[Archwire segmentation: a solution to the problems involved in treating atypical cases]. / La segmentation de l'arc, une réponse aux difficultés de traitement de cas atypiques.

INTRODUCTION: Asymmetrical orthodontic cases frequently prove very difficult to correct. Anchorage mini-screws are often needed to treat these cases when the malocclusion is of maxillary origin. Nonetheless, a precise biomechanical assessment must be made to avoid undesirable sideeffects resulting from the mechanics used. Whether one uses a continuous or a segmented archwire, adverse events can occur and must be planned for in order to contain them. MATERIALS AND METHODS: The authors will first give an overview of the possible undesirable effects using the continuous arch technique and the principles underlying the segmented archwire technique. Various clinical cases will also be described to support their argument. CONCLUSION: The advantage of the segmented techniques lies in the precision and speed of the movements obtained in the three dimensions of space. However, they can also present major drawbacks. In practice, these techniques seem best-suited to complex atypical cases, and particularly cases involving asymmetry of the frontal and transverse planes.

Mechanical properties of different esthetic and conventional orthodontic wires in bending tests : An in vitro study.

AIMS: The goal of this study was to determine the mechanical properties of different esthetic and conventional orthodontic wires in three-point and four-point bending tests, and in a biomechanical test employing three bracket systems. METHODS: The behavior of round wires with a diameter of 0.46 mm (0.018″) were investigated: uncoated nickel titanium (NiTi) wires, surface modified NiTi wires; FLI® Orthonol Wire® and glass fiber reinforced plastic wires. The biomechanical bending test was performed using the following bracket types: metal brackets (Discovery®, Dentaurum), ceramic brackets (Fascination®, Dentaurum), and plastic brackets (Elegance®, Dentaurum). All bending tests were performed in the orthodontic measurement and simulation system (OMSS) at a temperature of 37 °C. The classical three-point bending test was performed according to an ISO standard (DIN EN ISO 15841:2007) using the appropriate thrust die and supports with a predefined span of 10 mm. In the other tests the supports or interbracket distances were chosen such that the free wire length was also 10 mm (5 mm between adjacent brackets). All wires were loaded centrally to a maximum of 3.1 and 3.3 mm in the biomechanical test, respectively. The force was measured upon unloading with a loading velocity of 1 mm/min. Each specimen was loaded twice and a total of 10 specimens tested for each product. Weighted means and the error of the weighted mean were calculated for each product. RESULTS: Fiber reinforced wires displayed lowest forces in three-point bending with values of 0.4 N at a displacement of 1 mm and 0.7 N at a 2 mm displacement. In four-point bending the forces were 0.9 N and 1.4 N, respectively, at the same displacements. Almost all of the translucent wires showed fracture upon bending at displacements greater than 3 mm, independent of the bending test and bracket type. The different investigated NiTi wires, surface modified or conventional, only showed minor variation, e.g., 2.2 N for rematitan® Lite White and 2.0 N for rematitan®, 2.1 N for FLI® Coated Orthonol® and 1.7 N for Orthonol® in four-point bending. The rhodinized wire generated forces between these values (2.1 N). CONCLUSION: The translucent wires had the lowest forces in all three bending tests; however, displacements above 3 mm resulted in increased risk of fracture. Forces of investigated NiTi wires were very high and in part above clinically recommended values.

Stiffness comparison of mushroom and straight SS and TMA lingual archwires.

BACKGROUND: The aim of this study is to investigate the relative stiffness of straight and mushroom lingual archwires of different diameters, cross sections and alloys, plotting their load/deflection graphs and using a modified three-point bending test. METHODS: Fujita's mushroom archwires and straight lingual archwires of different diameters, cross sections and alloys were derived by a virtual set-up of an equal malocclusion and were cut at their straight distal portion. These distal portions were tested using a modified three-point bending test by an Instron 4467 dynamometer and the forces, were exerted at 1-mm deflection and were compared on each resulting load/deflection curve by means of ANOVA (p < 0.05). RESULTS: All upper lingual mushroom wires exerted significantly lower forces than the straight wire. Lower mushroom archwires were stiffer than their upper counterparts, which were longer and featured inset bends. In the lower arch, similar levels of forces were recorded for the two types of wire. Load-deflection curves were higher for the straight wires, and stiffness increased proportionally with their diameter. CONCLUSIONS: The stiffness of an archwire is a function of its diameter, length and the alloy it is made from. In lower lingual wires, there is little difference in stiffness between mushroom and straight wires, but in upper wires, the straight version is considerably stiffer. The greater bearing effect exhibited by the straight wire in the working and finishing phases makes it less susceptible to bowing effect and therefore preferable for sliding mechanics during en masse retraction, particularly in the upper arch.

