A n d r e w J . K u h l b e r g , D M D , M D S , a a n d C h a r l e s J . B u r s t o n e , D D S , M S b Farmington, Conn. The ef f ect of of f - cent er posi t i oni ng on t he f or ce syst em pr oduced by segment ed 0. 017 0. 025- i nch TMA T- l oops was measured. A T- l oop was desi gned t o pr oduce equal and opposi t e moment s in t he cent er ed posi t i on. The spri ng was t est ed in seven posi t i ons, cent er ed, 1, 2, and 3 mm t owar d t he ant eri or at t achment , and 1, 2, and 3 mm t owar d t he post er i or at t achment s. The hori zontal f orce, verti cal f orce, and al pha and bet a moment s wer e measur ed over 6 mm of spri ng acti vati on. T h e resul ts showed t hat t he al pha/ bet a moment ratio was dependent onl y on t he spri ng posi t i on, and i ndependent of spri ng acti vati on. Eccent ri c posi t i oni ng of T- l oop spri ngs effecti vel y pr oduces a consi st ent moment di fferenti al t hr ough t he range of spri ng acti vati on. (Am J Or t hod Dent of ac Or t hop 1997;112:12-8.) T h e application of differential moments bet ween teeth is recognized as an effective means for achieving desired t oot h movement. These mo- ments are t ermed alpha and beta moments for the anterior and posterior teeth, respectively. Differen- tial moments are used for obtaining differential anchorage, intrusive or extrusive forces, and root movement. ~-4 Precise control of tooth movement during clo- sure of extraction spaces in three dimensions is of paramount importance in meeting treatment goals. This includes control of the anchorage units, vertical forces, root positions, and rotations. Many methods for controlling the posterior anchorage movement in extraction space closure have been described. 5-12 Regulation of the space closure is ultimately deter- mined by the biomechanical forces applied to the teeth. Variation in the force and moment magnitude and the moment-to-force ratio are important deter- minants of the resulting tooth movement. Tweed tip-back bends, Begg or Tip-edge mechanics, inter- maxillary elastics, and headgear can produce differ- ences in the moment-to-force ratios (and the mo- ment differential) bet ween the anterior teeth and posterior teeth. This difference in the moment-to- force ratio acting on the anterior versus the poste- rior teeth is produced by either applying unequal moments (a moment differential) or unequal forces (i.e., use of a headgear or intermaxillary elastics). Previously, other methods were described to pro- duce the differential moments with segmented T- From the Department of Orthodontics, University of Connecticut School of Dental Medicine. ~Assistant professor. bprofessor. Reprint requests to: Dr. Andrew J. Kuhlberg, University of Connecticut Health Center, School of Dental Medicine, Department of Orthodontics, MC 1725, 263 Farmington Ave., Farmington, CT 06030. Copyright 1997 by the American Association of Orthodontists. 0889-5406/97/$5.00 + 0 8/1/72484 1 2 loops, including the composite T-loop (a 0.018-inch titanium molybdenum alloy (TMA) T-loop welded to a 0.017 0.025-inch TMA base segment), chang- ing the angulation of the preactivation (gable) bends, and placing the spring off cent er? 5,11,~2 The segmented T-loop has been extensively studied for its mechanism of action. The force system produced by a segmented T-loop spring consists of several component s--t he alpha moment, the bet a moment, horizontal forces, and vertical forces. These forces have three-dimensional effects, however, the second order (the buccal aspect) is most frequently considered in the analysis of space closure mechanics. Command of the second-order force system is a key to effective management of the movement of the anterior and posterior teeth. The purpose of this study is to examine the effects of off-center positioning on the force system produced by symmetric T-loop springs. It is hypoth- esized that the moment differential (represented by a ratio of the moments) is dependent on the