Continuous arch and rectangular loops for the correction of consistent and inconsistent load systems in extruded and tipped maxillary second molars

Mechanical effect of different patterns for preparation of orthodontic appliances: An experimental study

Archwire bending is the key to orthodontic treatment, and multi-time bendings are inevitable during manual and robotic automated bending. The purpose of this paper is to quantitatively evaluate the mechanical effects of the different preparation modes and to compare the mechanical properties of the orthodontic loops in one and multiple bends. Three types of typical stainless steel orthodontic loops (vertical loop, T-loop, and L-loop) were used to quantify the mechanical effect of patterns for preparation by experimental comparison between loops with different bending times by using an orthodontic force tester (OFT). The results were statistically analyzed by t-test. The fracture test of the stainless steel archwire was also carried out, and the bending times at fracture were recorded. Results of the tests indicate that one-time and multi-time bending have a significant mechanical effect on orthodontic appliances. Multi-time bending causes significant mechanical decreases and can damage the appliances.

Quantification of orthodontic loads on teeth in the correction of canine overeruption using different archwire designs

INTRODUCTION

This study quantifies the effects of material, size of the continuous archwires, and level of overeruption on the loads on teeth in the correction of overerupted canines.

METHODS

An orthodontic force test (OFT) was used to measure the 3-dimensional loads delivered by the archwires to the brackets attached to the maxillary right incisors, canine, and premolars. Dentoforms simulating canine overeruptions at the 0.5 mm and 1 mm levels were made from computerized tomography scans. Archwires with 2 types of material (stainless steel [SS] and nickel-titanium [NiTi]) and 2 sizes (0.014-in and 0.016-in) were tested, respectively, on the 0.022 × 0.028-in brackets through elastomeric ligatures.

RESULTS

The forces were dominantly intrusive on the canines and extrusive on the first premolars and lateral incisors. The magnitudes of the extrusive forces were about 74% and 52% that of intrusive force on the canines, which range from -0.48 ± 0.01 N to -5.70 ± 0.14 N depending on the wire material, size, and severity of overeruption (P <0.01). The canine intrusive forces created by SS wires were about 3 times higher than that of NiTi wires with the same sizes, 0.016-in archwires were about twice higher than that of 0.014-in with the same materials, and 1 mm overeruption level doubled with respect to 0.5 mm. Significant second-order moment as coupled with the intrusive or extrusive forces.

CONCLUSIONS

The intrusive and extrusive forces on teeth in the correction of canine overeruption can be quantified by the in vitro orthodontic force test, and the effects of the 3 factors significantly affect the loads on the teeth.

Loads of continuous mechanics for uprighting the second molar on the second molar and premolar

INTRODUCTION

This paper aims to evaluate the effect of tube height on uprighting a mandibular second molar with a continuous arch, specifically the main effects on the molar tube and the side effects on the second premolar bracket.

METHODS

Slot brackets (0.18-in) and tubes were passively bonded from the left second molar to the right second premolar of the patient's cast and fixed to an orthodontic force tester. A mesially tipped second molar along with its tube was positioned at 5 different heights in relation to the bracket slots of the remaining appliance: 2 mm below (group -2), 1 mm below (group -1), leveled (group 0), 1 mm above (group 1) and 2 mm above (group 2). Each group had 10 different 0.016 × 0.022-in superelastic nickel-titanium wires tied one at a time to the appliance to register the vertical forces (Fz) and tipping moments (Mx) produced at the molar tube and the premolar bracket, statistically. Analysis of variance was used to identify differences of load among the groups for wire response to the position of the tube in relation to the other brackets' slots.

RESULTS

As the molar tube was positioned more occlusally, Fz and Mx decreased at the molar tube from 1.31 N to 0.75 N and 13.98 N.mm to 11.84 N.mm, respectively, whereas at the premolar bracket, Fz and Mx decreased from 1.52 N to 0.88 N and 8.77 N.mm to 1.05 N.mm, respectively.

CONCLUSIONS

In all groups, the load system at the molar tube (the main effects) registered a distal tipping moment and an extrusive force, whereas at the premolar bracket, the load system (side effects) included a distal tipping moment and an intrusive force. As the tube moved occlusally, the extrusive force and the uprighting moment decreased, along with the side effects at the premolar bracket. Attempting to bond the molar tube more occlusally (within reasonable intraoral dimensions) when trying to upright a molar does not appear to be sufficient to keep a molar from extruding.

Expansion with transpalatal arch or continuous arch mechanics

INTRODUCTION

This study aimed to compare the 3-dimensional force system produced by transpalatal arch (TPA) mechanics with that produced by a continuous arch (CA) on the expansion of maxillary first molars.

METHODS

A patient's model with 2 molars in 4-mm crossbite had orthodontic appliances bonded to all teeth. The first and the second molars were connected to two 3-dimensional load cells to compare the forces in the transverse and anteroposterior planes (Fx and Fy) and the rotational moments (Mz) produced in both molars by the expanded TPA and by 0.016-in nickel-titanium CA. The data were evaluated using 6 independent t tests, and the net moment at the molar's center of resistance was also calculated.

RESULTS

All forces and moments were different at both molars. At the first molar, CA produced Fx of 2.60 N, Fy of -0.08 N, Mz of -5.16 N·mm, and Net Mz of -5.68 N·mm, whereas the TPA produced Fx of 2.87 N, Fy of -0.60 N, Mz of -22.08 N·mm, and Net Mz of -25.09 N·mm. At the second molar, the TPA did not produce significant forces and moments, whereas the CA produced Fx of -1.00 N, Mz of 3.95 N·mm, Fy of -0.84 N, and Net Mz of -0.67 N·mm.

CONCLUSIONS

Based on our findings in a clinical set up with the specific horseshoe TPA and archwire tested, with the TPA used only on the first molars and the CA used from one second molar to the other, the mechanics produced different expansion forces at the first molar. The TPA produced a larger rotational side effect on the first molar, whereas the CA produced side effects on the second molar.