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Introduction: It has been found that controlled movement of the anterior teeth can be obtained by attaching a
certain length of power arm onto an archwire in sliding mechanics. However, the impact of the archwire/bracket
play on anterior tooth movement has not been clarified. The purpose of this study was to compare the effect of
the power arm on anterior tooth movements with different dimensions of bracket slots and archwires. Methods:
A 3-dimensional finite element method was used to simulate en-masse anterior tooth retraction in sliding
mechanics. Displacements of the maxillary central incisor and the archwire deformation were calculated
when applying retraction forces from different lengths of power arms. Results: When a 0.017 3 0.022-in
archwire was engaged into the 0.018-in slot bracket, bodily movement of the incisor was obtained with
9.1-mm length of the power arm. When a 0.022-in slot system was coupled with a 0.019 3 0.025-in archwire,
bodily movement was observed with a power arm length of 11.6 mm. Conclusions: Archwire/bracket play
has a remarkable impact on anterior tooth movement. An effective torque application to the anterior teeth be-
comes clinically difficult in sliding mechanics combined with power arms when the archwire/bracket play is large.
(Am J Orthod Dentofacial Orthop 2014;146:166-74)
T
he demand for speedy, effective, and accurate use of implant anchorage in sliding mechanics has
orthodontic treatment systems has increased to become more common all around the world. In
shorten the treatment period.1-6 Accordingly, the addition to this system, sliding mechanics with the
combined use of power arms has gradually been
a
Assistant professor, Department of Orthodontics and Dentofacial Orthopedics, applied for obtaining controlled anterior tooth
Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan; movements during space closure (Fig 1). That is, the
research fellow, Department of Oral Technology, School of Dentistry, University desired type of anterior tooth movement, such as lingual
of Bonn, Bonn, Germany.
b
Postgraduate student, Department of Orthodontics and Dentofacial Orthope- crown tipping, bodily movement, or lingual root tipping,
dics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, can be easily achieved by attaching various lengths of
Japan.
c
power arms onto an archwire in sliding mechanics.7-14
Assistant professor, Department of Orthodontics and Dentofacial Orthopedics,
Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan. Several studies have been carried out to investigate
d
Senior assistant professor, Department of Orthodontics and Dentofacial Ortho- various biomechanical factors affecting tooth movement
pedics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, in sliding mechanics, such as the flexural rigidity of the
Japan.
e
Cendres+Metaux endowed professor and chair, Department of Oral Technology, archwire, friction, and height of the retraction
School of Dentistry, University of Bonn, Bonn, Germany. force.8,12–16 However, optimal loading conditions for
f
Professor and chair, Department of Orthodontics and Dentofacial Orthopedics, controlled movement of anterior teeth in sliding
Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
All authors have completed and submitted the ICMJE Form for Disclosure of mechanics combined with power arms are not fully
Potential Conflicts of Interest, and none were reported. understood. A few attempts with the finite element (FE)
Address correspondence to: Noriaki Yoshida, Department of Orthodontics method have been reported on tooth displacement
and Dentofacial Orthopedics, Nagasaki University Graduate School of Biomedical
Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan; e-mail, nori@ when a single canine retraction or an en-masse retraction
nagasaki-u.ac.jp. is performed in sliding mechanics.17-19 In those studies,
Submitted, September 2013; revised and accepted, April 2014. spring elements are used between a tooth and an
0889-5406/$36.00
Copyright Ó 2014 by the American Association of Orthodontists. archwire instead of friction between the surface of a
http://dx.doi.org/10.1016/j.ajodo.2014.04.016 bracket slot and an archwire. Therefore, the mechanical
166
Tominaga et al 167
American Journal of Orthodontics and Dentofacial Orthopedics August 2014 Vol 146 Issue 2
168 Tominaga et al
Fig 2. Three-dimensional FE model of the maxillary dentition, including the PDL, alveolar bone,
brackets, and archwire.
