Torque expression capacity of 0.018 and 0.022 bracket slots by changing archwire material and cross section

Torque expression of superelastic NiTi V-Slot and conventional stainless steel orthodontic bracket-archwire combinations - A finite element analysis

BACKGROUND

To investigate the torque expression of conventional stainless steel (SS) brackets in combination with rectangular SS archwires and nickel-titanium (NiTi) V-slot brackets in combination with V-shaped NiTi archwires using finite element analysis (FEA).

METHODS

CAD models were created for a conventional bracket and rectangular archwires with dimensions of 0.018″x0.025″ and 0.019″x0.025″, and for a V-slot bracket and V-shaped archwires with heights of 0.55 mm, 0.60 mm and 0.70 mm. FEA was performed using Ansys 2022R2 software to assess the forces and moments during simulated torsion of the archwires in the brackets between 0° and 25° with varying interbracket distances and free path lengths.

RESULTS

The V-slot bracket-archwire combination exhibited force transmission and moment generation within 1° of torsion. The transmissible force increased with the torsion angle, but showed an upper limit of about 13-14 Nmm. The SS bracket-archwire combination showed negligible forces and moments for simulated torsion between 0° and 15°. At torsions of 25°, moments of 12 Nmm and 14 Nmm occurred for the 0.018″x0.025″ and 0.019″x0.025″ archwire dimensions, respectively.

CONCLUSIONS

The V-slot bracket-archwire combination is effective in expressing torque and preventing both over- and under-activation. Conventional bracket-archwire combinations showed torsional losses due to play between 10 and 15°, depending on the dimensions of the respective archwire, and no upper torsional moment limit.

Precision of slot widths and torque transmission of in-office 3D printed brackets : An in vitro study

PURPOSE

To investigate a novel in-office three-dimensionally (3D) printed polymer bracket regarding slot precision and torque transmission.

METHODS

Based on a 0.022″ bracket system, stereolithography was used to manufacture brackets (N = 30) from a high-performance polymer that met Medical Device Regulation (MDR) IIa requirements. Conventional metal and ceramic brackets were used for comparison. Slot precision was determined using calibrated plug gages. Torque transmission was measured after artificial aging. Palatal and vestibular crown torques were measured from 0 to 20° using titanium-molybdenum (T) and stainless steel (S) wires (0.019″ × 0.025″) in a biomechanical experimental setup. The Kruskal-Wallis test with post hoc test (Dunn-Bonferroni) was used for statistical analyses (significance level p < 0.05).

RESULTS

The slot sizes of all three bracket groups were within the tolerance range according to DIN 13996 (ceramic [C]: 0.581 ± 0.003 mm; metal [M]: 0.6 ± 0.005 mm; polymer [P]: 0.581 ± 0.010 mm). The maximum torque values of all bracket-arch combinations were above the clinically relevant range of 5-20 Nmm (PS: 30 ± 8.6 Nmm; PT: 27.8 ± 14.2 Nmm; CS: 24 ± 5.6 Nmm; CT: 19.9 ± 3.8 Nmm; MS: 21.4 ± 6.7 Nmm; MT: 16.7 ± 4.6 Nmm).

CONCLUSIONS

The novel, in-office manufactured polymer bracket showed comparable results to established bracket materials regarding slot precision and torque transmission. Given its high individualization possibilities as well as enabling an entire in-house supply chain, the novel polymer brackets bear high potential of future usage for orthodontic appliances.

The dimensions of preformed nickel-titanium archwires measured at the bracket positions corresponding to the central incisor, canine, and first molar

INTRODUCTION

Variation in the thickness of commercially available preformed rectangular archwires at the bracket positions has not been thoroughly studied. Therefore, this study measured the edgewise (height) and flatwise (width) dimensions of preformed rectangular nickel-titanium (NiTi) archwires at bracket positions corresponding to the central incisor, canine, and first molar and compared them among bracket positions.

METHODS

Sixty types of preformed rectangular NiTi mandibular archwires indicated as 0.019 × 0.025-in were obtained from 14 manufacturers. The height and width dimensions of archwires were measured at 4 points (3 bracket positions corresponding to the central incisor, canine, and first molar, and 1 terminal end) of each side of each archwire using a micrometer and compared with the indicated dimensions using 1-sample t tests. Furthermore, the measured dimensions were compared among the 3 bracket positions using a 1-way analysis of variance and Bonferroni post-hoc test.

