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INTRODUCTION

Proper buccolingual inclination of anterior and posterior teeth is essential to provide better

esthetic, stability and functional occlusal relationship. With Edgewise appliance Torque or

buccolingual inclination was achieved by third order bends placed in arch wire. With Begg

appliance inclination was achieved with auxiliaries. But today, majority of orthodontic brackets

are pretorqued,it doesn’t mean there is no need to give third order bend in the arch wire.. In

reality many factors affects the torque expression. It may be biological factors or mechanical

factors. Moreover if the orthodontist does not have an understanding of torque, many adverse

tooth movements will result, making orthodontic treatment more difficult and treatment results

less desirable

In Orthodontics, as stated by Dr. EARMAN D. RAUCH

“Torque is the force that enable the orthodontist to control the axial

inclination of the teeth and to place them in the harmonizing positions that are so desirable

for a nicely finished results. Torque is the force that gives the operator control over the

movement of the roots of the teeth”.

Torque is a force that assists him to bring about a desirable change of point A &

B which in turn helps to bring about desirable facial changes in his patients.

Torque according to William proffit,James Ackermann and David Sarver…..

Relative crown and root inclination perpendicular to line of occlusion


Crown inclination is determined by the resulting angle between a line 90 degrees to the

occlusal plane and a line tangent to the middle of the labial or buccal clinical crown.

A Positive value or plus denotes the gingival portion of the tangent line (or of the crown) is

lingual to the incisal portion.

A Negative or minus denotes the gingival portion of the tangent line (or of the crown) is

labial to the incisal portion.

CROWN INCLINATION

Andrews Six Keys to Optimal Occlusion on 120 Non Orthodontic study models showed
-inclinations of maxillary incisors are positive;canines,premolars are negative and molars are

more negative than premolars.

The inclinations of mandibular crowns are progressively more negative from incisors

through the second molars.

Dr. Burstone presentation on Common Myths in Orthodontics reviewed on Torque as one

of the myth out of four subject areas:

The term “torque” is not used properly in orthodontics:


1. Torque is a force system. It is produced by torsion in an arch wire that creates a

couple when interacted with a bracket slot, which is the result of twist in the wire

compared to the bracket slot.

2. Torque is not “in the wire”. Torque is not the angle of the bracket slot. Torque is not the

axial inclination of the tooth. These are common orthodontic misuses of the term.

3. Torque applied to a tooth created by torsion in the arch wire against the bracket slot

spins the tooth around its center of resistance.


WHY? WHEN? & HOW?

Why ?

To bring about labiolingual movement of the teeth

To retain the teeth in the cortical bone

To avoid relapse

To give a natural finish to the dentition

How ?

Torque can be done both in fixed and removable machanotherapies

Torque in fixed appliance can be employed in different ways

1. By giving a twist in an arch wire

– commonly used in edgewise techniques

2. Torque exerted by the bracket itself

– Pre adjusted edgewise appliance

3. By use of torquing auxiliary

- widely used in Beggs technique and edgewise technique

PRINCIPLES OF TORQUE MECHANISM IN ORTHODONTICS

In a Rectangular wire, torque is incorporated by using a permanent twist in the arch wire; where

as in a Round wire, torquing auxiliaries are used to deliver third order couples to the anterior

teeth.
The amount of torsional activation achieved upon complete appliance engagement is however

actually less than this permanent twist angle. The principal portion of difference is the third

order clearance between the arch wire and the bracket slot. This clearance may be computed

from the actual cross section of the arch wire and occlusogingival bracket slot width. The third

order clearance depends upon the actual wire in the slot dimensions and in effect, upon stiffness

of the bracket slot

In response to the third order activation, the slot will open slightly as the wire attempts to

deactivate.

THIRD ORDER CLEARANCE BETWEEN RECTANGULAR WIRE AND EDGEWISE

BRACKET

THIRD ORDER CLEARANCE BETWEEN RECTANGULAR ARCH WIRE AND BRACKET

SLOTS

Pre Torque Brackets are sized, in part according to the third order angulation of their slots with

respect to faciolingual reference

Torque is determined in gram-millimeters or ounce inches

To quantify torque correctly the combination shaft stiffness and twist activation are necessary.

