Recent advances in arch wires

PRESENTED BYDr. Ajinkya A Patel

Pg StudentDept of ORTHODONTICS

RECENT ADVANCES IN ARCH WIRES

INTRODUCTION

ORTHODONTIC ARCH WIRE : “Generate the biomechanical

forces transmitted through the brackets to effect tooth movement”

Factors to be considered

Amount of force required

Stiffness

Strength

Elastic working range or spring back

Ease of manipulation or formability

Need to weld or solder

Corrosion resistance

Biocompatibility

Aesthetics

Frictional resistance

Load deflection rate

Purpose of Archwires

1. Exert the force to move the teeth

2. Maintain the arch form

3. Acts as a track along which the teeth move

4. Provides a pattern for the shape of the arch

5. joins the brackets together from the distal of one side to the distal of the other

6. Exerts force by being engaged in archwire slot

Various Recent Archwires

ARCHWIRES

1. Titanium Niobium wire2. Timolium titanium wire3. Super cable4. Combined archwire5. Bio force archwire6. Optiflex archwire7. Fiber reinforced composite archwire

References:1. Titanium-niobium, a new finishing wire alloy. By Michel

dalstra, Gabriella denes, birte melsen J.Clin orthod res. 2000 feb;3(1):6-142. A comparative evaluation of metallurgical properties of stainless steel and

tma wires with Tiolium and titanium niobium archwires by r devaki vijayalakshmi,ks nagachandran, pradeep kummi, p jayakumar (indian j dent res,20(4),2009

TITANIUM NIOBIUM WIRE

Titanium Niobium Wire

It was introduced in early 1995 by DR ROHIT SACHDEVA &

Manufactured by Ormco

PROPERTIES:

Ti- nb is soft and easy to form, yet it has the same working range

of stainless steel.

Its stiffness is 20% lower than TMA and 70% lower than stainless steel.

Ti-nb wire have a larger plastic range, similar activation and deactivation curves and relatively low spring back.


Its bending stiffness corresponding to 48% lower than that of stainless steel and a spring back 14% lower than that of stainless steel.

We can easily make creative bends and avoid excessive force levels of a steel wire.

The stiffness of ti-nb in torsion is only 36% of steel,

yet the spring back of ti-nb in torsional mode is Slightly higher than stainless steel

This property makes it possible to utilize the ti-nb wire for even the major third order corrections.


Clinical applications

The low spring back and high formability of the titanium-niobium archwire allows creation of finishing bends

Hence, this wire can be used as an finishing archwire.

( J. Clin orthod res. 2000 feb;3(1):6-14).

TIMOLIUM TITANIUM ARCHWIRE

References:1. A comparative evaluation of metallurgical properties of stainless

steel and tma wires with Tiolium and titanium niobium archwires by r devaki vijayalakshmi,

ks nagachandran, pradeep kummi, p jayakumar (indian j dent res,20(4),2009

2. Mechanical Properties and Surface Characteristics of Three Archwire Vinod Krishnan, MDSa; K. Jyothindra Kumar, MDS, M. Orth RCS, MDO RCPS, FDS RCS Alloys (Angle Orthod 2004;74:825–831.)

TIMOLIUM TITANIUM WIRE

It is manufactured by TP ORTHODONTICS

Timolium archwires combines

The flexibility, continuous force and spring back of nickel titanium with the high stiffness and bendability of stainless steel wire.

When compared to nickel titanium or beta titanium wire, (angle orthod 2004;74:825–831.)

Timolium outperforms in the following:

More resistant to breakage,

Smoother for reduced friction,

Brightly polished and aesthetically pleasing,

Ti


Nickel free for sensitive patients,

Easier to bend and shape,

Can be welded

Loops and bends can be made without breakage


Clinical applicationTimolium wire is excellent for all phases of treatment.

During initial treatment :

it is excellent for space closure, tooth alignment, levelling and bite opening.

During intermediate treatment :

early torque control can begin because of the moderate forces that are delivered.

Final treatment phase:

total control during detailing makes Timolium the wire of choice

SUPER CABLE ARCHWIRE

References:1. Supercable and the SPEED system by Berger J, Byloff FK, Waram T

j clin orthod 1998 Apr;32(4):246-532. Alignment efficiency of superelastic coaxial nickel-titanium vs

superelastic single-stranded nickel-titanium in relieving mandibular anterior crowding A randomized controlled prospective study by Biju Sebastiana (Angle Orthod. 2012;82:703–708.)

