Comparing Torque Transmission of Different Bracket Systems in Combination with Various Archwires Considering Play in the Bracket Slot: An In Vitro Study

This study aims to examine the play between various archwires and bracket systems, exploring potential variations in angle values for specific torque and torque values for a given angle along different bracket systems. Therefore, seven brackets systems were evaluated in conjunction with different stainless steel archwires of varying dimensions (0.016″ × 0.022″, 0.018″ × 0.025″, and 0.019″ × 0.025″). Biomechanical behavior during torque development and transmission was assessed using a six-component force/torque sensor. Torque angles (5-45°) were specified with subsequent torque measurement, and the sequence was reversed by setting the torque (5-30 Nmm) and measuring the angle. A reference measurement with 0 Nmm torque served to evaluate bracket slot play. Bracket play (0 Nmm) during palatal load ranged between 20.06° and 32.50° for 0.016″ × 0.022″ wire, 12.83° and 21.11° for 0.018″ × 0.025″ wire, and 8.39° and 18.73° for 0.019″ × 0.025″ wire. The BioQuick® bracket exhibited the highest play, while Wave SL® and Damon® Q brackets demonstrated the lowest play (p < 0.001). Significant differences (p < 0.001) between the brackets were observed in the torque angles required to achieve torques of 5-20 Nmm. In summary, each bracket system has a different torque transmission, which is of great clinical importance in order to achieve correct torque transmission and avoid complications such as root resorption.

Force-Controlled Biomechanical Simulation of Orthodontic Tooth Movement with Torque Archwires Using HOSEA (Hexapod for Orthodontic Simulation, Evaluation and Analysis)

This study aimed to investigate the dynamic behavior of different torque archwires for fixed orthodontic treatment using an automated, force-controlled biomechanical simulation system. A novel biomechanical simulation system (HOSEA) was used to simulate dynamic tooth movements and measure torque expression of four different archwire groups: 0.017″ x 0.025″ torque segmented archwires (TSA) with 30° torque bending, 0.018″ x 0.025″ TSA with 45° torque bending, 0.017″ x 0.025″ stainless steel (SS) archwires with 30° torque bending and 0.018″ x 0.025″ SS with 30° torque bending (n = 10/group) used with 0.022″ self-ligating brackets. The Kruskal-Wallis test was used for statistical analysis (p < 0.050). The 0.018″ x 0.025″ SS archwires produced the highest initial rotational torque moment (My) of -9.835 Nmm. The reduction in rotational moment per degree (My/Ry) was significantly lower for TSA compared to SS archwires (p < 0.001). TSA 0.018″ x 0.025″ was the only group in which all archwires induced a min. 10° rotation in the simulation. Collateral forces and moments, especially Fx, Fz and Mx, occurred during torque application. The measured forces and moments were within a suitable range for the application of palatal root torque to incisors for the 0.018″ x 0.025″ archwires. The 0.018″ x 0.025″ TSA reliably achieved at least 10° incisal rotation without reactivation.

Evaluation of torque moment in esthetic brackets from bendable alloy wires

OBJECTIVES

To 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 METHODS

This 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.

RESULTS

The 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.

CONCLUSIONS

The 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.

Implications of pretreatment incisor inclinations for the achievement of cephalometric normal values-a study on two patient collectives

PURPOSE

The objective was to clarify whether standardized multibracket therapies-differing only in finishing-wire dimensions (0.016 × 0.022 inch vs. 0.017 × 0.025 inch CNA [Connecticut New Archwire]) and excluding any extraction treatment or additional appliances other than intermaxillary elastics-can produce normal incisor inclinations starting from different baseline inclinations.

METHODS

We analyzed pre- and posttreatment cephalograms of 156 patients (age: 15.6 ± 1.3 years) treated with Roth system (0.018 inch slot). Each archwire group (n = 89 or 67) was divided into subjects with initially retroclined, orthograde, or proclined upper and/or lower incisors (U1, L1). For the resultant 12 subgroups, descriptive statistics were compiled relative to five reference planes (NL, ML, NA, NB, BOP), followed by multiple intragroup (Kolmogoroff-Smirnoff and Wilcoxon signed-rank test) and intergroup (Kruskal-Wallis and Mann-Whitney U test) comparisons relative to NL or ML.

RESULTS

The following intra- (1, 2) and intergroup (3, 4) differences were statistically significant (p ≤ 0.05) in both archwire groups: (1) post- vs. pretreatment inclinations in the subgroups initially retroclined U1, retroclined L1 and orthograde U1, but without normal values being achieved (subgroups retroclined U1, L1) or preserved (subgroup orthograde U1); (2) observed vs. expected alterations for the subgroups initially orthograde and proclined U1 and L1; (3) posttreatment inclinations for the subgroups initially retroclined vs. orthograde L1 and proclined L1; (4) observed alterations for the subgroups initially retroclined vs. proclined U1 and L1, but neither retroclined nor proclined vs. orthograde. Archwire thickness influenced the outcome to only a limited extent under the special circumstances of this study.