To compare third order couple generated by the rectangular arch wire and the

torquing span, the difference and the direction of the pairs of forces and the moment arms should

be noted.

The force exerted by the rectangular arch wire are directed nearly

occlusogingivally whereas the force pair from the torquing spur acts labiolingually. The

difference in the direction meaning less with respects to the action delivered to the dentition
Sagittal views of Maxillary incisors

Rectangular wire torque (left) and spur torque(Right)

The inheritant moment arms of the rectangular wire and the spur, couples are the

labiolingual wire cross section and occlusogingival height of the spur respectively.

They differ approximately in one order of magnitude i.e. the factor of ten. Hence

if the size of each force generator by the spur is about 1/10 that off each force of the pair

generated within the bracket. So the results approximately equal third order couples applied by

two appliances.

The Begg torquing auxiliary is usually formed in 0.012, 0.014 or 0.016 stainless

steel wire. The purpose of the base arch wire is to counter the extrusive potential associated with

activation of auxiliary.

Square or rectangular arch wires are fabricated from round wires by a process of

rolling rather than drawing. The round wire is passed through a device called a Turks head which

is a set of two rollers positioned 900 to each other and rolled to the desired dimensions. The

edges of the wire remain rounded after rolling process, resulting in edge bevel. The edge bevel is

expected to be a critical factor for actual torque expressed by a specific square or a rectangular

arch wire and bracket combination. Since the edges of the arch wire is first engaged the bracket

for torque delivery.

Largest edge bevels are observed on beta titanium segments due to the mechanical

and wire properties of this alloy. The amount of edge bevel on the wire will influence the

amount of torque exhibited by the wire bracket combination for a rectangular wire in a
rectangular molar tube, the critical value of the wire dimension is the diagonal or hypotenuse of

the wire cross section as shown in the figure

It is this dimension that contacts the wall of the lumen and engages the wire

against further rotation. This with the variation in the tube dimension causes deviation in torque

clinically. This deviation in torque may differ significantly enough to require diverse torque on

left and right molars in the same arch.

METHODS OF TORQUING IN VARIOUS APPLIANCE MECHANICS

BEGGS MECHANOTHERAPY :

The torquing in BEGG is testimonial to the genius Dr.BEGG, both with regards

to its concept and the designs. The special feature of BEGG appliance in separating the tooth

moving forces from the arch wire forces gives at a unique advantage. Various torquing

auxiliaries developed Dr.BEGG the

1. 2,4 and 6 Spur Auxillary

2. Mouse-strap for lingual root torque

3. Udder arch for labial root torque

4. Reciprocal lateral torquing auxiliary

5. Reverse torquing auxiliary

6. KITCHTON torquing auxiliary

Single root torquing auxiliary developed Dr.Kesling

RECENT ADVANCES - Refined BEGG

1. Reciprocal torquing auxiliary (‘SPEC’) Design

2. Reverse torquing auxiliary for controlling the roots of the canine or premolar by

Franciskus Tan in November 1987.


3. Buccal root torque and upper molars

4. Labial root torque only in the lateral incisors

5. MAA Auxiliary by Mollenhauer

TORQUING AUXILIARY WITH SPURS

Action of the torquing auxiliary

1. The auxiliary bent into a small circle, when fixed in the mouth, is spread out along the

wider anterior curvature of the arch wire. The lingual torquing effect is an account of two

factors.

a. Firstly, the vertical plane in which the torquing auxiliary orients when fitted on

two central incisors, is changed to a horizontal plane of arch wire when fully tied to it.

Secondly, when the torquing auxiliary is opened to a larger arc of anterior

portion of the arch wire it rolls inwards.

Both the effects, force the tips of the spurs to press in a lingual direction against

the gingival portion of the crown. Reciprocally the inter spur spans of the auxiliary tend to lift

away in the labial direction. THUS A FORCE COUPLE IS CREATED. The labial forces are

resisted by the bracket slots and the base arch wire to which the auxiliary is tied. Thus

accentuating the action of lingual root moving forces

ABOUT “THE SPUR”

1. The Auxiliary should be constructed in 0.012 premium plus wire (preferable pulse

straightened) unlike in 0.014 or 0.016 special plus wire which were previously used.
2. The length of the spur does affect the force produced. A short spur will produce much

greater force that will drop rapidly when the teeth start getting torqued, as against a longer spur

that produces a gentler and more constant force.

