Orthodontic Elastic Materials Auten K. Wone, D.DS., MS. Materials used in an orthodontic of- fice to apply forces to move teeth in- clude archwire loops, coil springs, latex elastics, and synthetic elastomers. This study will compare the changes in forces of the last two materials under different conditions that may be likely to occur intraorally. The work will observe: a) the changes that occur in the force of latex elastics and several newer elastomer materials used in the orthodontic office, and b) the changes in the physical properties of the materials. Review oF THE LiteRaTURE Latex elastics are a source of con- tinuous orthodontic forces. The force- elongation relation has been investi- gated and results vary between investi- gators. Some reported a linear relation and others indicated a curvilinear re- lation The results depend upon the condi- tions under which the elastics were tested. They lose some force when tested under water or in the mouth. Exposure of latex to air was found to cause a loss of force. Variations in com- position occur in latex elastic depend- ing upon the place of purchase. The composition of plastic elastomers such as Omolast, AlastiKs, Zing String, and Power Thread are proprietary secrets. At one time the word “rubber” con- notated natural or tree rubber which is a hydrocarbon polymer of isoprene units. The synthetic rubbers which have been developed possess different chemical structures, but resemble tree rubber in many physical properties. Both natural and synthetic rubbers are composed of long, thread-like mole- cules, The characteristic property of reversible extensibility results from the randomly coiled structure of long, folded polymer chains. Upon extension, these randomly coiled chains are elon- gated into an ordered structure consist- ing of linear chains except when cross- linked. This tendency to revert to the original disordered state upon removal of elongation stress accounts for the elastic behavior. Natural rubber may be obtained from hundreds of different types of plants. The major source, however, is the rubber tree (Hevea brasiliensis). The chemical structure of natural rub- ber is cis-1,4 polyisoprene which con- tains approximately 500 isoprene units in the average natural rubber polymer chain, This structure varies in molecu- lar weight from plant to plant, region to region, and from season to season. The gray color found in some rubber bands denotes an inferior product with inclusions of impurities. Occasionally, the producer of the raw latex will at- tempt to bleach the latex resulting in the loss of some of its resilient proper- ties. Latex elastics should be obtained from orthodontic supply houses that have adequate quality controls. To ob- tain optimal properties, the rubber la- tex which is used in the preparation of orthodontic elastics is a blend of care- fully selected lots of the purest, high molecular weight latex. ‘The major useful property of natural latex rubber is its resiliency. This prop- erty makes it useful intraorally for the application of tractive forces in the ranges up to 6 or 8 ounces, Greater forces would result in a large increase in the cross-sectional area of the rub- ber and would be difficult to be placed in orthodontic attachments. High qual- ity latex more or less retains its resili- ence in water and under optimal con- 196Vol. 46, No. 2 ditions displays a minimal force decay. The forces of mastication and the in- traoral environment cause natural rub- ber to break down by formation of knotty tearing mechanisms. The most significant limitation of natural latex is its enormous sensitivity to the effects of ozone or other free radical generat- ing systems such as sunlight or ultra- violet light that produces cracks. The ozone breaks down the unsaturated double bonds at the molecular level as the water molecule is absorbed. This weakens the latex polymer chain. The swelling and staining is due to the fill- ing of the voids in the rubber matrix by fluids and bacteria debris. In clini- cal use the latex elastics are replaced before this stage is reached. Antiozone and antioxidant agents are added at the time of manufacture of the latex tubing. However, when it is chopped into individual latex bands, the surface area is increased and ozone can diffuse more rapidly into the bands, This sharply limits the shelf life of the latex elastics. Out-of-date elastics may break after