SUPER CABLE

In 1993,

Hanson combined the mechanical advantages of multistranded cables with the material properties of superelastic wires to create a superelastic nickel titanium coaxial wire.

This wire, called super cable,

It comprises seven individual strands that are Woven together in a long, gentle spiral to maximize flexibility and minimize force delivery.

SUPER CABLE

PROPERTIES

• Improved treatment efficiency

• Simplified mechanotherapy

• Elimination of archwire bending.

• Flexibility and ease of engagement regardless of crowding

SUPER CABLE

No evidence of anchorage loss.

A light, continuous level of force, preventing any adverse response of the supporting periodontium.

Minimal patient discomfort after initial archwire placement.

Fewer patient visits, due to longer archwire activation.

SUPER CABLE

DISADVANTAGES

•Tendency of wire ends to fray if not cut with sharp instruments.

•Tendency of archwires to break and unravel in extraction spaces

•Inability to accommodate bends, steps, or helices.

•Tendency of wire ends to migrate distally and occasionally irritate soft tissues as severely crowded or displaced teeth begin to align.

COMBINED ARCHWIRES

References:1. Combination anchorage technique: an update of current

mechanics by Thompson WJ. Am J Orthod Dentofacial Orthop. 1988 May;93(5):363-79.

2. Dual-Flex Archwires by JAMES L. CANNON, DDS, MS JCO VOLUME 18 : NUMBER 09 : PAGES (648-649) 1984

Combined wires

The key to success in a multi attachment straight wire system is

To have the ability to use light tipping movements in combination with rigid translation

To be able to vary the location of either, at any time the need arises during treatment.

They used three specific combined wires for the technique

1. Dual Flex-l, 2. Dual Flex-2, and 3. Dual Flex-3 (Lancer Orthodontics).

COMBINED WIRES

The Dual Flex-1

it consists of a anterior section made of 0.016-inch round Titanal and a posterior section made of 0.016-inch round steel.

The flexible front part easily aligns the anterior

teeth and the rigid posterior part maintains the anchorage and molar control by means of the “V” bend, mesial to the molars.

It is used at the beginning of treatment.

COMBINED WIRES

The Dual Flex-2

it consists of a flexible anterior segment composed of an 0.016 ´ 0.022-inch rectangular Titanal and a rigid posterior segment of round 0.018-inch steel.

COMBINED WIRES

The Dual Flex-3,

This however, consists of a flexible anterior part of an 0.017 ´ 0.025-inch Titanal rectangular wire and

a posterior part of 0.018 square steel wire.

The Dual Flex-2 and 3 wires establish anterior anchorage and control molar rotation during the closure of posterior spaces.

They also initiate the anterior torque.

BIO FORCE ARCHWIRE

References:1. Effect of coating on properties of esthetic orthodontic nickel-

titanium wires by Masahiro Iijimaa; Takeshi Mugurumab; William A. Brantleyc; Han-Cheol Choed; Angle Orthodontist, Vol 82, No 2, 2012

BIOFORCE WIRE

Introduced by GAC

It was possible to produce variation in force

delivery between archwires of identical

dimension

This was possible by specifying transition temperatures within given ranges.

And were graded as thermodynamic arch wires.

This property was further advanced to produce variable transition temperatures within the same archwire

This arch wire was called Bioforce archwire

BIOFORCE WIRE

It is aesthetic

Is the first and only family of biologically correct archwires

It applies low and gentle forces to anteriors

Increasingly stronger forces across the posteriors until plateauing at the molars.

BIOFORCE WIRE

Beginning at approximately 100 grams

increasing to approximately 300 grams

It provides the right force to each tooth

Reducing the number of wire changes &

Providing greater patient comfort

BIOFORCE WIRE

Clinical applications:

During initial stages when anterior torque is needed,

use of an relatively large size (i.e. 0.018x0.025) can be given without the fear of significant root resorption.

BIOFORCE WIRE

During later stages of treatment i.e. If the posterior occlusion is not settled in, rotations have not been fully corrected or the bite opening is taking a long time because of

the heavy musculature.

These are an good reason to give an bioforce arch wire as the undesirable effects of the applied force-producing mechanisms will be minimized.

