Space Closure and Anchorage Control

Andrew J. Kuhlberg and Derek N. Priebe

The ability to close extraction spaces preferentially is an essential skill

required during orthodontic treatment. Although many approaches to space
closure and anchorage control have been described, the biomechanical
principles defining the nature of the force systems applied show many
similarities between otherwise diverse techniques. The core concept of
anchorage control is the delivery of a differential force system to the anchor
teeth relative to the active teeth. Specifically, anchorage is determined by
applying unequal moment-to-force ratios (M/F ratios) to each unit. This
implies the use of orthodontic appliances that provide either unequal forces
or unequal moments. Unequal moment force systems or differential mo-
ment force systems are an excellent means of achieving anchorage control.
The fundamental concepts and clinical methods of anchorage control are
described. (Semin Orthod 2001;7:42-49.) Copyright© 2001 by W.B. Saunders
Company

o a n c h o r is to secure firmly, to hold an T h e p r o b l e m of a n c h o r a g e control is rooted

T object against m o v e m e n t ; anchorage is that
which provides the secure hold. Specifically,
orthodontic anchorage is the ability to prevent
tooth m o v e m e n t of one g r o u p of teeth while
moving a n o t h e r tooth or teeth. Controlling an-
chorage is one of the most critical elements of
orthodontic treatment.
O r t h o d o n t i c tooth m o v e m e n t is the result of
the controlled application of mechanical forces
to the teeth and periodontium. T h e stimulus
that provokes the biologic activity leading to
tooth m o v e m e n t is the mechanical forces ex-
erted by orthodontic appliances. The response is
b o n e r e m o d e l i n g and repositioning of teeth.
From this perspective, orthodontic t r e a t m e n t
can be conceived of as a stimulus-response
model. Anchorage control involves the ability to
create appropriate force systems (stimulus) that
will provide the desired t r e a t m e n t effects (re-
sponse).
From the Department of Orthodontics, University of Connecticut,
School of Dental Medicine, Fa*mington, CT.
Address corresponden~ to An&vw J. Kuhlberg, DMD, MDS,
Department of Orthodontics, University of Connecticut, School of
Dental Medicine, l~}*~raington, CT 06030.
Copyright © 2001 by W.B. Saunders Company
1073-8746/01/0701-0006535.00/0
doi:l O.1053/sodo. 200 l. 21073
in Newton's third law of motion, for every action
there is an equal and opposite reaction. Thus,
the distal forces acting to retract anterior teeth
must be o p p o s e d by equal forces acting on the
anchorage units in the mesial direction. The
mesial forces must be accounted for to avoid
anchorage loss. In light of this, orthodontists
have developed a variety o f strategies and tech-
niques to maintain a n c h o r a g e by applying m a n y
m e t h o d s to inhibit or prevent m o v e m e n t of the
a n c h o r teeth. Historically, most techniques for
a n c h o r a g e control were developed empirically,
yet their efficacy reflects the ingenuity of their
inventors.
Several anchorage control m e t h o d s have
b e e n developed over the last century. TM T h e con-
tributions of such icons as Angle, Case, Tweed,
Begg, and others have provided a f o u n d a t i o n for
modern orthodontic m e c h a n o t h e r a p y . Al-
t h o u g h each of t h e m espoused different meth-
ods and philosophies, a review of their individ-
ual works shows m o r e similarities than
differences.
By 1907, E.H. Angle advocated 5 types of
anchorage control. Occipital a n c h o r a g e de-
p e n d e d on the use of extraoral headgear. Inter-
maxillary a n c h o r a g e included the use of elas-
tics. 1 T h e 3 r e m a i n i n g m e t h o d s were dental
a n c h o r a g e techniques. Angle decribed simple,