CONCLUSION

The bracket/archwire combinations evaluated did not lead to normal incisor inclinations in most cases. Posttreatment values did significantly depend on the pretreatment situation. Most frequently, alterations were protrusive in direction, which notably even included incisors that showed norm values at the outset of treatment. It can be concluded that bracket torque will influence but not dominate incisor inclinations.

Experimental evaluation of orthodontic bracket slot deformation to simulated torque

In orthodontic fixed appliance therapy, the archwire torque used to refine the teeth position during the treatment imparts significant forces inside the bracket slot. The objective of this study was to measure the torque relevant bracket slot deformation in Stainless Steel (SS) brackets during various degree of archwire twist. Standard edgewise brackets 0.018-inch (in.)/0.022-in. each 20 no. and 0.016 × 0.022, 0.017 × 0.025, 0.019 × 0.025, and 0.021 × 0.025 in. archwires each 10 no. were used. A novel experimental setup consisting of loading fixture and torque key mounted on a Vision Measuring System (VMS) were used to measure the brackets slot deformation. The Top Slot and Middle Slot Deformations (TSD and MSD) of the brackets for 35° angle of twist in 0.016 × 0.022 in. archwire in 0.018-in. slot, 0.019 × 0.025 in. archwire in 0.022-in. slot and for 30° angle of twist in 0.017 × 0.025 in. archwire in 0.018-in. slot and 0.021 × 0.025 in. archwire in 0.022-in. slot were measured. Results showed that the mean TSD and MSD were higher when the archwire size, the slot size and the angle of twist were greater. In the evaluated bracket-archwire combinations, the TSD were higher than MSD and the bracket slots were elastically deformed within the clinically required 35° angle of twist in the archwire. Clinicians should be aware of this torque relevant bracket slot deformation which might be a factor for torque loss and suitably incorporate archwire angle of twist.

Comparation of three methods for measuring the Edge Bevel Radius of rectangular orthodontic wires: An in-vitro study

OBJECTIVE

To establish a simplified method for measuring the edge bevel radius of 0.019×0.025-in steel rectangular orthodontic wires, achievable in the clinical environment, and to compare it with the photographic method.

MATERIALS AND METHODS

Aided by the AutoCAD™ 2016 software, the theoretical mathematical relationship was determined between the edge rounding radius and cross-sectional dimensions (height, width, diagonals), through rectangle drawings that represent cross-sections. Two hundred segments (n=20) were obtained from the posterior portions of 100 archwires from 10 brands (Dentaurum™; American-Orthodontics™; GAC™; 3M-Unitek™; Abzil™; Morelli™; Orthometric™; Aditek™; A-Company™; Orthomundi™). The cross-sectional measures of each segment were obtained with a micrometer and a caliper, and the edge bevel radii of these segments were calculated with the use of a mathematical formula. For the "gold standard", the segments were included longitudinally in a phenolic resin cylinder, cross-sectioned, polished, and photographed in scanning electron microscope (SEM). The images were amplified 770× and the radii were measured with an acetate template. The micrometer and caliper measuring methods were subjected to Bland-Altman analysis and compared with the gold standard (SEM), considering ±10μm as the maximum acceptable difference between methods.

RESULTS

In the micrometre measurement, 95% of the differences from the standard were within the limits of agreement (-7.21 and 5.56μm). For the caliper method, 95% of the differences were between -5.46 and 19.83μm, which exceeded the fixed limit ±10μm.

CONCLUSION

The calculation method with micrometre measurements is equivalent to the photographic method, but there is no such equivalence for the caliper measurements.

Variability of slot size in orthodontic brackets

Objective

The accuracy of the information incorporated into brackets is a determining factor for the efficacy of torque applied to teeth. The aim of this study was to compare the dimensions of a bracket's slots with the nominal values announced by the manufacturer.

Materials and methods

A total of 730 maxillary right central brackets manufactured by seven companies (Dentsply Gac, American Orthodontics, Rocky Mountain Orthodontics, GC Orthodontics, 3M Unitek, and Dentaurum) were studied. The sample included 0.018 × 0.025 and 0.022 × 0.028 in., metal and ceramic, conventional and self-ligating brackets. Images were obtained with an Olympus BX51 optical microscope. Slot dimensions were measured at the base and at the face on both mesial and distal sides using ImageJ software. Data were analyzed using Wilcoxon, sign tests, two- and three-way ANOVA, and Tukey's tests. Intraclass correlation coefficient was employed to assess the intraobserver and interobserver variability. The threshold for statistical significance was p ≤ .05.