Do the NiTi low and constant force levels remain stable in vivo?

OBJECTIVE: The aim was to evaluate the alteration of the deactivation forces of the most commonly used nickel-titanium wires under long-lasting oral cavity environmental influence. MATERIALS AND METHODS: Randomized in vitro and in vivo trials of 540 pieces of orthodontic archwires, NeoSentalloy®, Copper NiTi® 35°C and Titanol Superelastic(®), round (0.016 inch), and rectangular (0.016 × 0.022 inch), were carried out. Randomization and blinding was achieved with 12-colour system that ensured encoding of key information on the tested specimens. Each of 270 patients (females, 18-20 years old, in the finishing stage of orthodontic treatment) received the piece of NiTi wire ligated piggyback, for a period of 4-6 weeks. Eventually, all samples were subjected to a three-point bending test. Data were statistically analysed at a 5 per cent significance level. RESULTS: In the group of the round used wires, when compared with the new ones, the deactivation force (F dav) values increased significantly for Titanol Superelastic®; the NeoSentalloy® and Copper NiTi® 35°C wires did not change their values of F dav. In the group of rectangular wires, F dav decreased for Titanol Superelastic®, but increased for NeoSentalloy® wires. The F dav values of the Copper NiTi® 35°C used wires practically did not change, but a remarkable increase of the standard deviation was noted. LIMITATIONS: No calculations concerning effectiveness of in vivo aligning of analysed wires were made. CONCLUSIONS: For the purpose of a 4-6-week aligning stage, round NeoSentalloy® with a diameter of 0.016 inches seems to be the wire of choice because of the low level of F dav.

Effects of 2 bracket and ligation types on plaque retention: a quantitative microbiologic analysis with real-time polymerase chain reaction.

INTRODUCTION: The aim of this study was to evaluate the effects of self-ligating brackets and conventional brackets ligated with stainless steel ligatures on dental plaque retention and microbial flora. METHODS: Twenty boys (mean age, 14.2 ± 1.5 years) underwent bonding with self-ligating bracket systems and conventional standard edgewise bracket systems ligated with stainless steel ligatures with a split-mouth design. Clinical measurements, including plaque index, probing pocket depth, and bleeding on probing, were obtained before bonding, 1 week after bonding, and 3 months after bonding. Supragingival plaque samples were obtained at baseline and 3 months after bonding for the detection of bacteria. A quantitative analysis for Streptococcus mutans, Streptococcus sobrinus, Lactobacillus casei, and Lactobacillus acidophilus was performed using real-time polymerase chain reaction. The Mann-Whitney U test and the Hotelling T(2) multivariate test were used for statistical comparisons of the groups. RESULTS: The numbers of S mutans, S sobrinus, L casei, and L acidophilus were not statistically different between self-ligating brackets and conventional brackets ligated with stainless steel ligatures (P >0.05). The 2 archwire ligation techniques showed no statistically significant differences in plaque index, bleeding on probing, and probing pocket depth values of the bonded teeth (P >0.05). All clinical parameters and the numbers of all microorganisms showed statistically significant increases from baseline to 3 months after bonding in both groups (P <0.001). CONCLUSIONS: Self-ligating brackets and conventional brackets ligated with stainless steel ligatures do not differ with regard to dental plaque retention.

Three-dimensional orthodontic force measurements.