a few clongation-relaxation cycles. Usually, this type of break is due to crack-propagation which occurs some- where in the elastics due to ozone ef- fects. An additional manifestation of ‘ozone attacks on latex bands is the re- duced force values which may be seen after a short period of two or three months after manufacture. Commonly, one may see elastics, which are rated at four ounces when manufactured, show force value of 2.5 to 3 ounces after a few months of storage. The ten- sile strength, therefore, is unpredictable and is more critical in higher force range applications. Polyurethane rubber is a generic term given to the elastic polymers which con- tain the urethane linkage. They can be synthesized by extending a polyester or a polyether glycol or polyhydrocarbon diol with a di-isocyante. In either case Elastic Materials 197 the chosen diol that is used is up in the 500,000 molecular weight range. The basic repeating structure of this polymer leads to enormous varieties in physical properties for plastic and rub- ber. Depending upon the end use, a variety of means of processing and syn- thesizing may be employed. Polyure- thane polyesters have been used for elas- tic ligatures. It has been found that they excel in strength and resistance to abrasion when compared with natural rubber. They tend to permanently dis- tort, however, following long periods of time in the mouth and often lose their elastic properties. Several elastomer materials _ have been introduced to the orthodontic pro- fession for intraoral use. This study will evaluate the changes in force and phys- ical properties that may occur in the mouth. Another purpose is to provide a greater understanding of the mate- rials involved. MetHops AND ProceDURES The investigation was divided into several parts to evaluate and compare values under different conditions: 1) The first was the evaluation of the tear strength, or the fracture test. 2) The second part studied the changes of force when stretched to a given distance. 3) The third tested the changes in the modulus of elongation. 4) The fourth tested the rate of force decay. Three different testing instruments were used in this study. The first and second sections of this study used a bench laboratory instrument to which an intermediate twin edgewise bracket was fixed at one end, Another edge- wise bracket was attached to a testing force gauge that ran along the track of this instrument. The movable portion which contained the force gauge wasFig. 1 moved by a screw thread mechanism. The brackets with the samples to be tested were moved apart as force was applied by tuming the hand crank at- tached to the screw (Fig. 1). One force gauge with a capacity of 0-20 pounds was used to test the frac- ture-tear strength of the samples. On this testing device a millimeter scale was fixed and a marker to the scale was placed. This permitted the investigator to determine the distance as the two bracket holders were moved apart. With this instrument the force exerted and distance traveled (or the amount the sample was stretched) could be read and plotted at the same time. For the second part of the study an- other force gauge with a capacity of 0-20 ounces was used to test the mate- rials at a force range normally found to move teeth. This gauge was read at Wong April 1976 SAMPLE | no a predetermined distance of 17 milli- meters. A jig of 17 millimeters was used to measure the exact predetermined dis- tance between the two brackets, This jig permitted the reproduction of the distance on the bench force gauge test ing device when the force value read- ings were taken for the second part of this study. The third part of this study utilized a laboratory testing apparatus to meas- ure the elongation of the samples un- der incremental weight loading (Fig. 2). The vise holders secured the inter mediate size edgewise brackets. The lower vise was free hanging except for a metal ring just above the dial indi- cator to eliminate horizontal move- ments. The dial indicator was inter- nally spring loaded so its top shaft re- turned to its most extended vertical position when the bottom shaft was gradually released from its depressed position by slacking the finger pressure on the bottom shaft of the dial indica tor. The readings were recorded whenVol. 