Professional Documents
Culture Documents
and V bends
Charles J. Burstone, 0.0.S., M.S., and Herbert A. Koenig, Ph.DJ
Farmington, Conn.
The force system produced by wires with steps and V bends was s'udied analytically by means of a
small deflection mathematic analysis. Characteristic force relations ips were found in both the
step and the V bend. Step bands centrally placed between adjacen brackets produce unidirectional
couples that are equal in magnitude. Along with these couples, ve ical or horizontal forces are
produced depending upon the plane of activation. Mesiodistal place ent of step bends is not critical
because very little alteration in force system occurs if a step is cent red or positioned off center.
V bends, on the other hand, are very sensitive to the positioning mesiodistally of the apex of the V. If
the apex of the V bend is placed on center, equal and opposite couples are produced. As the
V-bend apex is moved off center, predictable combinations of moments and forces are created. A
method for determination of the relative force system is described that allows for simple interpretation
and prediction of the force system from a V bend. The clinical applications of these data and a
rational basis for wire bending are presented based on the producing of a desired force system.
(AM J 0RTHOD DENTOFAC 0RTHOP 1988;93:59-67.)
In a previous study, the force systems pro- deflection rates that require overbending beyond the
duced by a straight wire in malaligned brackets were position of" an ideal arch" to build up to more optimum
determined. 1 It was found that a predictable ratio of the force values for tooth movement; and (4) certain types
moments produced between two adjacent brackets re- of specialized tooth movement, such as space closure,
mained constant regardless of interbracket distance or tipback mechanics, intrusion, and root movement, re-
the cross section of the wire used if the angles of the quire appropriate wire bending.
bracket remained constant to the interbracket axis. On There are two approaches to the placement of bends
the basis of this work, a classification of bracket-wire in an arch wire. One could be described as the "ideal"
geometries was established that can serve as a guide to shape-driven approach. The orthodontist forms a wire
the force systems that would be expected from a straight to the shape in which the desired occlusion would be
wire appliance. if all of the brackets were to finally align themselves
Although in recent years there has been a trend away on the wire. This is the "ideal" arch concept. As has
from placing bends in wires by building more activation been previously shown, the "ideal" shape-driven ap-
with bracket position and design, there is no question proach to bending an orthodontic appliance can lead to
that comprehensive orthodontic treatment requires the undesirable side effects and may not operate in a manner
placement of bends in wires. Bends are placed for a predicted by a superficial reading of the relationship of
number of reasons-for example, (I) to correct tooth a wire to a bracket. 1 Even if eventually the teeth will
position if a discrepancy or error is present in bracket align themselves on a straight wire (which may require
position; (2) as teeth approach their final position of increasing the stiffness of the wire by replacement with
alignment, it may be necessary to increase the mag- wires of a larger cross section), the overall orientation
nitude of force, which can be accomplished by replac- of the teeth in space may not be what is desired; fur-
ing the original wire with a wire of a larger cross section thermore, during this process of alignment, teeth do
or by using the original wire and placing an exaggerated not move to the final straight wire position but undergo
bend; (3) wires may be selected with very low load- extraneous and undesirable movements because of the
intervening force systems produced. A more rational
approach to the bending of a wire is to make bends that
From the University of Connecticut Health Center. deliver the required force system to produce wanted
Supported by NJH/NIDR Grant DE-03953. tooth movement. Although there is still much to be
59
,:\.m ·1 Orthod. Oi:tll<~fat Orthup.
60 Burstone and Koenig
f11m.u1n 198X
M,
J.~
M,
n 1
l F,
f,
==
Bracket 1 Bracket 2
>-
z
~ 800
0
::E
;;; •OO
'
~
::E
two aligned brackets with interbracket distances of
i300t
I
~ 7 mm and 14 mm. Two sets of bends were studied-
.... steps and V bends. As measured from the levels of the
~ 200 f
brackets vertically, the step and V bends were made so
...0 i
A.
347 g m ! )
1210
_ gm-mm
;; 1200r
~ IOOO
----7 m m - - -...
.,2
er soc
8.
