Innovative design of closing loops producing an optimal force system applicable in the 0.022-in bracket slot system

Position and root resorption of the incisors following anterior segment retraction using friction versus frictionless mechanics: A randomised controlled trial

AIM

To evaluate the three-dimensional position and root resorption of incisors after anterior segment retraction (ASR) using friction versus frictionless mechanics.

PARTICIPANTS AND METHODS

Thirty female patients (13-18 years) with bimaxillary protrusion were randomly allocated into two groups. In the intervention group, ASR was undertaken using an elastomeric chain rendering 160 g/side extending between mini-screw implant and a hook crimped on 0.017 × 0.025-inch stainless-steel wire distal to the lateral incisor. In the comparison group, ASR was undertaken using closing T-loops fabricated from 0.017 × 0.025-inch titanium molybdenum alloy (TMA) wire rendering comparable retraction force. In both groups, the canine brackets were ligated after retraction to the mini-screw implants that were inserted in both the upper and lower arches bilaterally. The primary outcome was the three-dimensional changes in the position of the incisors. The secondary outcome was root resorption. These were measured from cone-beam computed tomography scans.

RESULTS

Statistically significant decreases in the upper (UI) and lower incisors (LI) crown torque were seen in both groups; however, the difference between groups was not statistically or clinically significant (UI MD -2.04°; 95% confidence interval [CI] = -8.02-3.95; LI MD -0.49°; 95% CI = -7.06-6.08). Significant tipping of upper (MD -1.17°; 95% CI = -2.06--0.27) and lower (MD -1.13°; 95% CI = -1.66--0.60) incisors was found in the friction, but not the frictionless group after retraction; however, the changes were not clinically significant. Significant lower incisor intrusion was found in both groups after retraction; however, the difference between groups was not statistically or clinically significant (MD -0.61°; 95% CI = -1.99-0.77). Statistically significant decreases in the UI and LI root length were seen in both groups. The difference between groups for UI changes was statistically significant (MD 0.54 mm; 95% CI = -0.02-1.07) but probably not clinically significant.

CONCLUSION

Considering the limitations in the current study, there was no advantage of either mechanics over the other regarding the final position of incisors. The likelihood of root resorption should be considered when frictionless mechanics are used for retraction of incisors.

REGISTRY

Clinicaltrials.gov (NCT04878939).

Comparison of stainless steel and titanium-molybdenum alloy closing loop archwires using numeric simulation model based on finite element method

INTRODUCTION

The objective of this study was to determine and compare the moment-to-force (Mc/F) ratio and the type of tooth movement generated in the anterior and posterior segments in orthodontic space closure with stainless steel and titanium-molybdenum alloy loop archwires.

METHODS

Three-dimensional model of the maxilla from which the first premolar was extracted, 18 × 25-mil slot stainless steel brackets, and 16 × 22-mil stainless steel and β titanium-molybdenum alloy (TMA) closing loop archwires with anterior gable bend of 15° and posterior gable bend of 25° were constructed. The archwires were engaged in the brackets, and 1-mm activations were carried out, which were repeated 5 times. The anterior and posterior segment Mc/F ratio and the type of tooth movement generated by the 2 wires were compared.

RESULTS

It was found that the Mc/F ratio for the anterior segment was approximately 5 mm, and for posterior teeth was approximately 10 mm for both stainless steel and TMA closing loop archwire. The anterior teeth exhibited controlled tipping, whereas the posterior teeth showed bodily tooth movement, which was in accordance with the Mc/F ratio that was obtained.

CONCLUSIONS

The Mc/F ratio and the type of tooth movement exhibited by stainless steel and TMA closing loop archwires were similar in both anterior and posterior segments.

Mesial or distal to canine: Which is better for the position of closing loops? Analysis of tooth movements based on numerical simulation

INTRODUCTION

Although many studies investigating the mechanical behavior of loop mechanics have focused on loop designs to produce a higher moment-to-force ratio, few studies have clarified the effect of loop position on the force system and resultant tooth movements. This study aimed to simulate orthodontic tooth movements during space closure and to compare the effects of loop position in association with different degrees of gable bend on tooth movements using the finite element method.

METHODS

Two finite element models of the maxillary dentition were constructed, with the loop placed mesial or distal to the canine. Tooth movements during loop activation were simulated while varying the degree of gable bend.

RESULTS

When the loop was placed distal to the canine, the incisor showed uncontrolled tipping even with the gable bend. Placement of the loop mesial to the canine produced controlled tipping or root movement of the incisor, depending on the degree of gable bend.

CONCLUSIONS

Placement of the closing loop mesial to the canine in combination with the incorporation of a gable bend into the archwire distal to the canine could provide better control of incisor movements, such as controlled tipping or root movement, as compared with placement of a gable bend into the loop located distal to the canine.

Comparison of retraction efficacy of titanium-molybdenum and titanium-niobium alloy wires – A prospective split-mouth study

Objectives:

The study aimed to compare the efficacy of Titanium-Molybdenum (Ti-Mo) and Titanium-Niobium (Ti-Nb) alloy wires as retraction springs, by comparing: The amount and rate of canine retraction, the degree of canine rotation, the change in axial inclination of canines, and the associated anchorage loss.

Material and Methods:

All 17 participants (age: 18–25 years) to be treated with the first premolar extraction approach by canine retraction were assigned Ti-Mo and Ti-Nb alloy T-loop springs to either of the upper quadrants randomly. Digital intraoral 3-D scans and panoramic radiographs orthopantomagram (OPG) were taken before (T0) and after (T1) the study period (4 months). 3-D superimposition was performed and using the digital models and OPG, changes in canine position, angulation, and anchorage loss were compared between the two groups.

