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Curvature Versus V-Bends in a Group B Titanium T-Loop Spring

Article in The Angle Orthodontist · June 2008

DOI: 10.2319/030207-109.1 · Source: PubMed

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 Original Article

Curvature Versus V-Bends in a Group B Titanium T-Loop Spring

Renato Parsekian Martinsa; Peter H. Buschangb; Rodrigo Viecillic; Ary dos Santos-Pintod

ABSTRACT
Objective: To compare the system of forces acting on curvature and preactivated V-bends in
titanium T-loop springs (TTLSs) made of 0.017- ⫻ 0.025-inch TMA (titanium molibdenium alloy)
wire.
Materials and Methods: Pictures of TTLSs preactivated by curvature and V-bends were inserted
in the LOOP software program to design both TTLSs. Symmetry was assured using the program.
Both TTLSs used the same amount (length) of wire and had the same angulation between their
anterior and posterior extremities when passive. The loops were activated 7 mm, and forces and
moments were registered after each 0.5 mm of deactivation. The brackets were at the same
height, separated by 23 mm and angulated 0⬚.
Results: The preactivated curvature TTLS delivered horizontal forces ranging from 34 gF to 456
gF, while the TTLS preactivated by V-bends delivered forces ranging from 54 gF to 517 gF. The
forces decreased more (30 gF vs 33 gF) with every 0.5 mm of activation on the preactivated
V-bend TTLS than on the preactivated curvature TTLS. Vertical forces were low and clinically
insignificant for both TTLSs. The moment to force (MF) ratios were systematically higher on the
preactivated curvature than on the preactivated V-bend TTLS (from 5.8 mm to 38.8 mm vs 4.7
mm to 28.3 mm).
Conclusions: Although both loops show symmetrical moments in their anterior and posterior
extremities and can be used for group B anchorage, the curvature preactivated TTLS delivers
lower horizontal forces and higher MF ratios than the acute preactivated V-bend TTLS.
KEY WORDS: T-loops; Moment to force ratios; Group B anchorage; TMA; Loop software

INTRODUCTION ratio and, if similar vertical dimensions are compared,

delivers a more constant force over a larger deacti-
Efficient space closure is an important objective in
vation span than vertical loops,1 such as bull loops.
orthodontics. Segmental space closure can be more
The load/deflection ratio can be further improved with
efficient due to frictionless mechanics and large inter-
the use of TMA (titanium molibdenium alloy).1–3 The
bracket distances (IBD). The ‘‘T’’ loop used for group
titanium T-loop spring (TTLS) allows for more predict-
B or reciprocal anchorage has a low load/deflection
able tooth movements over longer spans of activation
than vertical loops and can be used for specific types
a
PhD candidate, Faculdade de Odontologia de Araraquara,
of movements, including translation. The various de-
UNESP, Araraquara, São Paulo, Brazil, Research Fellow, Bay-
lor College of Dentistry, Dallas, Tex. signs of the TTLS for group B anchorage1,4–7 that have
b
Professor, Department of Baylor College of Dentistry, Dal- been introduced differ primarily in terms of loop size
las, Tex. and preactivations.
c
PhD candidate, Indiana University School of Dentistry, In- Although it has been established that increasing the
dianapolis, Ind, Biomechanics Laboratory, Indiana University
School of Dentistry and Purdue School of Engineering and
height of the loop also increases the moment to force
Technology, Indianapolis, Ind. (MF) ratio,8–10 the effects of different types of preacti-
d
Professor, Faculdade de Odontologia de Araraquara, vation are not completely understood. More specifi-
UNESP, Araraquara, São Paulo, Brazil. cally, differences between TTLS preactivated by a cur-
Corresponding author: Dr Renato Parsekian Martins, Uni- vature vs TTLS preactivated by a V-bend have not yet
versidade Estadual Paulista, UNESP, Department of Orthodon-
tics, Rua Voluntários da Pátria 1766, Araraquara, Sao Paulo
been systematically studied. Manhartsberger et al5 re-
14801-320, Brazil ported less horizontal force and higher MF ratios in the
(e-mail: dr[email protected]) preactivation bend with a large activation and more
Accepted: May 2007. Submitted: March 2007. force and a lower M/F with smaller activation. Their
 2008 by The EH Angle Education and Research Foundation, study, however, was not designed to compare curva-
Inc.
DOI: 10.2319/030207-109.1 517 Angle Orthodontist, Vol 78, No 3, 2008
518 MARTINS, BUSCHANG, VIECILLI, SANTOS-PINTO