August 2014 Vol 146 Issue 2 American Journal of Orthodontics and Dentofacial Orthopedics
Tominaga et al 169
Fig 3. Illustration of the experimental conditions of anterior tooth retraction with the combinations of
various lengths of power arms and skeletal anchorage in sliding mechanics.
incisor was moved lingually, and the crown was moved DISCUSSION
labially (Fig 7, A). The labiolingual tipping was 0.17 We found that the dimension of the play between the
(lingual root tipping). bracket slot and the archwire has a significant impact on
When the 0.019 3 0.025-in archwire was used in the anterior tooth movement when the retraction force was
0.022-in slot, the incisor showed almost bodily move- applied to a power arm in sliding mechanics. Even if the
ment with less lingual root tipping of 0.02 , although same height of the horizontal retraction force was
the tendency of archwire deformation was similar to that applied, there were great discrepancies in the types of
of the 0.018-in slot coupled with the 0.017 3 0.022-in anterior tooth movement between the 2 combinations
archwire (Fig 7, B).
American Journal of Orthodontics and Dentofacial Orthopedics August 2014 Vol 146 Issue 2
170 Tominaga et al
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Tominaga et al 171
Fig 6. Loading conditions when controlled movements of a maxillary central incisor are obtained:
A, 0.017 3 0.022-in archwire in 0.018-in slot; B, 0.019 3 0.025-in archwire in 0.022-in slot. CRe, Center
of resistance; CRo, center of rotation.
Fig 7. Displacement of the maxillary central incisor and the deformation of the archwire on the appli-
cation of retraction force at the height of 12 mm. For a better understanding of the displacement of the
tooth and deformation of the archwire, these movements are magnified 50 times. Initial positions of the
tooth and archwire are indicated by blue lines. A, 0.017 3 0.022-in archwire in 0.018-in slot;
B, 0.019 3 0.025-in archwire in 0.022-in slot.
American Journal of Orthodontics and Dentofacial Orthopedics August 2014 Vol 146 Issue 2
172 Tominaga et al
Fig 8. Sagittal cross-section at the mesial surface of the maxillary central incisor bracket before exert-
ing retraction force (left) and after the application of the force at the height of 12 mm (right):
0.017 3 0.022-in archwire in 0.018-in slot (top) and 0.019 3 0.025-in archwire in 0.022-in slot (bottom).
the application of the orthodontic force at the level of desired type of anterior tooth movement if there is a
12 mm (Fig 8). When an archwire is twisted by a large archwire/bracket clearance.
bending moment of the power arms, the diagonally As mentioned above, the dimension of the play is
opposite corners of the archwire contact the surface the most influential factor in determining the type
of the bracket slot. Then a pair of normal forces, called of anterior tooth movement in sliding mechanics
lingual root tipping moments, is generated. That is, combined with power arms. Thus, the conventional
torque acting on the anterior tooth becomes applicable biomechanical principles of tooth movement in ortho-
with a combination of a 0.017 3 0.022-in archwire and dontics cannot be directly applied in actual clinical sit-
0.018-in slot brackets with smaller archwire/bracket uations. Although a comprehension of the relationship
clearances (Fig 8, top). However, a normal force in between a line of action of a retraction force and the
the downward direction is not produced at this cross- position of the center of resistance of a tooth is an
sectional view when a 0.019 3 0.025-in archwire was important key to an estimation of how the tooth will
used in the 0.022-in slot, which has a larger play move, the effect of the archwire deflection within
(Fig 8, bottom). Although the horizontal dimension of the bracket slot and its general deformation on the
the play in the 0.018-in slot system is the same as force system acting on a tooth should also be consid-
that in the 0.022-in slot, the vertical dimension of the ered (Figs 7 and 8).
play in the 0.022-in slot is 3 times as large as that in Although applying a retraction force on the power
the 0.018-in slot (Fig 8). This indicates that play in arm modifies the type of anterior tooth movement in
the vertical dimension has a greater impact on the sliding mechanics in a simple way, quite long power
movements of the anterior teeth than in the horizontal arms of 10 to 13 mm are required to achieve controlled
dimension. It is considered that the greater the play be- movement of the anterior teeth in the 0.022-in slot sys-
tween the archwire and the bracket, the weaker the tem. Particularly, controlled lingual root tipping is only
normal forces. As a result, less lingual root tipping obtained with power arms of 13 mm; this is too long
moment is transmitted to the incisor in the 0.022-in to be applied in a clinical situation. In this case, the
slot system. Therefore, it becomes more difficult to pre- use of high-torque brackets on the anterior teeth seems
scribe an optimal power arm length for achieving the recommendable to optimize torque application.
August 2014 Vol 146 Issue 2 American Journal of Orthodontics and Dentofacial Orthopedics
Tominaga et al 173
American Journal of Orthodontics and Dentofacial Orthopedics August 2014 Vol 146 Issue 2
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