OPTIFLEX ARCHWIRE

References:1. Talass M E .Optiflex archwire treatment of a skeletal Class HI open

bite. J Clin Orthod 1992; 26: 245-52.2. Effect of coating on properties of esthetic orthodontic nickel-

titanium wires by Masahiro Iijimaa; Takeshi Mugurumab; William A. Brantleyc; Han-Cheol Choed; Angle Orthodontist, Vol 82, No 2, 2012

OPTIFLEX ARCHWIRE

Optiflex is a non metallic orthodontic arch wire

It was designed by DR. TALASS In the year 1992

and manufactured by Ormco.

It has got unique mechanical properties with a highly aesthetic appearance made of clear optical fiber.

OPTIFLEX ARCHWIRE

It comprises of 3 layers.

A) A silicon dioxide core that provides

the force for moving tooth.

B) A silicon resin middle layer that

protects the core form moisture and

adds strength.

C) A strain resistant nylon outer layer that

prevents damage to the wire and further increases strength

OPTIFLEX ARCHWIRE

1) It the most aesthetic orthodontic archwire.

2) It is completely stain resistant, and will not stain or loose its clear look even after several weeks in mouth.

3) Its effective in moving teeth using light continuous force

OPTIFLEX ARCHWIRE

4) it is Very flexible ,

5) has an extremely wide range of actions,

6) when indicated it can be tied with electrometric ligatures to severely malaligned teeth without fear of fracturing the arch wire.

7) Due to superior properties optiflex can be used with any bracket system

OPTIFLEX ARCHWIRE

Precaution’s while using optiflex archwires

1) Optiflex archwires should be tied into brackets with elastomeric ligatures. Metal ligatures should never be used since they will fracture the glass core.

2) Sharp bends similar to those placed in a metal wire should never be attempted with optiflex, as these bends will immediately fracture the glass core.

OPTIFLEX ARCHWIRE

Precaution’s while using optiflex archwires

3) Using instruments with sharp edges, like the scaler etc should be avoided instead a gentle finger pressure is used to insert the archwire into the slot.

4) To cut the end of the archwire distal to the molar, it is recommended to the use the mini distal end cutter which is designed to cut all 3 layer’s of optiflex.

OPTIFLEX ARCHWIRE

clinical applications

1) It is used in adult patients who wish that their braces not be really visible for reasons related to personal concern’s or professional consideration.

2) Can be used as initial archwire in cases with moderate amounts of crowding in one or both arches.

OPTIFLEX ARCHWIRE

Clinical applications

3) ideal for non extraction cases and also cases with no partially edentulous areas

4) Optiflex can be used in presurgical stage in cases which require orthognathic intervention as a part of the treatment. Optiflex is available in a pack of ten 6 inch straight length wires of .017” and .021” sizes

FIBER REINFORCED COMPOSITE ARCHWIRE

References:1. Zufall S W, Kusy R P. Sliding mechanics of coated compo site wires

and the development of an engineering model for binding. Angle Orthod 2000; 70: 34-47.

2. Burstone C.J., Kuhlberg A.J. Fiber-reinforced composites in orthodontics. JCO 2000; 36: 271-9.

3. Fiber Reinforced Composite Arch-Wires in Orthodontics:Function Meets Esthetics by Ashima Valiathan and Siddhartha Dhar


Excellent combination of high elastic

recovery, high tensile strength and

low weight.

Excellent formability

Allow for tailoring of flexural and torsional properties.

Excellent aesthetics because of their translucency.

Ability to form wires of different stiffness values for the same cross-section.


This would facilitate the practice of Constant Cross-section Orthodontics.

Ability to directly bond attachments to these wires,

Eliminating the need for soldering and electrical resistance welding

Such wires can also be directly bonded to teeth, obviating the need for brackets (i.e. When anchorage from a large number of teeth is required)


Recent Reports on Fiber Reinforced Composite Archwires

Recent modification (Reports by Zufall, Kennedy and Kusy, Angle Orthod 2000; 70: 34-47)

They compared the frictional characteristics of composite archwires against stainless steel and ceramic brackets

They found composite archwires had higher kinetic coefficients of friction than stainless steel but lower than nickel-Titanium or beta titanium.


They also noted abrasive wear of composite at high forces.