46, No, 2 Fig. 3 the dial indicator made contact and completed an electrical circuit as reg- istered on an ampere meter. The dial indicator was sensitive to 1/100 of a millimeter. The range of the instru- ment was 100 millimeters with 800 grams of loading. The reading of the test results on the instruments would stop when cither elongation or load were exceeded. For the fourth part of the study an upright test instrument with adjustable stops and a leaf spring gram gauge was used to exert continuous force and to provide a direct monitoring of changes in force decay (Fig. 3). The test ap- paratus was placed in the water bath and heated to 98°F (37°C) during the test period. Stainless steel plates to which a se- Elastic Materials 199 ries of intermediate edgewise brackets were welded 17 millimeters apart were used. Various materials were stretched between the brackets. The 17 millime- ter distance represents the interbracket distance between the brackets of the cuspid and the second premolar. The plates were immersed in the water bath during the various testing periods. The materials were removed from the plate and placed on the bench force gauge testing device. The sample was re- stretched to the original 17 millimeters and the force value recorded. The samples were tested under dif- ferent environmental conditions to ob- serve how they were affected. Ten sam- ples of each group were tested under the following conditions: I) dry and unaltered from the manufacturer, 2) dry and stretched 17 millimeters for 21 days, and 3) submerged under water at 98°F and stretched 17 millimeters be- tween edgewise brackets on the stain- less steel plates. The samples were tested under different time intervals, from one day to three weeks, on the assumption that the patient is seen every three weeks. In the tear, or fracture tests ten sam- ples of each group of materials were tested: 3/16”-444 ounce latex elastic, Ormco Power Chain, Unitek AlastiK Cz double and triple loops. The force value was read at cach five millimeter interval and recorded on graph paper. The sample was stretched between the brackets until fracture. For the second part of the test from ten to twenty samples of each group were stretched to the predetermined distance of 17 millimeters with the help of the previously described jig. The force values were then recorded. The rate of elongation, or modulus of elasticity, was measured with the u right test instrument as described in part three of this study. Incremental weights were placed and the amount of200 elongation was recorded, Five samples of each condition were tested and plot- ted on graph paper to determine the slope. In the fourth part of this study the rate of force decay under continuous force application was determined. The materials were tested using the upright leaf spring device in a waterbath at 98°F, The 3/16” latex elastic, Ormco Pow- er Chain, and Unitek AlastiK C, double loop were tested up to three weeks. A second group of materials was tested also: nylon covered latex thread, T.P. Zing String, American Orthodontic Plastic Tie, and Ormco Power Thread This group of materials is available to the orthodontic profession in thread- string form. A method was necded to compare samples of similar circumfer- ences to each other. A jig with a cir- cumference of 30 millimeters was used to fabricate the material into a loop. ‘The two ends of the string were secured by a crimpable clamp to fix the thread and was additionally knotted to pre- vent possible slippage through the clamp. The same amount of material was contained in cach sample in the relaxed state. The upright spring leaf gram gauge testing instrument (Fig. 3) used was placed in a 98°F water bath. The amount of force reduction was recorded at one hour, two hours, four hours, cight hours, and at each 24 hour inter- val thereafter for 21 days, The two ranges of forces were applied by the leaf spring. One set of samples had an initial force of 450 grams while the sec- ond set had an initial force of 300 grams. Finpines Part One 3/16” latex clastics fractured at ap- proximately 7.1 grams at an elongation of 45. millimeters. The range varied from 6.5 to 10.6 grams. After 21 days Wong April 1976 the latex elastics lost about 50% of their strength fracturing at 3.2 grams at 38 millimeters. The double loop Ormco Power Chain in the dry, unaltered factory condition had an average fracture val- ue of 5.0 grams at 19 millimeters. The range of force recorded varied from 3.5 to 5.3 grams while the elongation