"
1-
..,z
2
0
2
600
400
1210
gm-mm
1
347 gm
347 gm l) 1210
gm-mm
WWW
200 ----7 mm----+
-··-~----L---~--~--~-----
' Fig. 5. A, Force system produced by 0.016-inch stainless wire
!> (MM I
with 0.35-mm step, 7-mm interbracket distance. Note large
Fig. 4. As step height (~) is increased, a linear relationship with magnitude of forces and moments. All forces and moments are
the moment occurs. acting on the wire. B, Same force systems shown in A except
directions of forces and moments have been reversed to show
the force system acting on the teeth.
<
deflection system at one end of the wire is directly
related to the force and deflection system at the other "" 1200
V bench
1-
z -2000
!) JO \J.-1 xx xx
w
::E l.l.20 O.~ xxx
0
::E -"30CC}
0 .. \3 OU xx
0 -IO O.. ' x
(j 'i(I I L None
Table II. M2/M, ratios for V bends as a function "V" BEND FORCE SYSTEMS
of apex position from bracket I
V-bend apex position (mm)
A.
803
gm-mm ( ~
...... -........
_ ...... -~·~ ....... _
~
) 803
gm-mm
2210
gm-mm (~
"' ......
f
"'"' ..................
353 gm
."\
,
262
grn-mm
C. 937 gm~-
If the height of the apex of the V bend is increased "'2 M1 (all"- 0.5)
0 -1000
2
or decreased, the relative force system M2/M 1 does not
change. Fig. 9 shows the linear relationship between
-2.000
the height of the V bend and the moments produced.
It should be remembered that if the height of the -2!500
I 2
->t<--3 ~
''
D --~·
l i''
....L
'J /2
,
B ' }v
l I
~-()
~ .l.-->k6",'
o 2
- - .l.2 ~ I
D
c
c
I
I I
~ i
--...i"'-.- -:; ~
: J
I
I
Fig. 11. Mesiodistal position of V bends placed between canine
Fig. 1O. Mesiodistal placement of V bend between molars and and molar alters force system on the molars. A, Lingual force
incisor has a large effect on the force system. A, Bend at only. 8, A pure moment (couple) on the molar producing me-
a/L = 0.33 (a: measured from the molar tube; the incisor re- siobuccaf rotation; no lateral forces. C, Moment producing me-
ceives only an intrusive force). 8, Bend centered at a/L = 0.5. siobuccal rotation. Buccal force is on the molar. All forces are
Incisors and molars are acted on by equal and opposite couples. shown acting on the teeth.
If the arch is tied back, incisor root movement would occur.
C, Bend placed anteriorly, a/L = 0.66. Lingual root torque and
an eruptive force are acting on the incisors. All forces are shown Let us place a V bend in a continuous arch with the
acting on the teeth. apex of the V one third the distance from the molar
tube to the incisor brackets (a/L = 0.33). A single
intrusive force is produced on the incisor and on the
the correct direction. In this section on clinical appli- molar both an eruptive force and a moment tending to
cations, we will address the relative force systems. move the roots forward and the crowns back. This could
Since the relative magnitude of these forces and mo- lead to incisor intrusion, molar tipback, and, ifthe arch
ments will be emphasized, no force magnitudes will be wire is tied back, possible retraction of the upper in-
used in the diagrams. (Unlike previous equilibrium di- cisors (Fig. 10, A). If we decide to place our V bend
agrams in the RESULTS section, the forces and moments even farther posteriorly, perhaps next to the molar tube,
are shown acting on the teeth.) the force system will change. This configuration would
Fig. 10 shows a lateral view of an arch in which produce a moment on the central incisor tending to
attachments have been placed only on the first molar move the crown back and the root forward (labial root
and the four incisors. We are taking some liberties with torque). This moment produced on the central incisor
the actual clinical situation, which might be more com- could be useful in preventing flaring of the upper incisor
plicated since the arch curves around the comer and during intrusion; however, in other situations it could
there may be friction and/ or play between the attach- be an undesirable side effect, moving the root labially.
ments and the wire. Here we assume (1) forces acting When the V bend is placed off center posteriorly so that
in one plane, (2) full-bracket engagement from a rec- a/Lis smaller than 0.33, the more the bend is increased,
tangular wire, and (3) freedom to slide, eliminating both the intrusive force and the labial root moment on
mesiodistal forces. the incisor will increase. If we place the V bend
Volume 93
Number I
Creative wire bending 65
one third of the distance from the molar tube to the ESTHETIC BENDS - UPPER INCISORS
bracket, we reach that crossover point where the mo-
ment is eliminated and any increased activation pro-
duces greater force without concern for spurious torque
on the incisors.