Results:

There was no significant difference between the two treatment groups for all the parameters pertaining to maxillary canine retraction, that is, canine retraction (P = 0.72), change in axial inclination of canines (P = 0.71), rotation of canines (P = 0.74), and anchorage loss (P = 0.13) as well as extraction space closure (P = 0.74).

Conclusion:

Ti-Nb and Ti-Mo alloy wires show a similar potency for use in retraction mechanics for orthodontic space closure.

Mechanical force system of double key loop with finite element analysis

Background

The mechanics of double key loop (DKL) are not well defined, and this finite element study was designed to explore its force system.

Methods

A simplified 3-dimensional finite element model of single and double key loops with an archwire between the lateral incisor and second premolar was established in Ansys Workbench 17.0. Activation in Type-1 (retraction at the distal end), Type-2 (retraction at the distal key) and Type-3 (Type-2 plus ligation between keys) was simulated. The vertical force, load/deflection ratio and moment/force ratio of stainless-steel and titanium-molybdenum alloy (TMA) loops were calculated and compared.

Results

The double key loop generated approximately 40% of the force of a single key loop. Type-2 loading of DKL showed a higher L/D ratio than Type-1 loading with a similar M/F ratio. Type-3 loading of DKL showed the highest M/F ratio with a similar L/D ratio as single key loop. The M/F ratio in Type-3 loading increased with the decreasing of retraction force. The DKL of TMA produced approximately 40% of the force and moment compared with those of SS in all loading types. When activated at equal distances below 1 mm, the M/F ratios of SS and TMA DKL with equal preactivation angles were almost the same.

Conclusion

The M/F ratio on anterior teeth increases with the preactivation angle and deactivation of DKL. The M/F ratio at a certain distance of activation mainly depends on the preactivation angle instead of the wire material. TMA is recommended as a substitute for SS in DKL for a lower magnitude of force.

Simulation of orthodontic tooth movement during activation of an innovative design of closing loop using the finite element method

INTRODUCTION

Although many attempts have been made to study the mechanical behavior of closing loops, most have been limited to analyses of the magnitude of forces and moments acting on the end of the closing loop. The objectives of this study were to simulate orthodontic tooth movement during the activation of a newly designed closing loop combined with a gable bend and to investigate the optimal loop activation condition to achieve the desired tooth movement.

METHODS

We constructed a 3-dimensional model of maxillary dentition reproducing the state wherein a looped archwire combined with a gable bend was engaged in brackets and tubes. Orthodontic tooth movements were simulated for both anterior and posterior teeth while varying the degree of gable bend using the finite element method.

RESULTS

The incorporation of a 5° gable bend into the newly designed closing loop produced lingual crown tipping for the central incisor and bodily movement for the first molar. The incorporation of 10° and 15° gable bends produced bodily movement and root movement, respectively, for the central incisor and distal tipping for the first molar.

CONCLUSIONS

Torque control of the anterior teeth and anchorage control of the posterior teeth can be carried out effectively and simply by reducing by half the thickness of a teardrop loop with a height of 10 mm and a 0.019 × 0.025-in cross-section, to a distance of 3 mm from its apex, and by incorporating various degrees of gable bend into the loop corresponding to the treatment plan.

Bracket slot size selection: after all a matter of taste?

The publication of the three-paper series on the effects of two slot sizes on treatment parameters in this issue, targets a topic, which has attracted a lot of discussion based primarily on anecdotal evidence. The conclusive evidence contribute to the lack of variation of treatment variables with slot size selection, clarifies one of the traditional beliefs on this issue; several others still hold strong however. This commentary has the objective of highlighting some points, which could be taken into consideration in interpreting the results of this three-part trial.

Finite element analysis of archwire parameters and activation forces on the M/F ratio of vertical, L- and T-loops

Background

The ability of a loop to generate a certain moment/force ratio (M/F ratio) can achieve the desired tooth movement in orthodontics. The present study aimed to investigate the effects of elastic modulus, cross-sectional dimensions, loop configuration geometry dimensions, and activation force on the generated M/F ratio of vertical, L- and T-loops.

Methods

A total of 120 three-dimensional loop models were constructed with the Solidworks 2017 software and used for simulating loop activation with the Abaqus 6.14 software. Six vertical loop variations, 9 L-loop variations, and 9 T-loop variations were evaluated. In each group, only one parameter was variable [loop height, ring radius, leg length, leg step distance, legs distance, upper length, different archwire materials (elastic modulus), cross-sectional dimension, and activation force].

Results

The simulation results of the displacement and von Mises stress of each loop were investigated. The maximum displacement in the height direction was recorded to calculate the M/F ratio. The quantitative change trends in the generated M/F ratio of the loops with respect to various variables were established.

Conclusions

Increasing the loop height can increase the M/F ratio of the loop. This increasing trend is, especially, much more significant in T-loops compared with vertical loops and L-loops. In vertical loops, increasing the ring radius is much more effective than increasing the loop height to increase the M/F ratio of the loop. Compared with SS, TMA archwire loops can generate a higher M/F ratio due to its lower elastic modulus. Loops with a small cross-sectional area and high activation force can generate a high M/F ratio. The introduction of a leg step to loops does not increase the M/F ratio of loops.