RESULTS

The measured dimensions were significantly smaller than the indicated dimensions for all points except the central incisor point for height and significantly smaller than the indicated dimensions for all points for width. Comparisons among points showed that for height, the central incisor point was significantly larger than the first molar and terminal points. However, no significant differences were found for width at any point.

CONCLUSIONS

The measured dimensions of preformed NiTi archwires at the bracket positions were generally smaller than the indicated dimensions, with variations observed not only among products but also among manufacturers.

Comparative evaluation of the dentoalveolar effects of three Class II correctors: A finite element analysis study

OBJECTIVE

To compare the stress distribution and total strain applied to the dentition, periodontal ligament (PDL) and cortical and trabecular bones by three Class II correctors using finite element analysis.

DESIGN

Three-dimensional analysis of stresses and total strain of the dentition with three Class II correctors.

SETTING

Computational study.

METHODS

Three-dimensional finite element models of Class II elastics, the Forsus Fatigue Resistant Device (FRD) and the Carriere Motion Appliance (CMA) were constructed from a cone-beam computed tomography (CBTC) image of an orthodontic Class II patient. The distribution of stress (von Mises and principal stress) and the total strain (mm) in maxillo-mandibular dentition, PDL, cortical and trabecular bone were analysed.

RESULTS

The highest von Mises yield and the maximum principal stress in the three models were found at the teeth, followed by the cortical bone, trabecular bone and PDL. The maximum stress and total deformation were located at the upper canines and lower molars in the Class II elastics and CMA models, in the upper first molars in the Forsus FRD and CMA, and in the lower first premolars in the Forsus FRD. In addition, stress was distributed in the anterior and posterior regions of the teeth, and the total deformation was found in the distal direction in the upper arch and in the mesial direction in the lower arch.

CONCLUSION

The stress concentrations in the three models were located close to the active components of each appliance, producing specific patterns of stress distribution and displacement that should be taken into account when planning the type of appliance to be used for the correction of the Class II malocclusion.

Effect of power arm length combined with additional anterior torque on the axial orientation of the maxillary incisors during en-masse retraction: A finite element analysis

INTRODUCTION

This study aimed to clarify the effect of power arm length combined with additional torque incorporated into the archwire on the controlled movement of the anterior teeth using the finite element method.

METHODS

An adult patient requiring medium anchorage after extraction of the maxillary first premolars was selected for this study. The power arms were placed between the lateral incisor and the canine at 3 levels: 3 mm, 6 mm, and 9 mm. A 150 g of retraction force was applied from each height of the anterior hook to the first molar tube, with 0°, 5°, and 10° of applied lingual root torque on the incisors.

RESULTS

A 3-mm hook with 10° of applied torque, a 6-mm hook with 5° of applied torque, or a 9-mm hook with no extra torque constituted the best combinations targeted at controlling the inclination of incisors during retraction. Extrusion and distal tipping of the canine were observed. Moreover, mesial tipping and mesiopalatal rotation of the molar were unavoidable. Finally, intercanine and intermolar widths were decreased.

CONCLUSIONS

Adding extra torque on the incisors or using high torque brackets is recommended for patients with maxillary first premolar extraction.

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.

Incisor torque expression characteristics in two passive self-ligating brackets placed at different heights. A finite element investigation

Objective

This study investigated torque expression in maxillary incisors using two passive self-ligating bracket types (Damon Q and Pitts 21) placed at different heights using the Finite element method.

Materials and methods

Two passive self-ligating brackets, Damon Q (Ormco, USA) and Pitts 21 (OC Orthodontics, USA) were 3D modeled using micro-computed tomography. Damon Q (0.022ˮ x 0.028″ slot size) and Pitts 21 (0.021ˮ x 0.021″ slot size) brackets were placed on a maxillary central incisor at predetermined vertical heights. Arch wires of size 0.019ˮ x 0.025″ stainless steel (Damon Q) and 0.020ˮ x 0.020" Titanium Molybdenum (Pitts 21) were placed in the bracket slots.

Results

Pitts 21 brackets showed higher torquing moments at all bonding heights as compared to Damon Q brackets. The minimum torquing moment was 9.03Nmm at 5 mm for Damon Q and the maximum torquing moment was 14.92Nmm for Pitts 21 at a bracket bonding height of 8 mm. Total deformation for Pitts 21 at a height of 5 mm from the incisal edge was 0.61 × 10-6mm as compared to that of Damon Q which was 0.41 × 10-6mm. Lowest Von Mises stress values were at 27.07 MPa in Damon Q brackets at a bracket height of 5 mm from the incisal edge. Highest Von Mises stress values were 36.80 MPa for Pitts 21 brackets at a bracket height of 8 mm from the incisal edge.