spring position and spring activation. Also, each compo- nent of the entire force system (the alpha moments, bet a moments, horizontal forces, and vertical forces) is dependent on two variables, spring activa- tion and spring position. M A T E R I A L S a n d M E T H O D S Prefabricated 0.017 0.025-inch TMA segmented T-loop springs (Ormco Corp.) were used in this study. The initial and preactivation shapes are shown in Fig. 1,A and B. This design was based on the segmented T-spring for symmetric space closure as described by Burstone? ,4 Specific design criteria were (1) production of equal and opposite alpha and beta moments at full activation (6 mm), (2) moment-to-force ratio of 6 to 7 at full activation, (3) smooth gradual curvature for the preactivation bends, and (4) a neutral position with the vertical legs of the spring touching. 4 Preliminary testing was completed to American Journal of Orthodontics and Dentofacial Orthopedics Kuhl ber g and Bur s t one 13 Volume 112, No. 1 A 10 mm 4mrn! 115mm : q B E T A 5 mm A L P H A B B E T A A L P H A Standard Form With Preactivation Bends (without preactivation bends) for Equal and Opposi te Moment s Fig. 1. A, Standard form and dimensions of 0.017 0.025-inch TMA T-loop described by Burstone 4,5,11 before placement of preactivation bends. B, T-loop with preactivation bends placed, note that angulation of alpha and beta sides is produced by gradual curvature placed in wire. BETA POSITION Posterior ALPHA POSITION Anterior Fig. 2. Checking neutral position. Equal and opposite moments are applied to spring, no horizontal forces are applied so that horizontal arms become parallel, position of vertical arms are checked. In this study, vertical arms just touch in neutral position. adj ust t he spri ng t empl at e design t o meet t hese specifica- tions. Al l pr eact i vat i ons bends were "over bent " to r emove r esi dual st resses i n t he wi re, and t ri al act i vat i ons were done to eval uat e t he st abi l i t y of t he spri ng shape. Figs. 2 and 3 show t he neut r al posi t i on and t he t ri al activation. The t est s were per f or med on t he spri ng t est er appa- rat us in t he bi omechani cs l abor at or y of t he Uni versi t y of Connect i cut School of Dent al Medi ci ne Or t hodont i cs Depar t ment . The desi gn of this t est er has been descr i bed previ ousl y. 13 Thi s appar at us measur es uni pl anar forces and moment s acting on each end of t he spri ng at t achment . Specifically, t he al pha ( ant er i or ) and bet a ( post er i or ) moment s wer e measur ed, as well as t he hor i zont al (at t rac- tive) and vert i cal forces (intrusive/extrusive). The force system as measur ed by t he spri ng t est er is shown in Fig. 4. Angul ar moment t r ansducer s measur e t he moment s and l i near di spl acement t r ansducer s measur e t he forces. The spri ng is act i vat ed by a comput er cont r ol l ed mot or i zed carri age. Out put vol t ages wer e r ecor ded by t he comput er and t r ansf or med i nt o force and moment values. The accuracy of t he spri ng t est er was appr oxi mat el y +4 gm for t he forces and _+ 25 gm/ mm for t he moment s. Cal i br at i on was per f or med by t he appl i cat i on of known forces and moment s with dead weights and cantilevers. 14 Kuhlberg and Burstone American Journal of Orthodontics and Dentofacial Orthopedics July 1997 ] l | | l r _- BETA . J AL P HA F i g . 