The Effects of Interbracket Position and Distance on the Orthodontic Triangular Loop

Abstract

Orthodontic closing loops offer an efficient way to control the moment to force ratios (M/F) delivered during space closure. The triangular loop is often used in the Graduate Orthodontic Clinic at the Indiana University School of Dentistry. Previous studies on the triangular loop were concerned with various loop geometries. The present project was designed to study the triangular loop in a clinically realistic experimental set up. Compared to the previous studies, three major changes were implemented: instead of two coplanar brackets, the current study employed a bracketed typodont arch (1) the effects of loop locations (2) and different interbracket distances were considered (3). The measured moment and forces reflect considerable differences in the systems due to the new experimental set up. As in previous studies, the triangular loops were fabricated from 0.016 X 0.022- inch stainless steel wire. The loops were equilateral triangles with 8 mm sides, ligated to the arch wire by elastomeric rings. There were 4 loop locations: location 1 was at 1.2 mm away from the mesial bracket; location 2 was at 3 .2 mm away from the distal bracket; location 3 was centered in the middle of the original interbracket distance; location 4 was located 2.6 mm away from the mesial bracket. There were three interbracket distances (IB). The original IB (IBl) of 12.6 mm was decreased by 3 mm (IB 2) and by 6 mm (IB 3). The loops were activated by 1.6 mm and 3.3 mm. Force and moment components were measured along three mutual perpendicular axes (x, y, and z) corresponding to the buccolingual, mesiodistal, occlusogingival axes respectively. Comparisons of Mx/Fy and Mz/Fy at the mesial and distal, by three activation levels, three interbracket distances, and four locations, and all interaction effects, were performed using a mixed design repeated measures ANOV A procedure. The General Linear Model (GLM) procedure for unbalanced designs was used because not all interbracket distances could be accommodated with all loop locations. Activation distance was the within specimen repeated factor. Loop location and interbracket distance were the between specimen factor. It was theorized that the location of the triangular loop, as well as the interbracket distance, have a considerable effect on the generated M/F. The Null Hypothesis was that there are no significant differences (p > 0.05) in the M/F ratios generated by the triangular loop as the loop position changes relative to the brackets, and there are no significant differences (p>0.05) in the M/F ratios generated by the triangular loop as the interbracket distance becomes shorter with space closure. Statistical significant interactions were found for Mx/Fy and Mz/Fy at location 2, for all activations, at both the mesial and distal measures. Therefore we rejected the first part of the Null Hypothesis (no differences as the loop location changes), and accept the second part (no differences as the interbracket distance shortens). We were able to see clear trends at all loop locations, as well as interbracket distances, and draw useful clinical implications. We found that the mesial closing forces are quite small when compared to those at the distal. We attributed this discrepancy to the U shape geometry of the continuous arch wire technique. We observed that if closing loops are delivered with no activation, then counterproductive M/F ratios are produced. Our data also indicated that anchorage becomes more critical as the interbracket distance shortens. Finally, we determined that wire tie ligation for prevention of rotation along the long axis of the tooth is especially important for the lateral incisor.