42 Seminars in Orthodontics, Vol 7, No 1 (March), 2001: pp 42-49

 Space Closure and Anchorage Control
reciprocal, and stationary m e t h o d s for dental
anchorage. Both simple and reciprocal anchor-
age methods relied on c o m p e t i n g support of the
dentition to effect tooth displacement. In con-
trast, Angle's stationary a n c h o r a g e m e t h o d s
were based on his view that firm support of the
a n c h o r a g e units, t h r o u g h handing multiple
teeth, acted to resist tipping and thus p r o m o t e
anchorage.
Calvin S. Case also advocated stationary an-
chorage m e t h o d s despite his ideological depar-
ture f r o m Angle's "New School. ''9 Although he
described the use of extraoral a n d intermaxillary
forces, he too recognized that resistance to tip-
ping movements was requisite for intraarch an-
chorage control. With a singular approach, Case
advocated the use of firm, soldered a t t a c h m e n t
of the anchorage teeth to one a n o t h e r to main-
tain their upright positions. Case stated that,
with this strategy, "the applied force will be
equally distributed over the entire mesial or dis-
tal surfaces of the alveoli for all the roots, in-
creasing the stability of the anchorage to an
incalculable degree. ''2
Approximately 20 years later, Charles Tweed
advocated similar techniques. His m e t h o d of an-
chorage p r e p a r a t i o n was a i m e d at maintaining
the anchorage teeth against unwanted tipping
and extrusive side effects. ~,5,6 A series of tip back
bends acted to a n c h o r the teeth like tent stakes
to resist vertical and anteroposterior displace-
m e n t during intermaxillary elastic traction. Al-
though Tweed r e p o r t e d that his m e t h o d s were
m o r e mechanical in nature than biologic, the tip
back bends were generally a further r e f i n e m e n t
of Angle's and Case's stationary anchorage
methods.
Despite his a d h e r e n c e to the differential
force theory, P.R. Begg also used a similar pro-
cedure for anchorage control. 7-9 With the use of
his light wire technique, Begg regularly used tip
back bends to help maintain the anteroposterior
position of the anchorage teeth to effect prefer-
ential tooth movement. 4,m Additionally, he pro-
posed tipping the anterior teeth during initial
retraction, followed by an uprighting phase.
All of these m e t h o d s have proven to be gen-
erally effective and well-accepted a p p r o a c h e s to
orthodontic m e c h a n o t h e r a p y . Further advance-
ments in these techniques have b e e n evolutions
rather than revolutions. The c o m m o n denomi-
nator of these and subsequent techniques is that
43
each aimed at controlling the type of tooth
m o v e m e n t that occurred, ie, tipping versus
translation.
Fundamentally, advocates of m a n y of the con-
t e m p o r a r y orthodontic techniques have a d a p t e d
their a p p r o a c h e s to different hardware designs.
U n d e r s t a n d i n g the conceptual basis of biome-
chanics in a n c h o r a g e control permits greater
latitude in t r e a t m e n t delivery and transcends the
limits of any specific technique. Additionally, the
c o n t e m p o r a r y shift toward compliance-indepen-
d e n t orthodontic t r e a t m e n t further requires a
grasp of f u n d a m e n t a l biomechanical principles.
Anchorage from a Biomechanical
Perspective
The basic techniques for a n c h o r a g e control gen-
erally rely on 3 essential similarities: (1) ex-
traoral forces on the anchorage unit (headgear),
(2) intermaxillary elastics, (3) tipping move-
ments of the active teeth while simultaneously
discouraging tipping of the anchorage teeth.
Patient compliance is a m a n d a t o r y r e q u i r e m e n t
for h e a d g e a r and elastic wear. Without cooper-
ation, control of tooth m o v e m e n t is lost and
t r e a t m e n t o u t c o m e may be c o m p r o m i s e d .
T h e a t t e m p t to maintain anchorage by pro-
moting different types of tooth m o v e m e n t for
the active teeth versus the a n c h o r units shows
the biomechanical essence of a n c h o r a g e con-
trol. U n d e r s t a n d i n g how this strategy works re-
quires an analysis of how the applied force sys-
tems d e t e r m i n e the resulting type of tooth
m o v e m e n t . T h e relationship between mechani-
cal force systems and tooth m o v e m e n t has b e e n
well described and illustrates that the nature of a
tooth's m o v e m e n t depends on the ratio of the
applied m o m e n t relative to the applied force
( M / F ratio) at the orthodontic bracket, n
T h e way a tooth moves is d e p e n d e n t on the
nature of the forces (ie, the force system) im-
posed on it. T h e force system includes the ap-
plied force and m o m e n t s at the bracket (via
elastic, coil, loop, etc), and the actual force dis-
tribution a b o u t the p e r i o d o n t i u m (stress-strain
relationship). T h e force distribution is a func-
tion of the tooth's center of rotation. 11-21 Con-
trolled tipping is tooth m o v e m e n t with the cen-
ter of rotation of the tooth at the root apex. T h e
resultant forces tend to be distributed at the
marginal portion of the periodontal ligament
44 Kuhlberg and Priebe