3, Trial activation. Horizontal arms are kept parallel by appl yi ng force and moment. Trial acti vati on adds t o stabi l i ty of spri ng shape. A standard interbracket distance of 23 mm was used (at full spring activation), this distance represents an approximate average interbracket distance between a first molar and canine before extraction of a premolar. The force system was measured during activation from 17 to 23 mm at 0.5 mm intervals. The springs were placed in seven positions: center, and 1, 2, or 3 mm off center toward each of the alpha and beta attachments. Three springs were tested at each position and each spring was used for three trials. The springs were compared with the templates before and after each trial to evaluate for deformation. Any springs exhibiting deforma- tion during testing were discarded and replaced. The output measurements included the alpha mo- ment, the beta moment, the horizontal force, and the vertical force. From these values moment-to-force ratios, alpha/beta moments ratios, and the force/deflection rate(s) were calculated. To test for accuracy, the sum of the moments was calculated. S t a t i s t i c a l A n a l y s i s The mean and standard deviations for the alpha mo- ment, beta moment, horizontal force, and vertical force were calculated. A linear regression model was used to calculate the effect of spring position and activation (independent variables) on the alpha/beta moment ratio. Also, multivari- able linear regression equations were determined to predict the magnitude of each the alpha moment, beta moment, horizontal force, and vertical force for anteriorly and poste- riorly positioned springs. R E S U L T S The me a s ur e d f or ce syst em f or t he c e nt e r e d spri ng ( t he cont r ol spri ng) is shown in Tabl e I. The t abl e lists t he act i vat i on, al pha mome nt , bet a mome nt , hor i zont al f or ce, ver t i cal f or ce, mome nt - t o- f or ce r at i o ( al pha) , mome nt - t o- f or c e r at i o ( bet a) , and t he r at i o of t he al pha mome nt / be t a mome nt . For convent i on, mome nt s t hat woul d move t he r oot s of t e e t h mesi al l y ar e r e por t e d as posi t i ve ( +) , mome nt s t hat woul d move t he r oot s di st al l y ar e negat i ve ( - ) . Hor i z ont a l f or ces t hat woul d move t he t eet h mesi al l y ar e r e por t e d as negat i ve ( - ) , hor i zont al f or ces t hat woul d move t he t e e t h distally ar e posi t i ve ( +) . Al so, ver t i cal f or ces t hat ar e i nt r usi ve ar e negat i ve ( - ) , ext r usi ve ver t i cal f or ces ar e posi t i ve ( +) . The r at i o of t he mome nt s is r e por t e d as negat i ve becaus e t he al pha mome nt is negat i ve. For t he symmet ri c ( cent er ed) spring, t he al pha and bet a moment s wer e f ound t o be nearl y equal and t he rat i o of t he moment s was close t o 1.0 t hr oughout t he r ange of activation. At full act i vat i on (6 mm) , t he spring del i vered nearl y equal and opposi t e moment s (al pha = 2079 + 73 gm/ mm, bet a = 2126 + 177 gm/ mm). The al pha moment decr eased t o 1234 ( +89) gm/ mm at 0 activation. The bet a moment decr eased t o 1194 (_+92) gm/ mm at 0 activation. The moment / deact i vat i on r at e approxi- mat ed 95 gram/ ram f or bot h t he al pha and bet a moment s. The hor i zont al f or ce me a s ur e d 344 _+ 20 gm at 6 mm act i vat i on wi t h a f or ce/ deact i vat i on r at e of appr oxi mat el y 60 gm/ mm. The c e nt e r e d spri ng also del i ver ed smal l ver t i cal f or ces ( i nt r usi ve t o t he ant er i or at t achment ) despi t e t he equal al pha American Journal of Orthodontics and Dentofacial Orthopedics Kuhlberg and Burstone 15 Volume 112, No. 1 and bet a moment s. These forces balance t he moment of t he horizontal force pr oduced because of t he 1 mm offset (post eri or mor e i nferi or or gingivally posi t i oned) i ncorporat ed into t he spring design. T h e Ef f ect of Posi t i oni ng on t h e M o me n t Di f f er ent i al Wi t h a St a n d a r d Spr i ng Sh a p e Off-center positioning produced a moment dif- ferential. The higher moment was associated with the attachment closer to the cent er of the spring (i.e., a spring positioned more anteriorly produced a higher alpha moment, whereas a spring positioned more posteriorly produced a higher beta moment). The alpha/beta moment ratio was found to be det ermi ned by the spring position, i ndependent of spring activation. The ratio of the moments was analyzed with a multivariable linear regression. Sep- arate models for springs positioned