and compare the forces to bend and fracture different mini implants. Ti-6Al-4V titanium and stainless steel TADs of different manufacturers (Spider ScrewHDC; Mini Implants⁻Leone; Benefit⁻Orteam; Storm⁻Kristal) were evaluated. Two different diameters (1.5 mm and 2.0 mm) were tested. The sample included 10 unused specimens for each group, blocked in an Instron Universal Testing Machine, and a shear load was applied at the neck of the miniscrew. The force to bend the miniscrew was measured at 0.1 mm and 0.2 mm deflections. Also, the maximum force before screw fracture was recorded. Data were submitted for statistical analysis. Results showed significantly higher forces for 2.0 mm than 1.5 mm screws, both at 0.1 mm and 0.2 mm deflections and at maximum load. Moreover, no significant differences were reported between titanium and stainless steel miniscrews of equal diameters.

Comparison of the force levels among labial and lingual self-ligating and conventional brackets in simulated misaligned teeth

Background/objective

The aim of this study was to evaluate force levels exerted by levelling arch wires with labial and lingual conventional and self-ligating brackets.

Materials/methods

The tested orthodontic brackets were of the 0.022-in slot size for labial and 0.018-in for lingual brackets and were as follows: 1. Labial brackets: (i) conventional bracket (GAC-Twin, Dentsply), (ii) passive self-ligating (SL) brackets (Damon-Q®, ORMCO; Ortho classic H4™, Orthoclassic; FLI®SL, Rocky Mountain Orthodontics) and (iii) active SL brackets (GAC In-Ovation®C, DENTSPLY and SPEED™, Strite). 2. Lingual brackets: (i) conventional brackets (Incognito, 3M and Joy™, Adenta); (ii) passive SL bracket (GAC In-Ovation®LM™, Dentsply and (iii) active SL bracket (Evolution SLT, Adenta). Thermalloy-NiTi 0.013-in and 0.014-in arch wires (Rocky Mountain Orthodontics) were used with all brackets. The simulated malocclusion represented a maxillary central incisor displaced 2 mm gingivally (x-axis) and 2 mm labially (z-axis).

Results

Lingual bracket systems showed higher force levels (2.4 ± 0.2 to 3.8 ± 0.2 N) compared to labial bracket systems (from 1.1 ± 0.1 to 2.2 ± 0.4 N). However, the differences between SL and conventional bracket systems were minor and not consistent (labial brackets: 1.2 ± 0.1 N for the GAC Twin and 1.1 ± 0.1 to 1.6 ± 0.1 N for the SL brackets with 0.013-in thermalloy; lingual brackets: 2.5 ± 0.2 to 3.5 ± 0.1 N for the conventional and 2.7 ± 0.3 to 3.4 ± 0.1 N for the SL brackets with 0.013-in Thermalloy).

Limitations

This is an in vitro study with different slot sizes in the labial and lingual bracket systems, results should be interpreted with caution.

Conclusions/implications

Lingual bracket systems showed higher forces compared to labial bracket systems that might be of clinical concern. We recommend highly flexible nickel titanium arch wires lower than 0.013-in for the initial levelling and alignment especially with lingual appliances.

Evaluation of deflection forces of orthodontic wires with different ligation types

The aim of this study was to evaluate deflection forces of orthodontic wires of different alloys engaged into conventional brackets using several ligation types. Stainless steel, conventional superelastic nickel-titanium and thermally activated nickel-titanium archwires tied into conventional brackets by a ring-shaped elastomeric ligature (RSEL), a 8-shaped elastomeric ligature (8SEL) and a metal ligature (ML) were tested. A clinical simulation device was created especially for this study and forces were measured with an Instron Universal Testing Machine. For the testing procedure, the block representing the maxillary right central incisor was moved 0.5 and 1 mm bucco-lingually at a constant speed of 2 mm/min, and the forces released by the wires were recorded, in accordance with the ISO 15841 guidelines. In general, the RSEL showed lighter forces, while 8SEL and ML showed higher values. At the 0.5 mm deflection, the 8SEL presented the greatest force, but at the 1.0 mm deflection the ML had a statistically similar force. Based on our evaluations, to obtain lighter forces, the thermally activated nickel-titanium wire with the RSEL are recommended, while the steel wire with the 8SEL or the ML are recommended when larger forces are desired. The ML exhibited the highest force increase with increased deflections, compared with the elastomeric ligatures.