Conclusion

Pitts 21 brackets exhibited superior torquing characteristics compared to Damon Q. Total deformation in Pitts 21 was higher than Damon Q at all tested bracket bonding heights.

Is a non-radiological-assisted method valid for establishing crown-root relationships in an orthodontic set-up incorporating the roots? A retrospective study

INTRODUCTION

This study aimed to obtain information on the relationship between crown and root in terms of morphology - dimensions and crown-root angles -to be used for orthodontic set-ups without the use of radiological examinations.

MATERIAL AND METHODS

All the good quality CBCTs of patients obeying the eligibility criteria, from 2000 to 2015, were analysed. All teeth were analysed except for third molars. Six variables were evaluated: crown (CL) and root length (RL), crown width (CW), root width (RW), crown-root angles in both the frontal (CR-frontal) and sagittal plane (CR-sagittal). All teeth were divided into 3 groups according to number of root (single, two, three-rooted). The measurements were assessed with the Invivo professional software and then, subjected to correlation matrices and linear regression statistical analysis in order to find any significant correlations between crown and root measurements (α≤0.05).

RESULTS

Seventy-three out of 247 good quality CBCTs were assessed. Correlation matrices statistical analysis showed linear correlations for some variables investigated, especially for CW/RW pairing in all subgroups (r=0.81, r=0.70 and r=0.58 respectively for single-, two- and three-rooted) and CL/RL in the single-rooted subgroup (r=0.29). Subsequent linear regression analysis allowed to obtain information about roots starting from crown measurements by means of equations [RW=0.76+(0.73×CW) and RL=10.94+(0.25×CL) for single-rooted teeth; RL=1.11+(0.73×CW) and RW=0.99+(0.76×CW), respectively for single- and two-rooted teeth]. No linear correlation was found between crown measurements and C-R angular values.

CONCLUSION

It is possible to obtain root information starting from some crown measurements but these do not fulfil the need of minimal information to guarantee a perfect root position starting from that of crown.

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.

Evaluating orthodontic bracket slot dimensions and morphology: A narrative review

The current article aims to review the previous studies that measure the orthodontic bracket slot dimensions and geometry. Searches in different databases, including PubMed Central, Science Direct, Wiley Online Library, the Cochrane Library, Textbooks, Google Scholar, and Research Gate, in addition to a manual search, were performed about the methods of assessing orthodontic bracket slot dimension up to March 2023. The irrelevant and duplicate studies were eliminated, leaving 35 studies for this narrative review. The findings indicate that the slots are oversized with diverging walls in most studies. Manufacturers must respect the standards during manufacturing brackets and adhere to the actual dimensions and tolerance values.

Sliding behaviour and surface quality after static air polishing of conventional and modern bracket materials : In vitro analysis

OBJECTIVES

As part of orthodontic treatment, air polishing is routinely used for professional tooth cleaning. Thus, we investigated the effects of static powder polishing on sliding behaviour and surface quality of three different bracket materials (polymer, ceramic, metal), including a 3D-printed bracket.

METHODS

Two bracket types of each material group were polished with an air-polishing device using sodium bicarbonate. Exposure times were set at 10, 20, and 60 s; the application distance was 5 mm. The force loss due to sliding resistance was tested with an orthodontic measurement and simulation system (OMSS) using a 0.016 inch × 0.022 inch stainless steel archwire. Untreated brackets served as control. Polishing effects and slot precision were evaluated using an optical digital and scanning electron microscope.

RESULTS

Sliding behaviour and slot precision differed significantly between and within the groups. Prior to polishing, polymer brackets showed the least force loss, ceramic brackets the highest. With progressive polishing time, the resistance increased significantly with titanium brackets (26 to 37%) and decreased significantly with steel brackets (36 to 25%). Polymer brackets showed the smallest changes in force loss with respect to polishing duration. Slot precision showed the largest differences between material groups and was primarily manufacturer-dependent with hardly any changes due to the polishing time.

CONCLUSION

Powder polishing can positively or negatively affect the sliding properties of the bracket-archwire complex but is more dependent on the bracket-archwire material combination (i.e., manufacture-dependent slot precision). For titanium brackets, resistance only increased after 60 s of polishing. For ceramic brackets, effective reduction was observed after 10 s of polishing. Polymer brackets, including the 3D-printed brackets, showed better sliding properties than ceramic or metal brackets even after polishing for 60 s. Removal of plaque and dental calculus should lead to a noticeable improvement of the sliding properties and outweighs structural defects that may develop.