The length of the spur should be kept at about 5 mm; but it should be varied

depending on the clinical crown height, leaving it about 1 mm short of the gum to facilitate

proper hygiene

3. Inclination of the spurs to the horizontal (occlusal) plane is kept 0 0. In

other words, the activation is 100%.

4. The distal leg of every spur is kept slightly shorter by about 0.5 mm, so

that the distal leg does not project incisally to the main arch wire on tying

5. Activation of the spur

a. The inter-spur span is curved as recommended by Dr.Kesling’

Two of the modification commonly required in the spur design torquing auxiliary

are as follows.

a. Reverse labial torque on one or both the lateral incisors : Boxes at right

angle to the plane of the spurs are made to lie at the incisal area of the lateral incisor(s).

Crossover bends are made on either side of the lateral incisor bracket to permit the auxiliary to

pass over the base wire, similar to the bends described in the section on the MAA

Torquing boxes on the canines for lingual root torque : Instead of making spurs

for the canines, boxes can be provided. The ends of this auxiliary need not extend beyond the

canine area
MAA auxiliary was developed by Dr. MOLLENHAUER and it was given the

name as “An Aligning Auxiliary for Ribbon Arch Brackets”. The MAA, attempts root control

from the very beginning, of the treatment without significantly affecting the anchorage and

overbite correction. This has become possible by using a combination of a stiff base arch wire

made from 0.018” Premium plus, and ultra light root moving forces from the MAA made from

the 0.009” Supreme grade wire

Requirements for use of the MAA

Mollenhauer has enumerated the requirements as

1. It must generate very light root moving forces. Therefore, the wire size must

not exceed 0.009”.

2. For the same reason, when reciprocal torque is required on adjacent teeth, the

adjacent rectangles must not diverge by more than 45 degrees.

3. At the same time, the auxiliary must be able to resist deformation. Hence, it

must be made in a highly resilient wire viz. Supreme grade (preferable pulse straightened)

4. The base wire should be able to resist the vertical and transverse reactive forces from the

MAA. Therefore, it must be made in 0.018” Premium Plus wire.

5. In Mollenhauer’s application, the MAA is always engaged first and the main wire is engaged

piggyback. The rectangles for lingual root torque lift away from the tooth surface, which are

held down with the help of pins, thus indirectly transmitting the torquing action through the pins

to the brackets onto the teeth.

Therefore, he recommends the thickest possible lock or hook pins (such as the pins for

Ceramaflex brackets)

Advantages of the MAA


According to Molenhauer, the advantages of MAA are :

1. Efficacy in intrusion and advantages retraction of the

anterior teeth,

2. Efficiency in rapid bodily alignment of the anterior teeth

using gentle forces

3. Stable results.

4. Reciprocability of torquing forces on the in standing

laterals or palatally placed canines.

5. Periodontal advantages in such cases, because the gingival dehiscence associated with

prolonged labial root torquing of such teeth during the 3rd stage is eliminated.

6. A short stage III, because the early root control minimizes (uncontrolled) root tipping in the

opposite direction

7. Possibility of growing cortical bone at the A and B points

VARIOUS APPLICATIONS OF THE MAA

1. Originally, the MAA was introduced for bodily alignment of crowded teeth. The looped

arch wire like effect (expansion + de rotation + vertical leveling) was combined with lingual

and / or labial root torque

VARIOUS APPLICATIONS OF THE MAA

2. By bending more positive torque into the MAA, it can be used after the stage I as a

braking mechanism.

Mollenhauer strongly recommends applying labial root torque on the lower incisors in

growing brachyfacial cases, to prevent their roots from lingualizing (which can happen due to

intrusive forces and due to contraction of trans-septal fibers in extraction cases). This helps in a
better profile control. The MAA can be used for labial root torque on the upper incisors in Class

III cases

3. In later writings, Mollenhauer described use of the same auxiliary for controlling the

mesio-distal root positions from the beginning. He called this application ‘MAA-tip. A ligature

wire tied to the auxiliary and to the pin transfers the tipping effect to the tooth.

