Mechanical loads exerted by different configurations of Burstone's 3-piece segmented mechanics during a simulated intrusion of the mandibular incisors

INTRODUCTION

Burstone's segmented intrusion arch technique allows variable incisor intrusion with lingual or labial tipping, depending on the position and direction of the force vectors exerted by the intrusion springs. To date, systematic biomechanical studies are lacking. This in vitro study aimed to determine the 3-dimensional force-moment systems applied to the 4 mandibular incisors and the deactivation behavior of the appliance by different configurations of the 3-piece intrusion mechanics.

METHODS

The experimental setup consisted of a mandibular model segmented into 2 buccal and 1 anterior segment mounted on a 6-axis Hexapod to simulate different incisor segment malpositions. Active elements were bilateral 0.017 × 0.025-in titanium-molybdenum alloy intrusion springs. Nine geometric appliance configurations at different superpositions of the anterior segment between 4 and 0 mm were evaluated.

RESULTS

For 3-mm incisor superposition, mesiodistal variation of the contact of the intrusion spring at the anterior segment wire resulted in labial tipping moments between -0.11 and -1.6 Nmm. Variation of the height of force application at the anterior segment showed no significant influence on the tipping moments. During the simulated intrusion of the anterior segment, a force reduction rate of 21% per mm intrusion was observed.

CONCLUSIONS

This study contributes to a more detailed and systematic understanding of the 3-piece intrusion mechanics and confirms the simplicity and predictability of the 3-piece intrusion. According to the measured reduction rate, the intrusion springs should be activated once every 2 months or 1-mm intrusion.

A novel biomechanical system to intrude the upper incisors and control overbite: Posterior miniscrew-assisted lever arm and 2 cases report

RATIONALE

Overbite control is a key factor in orthodontic treatment. In some cases, incisor intrusion is essential and could be an optimal strategy for overbite control. The aim of this article was to introduce a biomechanical system called the posterior miniscrew-assisted lever arm, which is innovative in using existing posterior miniscrews to intrude the upper incisors and to control anterior overbite while simultaneously retracting the anterior teeth. Its efficiency in incisor intrusion has been proved with 2 cases.

PATIENT CONCERNS

Two adult women who came for orthodontic treatment with the chief complaint of convex profile were included in this study.

DIAGNOSIS

Both patients had similar malocclusions of Class II molar relationship, anterior deep overjet, and anterior deep overbite.

INTERVENTIONS

Their treatment plans were to extract 4 first premolars and insert 2 maxillary posterior buccal miniscrews. After teeth aligning and leveling, en masse retraction was started in both arches. During the space-closing stage, posterior miniscrew-assisted lever arms were placed in their upper arches so as to intrude upper incisors and control the overbite.

OUTCOMES

After respectively 4 months and 3 months of incisor intrusion, the anterior overbite was successfully reduced to the normal range in each patient. Cephalometric analysis and superimposition also confirmed the treatment effect of this biomechanical system on incisor intrusion.

LESSONS

The posterior miniscrew-assisted lever arm is a valuable biomechanical system for intruding incisors and controlling anterior overbite.

Evaluation of the load system produced by a single intrusion bend in a maxillary lateral incisor bracket with different alloys

OBJECTIVES

To evaluate if a 0.5-mm vertical bend applied on an incisor bracket produces movements in other planes and if different wires influence these effects.

MATERIALS AND METHODS

An acrylic model of a treated patient with brackets passively bonded was attached to an Orthodontic Force Tester, and a load cell was attached to the left lateral incisor. Thirty 0.019 × 0.025-inch archwires were divided into three groups according to their alloy: SS (stainless steel), B-Ti (beta-titanium), and MF (beta-titanium wire coated with nickel-titanium). Step-bends of 0.5 mm high were placed on the lateral incisor bracket using a universal plier, and the forces and moments in three dimensions were statistically analyzed by analysis of variance and Tukey post hoc test.

RESULTS

SS produced a larger force (3.4 N) than the B-Ti (1.41 N) and the MF (0.53 N; P < .001). Lingual forces were produced by the SS (0.82 N) and B-Ti (0.31 N) groups, while in the MF group, the force was insignificant. SS produced a mesial force of 0.24 N, while the B-Ti force was insignificant and MF produced 0.09 N. Groups produced different crown-distal tipping moments (SS = 31.48 N-mm, B-Ti = 11.7 N-mm, and MF = 4.55 N-mm) and different crown-buccal tipping moments. SS produced larger moments (3.63 N-mm) than B-Ti (1.02 N-mm) and MF (0.36 N-mm) wires. A mesial-out rotational moment was observed in all groups (SS = 7.17 N-mm, B-Ti = 3.46 N-mm, and MF = 0.86 N-mm).

CONCLUSIONS

A 0.5-mm intrusion bend produced lingual and mesial side effects. In addition to the distal and buccal crown-tipping moments, there was a mesial-out moment. Compared with SS, B-Ti and MF wires produced lower forces. These more flexible wires showed side effects with lesser intensity.

Comparison of mechanical properties of beta-titanium wires between leveled and unleveled brackets: an in vitro study

Background

The objective of this study is to evaluate the force-deflection behavior of beta-titanium alloy wires between two leveled and unleveled bracket alignment scenarios using a three-point bending test.

Methods

Six groups of ten beta-titanium alloy wire segments (0.017 × 0.025-in. diameter) of different manufacturers (Orthometric, Ortho Organizers, GAC, Morelli, and Ormco) were used. Both brackets were bonded to an acrylic jig with a 10-mm interbracket distance. A 1-mm deflection test in two hypothetical conditions (with aligned brackets and by simulating a 2-mm horizontal displacement of the brackets) was explored. Forces of activation and deactivation of the wires during both tests were compared by an analysis of variance (ANOVA) tests followed by a Tukey test.

Results

A statistically significant difference was found in the force-deflection behavior between some of the wires in both simulated in vitro conditions. For the leveled-type alignment scenario, the differences between wires were up to 70 g (range 110 to 179 g). For the unleveled-type alignment scenario, these differences were up to 65 g (range 111 to 175 g).

Conclusions

The study showed some significant differences in forces generated during activation and deactivation among the five types of beta-titanium wires tested. In comparing leveled and unleveled brackets during activation, only Orthometric Beta Flexy and Ormco Beta-titanium were different between them.