5.-T-Loop Position and Anchorage Control

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ORIGINAL ARTICLES

T-loop position and anchorage control


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.

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