more anteriorly and for springs positioned more posteriorly were analyzed. Regression analysis revealed that the spring position was the only statistically significant det ermi nant of the alpha/beta moment ratio for springs positioned off center. The slope parameters (position) were 0.58 (p < 0.000) for the anteriorly positioned springs, and 0.21 (p < 0.000) for poste- riorly positioned springs. Ef f ect of Spr i ng Posi t i oni ng on t h e For c e Sy s t e m The components of the force system produced by a T-loop are the alpha moment, the beta mo- ment, the horizontal force, and t he vertical force. For off-centered positioning, the magnitude of the alpha moment, the beta moment, and the horizontal force was dependent on both the activation and the position. The horizontal force ranged from approx- imately 340 gm at full activation to 0 gm at zero activation. Eccentricity had a small but statistically significant effect on the horizontal force magnitude. The horizontal force increased with increased ec- centric positioning by approximately 6 to 8 gm/mm off centering. The alpha and beta moment magni- tudes also increased with activation. The moments were also dependent on the spring position, with the moment increasing for the side closer to the T-loop and decreasing for the further side. The vertical forces (extrusive or intrusive forces) increased with greater off centering. The vertical forces on anteriorly positioned springs (extrusive forces on t he anterior teeth) were dependent on the spring position and i ndependent (statistically) of the springs activation. The vertical forces increased ap- proximately 26 gm/mm off centering toward the Bet a Moment B E T A P O S I T I O N -Iori zontal For ce - - ( ~ Ve r t i c a l For ce ( Ext r usi ve) AL PHA Vert i cal For ce (I nt rusi ve) P O S I T I O N ~ - - t o r i z o n t a l F o r c e Al pha Moment Fig. 4. Schematic diagram of force system measured by spring tester. Vertical forces shown as intrusive or extrusive are labeled to indicate direction. However, actual measured forces could be intrusive or extrusive on either position depending on alpha/beta moment difference. Spring is oriented vertical in this diagram as it was in tested in spring tester, for clinical usage spring would be directed horizontally. anterior (extrusive to the anterior teeth). The verti- cal forces produced by posteriorly positioned springs (intrusive forces to the anterior teeth) were depen- dent on the spring position and activation. The vertical forces increased approximately 24 gin/ram of off-center positioning (intrusive to the anterior teeth). Table II summarizes the multivariable regres- sion coetticients det ermi ned for predicting the mag- nitude of these force system components. Table III lists the moment-to-force ratios for off-center springs for both the alpha and beta mo- ments. The greater the eccentricity of the spring, the greater the difference in the moment-to-force ratios for the alpha and beta moments. The moment-to- force ratios increase with decreasing activation of the springs. D I S C U S S I ON The force system produced by T-loop springs depends on many variables, including, wire size and material, spring shape (preactivation shape), spring 1 6 Kuhl berg and Bur stone American J ournal of Orthodontics and Dentofacial Orthopedics July 1997 Ta bl e I. Force syst em pr oduc e by s ymmet ri c T- l oop spri ng i n cent ered pos i t i on Alpha Moment Beta Moment Horizontal Force Activation (turn) Mean SD Mean SD Mean SD 0 -1234.1 89.2 1194.7 92.0 -16. 0 18.3 0,5 -1329.1 88.1 1303.8 95.5 24.7 19.3 1 -1428.1 80.1 1406.7 104.8 54.1 19,1 1.5 -1518. 9 86.1 1496.4 113.7 82.1 14.2 2 -1605.1 79,0 1588.9 122.7 115.2 17.8 2.5 -1687.1 76.5 1672.8 130.4 140.3 16.9 3 -1766.1 87.0 1750.9 136.3 170.9 19.8 3.5 -1841.1 87.0 1829.9 143.1 20.7 17.7 4 -1901.9 82.6 1894.7 155.5 229.9 21.0 4.5 -1950.1 74.3 1956.1 159.6 254.6 16.9 5 -1986.2 71.4 2018.0 168.2 283.4 18.8 5.5 -2033.7 72.0 2072.8 176.3 316.3 20.5 6 -2079.2 73.2 2126.8 176.8 344.3 20.6 Vertical Force * Mean SD M/ F Alpha M/F Beta Ratio Alpha~Beta -6. 