at fracture varied from 18 to 23 milli- meters. The dry Unitek AlastiK C, double loop had a mean value of 4.8 grams before fracturing at 16 millimeters. The force varied from 3.9 to 5.3 grams and fractured at 15 to 18 millimeters. The Ormco double Joop Power Chain, after immersion in a 98°F wa- ter bath for 24 hours, had an average fracture force of 4.8 grams at 23 mi meters. The Unitek AlastiK C, had an average fracture force of 5.3 grams at 12 millimeters. At 14 days the Unitek AlastiK C. had a fracture value of 5.3 grams at 12° millimeters. The Ormco double Power Chain at 14 days had a frac- ture value of 4.8 grams at 23 millime- ters. The Unitek AlastiK C, at 21 days had a fracture value of 6.2 grams at I millimeters with a range of 3.9 to 7.1 grams. After 21 days the Ormco double loop Power Chain had a fracture force of 48 grams at 19 millimeters. The force ranged from 3.9 to 5.2 grams and the elongation at fracture ranged from 18 to 23 millimeters. The dry triple link Ormco Power Chain fractured at 5.9 grams at 40 millimeters while the Unitek AlastiK G, triple link fractured at 5.5 grams at 27 millimeters. In 24 hours the read- ings for the Unitek AlastiK C. triple link were 4.3 grams at 18 millimeters The triple link Ormco PC IT Chain fractured dry at 4.3 grams at an elon- gation of 40 millimeters. It had a frac ture force range from 3.5 to 6.2 grams.Vol. 46, No. 2 Elastic Materials 201 TABLE I FORCE AND PERCENT LOSS AT CONSTANT ELONGATION Latex Ati7 mm — 3/16" Ormeo “Unitek = Ormeo_-—- Ormco‘ Unitek Unitek 44h 02 PC c, PC II PC Cy C, Dry oz 1.0 12.0 22.5 85 48 45 8.0 gm 12.4 21.2 39.9 15.1 85 8.0 14.2 1Day oz 5.75 6.0 69 6.0 2.0 2.0 2.0 gm 6.2 10.6 12.2 10.6 35 3.5 35 %loss—1T% —50% —T3% 29% 68% 56% 25% 7 Days on 5.0 45 45 4.0 1.15 2.0 18 gm 88 8.0 8.0 Ta BL 3.5 27 % loss —29% 63% 80% —53% 64% 56% —81% 21 Days oz 4.25 45 45 15 1.5 1.0 gm 7.5 8.0 8.0 2.7 2.7 15 % loss —40% —63% 79% 69% 61% 87% Dry- oz 5.0 1.0 8.0 3.0 3.0 2lDays gm 8.8 12a 13.9 5.3 53 %loss—28% —42% —63% 31% 33% After three days in the 98°F water reece bath the values were 3.9 grams at 42 millimeters. The elastomeric Ormco Power Chain with four circular configurations frac- ured when tested dry at a force value of 6.7 grams at 63 millimeters while the Unitek AlastiK had a force value of 7.5 grams at 47 millimeters. Part Two The samples were stretched over the brackets spaced 17 millimeters apart on the stainless steel plates. They were submerged in a 98°F water bath for various time intervals. This would de- termine the force decay at a constant elongation. The recording of the resid- ual force at constant elongation is one of the methods of describing force de- cay. The 17 millimeter distance repre- sents the interbracket space between the cuspid and the second bicuspid The findings of Part Two are shown in Table I. Part Three The results of the third part of this study, which is the change in the rate of elongation or the modules of elastic ity, are shown in Table IT. CHANGES IN THE MODULUS OF ELASTICITY (gm/mm) Latex 3/16" Ormeo Unitek 4% 02 PC c, Dry 22 46 89 1Day 20 42 80 3 Days 18 a4 82 14 Days wb Ba 80 21 Days 15 34 9 Part Four The initial rate of force decay was very rapid for all materials tested. The samples showed a loss of force in the first few hours after tension was ap- plied. The materials were tested at two force ranges. The first set had an ini- tial force of 450 grams and the second set had an initial force of 300 grams (Table III). Discussion The results of this series of tests in- dicated that elastomeric materials play an important adjunct in the orthodon- tic practice. Their roles include the re- traction force to move teeth into ex- traction sites, closing diastemas, selec-202 Wong April 1976 TABLE III FORCE DECAY UNDER CONSTANT FORCE APPLICATION ‘grams Initial 3 Hours 5 Days 21 Days ‘Ormeo PC 450 380 360 350 15% 20% 23% Unitek C, 450 370 340 330 11% 24% 27% Nylon Thread 450 430 430 430 — 5% — 5% — 5% Amer Ortho 450 340 340 340 Plastic Tie 25% 25% 25% Ormeo PC 300 260 250 13% 11% Unitek C, 300 270 270 250 —10% —10% 11% Nylon Thread 300 290 290 290 — 4% 4% — 4% TP Zing String 300 280 260 — 1% 13% Latex- 300 270 270 250 8/16" 4% oz 10% —10% 11% tive shifting of the midline, and gen- eralized space closure. The loops are used on the attachments as rotation and antirotation forces. The chains serve as ligatures to tie the archwire to the bracket. The elastomeric