Accuracy of indirect bracket placement with medium-soft, transparent, broad-coverage transfer trays fabricated using computer-aided design and manufacturing: An in-vivo study

INTRODUCTION

The objective of this study was to test the precision of in-vivo indirect bracket placement via medium-soft, transparent, broad-coverage, computer-aided designed and manufactured transfer trays using an automated digital method.

METHODS

Seventeen patients requiring vestibular fixed appliances were consecutively recruited, and bonding accuracy was measured at each bracket, evaluating 3 linear (mesiodistal, buccolingual, and vertical) and 3 angular measurements (torque, tip, and rotation) with an automated method involving digital superimposition of individual teeth. Mean and standard deviation values were calculated for both arches, single arch, and tooth type, and the percentages of single deviations over the thresholds of 0.25 mm and 1° were calculated, as well as maximum and minimum values for each deviation and directional bias. Correlations between each variable (arch, tooth type, and single tooth) and deviations were investigated through classification and regression trees (CART) predictive models.

RESULTS

Neither mean nor single linear deviations ever exceeded the set cutoff value of 0.25 mm. Mean angular deviations never exceeded 1°, but some individual angular deviations did, specifically 8.31% of torque, 13.16% of tip, and 7.16% of rotation deviations. The highest percentage of deviation was recorded for rotation of the maxillary incisors (18.11%). No evident trend in directional deviation bias was found. Tooth type appears to influence mesiodistal and torque deviations, whereas the single tooth variable influenced the percentage of rotation deviations exceeding 1° (P <0.05).

CONCLUSIONS

This computer-aided designed and manufactured medium-soft, transparent transfer tray provides accurate bracket placement and could be recommended for routine fixed appliance treatment.

Clinical implementation of axial angulation of incisors in the course of routine fixed appliance treatment - a retrospective cohort study

PURPOSE

To identify clinically relevant factors for changes in axial angulation of incisors during routine fixed appliance orthodontic treatment.

METHODS

A total of 106 patients (grades 1-2 of IOTN, 64 females, 42 males; mean age: 15.5 years) from a private practice and treated with metal or ceramic brackets were included in this retrospective cohort study. The axial angulation of the upper and lower incisors was measured on lateral cephalograms before insertion of the first rectangular 0.016 × 0.022-in NiTi archwire (T0) and at the end of treatment about 8 weeks after insertion of the working 0.019 × 0.025-in stainless steel archwire (T1). Treatment-related changes according to bracket type, initial situation, premolar extraction, angle class, and skeletal vertical configuration were analyzed.

RESULTS

Although statistically significant treatment-related changes were seen for both the upper incisors (+ 1.3°) and the lower incisors (- 5.2°), only in ten patients (9.4%) was the prescribed torque value of 17° for the upper incisors and in no patient for the lower incisors achieved. A negative association between the induced change of axial angulation of incisors and the initial values was detected for the upper incisors as well as for the lower incisors. A comparison of the angle classes revealed significant differences in incisor changes. At the end of therapy, only a slight change for the upper central incisors in patients in angle class I cases and a significantly greater change in patients with angle class II/2 was observed. Cases with premolar extraction ended with lower axial angulation of the incisor than cases without extraction. The individual analysis of possible influencing factors also revealed an association with the vertical skeletal configuration.

CONCLUSIONS

For the first time, the presented data show clinically relevant influencing factors for incisor axial angulation changes of the upper and lower incisors in relation to the torque value of the applied brackets in the course of routine clinical practice. For the orthodontist, it remains mandatory to decide whether a customized system must be individualized in order to achieve individual therapy goals.

Accuracy of 3-dimensional printed bracket transfer tray using an in-office indirect bonding system

INTRODUCTION

In this study, we aimed to evaluate and compare the bracket positioning accuracy of the indirect bonding (IDB) transfer tray fabricated in-clinic using the tray printing (TP) and marker-model printing methods (MP).

METHODS

The TP group was further divided into 2 groups (single-tray printing [STP] and multiple-tray printing [MTP]) depending on the presence of a tray split created using the 3-dimensional (3D) software. Five duplicated plaster models were used for each of the 3 experimental groups, and a total of 180 artificial teeth, except the second molar, were evaluated in the experiment. The dental model was scanned using a model scanner (E3; 3Shape Dental Systems, Copenhagen, Denmark). Virtual brackets were placed on facial axis points, and the IDB trays were designed and fabricated using a 3D printer (VIDA; EnvisionTEC, Mich). The accuracy of bracket positioning was evaluated by comparing the planned bracket positions and the actual bracket positions using 3D analysis on inspection software. The main effects and first-order interaction effects were analyzed together by analysis for the analysis of variance.