(PDL). The M / F ratio for controlled tipping is & i

reported at approximately 7/1 for most teeth

with normal periodontal support. Translation or
bodily movement, on the other hand, maintains
the axial inclination of the tooth with the center
of rotation at an infinite distance from the apex.
The resultant force distribution tends to be
more equally distributed along the pressure side
of the alveolar structures. Translation requires a
M / F ratio of about 10/1. Lastly, root move-
m e r i t - - o r displacement of the root apex while
holding the crown stationary--occurs with a
M / F ratio of 12/1. Here, the applied forces tend
to be concentrated along the apical ½ of the

C
root (Fig 1).
Why does this analysis show the biomechani-

Controlled
Tipping
M/F -7:1 Figure 2. The effect of a large M/F ratio on tooth
movement. A large M/F ratio produces root move-
ment (A). A pure moment would produce only rota-
tion, which would result in distal crown movement
(B).

cal essence of anchorage control? First, let us

Translation look at the effect of a high M / F ratio applied to
the a n c h o r teeth. An applied force at the crown
M/F -10:1
produces uncontrolled tipping as a result of the
m o m e n t of the force. The applied m o m e n t (mo-
m e n t of the couple) counteracts the tipping ef-
fect of the force. The applied m o m e n t acts in
the opposite direction of the m o m e n t of the
force. It moves the root(s) toward the extraction
space. In addition, as the magnitude of the ap-
plied couple increases, the rotation of the tooth
would move the crown away from the space
Root (Fig 2).
Movement
Conversely, a low M / F ratio produces tipping.
M/F -12:1 With the apex remaining stationary, the crown
tips toward the extraction space. Geometrically,
the result is greater tooth m o v e m e n t at the oc-
clusal plane relative to a tooth u n d e r g o i n g trans-
lation. Figure 3 shows a comparison of tipping
versus translation, the center of resistance of the
tooth for each example is displaced equally. The
v
crown movement, however, is noticeably greater
Direction of Movement
for the tipped tooth. This shows how tipping
Figure 1. Tipping, translation, and root movement. movements can result in greater movements of
The type of tooth movement depends on the M/F teeth from a clinical perspective.
ratio. The theoretical effectiveness of differential
 Space Closure and Anchorage Control 4-5

example, increase the retraction force on the

Figure 3. Tipping produces more movement at the
crown or occlusal plane compared with translation.
For both teeth in this illustration, the center of resis-
tance of the tooth is displaced the same distance.
anterior teeth (M/Fposterio r > M/Fanterior ) (Fig
4B). A n o t h e r means of increasing the retraction
force is the use of J - h o o k headgear applied to
the anterior teeth.
The applied m o m e n t is determined by the
wire-bracket relationship. In the case of a
straight wire, the magnitude of the moments on
the anterior and posterior teeth may be pre-
sumed to be equal (see Schlegel 2u for a discus-
sion on the effect of bracket width on the mo-
ment expressed as frictional force). For both
headgear and elastics, the biomechanical effec-
tiveness is largely a result of the generation of
unequal forces applied to posterior and anterior
teeth. Unfortunately, this approach depends on
patient compliance for success. W h e n this is the
only means of anchorage control, treatment re-
mains at the mercy of motivational tactics and
cooperative patients.