1 7.3 - - - - 1.03 -8. 8 7.4 -53. 9 52.9 1.03 -11. 1 9.4 -26. 4 26.0 1.02 -11. 4 9.4 -18. 5 18.2 1.02 -13. 4 6.1 -13. 9 13.8 1.01 -12. 9 7.0 -12. 0 11.9 1.01 - 14.6 7.4 - 10.3 10.2 1.01 -14. 7 9.2 -9. 1 9.1 1.01 -16. 4 8.2 - 8. 3 8.2 1.01 -17. 6 5.1 - 7. 7 7.7 1.00 -19. 6 5.5 - 7. 0 7.1 1.00 -21, 1 6.8 - 6. 4 6.6 0.98 -21. 4 9.8 - 6. 0 6,2 0.98 * ( - ) Value for vertical force indicates intrusive force acting on anterior. Ta bl e II. Mul t i vari abl e regres s i on coeffi ci ents f or det ermi ni ng Magni t udes of f orces and mo me nt s produced by of f - cent ered T- l oops Variable o f Act i vat i on Position Constant Mean Squares force system ( I V) (Slope 1) (Slope 2) (Intercept) (Variance, 0 -2) S.D. (Error) (or) R 2 Anteriorly posi t i oned springs Alpha moment - 194.56 227.41 - 1149.41 8816.75 93.90 0.96 Beta moment 115.59 286.25 1348.41 4883.14 69.88 0.97 Horizontal force 60.45 -6. 55 -13.11 35.04 5.92 1.00 Vertical force 0.01" 26.04 12.30 25.86 5.09 0.97 Posteriorly positioned springs Alpha moment -90. 26 303.04 - 1349.89 14306.73 119.61 0.91 Beta moment 209.65 169.11 1165.04 12815.46 113.21 0.94 Horizontal force 62.16 8.15 - 11.32 60.25 7.76 1.00 Vertical force -5. 27 -24. 95 -6. 70 82.86 9.10 0.92 Model Equation: IV = (Slope 1) x Activation + (Slope 2) Position + Intercept -+ Error p. < 0.000 that all other slopes 4:0.00 except*. *p > 0.05 that slope parameter = 0.00 Activation range = 0 to 6 millimeters Position range = - 3 mm (closer to anterior) to + 3 mm (closer to posterior) position, and activation. Controlling the force sys- tem produced by an orthodontic appliance or spring is essential to precise tooth movement. Force mag- nitude, direction, moment-to-force ratio, and force constancy are important variables determined byt he orthodontist during treatment? This study demonstrates another method that may be used for controlling the forces and moments produced by segmented 0.017 0.025-inch TMA T-l oop springs or closing l oops in general. Previ- ously, the approach described for achieving differ- ential alpha/beta moments with segmented T-l oops used asymmetric angulation of the preactivation bends. 3-5 However, with this method the moment differential does not remain constant with s pri ng activation, i.e., the moment differential is dependent on both spring activation and the differences in the preactivation angulations. This is in contrast to the findings of this study where only eccentric position- ing with a symmetric shape was used to achieve a moment differential, not spring shape. Off-center positioning maintains the constancy of the moment differential throughout the range of spring deactiva- tion (space closure). This concurs with Burstone and Koeni g 5 who demonstrated a moment differential and vertical forces with off-center vertical loops. Faulkner et al. 14 evaluated the effects of spring height, preactivation angulation, spring position, and the addition of helices on the force/ moment systems produced by segmented T-loops. The T- l oops were symmetric in shape (without the 1 mm offset in height bet ween the anterior and posterior sides of the T) but otherwise similarly designed to the present T-loops. They also found that off-center positioning had a significant impact on the moments produced with the higher moment occurring at the American Journal of Orthodontics and Dentofacial Orthopedics Ku h l b e r g a n d B u r s t o n e 1 7 Volume 112, No. 1 A B I n t e f o r a c k e l D is ta n c e I n t e r b r a c k e t D i s t a n c e C ~t~at~n IdTsten~e]- ~ I ~ d i ~ 4 I nt er br aeket Distance ! O f f s e t ( 1 r a m ) F i g . 