Mechanical environment for lower canine T-loop retraction compared to en-masse space closure with a power-arm attached to either the canine bracket or the archwire

Abstract

Objectives: To assess the mechanical environment for three fixed appliances designed to retract the lower anterior segment.

Materials and methods: A cone-beam computed tomography scan provided three-dimensional morphology to construct finite element models for three common methods of lower anterior retraction into first premolar extraction spaces: (1) canine retraction with a T-loop, (2) en-masse space closure with the power-arm on the canine bracket (PAB), and (3) power-arm directly attached to the archwire mesial to the canine (PAW). Half of the symmetric mandibular arch was modeled as a linear, isotropic composite material containing five teeth: central incisors (L1), lateral incisor (L2), canine (L3), second premolar (L4), and first molar (L5). Bonded brackets had 0.022-in slots. Archwire and power-arm components were 0.016 × 0.022 in. An initial retraction force of 125 cN was used for all three appliances. Displacements were calculated. Periodontal ligament (PDL) stresses and distributions were calculated for four invariants: maximum principal, minimum principal, von Mises, and dilatational stresses.

Results: The PDL stress distributions for the four invariants corresponded to the displacement patterns for each appliance. T-loop tipped the canine(s) and incisors distally. PAB rotated L3 distal in, intruded L2, and extruded L1. PAW distorted the archwire resulting in L3 extrusion as well as lingual tipping of L1 and L2. Maximum stress levels in the PDL were up to 5× greater for the PAW than the T-loop and PAB methods.

Conclusions: T-loop of this type is more predictable because power-arms can have rotational and archwire distortion effects that result in undesirable paths of tooth movement.