mate- tial provides an irritation-free system due to its smooth surface. Therefore, it does not have the problem of tissue ir- ritation as ligature wires do when they become protruded The oral hygiene problems have not been completely eliminated because there is a greater bulk of material around the bracket when compared with the wire ligature. Nylon covered la- tex loops collect food debris to a much greater extent than the elastomeric chain materials. Clinical observations show that the elastomeric materials are permanently clongated and undergo plastic deforma- tion. This deformation is related to the amount of time as well as the amount of stretch given to the materials. Latex elastics. remained more resilient and therefore have a more “relative” con- stant remaining force. Elastomeric ma- terials swelled less than latex elastics. Elastomeric materials do stain from certain types of food, such as mustard. As the manufacturers attempt to solve the staining problem by masking with metallic color inclusions, the strength and elasticity are reduced. The mate- rial’s resilient property is different from that of latex, The elastic retum curve, or resiliency recovery of the sample, does not necessarily follow the same slope. If the same sample is stretched again, the slope will be slightly differ- ent. This effect is the property of plas- tic deformation. The cross linkings of the molecular units and polymer chains, as well as the extent and time of elon- gation, are affected by heat and fluids. The resiliency property, or recovery, of synthetic elastomeric materials is not as fast as in latex. The elastomeric materials need to be prestretched one third of their length to prestress the molecular poly- mer chain. This procedure will increase the strength of the material. If the ma-Vol. 46, No. 2 terial is overstretched, a slow set will occur but will go back to the original state in time. If the material is over- stretched to near breaking point over and over again and remains fixed in its extension, permanent plastic deforma- tion will occur. The extent of resiliency and plastic deformation also depends on how fast and how long the material is stretched. There are many types and configura- tions of elastomeric materials available and more are being introduced to the profession for specific purposes. Differ~ ent sizes and spacing of circular con- figurations permit more efficient appli- cation of forces; for example, to close lower anterior teeth spaces the Unitek AlastiK C, and Ormco Power Chain II have closer links. The following discussion is related to some of the findings that were observed in the various parts of the study. Part One The latex elastic showed the greatest amount of strength lost after immer- sion in water as compared with the synthetic polymers. The latex showed the greater amount of resilience and strength before fracture. The Ormco Power Chain remained more constant in strength and resiliency when compared with the AlastiK ma- terials, Both materials fractured with similar forces. The Ormco Power Chain fractured at a greater stretch, almost 100% more than the Unitek Alastik chain. The fracture tests of both materials showed a great varia- bility in the range of tensile strength. Part Two The Ormco double loop chain ex- hibited a 50% loss in force as com- pared with the AlastiK double loop chain which showed a 73% loss in 24 hours. A. significant finding in this study was that the Unitek Alastik C: double loop, when stretched to 17 mil- Elastic Materials 203 limeters, had a force value of 641 grams (22.5 ounces) while the Ormco Power Chain gave a force value of 342 grams (12.0 ounces). In one day, both materials were down to 171 grams (6.0 ounces). Clinically, since the Alas- tiK G, gives a considerably higher ini- tial force, it may result in greater pa- tient discomfort. The decay in force explains why one may not achieve the desired tooth movement. The remain- ing force may be of such a magnitude that it will not be enough to move teeth on a continuous basis. Force de- cay (as much as 63%) was also ob- served when the samples were stretched dry for 21 days. Part Three The samples showed a great varia- tion in the modulus of elongation. The findings depended on the part of the plotted curve from which the readings were taken. They can serve only as a guide to determine what force could be obtained when applied to the tooth. ‘The