Determination of the 3D Load System for Space Closure Using Keyhole and Teardrop Closing Loops in a Full Arch

Abstract

The current movement in dentistry is to provide treatment that is evidence-based rather than opinion-based. Unfortunately, there is a lack of evidence for most orthodontic appliances. Much work has been done to find the appropriate load system to move teeth, but research has only been done with laboratory techniques that may not be applied clinically. Ideally, appliances should be tested in all three dimensions with techniques (e.g. type of ligation) that replicate clinical procedures. This can be accomplished with a new patented technology, the orthodontic force tester (OFT). The OFT allows an entire arch with brackets and a full arch wire to be set up while measurements are made on target teeth. With the OFT, appliances can be tested to ascertain if they provide the prescribed load system, and if not, then modify them or develop new ones. In this experiment two different commercially available prefabricated closing loop arch wires (keyhole and teardrop) were tested with variations in gable bends, interbracket loop position, and activation. The application being tested is closing space between a lateral incisor and canine in a first premolar extraction case after the canine has been retracted. While the trend shows that the keyhole loop produces higher overall force the two loops are not significantly different in the forces or moments that they generate. The one exception is that the keyhole loop produces higher lingual forces at the canine when the loop is in the mesial position. Also, few wire configuration were able to produce M/F sufficient to translate teeth. The wire configurations that can provide the proper load system to translate teeth in the lingual direction at the incisor were in the mesial position and had second order gable bends at the alpha position. The loop design had little effect on the M/F ratios.