RESULTS

The mean distance and height errors were significantly lower in the STP group than those in the MP and MTP groups (P <0.05). The mean distance error was 0.06 mm in the STP group and 0.09 mm in the MP and MTP groups. The mean height error was 0.10 mm in the STP group and 0.15 mm and 0.18 mm in MP and MTP groups, respectively. However, no significant differences were observed in the angular errors among the 3 groups.

CONCLUSIONS

The in-office-fabricated IDB system with computer-aided design and 3D printer is clinically applicable after considering the linear and angular errors. We recommend IDB trays fabricated using the STP method owing to the lower frequency of bracket positioning errors and ease of fabrication.

Computation and Collation of Torque Expression in 0.018 Inch and 0.022 Inch Preadjusted Bracket Slots on Passive Insertion of Full-Size Archwire: A Finite Element Study

Aim

To quantify and compare the prescribed torque expressed in preadjusted edgewise 0.018-inch and 0.022-inch bracket slot on passive insertion of full-size archwire using finite element method.

Materials and Methods

Geometric model of the maxillary arch created with dimensions of the brackets and archwires scanned using microcomputed tomography were converted to finite element model using HYPERMESH V 12.0 software. Material properties were assigned and boundary conditioning was given. 0.017 × 0.025 inch, 0.018 × 0.025 inch, 0.019 × 0.025 inch, 0.021 × 0.025 inch stainless steel wires were inserted and ligated using 0.010 inch stainless steel wire. The amount of torque in each wire was quantified and compared.

Results

0.018 × 0.025-inch stainless steel archwire in 0.018-inch slot expressed more torque than 0.017 × 0.025-inch wire; in 0.022-inch slot 0.021 × 0.025-inch wire showed more torque. Torque expression in 0.018-inch slot was more than 0.022-inch slot. Torque expressed was less than the prescribed value in both bracket slots.

Bracket Transfer Accuracy with the Indirect Bonding Technique-A Systematic Review and Meta-Analysis

Purpose: To investigate the bracket transfer accuracy of the indirect bonding technique (IDB). Methods: Systematic search of the literature was conducted in PubMed MEDLINE, Web of Science, Embase, and Scopus through November 2021. Selection Criteria: In vivo and ex vivo studies investigating bracket transfer accuracy by comparing the planned and achieved bracket positions using the IDB technique were considered. Information concerning patients, samples, and applied methodology was collected. Measured mean transfer errors (MTE) for angular and linear directions were extracted. Risk of bias (RoB) in the studies was assessed using a tailored RoB tool. Meta-analysis of ex vivo studies was performed for overall linear and angular bracket transfer accuracy and for subgroup analyses by type of tray, tooth groups, jaw-related, side-related, and by assessment method. Results: A total of 16 studies met the eligibility criteria for this systematic review. The overall linear mean transfer errors (MTE) in mesiodistal, vertical and buccolingual direction were 0.08 mm (95% CI 0.05; 0.10), 0.09 mm (0.06; 0.11), 0.14 mm (0.10; 0.17), respectively. The overall angular mean transfer errors (MTE) regarding angulation, rotation, torque were 1.13° (0.75; 1.52), 0.93° (0.49; 1.37), and 1.11° (0.68; 1.53), respectively. Silicone trays showed the highest accuracy, followed by vacuum-formed trays and 3D printed trays. Subgroup analyses between tooth groups, right and left sides, and upper and lower jaw showed minor differences. Conclusions and implications: The overall accuracy of the indirect bonding technique can be considered clinically acceptable. Future studies should address the validation of the accuracy assessment methods used.

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.

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.

Compliance with the ISO 27020:2019 norm of a sample of currently available preadjusted Orthodontic bracket systems. Are the actual dimensions as expected?

Background

Determine the exact slot dimension of a sample of a MBT prescription stainless steel conventional brackets from different manufacturers to compare the actual values with the nominal ones declared by the manufacturers and to verify the compliance with tolerance limits given by the ISO 27020:2019. Different batches from each manufacturer were evaluated to determine whether or not they are different in size. In addition, the geometry of the slot walls was assessed.

Methods

360 stainless steel preadjusted orthodontic brackets of 12 different manufacturers were assessed. All brackets had a nominal slot size of 0.022 by 0.028 inches, belonged to the right upper central incisor, and were fabricated with the metal injection molding technique (MIM). For each manufacturer, three different manufacturing batches were evaluated. Brackets were coded using a single-blind design.