M / F ratios is readily apparent. The question is,

how can these force systems be p r o d u c e d clini-
cally? For the purpose of discussion, consider
the correction of a Class II malocclusion in
which m a x i m u m posterior anchorage is needed.
The objective is unequal applied M / F ratios:
high M / F for posterior teeth, low for anterior
teeth. If M/Fposterio r > M/Fante,_ior, then there
must be either unequal forces or unequal mo-
ments.
Unequal forces cannot be simply p r o d u c e d by Force
a spring, loop, or chain elastic, because for every
action there is an equal and opposite reaction.
The retraction force a spring applies to the an-
terior teeth is reciprocally applied to the poste- B
rior teeth. To deliver unequal forces, external or
extra-arch mechanisms must be included. Head-
gear and intermaxillary elastics are probably the
2 most c o m m o n means of generating these ad-
ditional forces.
In its simplest form, headgear acts to p r o d u c e
a distal force on the anchorage teeth. By acting
in opposition to the traction force from a spring
or chain elastic, the headgear reduces the net
force on the posterior teeth (M/Fposterio r > Force
M/Fanterior ). Although there may be additional
headgear effects, the aim conceptually is to re- Figure 4. The effect of changing the force magnitude
on the M/F ratio. Headgear is a means of decreasing
tard the mesial forces on the posterior teeth (Fig the mesial force to the posterior teeth (A). Intermax-
4A). illary elastics (Class II elastics) increase the distal force
Intermaxillary elastics, Class II elastics in this to the anterior teeth (B).
46 Kuhlberg and Priebe
T h e inequality, M/Fposterio r > M/Fanterior, in-
dicates the n e e d for an alternative approach.
Rather than varying the forces, unequal mo-
ments may be applied. Increasing the m o m e n t
on the posterior teeth a n d / o r decreasing the
m o m e n t on the anterior teeth serves as a n o t h e r
option toward creating differential M / F ratios.
The horizontal force on the anterior teeth
equals the horizontal force on the posterior
teeth. T h e m o m e n t s or couples created by the
bracket/wire-spring combination generate a
greater m o m e n t to the a n c h o r a g e teeth. Simul-
taneously, a lower m o m e n t acts on the anterior
teeth.
For the Class I I / u p p e r anterior retraction
challenge, the M / F ratio on the posterior teeth
will p r o d u c e translation or root m o v e m e n t ,
while the low M / F ratio on the anterior teeth
will show controlled tipping. T h e large posterior
m o m e n t s encourage anchorage preservation as
they resist tipping. Also, a very large posterior
m o m e n t would actually cause distal crown move-
ment, effectively increasing the size of the ex-
traction space!
T h e application of unequal m o m e n t s must
also satisfy Newton's laws. Because the m o m e n t s
on each end of the spring are unequal, the total
force system must have additional effects. Verti-
cal forces, intrusive to the anterior and extrusive
to the posterior, are also acting. T h e vertical
force m a g n i t u d e d e p e n d s on the difference in
the 2 m o m e n t s and the distance between ante-
rior and posterior a t t a c h m e n t points (Fig 5).
In addition to the potential side effects cre-
ated by the vertical forces, this a p p r o a c h to space
J force magnitudes has an impact on relative rates
Figure 5. The force system from differential moment
orthodontic appliance designs for space closure.
closure frequently results in occlusal plane dis-
crepancies between the anterior a n d posterior
teeth. T h e posterior teeth may be positioned
with the crowns distally tipped a n d the roots
mesially oriented. T h e canines c o m m o n l y have a
root-mesial axial inclination and the incisors are
excessively upright. This situation is a natural
consequence of the force system used but may
also be an advantage given a p p r o p r i a t e maloc-
clusions (ie, anterior protrusion with excessive
dentoalveolar height and gingival display). An
a p p r o p r i a t e stage of root correction after space
closure prepares the occlusion for orthodontic
finishing details.
In comparison with the use of elastics or
headgear, a differential m o m e n t a p p r o a c h to
a n c h o r a g e control reduces the influence of
compliance on t r e a t m e n t outcome. Because the
force system is g e n e r a t e d by the intraoral appli-
ance, elastics or h e a d g e a r b e c o m e less critical.
In extremely difficult cases, h e a d g e a r or elastics
may be used to further s u p p l e m e n t anchorage.
Several orthodontic springs, loops, and de-
vices have b e e n designed using this a p p r o a c h to
anchorage control. 23-26 T h e wide variety of de-
signs reflects the b r e a d t h of the options available
to the clinician for i m p l e m e n t i n g this strategy
for anchorage control in patient care. The im-
p o r t a n t issue is not the specific spring, it is the
force system the spring applies to the dentition.
Biologic Considerations
A n o t h e r factor in a n c h o r a g e control is the rela-
tive rates of tooth m o v e m e n t for tipping, trans-
lation, and root m o v e m e n t . T h e stress distribu-
tion within the periodontal support is different
for each type of tooth m o v e m e n t . T h e stresses
on the PDL are greatest at the cervix of the tooth
for controlled tipping and a p p r o a c h zero at the
apex. Conversely, the greatest stresses are at the
apex for root m o v e m e n t . Translation applies a
u n i f o r m stress along the root surface. The rates
of tooth m o v e m e n t for each of these stress-strain
relationships may also affect a n c h o r a g e control.
T o o t h displacement rates have often b e e n
evaluated on the basis o f force magnitude. Smith
and Storey 7 r e p o r t e d that the m a n i p u l a t i o n of
of tooth displacement and thus anchorage con-
trol. Unfortunately their conclusions have not
b e e n s u p p o r t e d by others. 27-s2 It is suggested,
 Space Closure and Anchorage Control 47

