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MORNING
TORQUE IN
ORTHODONTICS
Introduction
Proper buccolingual inclination of anterior and
Definition
Torque being more related to engineering
terms is defined as
RAUCH:
BIOMECHANICS OF TORQUE
Torque or root movement of a tooth is achieved by
Torque
WHY.?
WHEN.?
& HOW?
When.....?
When there is uncontrolled tipping of the
crown
In third order bends of finishing and artistic
positioning in a pre adjusted edgewise system.
In pre surgical and post surgical phases for
the precise placement for axial inclination of
teeth
As a device to augment anchorage demands
of that particular situation.
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.
ARMAMENTARIUM:
METHODS OF
TORQUING IN
VARIOUS APPLIANCE
MECHANICS
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 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
TH IRD O RD ER M O VEM EN TS :
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
Anterior torque
The basic criteria is
To remove lingual
If the orthodontist
expects to move
the anterior teeth
bodily in a lingual
direction then
labial torque of
the incisal
segment is
increased until the
arch wire lies 6 to
8 mm. gingival to
the buccal tube
when the operator
tests for labial
Posterior
torque
Continuous
Progressive
Continuous
posterior torque
TORQUE
IN THE
PRE ADJUSTED
EDGEWISE
APPLIANCE
Torque in base was an important issue with the 1st and 2nd generation
PEA brackets because level slot line up was not possible with brackets
designed with torque in the face.
Torque in base ,as said by Andrews, is a pre requisite for a fully
programmed appliance.
Albert H Owen (1980) conducted a study comparing Roth
prescription and Vari Simplex Discipline. He concluded that while
torque in base had a strong theoretical basis, its effectiveness is
greatly influenced by clinicians success in accurately placing
brackets.
Torque in base
means that
bracket stem is
parallel and
coincides with
long axis of
bracket slot
The torque in face,
slot is cut at an
angle to the
bracket stem. The
-9
-7
-7
-7
+3
+7
-35
-30
-22
-17
-11
-1
-1
Upper
Lower
ROTH PHILOSOPHY
Roth selected brackets from Andrews SWA set up and developed the
Roth treatment and prescription.
These were made available in 1976 and they are considered as the
second generation of PEA.
The three main reasons for the Roth prescription were as follows:
TORQUE SPECIFICATIONS
-14
-14
-7
-7
-2
+8
+12
-35
-30
-22
-17
-11
-1
-1
Upper
Lower
MBT PHILOSOPHY
TORQUE SPECIFICATIONS
-14
-14
-7
-7
-7
0
+7
+10
+17
-10
-20
-17
-12
-6
0
+6
-6
-6
Upper
Lower
INCISOR TORQUE
Palatal root torque of the upper incisors and labial root torque
for the lower incisors were increased compared to previous
generations due to :
Inefficiency of PEA brackets in delivering torque.
In class II cases, class II elastics can cause torque to be lost on
upper incisors and lower incisors can get flared.
In class I cases, correct incisor torque helps to achieve good
anterior tooth fit.
In class III cases correct torque helps to compensate for mild
class III dental bases
CANINE TORQUE
Upper canines:
Torque in the upper canines are necessary because they
are key elements in a mutually protected occlusion.
The goal is to deliver ideal tip and torque to the canines so
that they can fulfill their role in lateral excursions and
have a small amount of freedom in maximum
intercuspation.
MBT uses two canine brackets for three torque options
( +7, 0, -7 )
Lower Canines:
Original SWA torque in canine is not satisfactory because
-11 tends to leave lower canine roots too prominent in
some cases.
MBT uses two canine brackets for three options
(+6 , 0 ,-6 )
3. EXTRACTION DECISION:
0 brackets tend to maintain canine roots in the cancellous bone
making tip control of roots easier.
4. OVERBITE:
In some Class II div 2cases, there is a requirement to move lower
canine roots labially and also centre the roots in bone. This is more
easily achieved if 0 or +6 lower canine torque is used.
5. RAPID PALATAL EXPANSION CASES
RPE of upper arch creates a secondary widening of the lower arch.
There are torque changes associated with this. Values of 0 or +6
brackets are recommended to assist in the favourable change.
6. AGENESIS OF UPPER LATERAL INCISORS
If one or both lateral incisors are missing, a decision may be made to
close spaces and bring canines mesially. It is helpful to invert -7
upper canine 180 , thus changing the torque to +7 with the tip
remaining the same.