Results

All bracket systems in the study group except one displayed a statistically significant difference with the nominal declared value, although only four of the systems did not comply with the tolerance limits established by the ISO 27020:2019. In most of the systems, the slot height was oversized when compared to the nominal one. A significant interbatch variability was found in most of the evaluated systems. Most of the brackets walls were divergent.

Conclusions

The dimensional accuracy of commercially available metal brackets is not guaranteed. The respect for the norm should be enforced as well as the quality controls along the manufacturing process since orthodontic brackets are a precision medical device.

Dual-section versus conventional archwire for en-masse retraction of anterior teeth with direct skeletal anchorage: a finite element analysis

BACKGROUND

The aim of this study is to compare the biomechanical effects of the conventional 0.019 × 0.025-in stainless steel archwire with the dual-section archwire when en-masse retraction is performed with sliding mechanics and skeletal anchorage.

METHODS

Models of maxillary dentition equipped with the 0.019 × 0.025-in archwire and the dual-section archwire, whose anterior portion is 0.021 × 0.025-in and posterior portion is 0.018 × 0.025-in were constructed. Then, long-term tooth movement during en-masse retraction was simulated using the finite element method. Power arms of 8, 10, 12 and 14 mm length were employed to control anterior torque, and retraction forces of 2 N were applied with a direct skeletal anchorage.

RESULTS

For achieving bodily movement of the incisors, power arms longer than 14 mm were required for the 0.019 × 0.025-in archwire, while between 8 and 10 mm for the dual-section archwire. The longer the power arms, the greater the counter-clockwise rotation of the occlusal plane was produced. Frictional resistance generated between the archwire and brackets and tubes on the posterior teeth was smaller than 5% of the retraction force of 2 N.

CONCLUSIONS

The use of dual-section archwire might bring some biomechanical advantages as it allows to apply retraction force at a considerable lower height, and with a reduced occlusal plane rotation, compared to the conventional archwire. Clinical studies are needed to confirm the present results.

Comparative Evaluation of Dimensional Accuracy, Surface Characteristics, and Load Deflection Attributes of 0.019" × 0.025" Stainless Steel Wires Sourced from Six Different Commercial Houses: An In Vitro Study

Aims & Objectives:

The aim of the study was to evaluate and compare dimensional accuracy, surface characteristics and load deflection attributes of SS wires sourced from six different commercial houses.

Materials & Methods:

0.019” x 0.025” SS wire samples were divided into 6 groups and evaluated and compared for the aforementioned properties. Dimensional accuracy, surface roughness, frictional resistance, load deflection rate and ultimate tensile strength were evaluated and compared.

Results:

Dimensional accuracy did not vary significantly. Surface Profilometry proved 3M Unitek (Group 1) to be the wire with least irregularities. According to SEM, Modern Orthodontics (Group 6) and 3M Unitek (Group 1) in terms of ‘Sa’ and ‘Sq’ respectively had the smoothest surface finish. SS wires sourced from G&H Orthodontics (Group 2) exhibited least frictional resistance. Load deflection rates varied for all the groups for all three parameters under the study. UTS was best for SS wires sourced from Rabbit Force Orthodontics (Group 5).

Conclusion:

No wire from a single commercial house excels in all the parameters that were evaluated, each one having its aces and minuses.

MicroCT X-ray comparison of aligner gap and thickness of six brands of aligners: an in-vitro study

Background

To investigate and compare the gap (i.e. fit) and thickness of six aligner systems (Airnivol, ALL IN, Arc Angel, F22, Invisalign and Nuvola) using industrial computed tomography (CT). The null hypothesis was that there would be no detectable differences in either measurement between the aligners investigated.

Materials and methods

Passive aligners of each brand were fitted to one single resin cast prototyped from an STL file from a single patient. The samples obtained were examined under high-resolution micro-CT, and the resulting tomographic microphotographs and volumetric data were compared. 3D analysis investigated the gap volume, the mean gap width and the maximum gap width of each sample. A total of 204 linear 2D measurements were made on 18 microtomographic images to investigate the aligner gap and thickness among different systems. Investigated regions were the central incisor, canine and first molar. The resulting measurements were analysed by ANOVA and compared using Tukey’s post hoc analysis (P < 0.05).