INTRODUCTION: Until recently, much of the orthodontic biomechanics literature was restricted to 2-dimensional experimental studies and, more recently, to assumption-based 3-dimensional computer modeling. There is little evidence in the literature regarding 3-dimensional experimental measurements and analysis of orthodontic force systems. METHODS: The purpose of this study was the design, construction, and validation of a laboratory-based human mouth model capable of accurately measuring forces and moments applied by orthodontic fixed appliances on all teeth in 1 arch. A high canine malocclusion was simulated, and forces and moments acting on the canine, lateral incisor, and premolar were measured with passive and conventional ligation. RESULTS: We were successful in building this human mouth model. The error in force measurements of the 14 transducers was 1.54%. The force system resulting from passive ligation brackets was considerably different from that of conventional ligation. CONCLUSIONS: This method will allow us, for the first time in the history of our specialty, to determine with great accuracy the forces acting on orthodontically treated teeth. Future research will focus on simulating many types of orthodontic clinical applications of full-fixed or partial-fixed appliances.

Enamel demineralization with two forms of archwire ligation investigated using an in situ caries model--a pilot study.

A modified in situ model to assess enamel demineralization around orthodontic devices was developed and a pilot study was conducted to evaluate two types of archwire ligation. Enamel blocks were placed in palatal removable appliances where orthodontic brackets were bonded. The brackets on one side of the appliance were ligated with elastomeric rings and those on the other side with stainless steel wires. Four volunteers (two males, two females), mean age 27 years, wore the appliances for 14 days during which time a 20 per cent sucrose solution was dripped eight times a day onto the enamel blocks. The biofilm formed around the brackets was collected for microbiological analyses and the mineral loss around the brackets was determined by cross-sectional microhardness measurement. The ligatures evaluated did not differ significantly from each other regarding biofilm weight, total bacteria, total streptococci, mutans streptococci, or lactobacilli counts (P > 0.05, Wilcoxon paired test). Enamel demineralization was also not different around the brackets for the different ligation methods (P > 0.05, split-split-plot analysis of variance). However, a statistical power analysis based on the data showed a trend to higher demineralization around brackets ligated with elastomeric rings. The developed modified in situ model may be suitable to assess the caries potential of clinical procedures used in orthodontic treatment.

Load-deflection characteristics of superelastic nickel-titanium wires.

OBJECTIVE: To determine the mechanical properties of commercially available thermodynamic wires and to classify these wires mathematically into different groups. MATERIALS AND METHODS: The samples examined were 48 nickel-titanium (NiTi) alloy orthodontic wires commercially available from five manufacturers. These samples included 0.016-inch, 0.016- x 0.022-inch, 0.017- x 0.025-inch, and 0.018- x 0.025-inch wires. The superelastic properties of the NiTi wires were evaluated by conducting the three-point bending test under uniform testing conditions. The group classification was made under mathematically restricted parameters, and the final classification was according to their clinical plateau length. RESULTS: The orthodontic wires tested are classified as follows: (1) true superelastic wires, which presented a clinical plateau length of >/=0.5 mm; (2) borderline superelastic with a clinical plateau length of <0.5 mm and >0.05 mm; and (3) nonsuperelastic, with a clinical plateau length of

Properties of superelastic wires and their relevance to orthodontic treatment.

In this study tools were developed to test and compare levelling archwires that the manufacturers claim to have superelastic properties. As the classic spring model and Hook's law cannot be applied, new parameters had to be found. It could be shown that three parameters are necessary to describe a superelastic archwire adequately: the distinctiveness of the pseudo-elastic plateau, the deflection at the beginning of the plateau, and the force level of the plateau. The results showed that many materials either did not show any pseudoelastic properties at all or that the wire parameters were such that they did not give any advantage over conventional work hardened NiTi materials. In many archwires the beginning of the plateau and thereby the desired characteristics began only when the archwire was displaced 1 mm or more. For many archwires the force level of this plateau also proved to be rather high with values often above 500 g.

Brackets cerámicos. Una revisión / Ceramic brackets. A review

Esta revisión de la literatura pretende mostrar de manera global aspectos propios de los brackets cerámicos tales como sus propiedades físicas y sus ventajas y desventajas sobre los brackets de acero inoxidable