Which lead to release of glass fiber within the oral cavity

This then lead them to test the use of coating material i.e. Poly(chloro-p-xylylele) and also an addition of 10 micron thick layer of parylene


This material when coated proved to be

Wear resistant

Low in friction

Eliminated the abrasive wear &

Consequent release of glass fiber from the wire

Thus judged to improve the clinical acceptability of the composite wires


Clinical application

According to Zufall and Kusy study,(Angle Orthod 2000; 70: 34-47) :

The composite archwire retained sufficient resilience to function during initial stage of orthodontic treatment and also

During intermediate stages of orthodontic treatment


According to Burstone and Kuhlberg (JCO 2000; 36: 271-9.):

Described that a new fiber reinforced composite called "Splint-It" which incorporates S2 glass fibers in a bis GMA matrix

This is available in various configurations such as rope, woven strip and unidirectional strip

These materials are only partly polymerized during manufacture (pre-pregs), which makes them flexible, adaptable and easily contourable over the teeth.


Later they are completely polymerized and can be bonded directly to teeth.

It can also be used for various purposes such as• post treatment retention, • as full arches or sectional arches, and • to reinforce anchorage by joining teeth together.

A particular advantage is that due to direct bondability to teeth, they can obviate the need for brackets in specific situations

CONCLUSION

CONCLUSION

“Fiber reinforced composites are regarded as the last great frontier of orthodontic materials”. (Kusy RP.. Am J Orthod Dentofacial Orthop. 1998; 113:91-95)

Due to their excellent aesthetics and strength, as well as the ability to customize their properties to the needs of the orthodontist,

They are expected to replace metals in orthodontics in the near future.

REFERENCES:

1. William R. Proffit -Contemporary Orthodontics, 5th edition, Mosby Company, 2012

2. Graber Thomas M., .Vanarsdall. Jr. Robert L. – Orthodontics, Current Principles and techniques

3. Titanium-niobium, a new finishing wire alloy. By Michel dalstra, Gabriella denes, birte melsen Clin orthod res. 2000 feb;3(1):6-14

4. A comparative evaluation of metallurgical properties of stainless steel and tma wires with Tiolium and titanium niobium archwires by r devaki vijayalakshmi,ks nagachandran, pradeep kummi, p jayakumar (indian j dent res,20(4),2009

5. A comparative evaluation of metallurgical properties of stainless steel and tma wires with Tiolium and titanium niobium archwires by r devaki vijayalakshmi,ks nagachandran, pradeep kummi, p jayakumar (indian j dent res,20(4),2009

6. Mechanical Properties and Surface Characteristics of Three Archwire Vinod Krishnan, MDSa; K. Jyothindra Kumar, MDS, M. Orth RCS, MDO RCPS, FDS RCS Alloys (Angle Orthod 2004;74:825–.)

7. Supercable and the SPEED system by Berger J, Byloff FK, Waram T j clin orthod 1998 Apr;32(4):246-53

8. Alignment efficiency of superelastic coaxial nickel-titanium vs superelastic single-stranded nickel-titanium in relieving mandibular anterior crowding A randomized controlled prospective study by Biju Sebastiana (Angle Orthod. 2012;82:703–708.)

9. Combination anchorage technique: an update of current mechanics by Thompson WJ. Am J Orthod Dentofacial Orthop. 1988 May;93(5):363-79.

REFERENCES:

11. Dual-Flex Archwires by JAMES L. CANNON, DDS, MS JCO VOLUME 18 : NUMBER 09 : PAGES (648-649) 1984

12.Effect of coating on properties of esthetic orthodontic nickel-titanium wires by Masahiro Iijimaa; Takeshi Mugurumab; William A. Brantleyc; Han-Cheol Choed; Angle Orthodontist, Vol 82, No 2, 2012

13.Talass M E .Optiflex archwire treatment of a skeletal Class HI open bite. J Clin Orthod 1992; 26: 245-52.

14. Effect of coating on properties of esthetic orthodontic nickel-titanium wires by Masahiro Iijimaa; Takeshi Mugurumab; William A. Brantleyc; Han-Cheol Choed; Angle Orthodontist, Vol 82, No 2, 2012

15. Zufall S W, Kusy R P. Sliding mechanics of coated compo site wires and the development of an engineering model for binding. Angle Orthod 2000; 70: 34-47.

16. Burstone C.J., Kuhlberg A.J. Fiber-reinforced composites in orthodontics. JCO 2000; 36: 271-9.

17. Fiber Reinforced Composite Arch-Wires in Orthodontics:Function Meets Esthetics by Ashima Valiathan and Siddhartha Dhar

THANK YOU

Recent advances in arch wires

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