Results

Statistical analysis showed that the slot dimensions of 90% to 97% of studied brackets were significantly different from nominal values. In general, slot size was oversized, with a face size larger than the base size. Comparison between mesial and distal sides showed that up to 45% of the brackets were significantly asymmetrical. The manufacturer had a significant effect for base and face widths (p = .0001) and for length (p = .003).

Conclusion

This study shows that a large proportion of measured brackets displays dimensional inaccuracies when compared with stated values. Clinically, the slot oversize and the divergence of slot walls cause an increase of wire-slot play, inducing a loss of torque control. Practitioners cannot fully trust the precision of used appliances and should be aware that adjustments could be needed in the finishing stages of the treatment.

The effect of buccal-lingual slot dimension size on third-order torque response

Introduction

The focus of the presented study was to investigate the effect of buccal-lingual (B-L) orthodontic bracket slot dimension on third-order torque mechanics.

Materials and methods

Three types of orthodontic brackets and two archwire sizes were considered. Ortho Classic H4 (0.026″ B-L slot, passive), Ormco Damon Q (0.028″ B-L slot, passive), and In-Ovation R (0.028″ slot, active) brackets were tested using 0.017″ × 0.025″ and 0.019″ × 0.025″ beta-titanium archwires. An in vitro orthodontic torque simulator (OTS) was used to rotate archwires relative to a single bracket while recording forces and moments in three directions. For each bracket-archwire combination, a total of n = 47 samples were tested. Repeated measures analysis of variance between brackets was conducted for third-order torque values at 3° increments between 9° and 30° during loading and unloading for each archwire size.

Results

Statistically significant differences between H4 and Q brackets were only found for 0.017″ × 0.025″ archwires during loading, and 0.019″ × 0.025″ archwires during unloading. Conversely, differences between H4 and R brackets were found for both archwires during loading and unloading phases. Finally, when using a 0.017″ × 0.025″ archwire the H4 brackets reached the 5 Nmm threshold before R and Q brackets; however, there was little difference found when using a 0.019″ × 0.025″ archwire.

Conclusions

The concept of using a smaller B-L bracket slot dimension in orthodontic treatment showed it may theoretically allow for more options, primarily using smaller archwires to correct third-order rotational misalignments. However, it is suspected that bracket material limitations and added loading on the door currently prevent this from being clinically applicable.

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.

Torque efficiency of square and rectangular archwires into 0.018 and 0.022 in. conventional brackets

BACKGROUND

The aim of this study was to compare the torque efficacy of square and rectangular wires in 0.018- and 0.022-in. conventionally ligated brackets.

METHODS

Brackets of the same prescription were evaluated in both slot dimensions. Identical acrylic resin models of the maxilla were bonded with the brackets and mounted on the Orthodontic Measurement and Simulation System. Ten 0.018 × 0.018 in., 0.018 × 0.022 in., and 0.018 × 0.025 in. stainless steel wires were evaluated in the 0.018-in. brackets and ten 0.019 × 0.019 in., 0.019 × 0.025 in., and 0.019 × 0.026 in. stainless steel wires were evaluated in the 0.022-in. brackets. A 15° buccal root torque was gradually applied to the right central incisor bracket, and the moments were recorded at this position. One-way ANOVA was applied for both bracket slot sizes along with post hoc analysis for the various archwire sizes.

RESULTS

The mean measured moments varied between 10.78 and 30.60 Nmm among the assessed wire-and-bracket combinations. Both square and rectangular archwires in the 0.018-in. bracket system exerted statistically significantly higher moments in comparison with their counterparts in the 0.022-in. bracket system. Rectangular archwires exerted statistically significantly higher moments than square archwires, both for the 0.018- and the 0.022-in. bracket system.

CONCLUSIONS

Rectangular archwires seem to be more efficient in torque exertion, especially in 0.018-in. brackets.

A comparative experimental investigation of torque capabilities induced by conventional and active, passive self-ligating brackets

INTRODUCTION

A proper selected bracket-archwire combination displays a determining factor in the efficacy of torque applied to a tooth at the final stages of an orthodontic treatment. The objective of the current study was to assess the torque capabilities of various bracket systems combined with diverse archwire materials and cross-sections.

