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Mechanical Principles in

Orthodontic Force Control

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Two Types of Orthodontic Appliances:


Removable vs. Fixed
Fixed appliances
• Bands
• Brackets
• Wires
• Accessory appliances

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Brackets Brackets
• Metal bracket • Clear Bracket

• 24K plating gold bracket

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Plastic brackets Ceramic brackets
• Staining and discoloration • Advantages over plastic brackets:
• Poor dimensional stability – Durable, resist staining
• Larger friction – Can be custom-molded
– Dimensionally stable
• Disadvantages over metal brackets:
– Bulkier than metal bracket
– Fractures of brackets
– Friction is bigger than that in metal bracket
– Wear on teeth contacting a bracket
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– Enamel damage on debonding

Self ligating bracket


• Metal-reinforced ceramic bracket

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Self ligating bracket

“Smart” Clips

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Step 1: Step 2: Step 3: Step 4: Step 5:
Visit your Invisalign® You receive You wear You've

Invisible orthodontics? orthodontist


or dentist
makes your
aligners
your aligners
in a few
your aligners. finished
treatment!
weeks.

• Lingual brackets

• Invisalign

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Invisalign

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Clear aligner therapy (CAT)
applicability
Fig 11-16
CAT performs well: CAT does not perform well:

•Dental expansion for


• Mild-moderate crowding with IPR blocked-out teeth
or expansion •Extrusion of incisors*
• Posterior dental expansion •High canines
• Close mild-moderate spacing •Severe rotations (particularly
• Absolute intrusion (1 or 2 teeth of round teeth)
only) •Leveling by relative intrusion
•Molar uprighting (any teeth 0.1-0.5 mm in thickness
• Lower incisor extraction for
with large undercuts)
severe crowding
•Translation of molars*
• Tip molar distally •Closure of premolar
extraction spaces*

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Invisalign vs. braces


• patients treated with Invisalign relapsed
more than those treated with conventional
fixed appliances.
– Kuncio D
D, et al
al. Angle Orthod 2007;77: 864
864-9
9
6 weeks later

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Wires Wire
• Type:
– NiTi wire (Nickel-Titanium wire)
– TMA wires (Titanium-Molybdenum-Alloy)
– Stainless steel wire
• Shape
– Round wire
– Rectangular wire

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Fixed appliance: properties of arch wires General Characteristics of
– related to force levels, rigidity, formability, etc. Orthodontic Forces

• Optimal: light, continuous


– Ideal material
• Maintains elasticity
• Maintains force over a range of tooth
movement

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Materials & Production of Orthodontic


Force
• Elastic behavior
– Defined by stress-strain response to external load
• Stress= internal distribution of the load; force/unit area
• Strain= internal distortion produced by the load;
deflection/unit length

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Orthodontic Model: Beam Beam Properties in Orthodontics


• Defined in force
deflection or stress-
strain diagrams
• Useful properties:
– Stiffness
• Force applied to a
– Range,
Range springback
beam = stress
– Strength
• Measure deflection
= strain; examples:
• Bending
• Twisting
• Change in length
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Bending Properties of an Orthodontic Wire Stiffness of an Orthodontic Wire
Defined by 3 points Modulus of elasticity (E)
1. Proportional limit – Young’s modulus
• Point at which
permanent deformation – Stiffness below
is first observed proportional limit
• Similar to “elastic limit”
– Slope
p of load-
2 Yield
2. Yi ld strength
t th
• Point at which 0.1%
deflection curve
deformation occurs – Stiffness α E
3. Ultimate tensile (yield) – Springiness α 1/E
strength
• Maximum load wire can
sustain

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Stiffness versus Springiness Range versus Springback


• Reciprocal • Range
relationship – Distance wire will
bend elastically
– Springiness=
before permanent
1/stiffness deformation
• Related to elastic • Springback
portion of force- – Found after wire
deflection curve deflected beyond its
(slope) yield point
– More horizontal= – Clinically useful
• Wires often deflected
greater springiness past yield point
– More vertical= stiffer 33 34

Relationship of Strength, Stiffness & Range Resilience, Formability


• Strength = stiffness x range • Resilience
– Area under stress-
strain curve to
proportional limit
– Represents energy
storage capacity
• Formability
– The amount of
permanent
deformation a wire
can withstand before
breaking
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Ideal Orthodontic Wire Material Wire Materials
• Deflection properties: • Precious metal alloys
– High strength – Before 1950’s: gold alloys, corrosion resistant
– Low stiffness (usually)
– High range
• Stainless steel, cobalt-chromium (elgiloy®)
– High formability alloys
• Other properties: – Improved strength
strength, springiness
– Weldable, solderable – Corrosion resistant: chromium
– Reasonable cost • Typical: 18% chromium, 8% nickel
• No one wire meets all • Nickel-titanium (NiTi) alloys
criteria! – 1970’s applied to orthodontics
– Select for purpose
– Demonstrates exceptional springiness
required
37 • Two special properties: shape memory, superelasticity
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Austenitic NiTi (A-NiTi) Uses of Ni-Ti Arch wires