Figure 1. Templates used for the design of the titanium T-loop springs (TTLSs) (left) and simulated by the LOOP software (right). (A) Curvature
preactivated TTLS. (B) Bend preactivated TTLS (each square is 1 cm2).

ture and bends. Moreover, the angulations between Because the planned activation of the loops was 5
both anterior and posterior extremities of the loops mm, the anterior and posterior lengths of wire were
they used were different, which could confound their estimated to be 9 mm based on the following formu-
results. la6,7: (IBD ⫺ Activation)/2. After the loop was designed,
The purpose of this study was to evaluate the dif- it was saved as two files, one for each of the preacti-
ferences in force levels and MF ratios between group vations. The curvature preactivation TTLS was per-
B TTLSs preactivated by a curvature and those preac- formed by inserting a template4 as a figure on the soft-
tivated by a V-bend. The LOOP software (dHAL, Ath- ware and checked to ensure that both sides were sym-
ens, Greece) was used to perform the preactivations metrical (Figure 1). The preactivation V-bend was per-
precisely and to estimate forces and moments. formed by inserting a picture of a TTLS preactivated
according to Marcotte7 (picture was taken after trial ac-
MATERIALS AND METHODS tivation) following trial activation on the software as
Two group B TTLSs, one with curvature preactiva- well.
tion4 and one with V-bend preactivation7 (Figure 1), TTLS total wire length, distance to bracket, angu-
were designed and tested using the LOOP software lation to bracket, and number of segments were stan-
(dHAL). The TTLSs were designed from 0.017- ⫻ dardized using the software to ensure comparability of
0.025-inch TMA to be 10 mm long and 6 mm high. An the two TTLSs without activation of the springs. The
IBD of 23 mm, from the canine bracket to the molar total amount of wire used in both TTLSs was 47.21
tube, was used. Both brackets were positioned at the mm and, when passive, the angulation between the
same level with the same orientation. extremities of the loops was 42⬚. The linear distances

Angle Orthodontist, Vol 78, No 3, 2008

CURVATURE VERSUS BENDS IN GROUP B TTLS 519

Figure 2. Characteristics of the titanium T-loop springs (TTLSs) when in neutral position. Note the similar amount of overlapping between the
vertical extensions of the loop of the two TTLSs. (A) TTLS preactivated by curvature. (B) TTLS preactivated by bends.