modulus of elongation changes as the material is affected by the length of time it is in the mouth and changes in elongation as the tooth moves. All three materials tested indicated that the modulus of elongation changes under different conditions. The 3/16” latex elastics gave the least amount of force with 22 grams per millimeter. The Unitek C; double loop chain gave 89 grams per millimeter while the Ormco Power Chain was 46 grams per millimeter. Part Four The actual force decay under con- stant force application showed the greatest rate loss occurred before three hours in the water bath. After three hours the force value remained rela- tively constant throughout the 21 day period. The nylon latex showed the least amount of force loss, therefore, more force remained than in the syn-204 thetic polymers. This may be the re- sult of the nylon thread reinforcement. The chief disadvantage of the nylon thread is the oral hygiene problem which includes the discoloration and the food debris accumulation that oc- curs under the bulky knot. Summary anp ConcLusions Latex elastics and synthetic elasto- mers have certain similarities and dif- ferences. In the fracture tests the latex elas- tics showed a greater amount of loss in strength than plastic elastomers when stretched over a 21 day period. There is a great variability, as much as 50%, in the tensile strength of the plastic materials taken from the same batch and stretched under the same condi- tions. The Ormco Power Chain was more resilient than the Unitek AlastiK chain. The Unitek AlastiKs had more force and stretched less. The force decay of synthetic elasto- mers, stretched over a specific length and time, exhibited a great loss in force. This loss could be as great as 739% during the first day. The decay of force continued at a slower rate during the rest of the 21 day period. Unitek AlastiK C, double links, when stretched 17 millimeters, had a higher initial force averaging 641 grams (22.5 ounces) than the Ormco Power Chain which averages 342 grams (12.0 ounces). In one day the force was re- duced to 171 grams (6.0 ounces) for both materials Wong April 1976 The clastic materials within the same batch showed a great variation in the modulus of elasticity under di ferent test conditions. The approxi- mate force generated when stretched dry, within the elastic limit, was 22 grams per millimeter for 3/16” heavy latex elastics. The Unitek AlastiK Cz gave a force of 89 grams per millime- ter, while the Ormco Power Chain had a value of 46 grams per millimeter. The modulus of elasticity of all of the materials was much lower after immer- sion in the water bath. The force decay under constant force application to latex, elastic, polymer chains, and tied loops showed that the greatest amount of force decay oc- curred during the first three hours in the water bath. The forces remained relatively the same throughout the rest of the test period. The elastic materials undergo. per- manent deformation in shape. The syn- thetic elastomers exhibited plastic de- formation when the elastomers were stretched 17 millimeters for 21 days, In the dry condition the force decay was 63% for the Unitek chains and 42% for the Ormco Power Chain The synthetic elastomers should be prestretched before being placed in the mouth. The elastomers should be used within their resilient ranges. Clinical treatment procedures should take into consideration the rapid ini tial force decay of elastic materials that occurs during the first day and the residual forces remaining. 360 South California Avenue West Covina, Calif. 91790Vol. 46, No. 2 . Fieser, Loui Elastic Materials 205 REFERENCES . Andreasen, G. F. and Bishara, S.: Comparison of Alastik chains ‘with elastics involved with intra-arch mo- lar to molar forces. Angle Orthodont. 40:151-158, 1970, ————: A comparison of time re- lated forces between plastic AlastiKs and latex elastics. Angle Orthodont. 40:319-328, 1970. Introduction to Organic Chemistry. D.C. Heath and Co., Bos- ton, Mass., 1957. 4. Morton, Maurice. Rubber Technology. Van Nostrand Reinhold Co., New York, N.Y., 1973. 5. Newman, George V.: Biophysical properties of orthodontic rubber elas- tics, J.N.J. State Dental Society, 1963, 6. Roff, W. J., Scott, J. R., and Pacitti, J.: Handbook of "Common Polymers. GRC Press, Cleveland, Ohio, 1971. 7. Stern, J. J.: Rubber: Natural and Synthetic, Maclaren and Sons, Ltd. London, 1967.