Orthotown June 2018 - 30

by "fenrisĂșlfr"
One of Orthotown's most-followed
members online, "fenrisĂșlfr" trained at
the University of North Carolina at Chapel
Hill and at the University of Texas at San
Antonio. The Townie practices orthodontics
full time in San Antonio, teaches part time,
and is a regular poster on Orthotown.com's
clinical message boards.

Frictionless
Mechanics
in Orthodontic
Space Closure
Introduction
Orthodontic treatment frequently requires the extraction of teeth to
alleviate crowding, optimize facial balance and establish desired functional
goals. The choice of teeth to extract usually depends on the characteristics of
the presenting malocclusion. Severe crowding/protrusion typically warrants
the extraction of first bicuspids, whereas milder manifestations allow for the
extraction of second bicuspids. A retrospective study by Haque et al., however,
failed to find a difference in anchorage loss between the extraction of maxillary
first and second bicuspids.1
Space closing mechanics can be broadly classified into:
* Frictional or sliding mechanics, where the teeth slide along
the arch wire.
* Frictionless or closing loop mechanics, where the teeth and
the arch wire move as a unit.
In general, sliding mechanics offers excellent control of the occlusal plane
and root position, with moment-to-force ratios approaching those required
for translation predictably generated with full-sized arch wires.2 The .022 slot
appliance is uniquely suited to facilitate sliding mechanics owing to the increased
clearance between the slot and the working arch wire (19x25 stainless steel).
However, in situations requiring moderate to maximum anchorage control
as well as intrusion during retraction, closing loops with differential moment
activations may offer a better alternative.3,4 The incorporation of a loop creates
discontinuity between the anterior and posterior segments, allowing them to
behave more independently when compared to a stiff continuous arch wire.

30

JUNE 2018 // orthotown.com


http://www.orthotown.com

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