Results

3D analysis revealed that the F22 displayed lower gap volume and mean gap width, followed by Airnivol and Invisalign, whereas Airnivol the lowest maximum gap width. 2D analysis showed that F22 had the lowest mean gap and aligner thickness at all teeth investigated. Comparison of the 2D point values revealed statistically significant differences between brands in terms of both measurements (P < 0.05), with the exception of six points in the gap analysis and one in the thickness analysis.

Conclusions

There are differences between the six aligner systems examined in terms of 2D and 3D measurements of aligner thickness and gap.

Accuracy evaluation of bracket repositioning by indirect bonding: hard acrylic CAD/CAM versus soft one-layer silicone trays, an in vitro study

OBJECTIVES

Rapid development of digital technologies and 3D printing provide new tools for orthodontic indirect bonding. The purpose of this in vitro study is to evaluate the clinical acceptability of hard CAD/CAM indirect bonding tray.

MATERIAL AND METHODS

Ten soft silicone transfer trays and ten hard CAD/CAM trays were produced, and 200 brackets were placed on them. The brackets were then transferred to twenty stereolithography -printed models by indirect bonding. These models were scanned and digitally compared with the reference model by three-dimensional superimpositions (GOM software). The linear and angular measurements were collected and analyzed.

RESULTS

For the CAD/CAM trays, 100% of the mesiodistal, vertical, and transverse measurements of incisors were within the clinically acceptable range of the American Board of Orthodontists (ABO) standards. More specifically, the clinically acceptable linear measurements were between 97 and 100% for silicone trays while they were between 89 and 100% for CAD/CAM trays. The clinically acceptable angular measurements varied between 87 and 100% for the silicone trays and between 79 and 100% for the CAD/CAM trays. Silicone trays were more precise than CAD/CAM trays. The difference was significant for all linear and angular measurements.

CONCLUSIONS

While the CAD/CAM group shows clinically acceptable results according to the ABO, silicone remains to be more precise than CAD/CAM for transfer trays and is therefore still the reference.

CLINICAL RELEVANCE

We demonstrate here that the orthodontic indirect bondings, whether they are realized using silicone transfer trays or CAD/CAM trays, are clinically acceptable in terms of the repositioning accuracy of brackets.

OPTIMUM FORCE SYSTEM FOR EN-MASSE RETRACTION OF SIX MAXILLARY ANTERIOR TEETH IN LABIAL ORTHODONTICS

The orthodontists generally do not recommend application of force system above the archwire level owing to additional attachments and patient’s discomfort. Hence, the present research study focusses on application of retraction force system at the archwire level. The objective of this study is to specify an optimum combination of archwire and bracket slot size for en-masse (simultaneous) parallel retraction of six maxillary anterior teeth in labial orthodontics (LaO). In this research study, the concept (theoretical) model has been developed based on simple principles of mechanics to estimate the torque generated by different sizes of archwire in bracket slots. Based on torque value, retraction force developed by each combination of archwire and slot size was determined and compared with required retraction force of 150 gram-force on each side of sagittal plane. For combination of [Formula: see text] inch stalinless steel SS archwire and 0.022 inch SS bracket slot, magnitude of computed retraction force matched closely with aforementioned required force than other combinations and hence, it is recommended in the present research study. The validation of selected combination of archwire and bracket slot size was done successfully by in vivo (clinical) experimentation on three patients. Thus, it proves that the aforementioned combination of archwire and bracket slot size is more suitable than others for retraction force system applied at archwire level.

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.

Fracture strength of monocrystalline and polycrystalline ceramic brackets during archwire torque

Abstract Introduction In recent years, there has been an increasing demand for esthetic treatments, especially among orthodontic patients. Objective This study determined the fracture strength of monocrystalline and polycrystalline ceramic brackets of different manufacturers during archwire torque. Material and method Sixty ceramic brackets (Roth, right upper central incisors, 0.022 x 0.028-inch slot) were allocated into two groups (30 specimens per group) according to the type of ceramics: monocrystalline and polycrystalline. Subsequently, the groups were divided into three subgroups (n = 10) according to the manufacturer: Orthometric, Eurodonto and Ortho Technology. Sixty PVC cylinders were filled with chemically activated acrylic resin (CAAR), the brackets were fixed with CAAR onto the cylinder surface and the excess material was used to partially cover the base of the bracket. After 24h, the U-shaped wire base (0.019 x 0.025 inches; 6 mm height and width) was inserted into the bracket slot and fixed thereon with a stainless-steel wire. Vertical folds were made at the ends of the “U” to support the universal test machine chisel. The fracture strength test was performed at a speed of 1.0 mm/min until fracture into a universal test machine (Instron). The data were recorded, transformed into g.mm and submitted to two-way ANOVA followed by Tukey’s post-hoc test (SAS Institute Inc., Cary, NC, USA, version 9.3) (α=5%). Result Monocrystalline brackets showed a higher fracture strength than polycrystalline brackets, regardless of the manufacturer (p<0.05). The highest fracture strength values were observed in Ortho Technology and Orthometric brackets, with no significant difference between them (p>0.05). Conclusion Monocrystalline ceramic brackets have a higher fracture strength than polycrystalline brackets, with significant manufacturer-dependent differences.