5. Illustration of placement of T-loop. A, Spring in passive form after insertion into molar auxiliary tube. B, Spring in neutral position, activation is horizontal distance spring must be pulled for insertion into canine vertical tube. C, Spring activated and inserted into canine tube. Tabl e III. Mo me n t - t o - f o r c e r a t i o s f o r o f f - c e n t e r T - l o o p s r e t r a c t i o n s p r i n g s Springs off-center to anterior (alpha) Springs off-center to posterior (beta) - 1 mm* - 2 mm* Activation M/F Alpha M/F Beta M/F Alpha M/F Beta - 3 ram* 1 mm M/F Alpha M/F Beta M/F Alpha M/F Beta 0.5 53.3 38.2 59.7 29. 2 58.3 22.3 24.6 41.9 24.1 48. 7 18.9 46.6 1.0 26.8 19.1 30.7 14.8 26.7 10.1 14.6 25.1 12.8 26.5 9.6 24.3 1.5 19.4 13.8 20.8 10.0 20.5 7. 7 10.4 17.8 9.0 18.7 6.9 18.2 2.0 15.3 10.9 16.9 8.0 16.3 6. 0 8. 4 14.4 7.1 15.1 5.5 15.0 2.5 13.2 9.5 14.3 6.8 14.1 5.1 7. 2 12.4 6.1 13.2 4.5 12.7 3.0 11.4 8.1 12.9 6.1 12.6 4.6 6.3 10.9 5.3 11.4 4.1 11.5 3.5 10.4 7. 4 11.4 5.4 11.6 4.3 5.7 9.9 4.8 10.4 3.6 10.5 4.0 9.2 6. 6 10.4 4.9 10.5 3.8 5.1 9.0 4.3 9.6 3. 2 9.6 4.5 8.5 6.2 9.8 4.7 9.8 3.5 4.6 8.2 4.0 9.0 2.9 9. 0 5.0 7.8 5. 7 8.9 4.2 9.2 3.3 4.4 7.8 3.6 8.3 2.6 8.5 5.5 7.3 5.3 8.3 3.9 8.5 3.1 4.0 7.2 3.3 7.8 2.4 8.1 6.0 6.9 5. 0 7.8 3.7 8.1 2.9 3.7 6.8 3.1 7.4 2. 2 7.6 2 m m 3 m m M/F Alpha M/F Beta M/F Alpha M/F Beta *Negat i ve i ndi cat es spr i ng posi t i oned cl oser t o t he ant er i or at t achment . bracket closer to the T-loop. They did not evaluate the moment differential. The constancy of the ratio of the moments independent of the spring activation for a particular spring position is an important finding. Maintenance of the moment differential as the spaces close im- proves the opportunities for anchorage control and force system predictability. The moment differential remains approximately the same as the spring deac- tivates and the space closes which ensures that the moment-to-force ratio acting on the anchorage unit(s) will always be greater, reducing the likeli- hood of anchorage loss. These results are consistent with the effect of the placement of V-bend activations in arch wires for obtaining differential moments. 15 The position of the V-bend determines the magnitude (and direc- tion) of the moments produced. Positioning a V- bend off center results in differential moments. The greater moment acts on the tooth closest to the V-bend. Analogous results were found here because the angulation bends and the angulation of the curves behaved similar to V-bends. The variance of the measurements of the alpha and beta moments (different variations as demon- strated by the standard deviations) indicates the variation of the spring tester rather than the spring itself. Newer spring tester improvements demon- strate markedly lower variance for the same springs. The alpha/beta moment differential obtained by eccentric positioning underscores the importance of careful clinical placement of the position of loop placement. Even 1 mm of eccentricity produced marked difference in the alpha and beta moments. With the vertical forces, positioning a loop off center for convenience may result in undesirable results. If these moment differentials were found with a 17 to 23 mm interbracket distances, positioning may be 18 Kuhlberg and Burst one American Journal of Orthodontics and Dentofacial Orthopedics July 1997 even more critical with smaller interbracket dis- tances, which is typical in closing loops in continu- ous arch wires. Spring positioning can be readily used as an effective means of obtaining differential moments. Fig. 5 depicts the placement of an off-center T-loop spring for space closure. This technique of obtaining a desired force system may be useful in selected clinical situations, especially in the con- trol of anchorage. The force system produced by a spring placed 2 mm closer to the beta (distal) attachment with 3.5 to 4.0 mm of activation is very similar to that produced by a composite T-loop. 3'4,12 A significant advantage of this spring over previous types is that the use of spring position creates a more universal template for use in a variety of clinical applications. The results of this study clearly show the dangers of placing the T-loop