• Introduced 1980’s • Good choice:
– Demonstrate superelasticity – Initial stages of Tx
• Large reversible strains – Leveling and aligning (good stiffness,
– Over wide range of deflection, force nearly constant range)
– Very desirable characteristic • Poor choice:
• Non-elastic stress-strain (force deflection) curve – Finishing
Fi i hi ((poor fformability)
bilit )
• E.g., Chinese Ni-Ti

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Elastic Properties: Effects of Size and


Shape

• Wire properties
– Significantly affected
by wire (beam) cross
section and length
g
6 weeks later • Magnitude of change
varies with wire
material
• Similar proportional
changes among wire
materials

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Elastic Properties: Effects of Size and
Effects of Diameter: Cantilever
Shape Effects of Diameter: Cantilever
• Strength
• Range
– Changes to third power
• Ratio between larger to – E.g., double
smaller beam diameter: half the
• E.g., double diameter: range
deliver 8x strength
• Springiness
– Changes to fourth
power
• Ratio between smaller
to larger beam
• E.g., double diameter:
wire 1/16 as springy 43 44

Effects of Length (Cantilever) Effects of Length (Cantilever)


• Strength • Range
– Decreases proportionately – Increases by square of ratio
– E.g., double length: half the strength – E.g., double length: 4x the range
• Springiness
– Increase by cube of ratio
– E.g., double length: 8x the springiness

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Spring Design Biomechanical Design Factors in


• Requires appropriate balance: Orthodontic Appliances
– Heavy wire: • Terms:
• High strength, high force, low range
– Force (F): load applied to object that
– Light wire: will tend to move it to a different
• Low strength, low force, high range position in space
• Example:
a p e removable
e o ab e app
appliance
a ce • Units: g
grams,, ounces
– Finger spring – Center of resistance (CR): point at
– High strength needed to avoid which resistance to movement can be
deformation concentrated
• Object in free space: CR=center of mass
– Force can be reduced by increasing
• Tooth root: CR=halfway between root apex
wire length and crest of alveolar bone
• Add helix

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Design Factors in Orthodontic Design Factors in Orthodontic
Appliances Appliances
– Moment: product of force times
the perpendicular distance from – Couple: two forces equal
the point of force application to in magnitude but opposite
the center of resistance in direction
• Units: gm-mm • No translation
• Created when line of action of a • Produces pure rotation
force does not pass through the around center of resistance
center of resistance
– Force will translate and tend to rotate
object around center of resistance

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Design Factors in Orthodontic Friction


Appliances
• Can dramatically affect the rate of tooth
movement
– Center of rotation: point • Considerations:
around which rotation 1. Contact angle between orthodontic bracket
occurs when object is and arch wire
being moved 2. Arch wire material
• Can be controlled with 3. Bracket material
couple and force
• Can be used to create
bodily tooth movement

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Contact Angle Friction and Tooth Movement


• When sliding a tooth • Effects of arch wire
on an archwire: material
– Tooth tips • The greater titanium
– Further tipping content, the more
prevented by friction
momentt created
t d as
– Due to surface
bracket contacts wire
reactivity (chemistry)
= contact angle
– Increase contact • Sliding resistance:
angle = increase titanium > stainless
resistance steel arch wires
• Greater force needed
to overcome friction 53 54

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Alternatives to Sliding (Friction)
Tooth Movement
• Effects of bracket Segmented mechanics
material or closing loops
– Stainless steel: least mechanics
friction • Activate loops
– Titanium brackets: • Loops close to original
shape
p
hi h ffriction
high i ti lik
likely
l
• Retract teeth toward
– Ceramic: space as loops close
• Rough, hard surface • No sliding, no friction
• Increases friction • “Frictionless” mechanics
– Ceramic with steel
slot
• Reduced friction
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Summary
• Ideal orthodontic forces
• Wire properties
– Strength, stiffness, range
(springback)
– Resilience, formability
• Wire materials
• Changes in diameter, length
• Design factors
– Force, center of resistance,
moments, couples, center of
rotation
– Use of rectangular wires: couples
• Friction 57
– Contact angle, wires, brackets

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