4. Modification can be used for reciprocal root torque

Other boxed Auxiliaries

Mini versions of MAA ranging from 0.009” to 0.012” and curvatures facing

incisally facing incisally or gingivally, for labial or lingual root control respectively. They are

employed on two or more number of anterior teeth in either or both the arches. The force exerted

by the boxes is varied, as per the individual requirement, by varying the diameter of the wire

from which the auxiliary is made, size of the boxes and acuteness of the curvature.

Obviously, the auxiliaries generating lighter forces are employed in the first and

second stages of treatment, while those generating higher forces are meant for the third stage and

sometimes in the second stage as a breaking mechanics

a. Two boxes on the upper central incisors for lingual root torque after the teeth are

aligned

b. Two boxes on the in standing upper or lower lateral incisors for labial root torque.

‘Jenner’ auxiliary two boxes on the upper or lower canines with very prominent

roots. That is made up of 0.012” wire. Lingual root torque exerted by the boxes reduces the

prominence to facilitate anterior retraction

d. ‘SPEC’ design – Reciprocal torquing auxiliary – it is employed when two

adjacent teeth require root torque in opposite directions. One such example is an in standing
lateral incisor needing labial root torque and the adjacent canine needing lingual root torque. This

auxiliary is made of lighter 0.009 or 0.010 could be used for controlling the root movements

during the first and second stages.

If needed in stage three it should be made of 0.012.The box on the tooth requiring

labial root torque is placed incisal to main wire, while the box on the other tooth requiring

lingual root torque sits piggyback on the main wire .hence a crossover bend is required between

the two adjacent teeth because the auxiliary has to cross over the main wire.varying the

angulation between the planes of two boxes can control the force generated by the auxiliary

Some other torquing auxiliary designs

a. Single root torquing auxiliary proposed by Dr.Kesling’. This is a very useful design for

any tooth (excepting the molars) requiring torque in the labial or the lingual direction. It is

particularly indicated on an UPPER PREMOLAR , which needs buccal root torque. To

eliminate the cuspal interference from its hanging palatal cusp. It is convenient to place the long

arm of the auxiliary piggy back over the main arch wire. Since the main arch wire may not be

untied it could also lie occlusal to the base arch wire in the slot as well. The long arm should

extend to three to four adjacent teeth when engaged in the brackets.

The long arm always faces mesially for the premolar teeth. Depending on

how the curvature is pointing before the auxiliary is tied, the torque generated will have lingual

(palatal) or buccal root moving effect.

For example, the auxiliary fitted with its convexity facing upwards will have a

buccal root torquing effect on the upper premolars, but the effect will be for lingual root torque

on the lowers, and vice-versa. The effect is transmitted by the vertical extension of the auxiliary

through the bracket pillar onto the tooth; The long arm could face either mesially or distally on
the anterior teeth, and action will depend on how the curvature of the long arm relates to the base

arch wire. This auxiliary is made up of 0.012 size Premium Plus wire. The force generated by it

can be varied by changing acuity of the curvature. More acute greater is the force generated.

b. Reverse torquing auxiliary for controlling the roots of canines or premolars proposed by

Dr.Franciskus Tan - It was described for the labial root movement of a palatally impacted

maxillary canine, whose crown has been aligned but the root is still placed palatally and needs

labial root torque. If required for lingual root torque in other situations it is simply inverted well

on the premolars made up of 0.012” P+ wire conjunction with a 0.018” or 0.020” inserted in the

molar tube from the distal end. An offset is placed in the auxiliary to bypass the main wire

rotated by 1800 for activating it

c. Buccal root torque on the molars – When the upper molar crowns roll buccally because of a

lack of control during the third stage, their roots must be torqued buccally to lift their palatal

hanging cusps. It is made in 0.014” size and is fitted in the round molar tubes alongside the main

arch wire. It has ‘boot’ design occlusal extensions on the molars, and it is inserted from the

mesial end of the molar tubes. The boot portion is twisted lingually and given a toe in, and the

whole auxiliary is suitable contracted. The auxiliary need not be engaged in other brackets.