however, that the stress distribution a b o u t the
periodontal ligament, rather than the absolute
magnitude of the force, has a greater impact on
rates of displacement. ~S Histologic studies have
shown that tipping produces localized regions of
high stress, whereas translation results in a m o r e
diffuse stress distribution. 34-36 Thus, a simple
force applied at the bracket will be concentrated
at the apical and marginal regions of the PDL
and effectively increase the stress in these areas.
If force magnitude, specifically the stress magni-
tude within the PDL, determines the rate of
displacement, m,29,:~1 then tipping m o v e m e n t s oc-
cur faster because of the higher localized
stresses. Storey r e p o r t e d that tipping m o v e m e n t s
occurred m o r e rapidly than translational move-
m e n t s Y Although there is still some question
regarding the effects of force magnitude on
rates o f tooth displacement, the c o m b i n a t i o n o f
these biologic concepts with the geometric ad-
vantage of tipping m o v e m e n t s over translation
(Fig 3) may help explain the effectiveness of
differential m o m e n t strategies for a n c h o r a g e
control.
has a similar effect. Because wire stiffness is in-
versely related to the third power of the length,
an off-centered or asymmetrically positioned
spring will deliver greater m o m e n t s to the teeth
that it approximates (Fig 6). 39
A n o t h e r m e t h o d of anterior retraction that
uses a differential m o m e n t strategy for anchor-
age control is c o m b i n e d incisor intrusion and
retraction. This simple yet effective appliance
uses the tip back m o m e n t of the intrusion arch
for creating the large posterior M / F ratio. 42A3
The retraction force is applied with either coil
springs or elastic chain (Fig 7). By carefully con-
trolling the intrusive and retraction forces, the
overbite and overjet can be simultaneously cor-
rected.
Careful m o n i t o r i n g is crucial for successful
anchorage control during space closure. A sys-