Table 1. Values for Force (Horizontal and Vertical) and Moment to Force (M/F) Ratios in Alpha (Anterior Bracket) and Beta (Posterior Bracket)
and Differences Between Curvature and Bend Preactivation Over a 7-mm Range of Activation of the Titanium T-loop Spring (TTLS) Tested
(Negative Values of Activation Pertain to the Horizontal Force Generated by the Neutral Position)
Curvature Preactivation Bend Preactivation Difference
Activation, M/Fx, mm M/Fx, M/Fx, mm M/Fx, M/Fx, mm M/Fx,
mm Fx, gf Fy, gf (alpha) mm (beta) Fx, gf Fy, gf (alpha) mm (beta) Fx, gf Fy, gf (alpha) mm (beta)
5.0 456.7 ⫺0.9 5.8 5.9 516.6 ⫺0.7 4.7 4.7 60.0 0.2 1.2 1.2
4.5 430.1 ⫺1.4 6.1 6.1 481.0 0.3 4.9 4.9 51.0 1.7 1.1 1.2
4.0 400.3 0.4 6.4 6.4 455.5 0.1 5.1 5.1 55.2 ⫺0.2 1.2 1.2
3.5 374.4 0.5 6.7 6.6 419.6 0.2 5.4 5.4 45.2 ⫺0.3 1.2 1.2
3.0 343.4 ⫺1.5 7.0 7.1 398.4 3.2 5.7 5.5 55.0 4.7 1.3 1.6
2.5 316.8 3.5 7.5 7.3 361.2 4.3 6.1 5.9 44.4 0.7 1.4 1.4
2.0 292.2 0.9 7.9 7.8 334.1 5.3 6.5 6.2 42.0 4.5 1.4 1.6
1.5 262.8 1.0 8.4 8.4 298.8 4.0 7.0 6.7 36.1 3.0 1.5 1.6
1.0 228.1 3.3 9.3 9.1 266.2 3.6 7.6 7.3 38.1 0.3 1.8 1.7
0.5 197.7 2.7 10.3 10.0 232.7 4.0 8.4 8.1 35.0 1.3 1.9 1.9
0.0 166.6 3.3 11.7 11.3 198.7 4.2 9.5 9.1 32.1 0.9 2.2 2.3
⫺0.5 135.4 3.1 13.7 13.3 163.8 4.5 11.0 10.5 28.4 1.3 2.6 2.7
⫺1.0 103.5 3.2 16.9 16.3 129.1 3.9 13.3 12.8 25.6 0.7 3.5 3.5
⫺1.5 72.2 2.1 22.7 22.2 92.4 4.1 17.7 16.9 20.2 2.0 5.0 5.2
⫺2.0 39.2 2.1 38.8 37.9 54.4 4.3 28.3 27.0 15.2 2.2 10.5 10.9
Average 38.9 1.5 2.5 2.6

from the unengaged extremity of the TTLS to the rected by a factor of 0.88.11,12 Changes in forces were
bracket were slightly different between the TTLSs estimated at each 0.5-mm increment of activation. No
(0.77 mm). statistical testing was performed because the software
The TTLSs were activated from 5 mm to ⫺2 mm mathematically calculates the M/Fx iteratively based
(negative values are due to the overlapping of the ver- on theoretical beam equations which produce similar
tical extensions of the TTLSs in their neutral positions results for the same wire configuration.
[ie, defined two dimensionally with the extremities of
the loop positioned at 180⬚; Figure 2]), for a total of 7 RESULTS
mm, in increments of 0.5 mm. At each increment the
horizontal forces (Fx), vertical forces (Fy), and mo- The TTLS preactivated by curvature delivered hori-
ment/force ratios (M/Fx) were estimated by the soft- zontal forces increasing from 40 gf to 457 gf between
ware and copied to a Microsoft Excel worksheet. The ⫺2 and 5 mm of activation, respectively (Table 1; Fig-
absolute values of the forces and moments were cor- ure 3). The force decreased approximately 30 gf for

Angle Orthodontist, Vol 78, No 3, 2008

520 MARTINS, BUSCHANG, VIECILLI, SANTOS-PINTO

Figure 3. Horizontal force variation in the titanium T-loop springs

Figure 4. Data from the present study on the moment to force (MF)
(TTLSs) preactivated by bends and by curvature over a range of 7
ratio variation over activation in both titanium T-loop spring (TTLS)
mm of deactivation.
preactivations, in alpha (anterior bracket) and beta (posterior brack-
et).