5. MODE OF LIGATION
A source of torque control loss is force relaxation in elastomeric
ligatures. Elastomeric ligatures have shown a force degradation
pattern characterized by initial decrease of nearly 40 % in the
first 24 hrs. Thus the engagement of the wire to slot is flexible
and incomplete resulting in further reduced expression of the
already compromised torque.
The use of steel ligatures has been found to diminish slot wire
clearance.
So as a bottom line, a clinician might actually require
more torque than incorporated into the currently
available PEA and alternatively sufficient activation
should be applied to arch wires to compensate for play,
various manufacturing defects and clinical procedures
which counteract the expression of torque built into the
bracket.
According to Raymond
Siatkowski (1999) there
is an average torque loss
of 5 in the retraction of
1.3mm in maxillary arch
and 1.2mm in the
mandibular arch.
This means that there is
an average of 15 torque
loss for 4mm of retraction.
Torque in BEGGS
MECHANOTHERAPY
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.
Spur design having 2,4 and 6 pairs
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
TO R Q U IN G A U X ILIA RY W ITH
SP U R S
ABO U T TH E SPU R
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.
are :
6.
7.
VARIO US APPLICATIO N S O F TH E M AA
1. Originally, the MAA was introduced for bodily
VARIO US APPLICATIO N S O F TH E M AA
2. By bending more positive torque into the
4.
Mouse trap
Mouse trap design is very efficient but
involves more time patience and skill
Torque in Tip-Edge
Appliance
Tip-Edge Appliance:
Kesling introduced these concepts in 1986. Tip
edge brackets are produced by removal of diagonally
opposed corners from edgewise slot to permit either
mesial or distal tip.
12
Side-winder springs
12
Deep bite
During stageI and stageII, as crowns are tipped to
the final position of the dental arches, Slot size will
also get increased. This permits passive engagement
of full size rectangular arch wire. Each tooth will
have either one point or no contact with the arch
wire. So the interbracket distance is from molar to
molar which yields light and long lasting torquing
forces
SELECTIVITY
LIMITATION
PHYSIOLOGIC
Long activation span: Reactivation of the SideWinder spring is not normally found to be necessary.
However, additional activation may be required near
the completion of treatment, for a precise definition of
finishing torque angulation.
.
Vari Simplex
Discipline:
0.018 inch SS slot was used instead of 0.022 inch SS
slot to have a better control of torque.
Bracket Torque was formulated after measuring
torque found in rectangular arch wire in finished 50
cases.
Max +14 +7 3 7 7 10 -10
Mand 5 5 7 11 17 22 -27
In Alexander Discipline Diamond Twin brackets were
used for upper incisors, Lang brackets for canine, Lewis
brackets for Premolars and mandibular incisors which
adds advantage of increased interbracket distance.
13
Lang Bracket
Lewis Bracket
13
13
B io-progressive therapy
The Standard Bioprogressive appliance was introduced in 1962.
13
Angulation Reference
Guide) instrumentation is
designed to transfer bracket
prescriptions from the more
reliable labial surfaces of
each tooth to the lingual at
a given bracket height.
This is in effect a method of
doing a diagnostic set-up
without sectioning the
model, and it allows the
laboratory technician to set
customized torque and
angulations for each
individual prescription.
.
Torquing of maxillary
and mandibular
anterior teeth requires
special consideration.
The first is the use of a
torquing auxiliary like
the ones used in
conventional Begg
mechanotherapy where
the application of force
on the tooth is at the
incisal edge.
A removable appliance is
constructed in a conventional
manner, with Adams clasps on first
permanent molars and triangular
clasps between first and second
premolars, for additional anchorage
and to combat leverage in the
anterior region.
movement in adults.
Light wire torque may also lead to root
resorption if the force is acting for a long
period.
In order to avoid root resorption the best
technical solution would be to apply light
torquing forces that acts interruptedly
over a fairly short distance.
With the advent of ceph head films many ceph analyses were
developed in an attempt to more objectively define the direction of
treatment.
Dental and skeletal normals were established for general populations
in certain analyses such as Tweed, Downs, Steiners etc
Problems associated with these:
i) Assumption was made that if dental and skeletal values were
normal
face would also be normal.
ii) Normals were obtained from patient samples with
malocclusions.
iii) Position of dentition was related to cranial base structures
which showed significant variability of position in patients with
more severe facial disharmony.
Arnett and Bergman (1993) drew attention to shortcomings of the
cranial base for facial planning with their two part paper.
Arnett et al (1999) suggested a method of STCA and STCP. This
new analysis was based on the true vertical line (TVL).
Lower Incisor
F: 64 3.2 M: 64 4