Clinical Techniques Using Differential

Moments for Anchorage Control
A n u m b e r of springs have b e e n designed that
use the differential m o m e n t strategy for anchor-
age control. 2-~-u6,:~s,:~-~T h e selection of one spring J
or a n o t h e r depends largely on individual pref-
erences. T h e T-loop spring described by Burst-
one and subsequently refined or modified is a
la
simple yet effective device for controlled space
closure. 23,ss-4° Although most frequently pre-
sented as a s e g m e n t e d spring, it can also be
?
effective within a continuous wire. 41 With cor- I
rect application, however, most retraction
springs may be effective at closing spaces while
simultaneously providing anchorage control.
The core principle of loop design for all of
these springs is increased stiffness of the wire on
the anchorage side of the spring. All other fac-
tors being equal, an increase in wire stiffness has
the effect of establishing greater m o m e n t s at the Figure 6. Anchorage control with a differential mo-
engaged teeth. Increases in stiffness may be ac- ment strategy through the use of a T-loop spring. A
complished by using composite springs with the T-loop positioned toward the posterior attachment
incorporation of wires showing different moduli increases the moment to the posterior teeth and de-
creases the moment to the anterior teeth (A). The
of elasticity, with the stiffer section engaging the expected tooth movements, the anterior teeth are
anchorage units. Conversely, asymmetric posi- expected to tip distally while the posterior teeth show
tioning of the loop toward the anchorage teeth root correction (B).
48 Kuhlberg and Priebe
B Well-controlled clinical studies of explicit orth-
Figure 7. C o m b i n e d anterior retraction and d e e p
overbite correction with posterior a n c h o r a g e control.
An intrusion arch is used to create the m o m e n t on the
posterior s e g m e n t with the c o n c u r r e n t intrusive force
on the anterior teeth and extrusive force on the pos-
terior teeth. A chain elastic or coil spring is used to
create the retraction force (A). The anticipated tooth
m o v e m e n t s would be intrusion and retraction of the
anterior teeth following the line of action of the re-
sultant force and m o l a r tip back which aids in anchor-
age presei-vation (B).
tematic evaluation of treatment progress identi-
fies t h e n e c e s s a r y a d j u s t m e n t s f o r e a c h p a t i e n t
visit. T h e a m o u n t a n d t y p e o f t o o t h m o v e m e n t
o f t h e a c t i v e a n d a n c h o r t e e t h n e e d to b e
assessed. S u b s e q u e n t appliance adjustments
should be based on treatment progress. Specific
s p r i n g a n d / o r w i r e a c t i v a t i o n s c a n b e m a d e tai-
l o r e d to t h e i n d i v i d u a l p a t i e n t ' s t r e a t m e n t o b j e c -
tives.
A f r e q u e n t l y o v e r l o o k e d c o n s i d e r a t i o n i n an-
c h o r a g e c o n t r o l is t h e f i r s t - o r d e r side effects o f
space closure. The mesially directed, buccally
l o c a t e d f o r c e o n t h e m o l a r will t e n d to p r o d u c e
a m e s i a l l y i n w a r d r o t a t i o n . T h i s r o t a t i o n gives
t h e a p p e a r a n c e o f a n c h o r a g e loss w h e n v i e w e d
f r o m t h e b u c c a l p e r s p e c t i v e . H o w e v e r , distaliza-
tion of the molar may not be necessary, a mesi-
a l l y - o u t w a r d f i r s t - o r d e r r o t a t i o n m a y b e all t h a t is
n e e d e d f o r r e g a i n i n g t h e d e s i r e d m o l a r posi-
tion. A transpalatal arch provides an excellent