It can be ligated to the main wire at 2-3 places on either side

d. Labial root torque only on the lateral incisors – This is made up of 0.012” size wire, and is

placed with the convexity of the auxiliary facing gingivally. The auxiliary is engaged first in the

incisor brackets, and the main wire is then engaged piggyback. The boxes extend labially on the

incisal area of the crowns. This design is often required on the lower incisors in those cases

where the central incisors and the canines are placed normally, and hence do not require

reciprocal lingual root torque


e. UPPER ARCH - The udder arch is made up of 0.16 S.S.wire. The vertical loops of the

auxiliary can be opened or closed as needed to assume accurate fit. The distal ends of the

auxiliary is tied to the lower cuspid bracket. The vertical loops are slipped behind the main arch

wire and the auxiliary is tided to one or two brackets to prevent dislodgement. It is very easy to

insert and remove. This is used for the reverse torquing of the mandibular incisors.

f. Kitchton torquing auxiliary - It is used for applying torque force on the anterior teeth.

Kitchton auxiliary can be used with Begg, edgewise and removable appliances. It is made up of

0.016 Australian wire. Coils in the midline assume gentle, and continuous torque force and also

provide means of attachment to the main arch wire.

It is of two types :

1) Small 2) Large

* Small auxiliary delivers gentle lingual root torque to the central incisors only. It can be used

with the Hawley’s retainer for additional root torque.

Large auxiliary can deliver greater force to the central incisor and can be adjusted

to deliver torquing force to the central and lateral incisors. It an also be used with Hawley

retainer for additional root torque

Mouse trap

Mouse trap design is very efficient but involves more time patience and skill

EDGEWISE MACHANOTHERAPY

The edgewise arch appliance is the last of many contributions of Dr.EDWARD H.

ANGLE and was introduced to the profession by one of his last students, Dr.ALLAN G.
BROADIE in 1929. It is an exacting appliance requiring the thorough understanding and skill

manipulation. This technique offers excellent controls in the labiolingual, mesiodistal and

vertical dimension

The classification of tooth movement associated with edgewise appliance seem to

be based upon the type of movements rather than direction.

i. Movement of the First order

ii. Movement of the Second order

iii. Movement of the third order

We will see here movement of the Third Order

Before we go into it we will have quick view over glossary

Passive torque – torque for proper placement of the wire

Active torque – for active tooth movement

Progressive torque- increase of the torque value progressively as we go posteriorly in the

dentition

Torque force is named according to the action upon the tooth crown.

1. Lingual torque – crowns are tipped lingually

and roots labially / buccally

2. Labial or buccal torque – crowns are tipped

labially or buccally and the roots lingually

THIRD ORDER MOVEMENTS :

It is defined as the difference in inclination of the facial plane of crown at its mid

point in an ideal occlusion.


The third order bends better known as torque are placed in the arch wire to effect

buccolingual or labiolingual root and crown movements in a single tooth or a group of teeth

TECHNIQUE FOR GIVING A THIRD ORDER BEND FOR VARIOUS THIRD ORDER

MOVEMENTS

Individual lingual Root torque central incisor area

Checking the amount of torque

Continuous posterior torque

Progressive Posterior Root Torque

PRE ADJUSTED EDGEWISE APPLIANCE:

Until the mid 1970’s most fixed appliance therapy was carried out using the

standard Edgewise bracket, either in a single or twin form having a 90 0 bracket base and brackets

slot angulation.

The Major disadvantage resulted from this treatment are;

1. Arch wire bending is time consuming and tedious.

The short comings of the bracket system and the extreme skill required of the orthodontists

resulted in many under treated cases and the results are appeared artificial

Molars were not in true CL-I relationship. Upper incisor are under torqued . So

the resulting occlusion had the appearance of a ‘nice orthodontic result’ rather that a pleasing

natural dentition. And also the long term stability of tooth adjustment was compromised by

failing to establish ideal tooth relationships.

Against this background Dr.Lawrence F.Andrews developed the straight wire

appliance which became widely available in the mid 1970’s. It was hailed by the clinician’s as a
radical step forward offering the dual advantages of less wire bending, coupled with an improved

quality of the finished cases

TORQUE IN THE BASE

Vs.