Table 2. Changes in Force for Every 0.5 mm of Activation in the

Curvature and Bend Preactivation Titanium T-loop Springs (TTLSs)
Variation in Force, gf
DISCUSSION
Range, mm Curvature Bend The force delivered by the bend preactivated TTLS
5.0 to 4.5 26.6 35.6 was systematically higher than the force delivered by
4.5 to 4.0 29.8 25.5 the preactivated curvature TTLS. These results appear
4.0 to 3.5 25.9 35.9 to be different from the findings of Manhartsberger et
3.5 to 3.0 31.0 21.2
3.0 to 2.5 26.6 37.2
al5 (Figure 5A,B), which showed initially higher forces
2.5 to 2.0 24.7 27.1 for the preactivated V-bend TTLS. While residual
2.0 to 1.5 29.4 35.3 stresses/plastic deformation could help explain this dif-
1.5 to 1.0 34.6 32.6 ference, it is more likely that the higher forces they
1.0 to 0.5 30.4 33.5 report for the preactivated curvature TTLS are due to
0.5 to 0.0 31.1 34.0
0.0 to (⫺0.5) 31.2 34.9
an error of activation, caused by greater activation of
⫺0.5 to (⫺1.0) 31.9 34.7 the curvature than the V-bend TTLS. Their data (Fig-
⫺1.0 to (⫺1.5) 31.3 36.7 ure 5A) show a sudden depression between 0.5 mm
⫺1.5 to (⫺2.0) 33.0 38.0 and 0 mm of activation for the curvature bend TTLS,
Average 29.8 33.0 which dramatically alters the slope of the line repre-
senting its load/deflection rate. Within their elastic limit,
TMA loops should display a constant load/deflection
every 0.5 mm of deactivation (Table 2). Vertical forces rate.2,7,10,13,14 The limited increase in MF ratios at the
ranging from 1.5 gF of intrusive force to 3.5 gF of ex- curvature preactivated TTLS (Figure 5B) is also indic-
trusive force were low and clinically insignificant. The ative of a problem. The lines on the graph should fol-
MF ratios increased with deactivation from 5.8 mm to low the same slopes until they cross the x-axis (Figure
38.8 mm on the anterior bracket (alpha) and from 5.9 5C), at which point the force delivered by the TTLS
mm to 37.9 mm on the posterior bracket (beta) (Figure would be 0 (neutral position). This indicates that the
4; Table 1). curvature preactivated TTLS was systematically ov-
The TTLS preactivated by the V-bends delivered eractivated by 1.43 mm when compared to the bend
horizontal forces increasing from 54 gf to 517 gf in the preactivated TTLS. In order to compare the differenc-
same range of activation as the preactivated curvature es between loops, their y- and x-intercepts should be
TTLS (Figure 3). The force decreased more (30 gf vs made to coincide. When the x-intercepts are made to
33 gf) with every 0.5 mm of activation than the preac- coincide, measurements are registered at the same
tivated curvature TTLS (Table 2). Vertical forces increments of activation from neutral position (which
ranged from 0.7 gf of intrusive force to 5.3 gf of extru- does not necessarily mean that the activation mea-
sive force. The MF ratio at 5 mm of positive activation sured by the vertical extensions separation will be the
was 4.7 mm and increased gradually to 28.3 mm in same). When the same procedure is performed in the
alpha and from 4.7 mm to 27.0 mm in beta (Figure 4; y-intercept, the activations can be measured from 0
Table 1). (neutral position of each loop). With these adjust-

Angle Orthodontist, Vol 78, No 3, 2008

CURVATURE VERSUS BENDS IN GROUP B TTLS 521

Figure 5. Plotted graph of the data from Manhartsberger et al5 on a 0.017- ⫻ 0.025-inch group B titanium T-loop spring (TTLS) on the effect
of deactivation. (A) On moment to force (MF) ratios. (B) On the horizontal force produced. (C) Graph A modified—the values pointed by the
arrows depict the approximate relative ‘‘activation’’ where horizontal force produced by the TTLSs would be 0. (D) Graph A adjusted so both
activations are the same at 0.

