Force levels in complex tooth alignment with conventional and self-ligating brackets

Abstract

Introduction: The force applied to the teeth is a variable of orthodontic treatment that can be controlled. Poor control of the applied force can lead to adverse biologic effects as well as undesirable tooth movements. The selected archwire-bracket combination is a primary determining factor in the force level applied to a tooth during orthodontic treatment. The aim of this research was to use an experimental biomechanical setup to measure forces generated during complex orthodontic tooth movements with various archwire-bracket combinations.

Methods: The materials consisted of 3 types of 0.022-in slot orthodontic brackets: (1) conventional brackets (Victory Series [3M Unitek, Monrovia, Calif] and Mini-Taurus [Rocky Mountain Orthodontics, Denver, Colo]), (2) self-ligating brackets (SmartClip [3M Unitek] and Time3 [American Orthodontics, Shegoygan, Wis]), and (3) a conventional low-friction bracket (Synergy [Rocky Mountain Orthodontics]); and 4 archwire types: (1) 0.012-in stainless steel (3M Unitek), (2) 0.0155-in coaxial (Advanced Orthodontics [Näpflein, Düsseldorf, Germany]), (3) 0.012-in Orthonol (Rocky Mountain Orthodontics), and (4) 0.012-in Thermalloy (Rocky Mountain Orthodontics). Stainless steel ligatures and elastomeric rings were used. The materials were used in different combinations in a simulated malocclusion that represented a maxillary central incisor displaced 2 mm gingivally (x-axis) and 2 mm labially (z-axis).

Results: The lowest forces were measured when the brackets were combined with either the coaxial or the Thermalloy archwires; the forces ranged from 3.4 ± 0.2 to 0.7 ± 0.1 N in the x-axis direction, and from 4.5 ± 0.3 to 0.5 ± 0.1 N in the z-axis direction. The highest forces were measured in combination with stainless steel archwires; the forces ranged from 6.3 ± 0.3 to 3.0 ± 0.1 N in the x-axis direction, and from 6.3 ± 0.3 to 1.7 ± 0.1 N in the z-axis direction.

Conclusions: We recommend 0.0155-in coaxial and 0.012-in Thermalloy archwires for leveling and alignment. Elastomeric rings, when used with conventional brackets, increased the force applied to the teeth.