means for preventing this side effect or actively
correcting it. 44,45
Few studies have investigated effectiveness of
differential m o m e n t strategies for anchorage
control. H a r t et a146 f o u n d adequate anchorage
control with differential torque mechanics for
extraction space closure in 18 Class I malocclu-
sions a n d 12 Class II, Division 1 malocclusions. 46
Rajcich and Sadowsky47 showed minimal anchor-
age loss with a differential m o m e n t a p p r o a c h for
a n c h o r a g e control using intra-arch mechanics.
odontic t r e a t m e n t strategies are difficult be-
cause of the great n u m b e r of c o n f o u n d i n g vari-
ables associated with orthodontic treatment.
The differences a m o n g patients and the specific
objectives of their treatments complicate the
analysis of the effectiveness of particular treat-
m e n t mechanisms. However, the studies that
have b e e n c o m p l e t e d provide support for a dif-
ferential m o m e n t strategy for anchorage con-
trol.
References
1. Angle EH. Treatment of Malocclusion of the Teeth, ed
7. Philadelphia, PA, S.S. White Dental Manufacturing
Co., 1907.
2. Case CS. A Practical Treatise on the Technics and Prin-
ciples of Dental Orthopedia and Prosthetic Correction
of Cleft Palate, ed 2. Chicago, IL, C.S. Case, 1921, pp.
486.
3. Tweed CH. Clinical Othodontics, ed 1 (vol 1). St Louis,
MO, Mosby, 1966, pp. 1-423.
4. Begg PR. Begg Orthodontic Theory and Technique.
Philadelphia, PA, Saunders, 1965.
5. Vaden JL, Dale JG, Klontz HA. The Tweed-Merrifield
edgewise appliance: philosophy, diagnosis, and treat-
ment, in Graber TM, Vanarsdall RL, (eds): Orthodon-
tics: Current Principles and Techniques. St. Louis, MO,
Mosby-Year Book, 1994, pp. 627-684.
6. Vaden JL. The Tweed-Merrifield philosophy. Semin
Orthod 1996;2:237-240.
7. Smith R, Storey E. The importance of force in orthodon-
tics: The design of cuspid retraction springs. AustJ Dent
1952;56:291-304.
8. Begg PR. Differential force in orthodontic treatment.
A m J Orthod 1956;42:481-510.
9. Begg PR, Kesling PC. The differential force method of
orthodontic treatment. A m J Orthod 1977;71:l-39.
10. Begg PR. The origin and progress of the light wire
differential force technique. Begg J Orthod Theory
Treat 1968;4:9-34.
11. Smith R, Burstone C. Mechanics of tooth movement.
Am J Orthod 1984;85:294-307.
12. Reitan K. Continuous bodily tooth movement and its
 Space Closure and Anchorage Control
histological significance. Acta Odontol Scand 1947;7:
115-144.
13. FortinJ. Translation of premolars in the dog by control-
ling the moment-to-force ratio on the crown. Ant J
Orthod 1971;59:541-551.
14. Brodsky JF, Caputo AA, Furstman LL. Root tipping: A
photoelastic-histopathologic correlation. Am J Orthod
1975;67:1-10.
15. Baeten LR. Canine retraction: A photoelastic study. AmJ
Orthod 1975;67:11-22.
16. Nikolai RJ. On optimum orthodontic force theory as
applied to canine retraction. AmJ Orthod 1975;68:290-
302.
17. Pryputniewicz RJ, Burstone CJ. The effect of time and
force magnitude on orthodontic tooth movement. J
Dent Res 1979;58:1754-1764.
18. Burstone CJ, Pryputniewicz RJ. Holographic determina-
tion of centers of rotation produced by orthodontic
forces. Am J Orthod 1980;77:396-409.
19. Quinn RS, Yoshikawa DK. A reassessment of force mag-
nitude in orthodontics. Am J Orthod 1985;88:252-260.
20. Tanne KM, Sakuda M, Burstone CJ. Three-dimensional
finite element analysis for stress in the periodontal tissue
by orthodontic forces, kanJ Orthod Dentofacial Orthop
1987;92:499-505.
21. Tanne K, Koenig HA, Burstone CJ. Moment to force
ratios and the center of rotation. Am J Orthod Dentofa-