In Fig. 10, B, the V bend is now placed in the center A.
+
I n r)
between the molar tube and the bracket; equal and op-
posite couples are produced. If the arch wire were tied
back so anteroposterior forces were created, this wire ii n
~I
n
i
n!
~?
1'
~ ?
could be used to move the roots lingually on the upper
incisors. The roots would also move mesially on the
molar, but this could be prevented by increasing the t !
number of teeth in the posterior segment or backing up Fig. 12. Forces produced by anterior esthetic bends to move
the posterior teeth with suitable headgear. roots distally. A, V bend between central incisors gives equal
Fig. IO, C, shows the V bend now positioned closer and opposite couples. B, Step bends between central and lat-
to the central incisor bracket (a/L = 0.66 from the eral incisors give vertical forces and unidirectional couples. C,
Summation of A and B. Moments are in corrE1ct direction for
molar). The force system completely changes; instead
root movement but are not equal. Vertical forces will erupt the
of an intrusive force as in Fig. 10, A, there is now an central incisors. All forces are shown acting on the teeth.
eruptive force on the central incisor with lingual root
torque. An intrusive force on the molar is also seen.
By moving the V bend forward, we have a root spring In the above two examples of force systems, one
for the incisors, provided the wire is tied back to prevent can see the principle of creative wire bending at work.
anterior flaring of the incisors. The eruptive force si- The older, traditional approach in orthodontic treatment
multaneously extrudes the incisors. has been an "ideal" shape-drive appliance. The
From an occlusal view, Fig. 11 shows the effects "ideal" shape thinking goes something like this: if you
of altering the placement of a V bend between the canine would like to move a molar lingually and rotate the
and the first molar. The forces and the moments between tooth mesiobuccally, bend the wire so that it lies lingual
the canines tend to cancel out across the anterior part and angled to the bracket. As we have seen, this may
of the arch (although side effects are still possible with create many different force systems and may not pro-
highly flexible wires). For that reason we will primarily duce the force system that is needed. A scientific and
concentrate on the force system on the first molars. If more creative approach is to (1) determine where the
the V bend is placed one third of the distance from teeth should be moved and (2) establish the directions
the canine bracket to the molar tube as measured of both the force and the moment needed. Ideally, we
from the canine bracket, a lingual force would be should also establish the magnitudes of these forces and
produced on the molar, moving it lingually without the ratio between the moment and force, but for now
any rotation (Fig. 11, A). If the V bend is placed we will consider only the directions of the force and
close to the first molar, a force is produced moving moment and (3) develop the proper shape in the wire
the first molars buccally and a moment produces to deliver that force system. This is what we mean by
mesiobuccal rotation (Fig. 11, C). As would be creative wire bending. A force-driven appliance is not
expected, if the V bend is placed centrally between the fabricated by the shape of an ideal wire or by falla-
canine and the first molar, equal and opposite couples ciously placing the wire in one bracket and looking to
would be produced. This allows for pure rotation of see where the wire is at the other bracket, imagining
the first molar without the buccal force (Fig. 11, B). the teeth will move to that position on the wire. It is
If we would like to rotate the molar with the mesial based on understanding some very fundamental rela-
aspect out and also have a lingual force, the V bend tionships between the force system and what type of
must be placed somewhere between the a/L of 0.3 and bend is used and where it is placed. The appliance thus
0.5 as measured from the canine bracket. In a situation becomes force driven and is shaped to deliver the de-
in which mesiolingual rotation and lingual force on the sired forces rather than some arbitrary shape that some-
first molar are required (this is sometimes indicated in how is related to the final position of the teeth or an
uniarch extraction cases), the V bend should be placed exaggeration of the final position of the teeth.