spring off center simply for convenience. The effects of even 1 mm displacement on producing differential moments can be great enough to produce significant clinical side effects. The moment differential can produce two types of side effects that significantly impact on the treatment. First, the moment-to-force ratio acting on each segment may be changed enough to produce unexpected tooth movement. The seg- ment closer to the loop may exhibit greater trans- lation/root movement, while the more distant segment tipping or dumping into the extraction space. The second side effect is the vertical forces produced as a result of the differential moments. The vertical forces could result in significant changes in the overbite relationship. This may be particularly detrimental when a loop is placed closer to the anterior teeth, extrusion may lead to a rapid increase of overbite. This in part may explain some of the difficulties experienced in this method of space closure. It is important that one properly positions the springs to achieve predict- able and desirable treatment results. CONCLUSI ONS This study examined the effect of off-center placement of T-loops with a standard shape at a standardized activation and interbracket distance. 1. A centered T-loop produces equal and opposite moments with negligible vertical forces. 2. Off-center positioning of a T-loop produces dif- ferential moments. More posterior positioning produces an increased beta moment. More ante- rior positioning produces an increased alpha moment. 3. A standard shaped T-loop can be used for dif- ferential anchorage requirements by altering the activation and mesial-distal position of the spring. REFERENCES 1. Burstone CJ. Rationale of the segmented arch. Am J Ort hod 1962;48:805-22. 2. Burstone CJ. The mechanics of the segmented arch techniques. Angle Orthod 1966;36:99-120. 3. Burstone CJ. The segmented arch approach to space closure. Am J Ort hod 1982;82:361-78. 4. Burstone CJ, Hanley KJ. Modern edgewise mechanics segmented arch technique. Farmington: University of Connecticut Health Center, 1985. 5. Burstone CJ, Koenig HA. Optimizing anterior and canine retraction. Am J Orthod 19.76;70:1-19. 6. Faulkner MG, Lipsett AW, E1-Rayes K, Haberstock D L On the use of vertical loops in retraction systems. Am J Ort hod Dentofac Ort hop 1991;99:328-36. 7. Gjessing P. Biomechanical design and clinical evaluation of a new canine retraction spring. Am J Orthnd 1985;87:353-62. 8. Zeigler P, Ingervall B. A clinical study of maxillary canine retraction with a retraction spring and sliding mechanics. Am J Orthod Dentofac Orthop 1989;95: 99-106. 9. Haskell BS, Spencer WA, Day M. Auxiliary springs in continuous arch treatment: part 1, an analytical study employing the finite element method. Am J Orthod Dentofac Orthop 1990;98:387-97. 10. Haskell BS, Spencer WA, Day M. Amdliary springs in continuous arch treatment: part 2, appliance use and case reports. Am J Ort hod Dentofac Orthop 1990;98: 488-98. 11. Sachdeva RC. A study of force systems produced by TMA ' 91T' loop retraction springs. [Masters thesis.] Farmington: The University of Connecticut School of Dental Medicine, 1985. 12. Manhartsberger C, Morton JY, Burstone CJ. Space closure in adult patients using the segmented arch technique. Angle Orthod 1989;59:205-10. 13. Solonche DJ, Burstone CJ, Vanderby R. A device for det ermi ni ng t he mechani cal behavi or of orthodontic appliances. I EEE Trans on Bi omed Eng 1977;24:538-39. 14. Faulkner MG, Fuchshuber P, Haberstock D, Mioduchowski A. A parametric study of the force/moment systems produced by "T"-lnop retraction springs. J Biome- chanics 1989;22:637-47. 15. Burstnne CJ, Koenig HA. Creative wire bendi ng--t he force system from Step and V-bends. Amer J Orthod Dentofae Orthop 1988;93:59-67.
Occlusal Adjustment Technique Made Simple: Masticatory System and Occlusion As It Relates to Function and How Occlusal Adjustment Can Help Treat Primary and Secondary Occlusal Trauma