ments, the results of the data by Manhartsberger et al5

(Figure 5D) are similar to the present study (Figure 6).
These adjustments are necessary due to the over-
lapping of the vertical extensions of the TTLSs (or any
other loop) in neutral position, which increases when
more angulation is added between the anterior and
posterior extremities. Because the angulations of both
TTLSs used in the present study were similar, the dif-
ference was small (0.17 mm) and resulted in an insig-
nificant increase in force (15 gf/0.5 mm) for the bend
preactivated TTLS. This demonstrates that the dis-
tance between the vertical extremities of the loop used
to access activation is error-prone and should not be
used when comparing different loops. Also, the clini-
cian should be aware that the horizontal force increas-
es when extra curvature is added adjacent to the loop
or even to archwires with bull loops (ie, when adding
more ‘‘gable’’ to a bull loop, the same 1 mm of acti-
vation generates more force).
It can be concluded that a preactivated curvature
Figure 6. Plotted data from the present study on the effects of preac-
tivation on the horizontal force on a 0.017- ⫻ 0.025-inch group B TTLS delivers lower forces with the same range of ac-
titanium T-loop spring (TTLS), mathematically adjusted so both ac- tivation as the preactivated V-bend TTLS. Because
tivations are the same. both force deactivation rates are roughly the same, the

Angle Orthodontist, Vol 78, No 3, 2008

522 MARTINS, BUSCHANG, VIECILLI, SANTOS-PINTO

curvature preactivation maintains a lower force applied 10 mm from the center of resistance of a tooth
throughout the entire range of deactivation. However, vertically oriented. Thus, in addition to increasing the
it appears to be harder to preactivate the TTLS with a height of a TTLS, the MF ratios can be increased by
specific curvature without the use of a chair-side tem- changing its preactivation from bend to curvature. Cur-
plate, whereas the bend preactivated one should not vature bends promote better internal stress distribution
require the use of a template. during bending. Also, it helps to minimize postinser-
The force decrease per unit of activation was lower tional permanent deformation by avoiding a compro-
on the curvature preactivation than the V-bend preac- mise in the microstructure of the wire due to micro-
tivation. The difference on average, 3 gf per 0.5 mm cracks in areas of stress concentration.15 As a con-
of deactivation, is larger than the 1 gf reported by Man- sequence, more preactivation can be incorporated
hartsberger et al,5 but clinically insignificant. This im- theoretically to the wire by curvature than by acute
plies that both loops have similar slopes and produce bends.
similar load/deflection ratios.
Both TTLSs tested in this investigation delivered CONCLUSIONS
symmetrical moments throughout the activations. This
was expected, since the loops were symmetrically de- • Both curvature and bend preactivated TTLSs pro-
signed, and there was no difference in height or an- duced symmetrical moments, with small vertical forc-
gulations between the brackets. This finding agrees es, ranging from ⫺1.5 gf to 4.5 gf. They also pro-
with Manhartsberger et al,5 who reported relatively duced low MF ratios when activated 7 mm (5.9 mm
symmetrical MF ratios of the preactivations. Their ra- and 4.7 mm for curvature preactivated and bend
tios were less symmetric than ours because the height preactivated, respectively).
differences in the vertical extensions of the loop gen- • The curvature preactivated TTLS produced horizon-
erate greater discrepancy between the alpha and beta tal forces that were lighter, 38.9 gf on average, than
brackets. This implies that curvature or bend preacti- the bend preactivated TTLS.
vations can be used for reciprocal space closure with- • The curvature preactivated TTLS produced MF ra-
out major effects on the vertical position of the pos- tios that were approximately 2.5 mm higher than the
terior and anterior segments. bend preactivated TTLS.
Both TTLSs produced initial MF ratios that were too • The curvature preactivated TTLS showed less force
low for controlled tipping, assuming 7/1 mm produces decrease per 0.5 mm of deactivation (29.8 gf) than
this movement (Figure 4; Table 1). This is important the bend preactivated TTLS (33 gf).
because the theory of reciprocal space closure with a
TTLS depends on moving the teeth initially by con- ACKNOWLEDGMENTS
trolled tipping, then by translation and finally by root The authors would like to thank Dr Demetrius Halazonetis for
correction, all of which occur as the MF increases.1,7 his intellectual expertise helping with the adjustments of the data
Manhartsberger et al5 found higher MF ratios with in the Manhartsberger paper and in ours. This paper was ac-
bend, and lower with the curvature preactivated TTLS, complished with financial support from CAPES/Brazil, process
number 3639/05-3.
which can be partially explained by the different sizes
of loops, interbracket distances, and the higher degree
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