as close as possible to the bracket on the canine (a/L The step bend, unlike the V bend, is not critical in
greater than 0.66). its mesiodistal placement. For those orthodontists using
66 Bursrone and Koenig , \n1 Or thud n, i-ifof\/i_. On:.,);,
frmfl(/f1 1\)8X
tipback mechanics with tipback bends such as the have considered brackets in a straight lme with vana-
Tweed technique, this fact offers great convenience. tions of V and step bends. The usual clinical situation
Historically, bends have been placed that are called long will have a combination of bends and malaligned brack-
or short tipbacks; these bends are placed either off cen- ets that are not in a straight line. The actual force system
ter or on center and may change in position during is produced by adding together the two effects. Previ
tipback mechanics. The favorable finding from this ously, the force system from malaligned brackets in
study shows that the placement of the bend does not straight wire was discussed and certain principles elic
appreciably influence the force system present. ited on the basis of the relative angulation of adjacent
The last clinical example that will be given is the brackets. To produce a desired force system, two ap-
placement of anterior esthetic bends. Fig. 12 shows an proaches are possible. The first approach allows the
upper anterior segment in which esthetic bends have orthodontist to use a straight wire, triggering the force
been placed between the four incisors. Although when system produced by the wire in malaligned bracket~
play is present there may be other effects between and adding the proper bends whose force systems are
brackets from one bracket down the line to nonadjacent summated to the straight wire force system. This is
brackets, our analysis will ignore this phenomenon and called the super-position method. The other approach
also the mesiodistal forces (in order) that the funda- is to first contour the wire passively between two brack-
mental effects of this configuration can be studied. ets and then to add the proper V or step bends. Since
Between the central incisors, a V bend is placed in this approach we remove the force system produced
that produces equal and opposite couples. This is shown by a straight wire and malaligned brackets, it is referred
as the block A of the force system in Fig. 12. Between to as the subtraction method. With small interbracket
the central and the lateral incisors, a step bend is seen. distances, it becomes increasingly difficult to use either
The unidirectional couples and vertical forces of the the super-position or the subtraction method. Small er-
step are shown in block B. If there is an addition of rors in wire bending can produce large errors in force
the force system from the V bend and the step, the total systems. As the interbracket distance increases. (>Ur
force system on each of the four brackets is shown in potential for delivering the desired force system is en
block C. The total force system acting at each of the hanced. Nevertheless. regardless of the interbracket
incisors is very interesting, producing both desirable distance, knowing where to place the bend and knowing
and undesirable effects in most patients. There are mo- what type of bend to place at least heads the clinician
ments tending to move the roots distally and this i~ in the right direction to achieve the proper tooth
desirable; unfortunately, the moments are not cqual- movement.
Jarger moments are present on the central incisors in ln this study we purposely have looked at the effect
comparison to the lateral incisors. The actual moments of only two basic types of bends, V and step, on the
that would be acting on the lateral incisor. of course. force system using small deflection theory. Although
would be dependent upon what type of bend is placed we have the capability of solving these problems in
between the lateral and the canine. which, for simplicity large deflection formulation, it is important to ha11e a
of analysis, we are ignoring. Intrusive forces are pro- first approximation using small deflection theory tc es-
duced at the lateral brackets. These teeth will not be tablish some of the basic principles. Future studies are
intruded provided the arch wire is connected to the important to determine what differences in the actual
posterior teeth. On the central incisors. an extrusive force systems exist with large deflections. Particularly,
force is produced and in patients who previously have rhe calculation of mesiodistal forces requires a consid-
had intrusion of teeth or who have deep overbites, this eration of both large deflection theory and bracket wire
extrusive force becomes an undesirable side effect interface phenomena such as freedom to slide and play.
Many orthodontists have noticed that when they place V and step bands are not the only bends that can
esthetic bends, the deep overbite increases. This could be placed to produce a given force system. Combina
be anticipated by an understanding of the force system. tions of V bends and steps can be used. In partirnlar.
Conversely, if one tried to correct a deep overbite by arcs or wire curvatures have many advantages in pro-
stepping the incisors apically, the moments produced ducing the desired forces and moments, more predict-
would tend to move the roots mesially. For these reasons ably, eliminating permanent deformation of wires and
esthetic bends may not be the most sensible way to creating an activated wire shape that more clo~eiy ap-
correct the axial inclinations of the incisors in many proximates a straight wire. A discussion of the use of
patients. wire curvatures instead of V and step bends is beyond
This study and the clinical applications of results the scope of this article.
Volume 91
Creative wire bending 67
Number 1