TORQUE IN THE FACE

Torque-in-base was an important issue with the first and second generation pre

adjusted brackets, because level slot line-up was not possible with brackets designed with torque-

in-face. Torque in the base is said by Andrews to be a prerequisite for a fully programmed

appliance – that is, one that produces acceptable results without arch wire bends, assuming the

brackets are placed correctly.

Albert H.Owen in 1980 conducted a study comparing Roth Prescription and the

Vari Simplex Discipline appliance of Alexander concluded that while torque in the base had a

sound theoretical basis, its effectiveness is greatly influenced by the clinician’s success in

accurately placing the brackets

The torque in the base means that the bracket stem is parallel and

coincides with the long axis of the bracket slot. But, with the brackets having torque in the face

the slot is cut at an angle to the bracket stem, therefore their long axis do not coincide and are not

parallel to each other

When the center of the bracket base is placed on FA point the long axis of

the bracket stem and bracket slot both are parallel to and are in line with Andrew’s plane. But

this is not possible with brackets having torque in the face

Theoretical effects of torque-in-face on the final positioning of FA point - The

undesirable effects of having torque in face are in-built errors in finale vertical positioning. The
absolute magnitude of vertical displacement will depend upon the torque angle, its direction

(occlusal or gingival) and of course its effect will be reversed if the torque is also reversed. The

only site however at which the torque direction changes completely in the standard straight wire

prescription is between lateral incisor (torque = +30) and canine (torque= -70)

Ferguson concluded that the advantages of the torque in base are largely

theoretical, but it should be kept in mind that there are other advantages. One such advantage is

that the wings of the brackets with torque in the face could bend under various forces

TORQUE IN VARIOUS STRAIGHT WIRE PRESCRIPTIONS

TORQUE ADDITION IN MBT APPLIANCE

1. Additional palatal root torque for upper incisors

and additional root torque in labial incisors

2. Upper cuspid brackets with a normal -70 torque

or 00 torque.

3. Upper molar brackets with an additional 50

buccal root torque.

4. Progressive Buccal root torque in the lower

cuspid and lower buccal segments

Note : Reversion of Bracket will reverse the torque prescription of the bracket but the tip

remains the same

PLAY OF THE WIRE IN THE BRACKET

What is play ?

The difference between the slot width and the

dimension of the arch wire is termed as play


The amount of the play wire bracket interface is

also influenced by ligation

If the wire not fully engaged the effective torque

decreases

But generally there is some play between the bracket and arch wire even if the slot is filled with

full dimension wire.

Because the dimension of the wire will be slightly smaller than the label dimension and slot

width are larger than they are labeled

TORQUING IN REMOVABLE APPLIANCES

Various types of torquing springs are used to bring about root movement or

torquing. Normally they derive their elasticity from the twisting of a section of wire in the same

way as torque bars of high tensile steels used for suspension systems in road vehicles

A typical torque springs have the following parts

A A’ : Fixed firmly in base plate

B B’ : Torque bars

C C’ : Apron spring for rotquing

Apron spring derive their main flexibility from the twisting of the section and the

length of the torque bars. These torque spring are flexible, easy to construct, easily positioned

and adjusted

It is ensure that the torquing springs act exactly at points intended and do

not slide away to the unsuitable points. For this reason it is sometimes necessary to make springs

rather stiff in order to ensure accuracy of the application to the teeth


In 1975 BASS has shown that palatal root movement is performed by applying

pressure in a lingual direction at the gingival margin on the incisor and preventing the lingual

movement of the crown by using “Swed bite plane”.

Watkin in 1933 used a box type of attachement for root movement.

In 1938 McKeag and Friel described a box attachment made up of stainless steel

to induce torque. This box was well known as “M” Ckeag Box”

CONCLUSION

Torque is probably one of the most important and potent forces of orthodontic treatment

mechanism with proper understanding and with systemic technical approach,is not difficult to

accomplish

The operator’s ability to control torque properly will mean the difference

between artistically treated case that has all esthetic beauty desired in a finished denture and an

ordinary tooth straightening accomplishment that contains very few of these desirable features

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