Impact of different rectangular wires on torsional expression of different sizes of buccal tube

Background

Torsions in rectangular wires are the essential part of corrections in the finishing stage of treatment. Moreover the greatest amounts of torques are applied in the molar areas. a clinically effective moment is between 5 and 20 Nmm. In this study we have decided to evaluate the impact of different tube sizes and different dimensions of wires with different modulus of elasticities on the amount torsional bond strength of molar tubes.

Material and Methods

60 human impacted molar teeth were collected. A buccal tube was bonded on the buccal surface of all the samples by using light cured adhesive resin. After that, the teeth were mounted in a hard acrylic block. According to the size of buccal tube and the rectangular wires to be tested 4 groups will be designed. Torsional force was applied by instron machine. The torque angle at 5Nmm and at 20Nmm point will be calculated: which means, how many degrees of torque is required to reach the maximum 20Nmm moment from the minimum 5Nmm.One-way ANOVA was used to compare torque angle in all of the groups.

Results

The least amount of clinically significant angle was 2.2 ᵒ in the 0.017×0.025 SS and the largest amount of it was 23.7 ᵒ in the 0.017×0.025 TMA in 0.018×0.025 slot molar tube. But, this angle was 19.9 ᵒand 13.6 ᵒ in 0.019×0.025 SS and 0.019×0.025 TMA archwire in 0.022×0.028 molar tube.

Conclusions

The 0.017×0.025 SS archwire in 0.018×0.025 molar tube had the lowest clinically significant angle. The largest amount was seen in group 0.017×0.025 TMA in 0.018×0.025 slot molar tube.

Key words: Torsional efficacy, rectangular wires, buccal tubes, torque angle.

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.

Assessment of dimensional accuracy of preadjusted metal injection molding orthodontic brackets

Background:

the aim of this study is to evaluate the dimensional accuracy of McLaughlin, Bennett, and Trevisi (MBT) brackets manufactured by two different companies (American Orthodontics and Ortho Organizers) and determine variations in incorporation of values in relation to tip and torque in these products.

Materials and Methods:

In the present analytical/descriptive study, 64 maxillary right central brackets manufactured by two companies (American Orthodontics and Ortho Organizers) were selected randomly and evaluated for the accuracy of the values in relation to torque and angulation presented by the manufacturers. They were placed in a video measuring machine using special revolvers under them and were positioned in a manner so that the light beams would be directed on the floor of the slot without the slot walls being seen. Then, the software program of the same machine was used to determine the values of each bracket type. The means of measurements were determined for each sample and were analyzed with independent t-test and one-sample t-test.

Results:

Based on the confidence interval, it can be concluded that at 95% probability, the means of tip angles of maxillary right central brackets of these two brands were 4.1–4.3° and the torque angles were 16.39–16.72°. The tips in these samples were at a range of 3.33–4.98°, and the torque was at a range of 15.22–18.48°.

Conclusion:

In the present study, there were no significant differences in the angulation incorporated into the brackets from the two companies; however, they were significantly different from the tiP values for the MBT prescription. In relation to torque, there was a significant difference between the American Orthodontic brackets exhibited significant differences with the reported 17°, too.

Comparative analysis of real and ideal wire-slot play in square and rectangular archwires

OBJECTIVE

To evaluate the degree to which the height, width, and cross-section of rectangular and square orthodontic archwires affect the play between the archwires and the bracket slot.

MATERIALS AND METHODS

The stated measurements (height and width) of 43 archwires from six different manufacturers were compared with real values obtained using a digital gauge. The curvature (radius) of the edge bevels was also measured to calculate the play within the slot, and this measurement was compared with the ideal value.

RESULTS

The real height and width of the archwires differed from those stated by the manufacturers, falling within the range -6.47% and +5.10%. The curvature of each bevel on each archwire cross-section was shown to differ, and consequently increased the real play between the archwire and slot with respect to the ideal to different degrees.

CONCLUSIONS

The archwire-slot play was greater than the ideal for each archwire considered, inevitably leading to a loss of information within the system.