METHODS

The study comprised of four different 0.018-inch slot orthodontic brackets: the passive and the active self-ligating 1. Swiss Nonligating Bracket (SNB) and 2. SPEED and the metallic and the plastic conventional ligating 3. Mini Mono and 4. Brilliant, respectively, and four different archwire types: stainless steel and Nitinol: 0.016×0.016 inch and 0.016×0.022 inch. A 20 degrees labial crown torque (+20 degrees) and then a 20 degrees palatal crown torque (-20 degrees) were applied gradually on the upper right central incisor. Maximum torquing moments and torque play were registered.

RESULTS

Highest torquing moments were expressed by combining SPEED® with 0.016×0.022 inch stainless steel archwire. Lowest moments, but highest torque loss were registered by inserting a 0.016×0.016 inch Nitinol archwire in conventional ligating brackets.

CONCLUSIONS

Active self-ligating system manifests the best torque effectiveness. An evident dependence of the torque expression is displayed both on the type of ligation and on the material of the archwire.

Evaluation of torque moment in a novel elastic bendable orthodontic wire

The objective of the study was to measure the torque moment delivered by a novel elastic bendable wire, Ti-Nb wire, and to compare it with nickel-titanium (Ni-Ti) and titanium-molybdenum (Ti-Mo) alloy wires. Two sizes of Ti-Nb, Ni-Ti and Ti-Mo alloy wires and 0.022-inch slot stainless steel brackets were ligated with elastic modules or ligature wires. The torque moment delivered by the various wire-bracket combinations was measured using a torque gauge at the temperature and humidity of 37°C and 50%, respectively. As the degree of applied torque and the inserted wire size increased, the torque moment gradually increased. The torque moment of Ti-Nb wires was smaller than those of Ni-Ti wires and Ti-Mo wires, at more than 20 degrees applied torque. The torque moment with wire ligation was significantly larger than those with elastic ligation.

Torque efficiency of different archwires in 0.018- and 0.022-inch conventional brackets

OBJECTIVE

To compare the archwires inserted during the final stages of the orthodontic treatment with the generated moments at 0.018- and 0.022-inch brackets.

MATERIALS AND METHODS

The same bracket type, in terms of prescription, was evaluated in both slot dimensions. The brackets were bonded on two identical maxillary acrylic resin models, and each model was mounted on the orthodontic measurement and simulation system. Ten 0.017 × 0.025-inch TMA and ten 0.017 × 0.025-inch stainless steel archwires were evaluated in the 0.018-inch brackets. In the 0.022-inch brackets, ten 0.019 × 0.025-inch TMA and ten 0.019 × 0.025-inch stainless steel archwires were measured. A 15° buccal root torque (+15°) and then a 15° palatal root torque (-15°) were gradually applied to the right central incisor bracket, and the moments were recorded at these positions. A t-test was conducted to compare the generated moments between wires within the 0.018- and 0.022-inch bracket groups separately.

RESULTS

The 0.017 × 0.025-inch archwire in the 0.018-inch brackets generated mean moments of 9.25 Nmm and 14.2 Nmm for the TMA and stainless steel archwires, respectively. The measured moments in the 0.022-inch brackets with the 0.019 × 0.025-inch TMA and stainless steel archwires were 6.6 Nmm and 9.3 Nmm, respectively.

CONCLUSION

The 0.017 × 0.025-inch stainless steel and β-Ti archwires in the 0.018-inch slot generated higher moments than the 0.019 × 0.025-inch archwires because of lower torque play. This difference is exaggerated in steel archwires, in comparison with the β-Ti, because of differences in stiffness. The differences of maximum moments between the archwires of the same cross-section but different alloys were statistically significant at both slot dimensions.

Labio-lingual root control of lower anterior teeth and canines obtained by active and passive self-ligating brackets

OBJECTIVE

To investigate the torque capabilities of passive and active self-ligating (SL) brackets on mandibular incisors and canines using three-dimensional (3D) imaging analysis.

MATERIALS AND METHODS

Two types of SL bracket systems were analyzed: a passive and an active. Both brackets had a 0.022 × 0.028-inch slot size. Treatment protocol and wire sequences were followed as recommended by the manufacturers. Twenty-six patients were included in the passive group and 20 were included in the active group; all received pretreatment and posttreatment cone-beam computed tomography (CBCT) scanning. Based on the CBCT scans, a customized 3D analysis was developed to assess labiolingual inclination of the roots of mandibular canines and incisors with respect to the occlusal plane before and after treatment.

RESULTS

Following treatment, a statistically significant labiolingual proclination of the teeth was seen in both groups. Moreover, in both SL systems the roots exhibited a large variation in labiolingual inclination between adjacent teeth even after treatment.

CONCLUSIONS

A significant proclination was seen for the mandibular front teeth; the claimed third-order torque control of SL systems could not be demonstrated. Therefore, a considerable play between the wire and the brackets could be hypothesized, even more in relation to the passive than the active SL brackets.