cial Orthop 1988;94:426-431.
22. Schlegel V. Relative friction minimization in fixed orth-
odontic bracket appliances. J Biomech 1996;29:483-491.
23. Burstone CJ, Koenig HA. Optimizing anterior and ca-
nine retraction. A m J Orthod 1976;70:1-19.
24. Gjessing P. Controlled retraction of maxillary incisors.
AmJ Orthod Dentofacial Orthop 1992;101:120-131.
25. Siatkowski RE. Continuous archwire closing loop design,
optimization, and verification. Part lI. Am J Orthod
Dentofac Orthop 1997;112:487-495.
26. Siatkowski RE. Wear and tear from sliding mechanics.
J Clin Orthod 1997;31:812-813.
27. Hixon EH, Atikian H, Callow GE, et al. Optimal force,
differential force, and anchorage. AnaJ Orthod 1969;55:
437457.
28. Hixon EH, Aasen TO, Clark RA, et al. On force and
tooth movement. A m ] Orthod 1970;57:476-489.
29. Boester CH, Johnston LE. A clinical investigation of the
concepts of differential and optimal force in canine
retraction. Angle Orthod 1974;44:113-119.
30. Andreasen GF, Zwanziger D. A clinical evaluation of the
differential force concept as applied to the edgewise
bracket. Am J Orthod 1980;78:25-40.
31. Ovarian-Moll P, Kurol J, Lundgren D. The effects of a
49
four-fold increased orthodontic force magnitude on
tooth movement and root resorptions. An intra-individ-
ual study in adolescents. EurJ Orthod 1996;18:287-294.
32. Pilon~J, Kuijpers-Jagtman AM, MalthaJC. Magnitude of
orthodontic forces and rate of bodily tooth movement.
An experimental study. Am J Orthod Dentofacial Or-
thop 1996;110:16-23.
33. Burstone C. Application of bioengineering to clinical
orthodontics, in Graber T, Vanarsdall R, (eds): Orth-
odontics: Current Principles and Techniques. St. Louis,
MO, Mosby, 2000.
34. Reitan K. Some factors determining the evaluation of
forces in orthodontics. Am J Orthod 1957;43:3245.
35. Reitan K. Tissue behavior during orthodontic tooth
movement. Am J Orthod 1960;46:881-900.
36. Thilander B, Rygh P, Reitan K. Tissue reactions in orth-
odontics, in Graber T, Vanarsdall RL (eds): Orthodon-
tics: Current Principles and Techniques. St. Louis, MO,
Mosby, 2000, pp. 117-191.
37. Storey E. The nature of tooth movement. Am J Orthod
1973;63:292-314.
38. Burstone CJ. The segmented arch approach to space
closure. Am J Orthod 1982;82:361-378.
39. Kuhlberg AJ, Burstone CJ. T-loop position and anchor-
age control. Am J Orthod Dentofacial Orthop 1997;112:
12-18.
40. Manhartsberger C, Morton JY, Burstone CJ. Space clo-
sure in adult patients using the segmented arch tech-
nique. Angle Orthod 1989;59:205-210.
41. Nanda R, Kuhlberg AJ. Biomechanics of extraction
space closure, in Nanda R (ed): Biomechanics in Clini-
cal Orthodontics. Philadelphia, PA, Saunders, 1997.
42. Shroff B, Lindauer SJ, Burstone CJ, et al. Segmented
approach to simultaneous intrusion and space closure:
Biomechanics of the three-piece base arch appliance.
Am J Orthod Dentofacial Orthop 1995;107:136-143.
43. Shroff B, Yoon WM, Lindauer SJ, et al. Simultaneous
intrusion and retraction using a three-piece base arch.
Angle Orthod 1997;67:455461.
44. Burstone C, Manhartsberger C. Precision lingual arches.
Passive applications. J Clin Orthod 1988;22:444-451.
45. Burstone C. Precision lingual arches. Active applica-
tions. J Clin Orthod 1989;23:101-109.
46. Hart A, Taft L, Greenberg SN. The effectiveness of
differential moments in establishing and maintaining
anchorage. A m J Orthod Dentofacial Orthop 1992;102:
434-442.
47. Rajcich MM, Sadowsky C. Efficacy of intraarch mechan-
ics using differential moments for achieving anchorage
control in extraction cases. Am J Orthod Dentofacial
Orthop 1997;112:441-448.