Ludger Keilig

University of Bonn, Bonn, North Rhine-Westphalia, Germany

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Publications (88)129.67 Total impact

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    ABSTRACT: Biomechanical analysis of orthodontic tooth movement is complex, as many different tissues and appliance components are involved. The aim of this finite element study was to assess the relative effect of material alteration of the various components of the orthodontic appliance on the biomechanical behaviour of tooth movement. A three-dimensional finite element solid model was constructed. The model consisted of a canine, a first, and a second premolar, including the surrounding tooth-supporting structures and fixed appliances. The materials of the orthodontic appliances were alternated between: (1) composite resin or resin-modified glass ionomer cement for the adhesive, (2) steel, titanium, ceramic, or plastic for the bracket, and (3) β-titanium or steel for the wire. After vertical activation of the first premolar by 0.5mm in occlusal direction, stress and strain calculations were performed at the periodontal ligament and the orthodontic appliance. The finite element analysis indicated that strains developed at the periodontal ligament were mainly influenced by the orthodontic wire (up to +63 per cent), followed by the bracket (up to +44 per cent) and the adhesive (up to +4 per cent). As far as developed stresses at the orthodontic appliance are concerned, wire material had the greatest influence (up to +155 per cent), followed by bracket material (up to +148 per cent) and adhesive material (up to +8 per cent). The results of this in silico study need to be validated by in vivo studies before they can be extrapolated to clinical practice. According to the results of this finite element study, all components of the orthodontic fixed appliance, including wire, bracket, and adhesive, seem to influence, to some extent, the biomechanics of tooth movement. © The Author 2015. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email:
    The European Journal of Orthodontics 07/2015; DOI:10.1093/ejo/cjv050 · 1.39 Impact Factor
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    ABSTRACT: Our objective was to investigate the effect of archwire cross-section increases on the levels of force applied to teeth during complex malalignment correction with various archwire-bracket combinations using an experimental biomechanical setup. The study comprised 3 types of orthodontic brackets: (1) conventional ligating brackets (Victory Series [3M Unitek, Monrovia, Calif] and Mini-Taurus [Rocky Mountain Orthodontics, Denver, Colo]), (2) self-ligating brackets (SmartClip, a passive self-ligating bracket [3M Unitek]; and Time3 [Rocky Mountain Orthodontics, Denver, Colo] and SPEED [Strite Industries, Cambridge, Ontario, Canada], both active self-ligating brackets), and (3) a conventional low-friction bracket (Synergy [Rocky Mountain Orthodontics]). All brackets had a nominal 0.022-in slot size. The brackets were combined with 0.014-in and 0.016-in titanium memory wires, Therma-Ti archwires (American Orthodontics, Sheboygan, Wis). The archwires were tied to the conventional brackets with both stainless steel ligatures of size 0.010-in and elastomeric rings. A malocclusion of the maxillary central incisor displaced 2 mm gingivally (x-axis) and 2 mm labially (z-axis) was simulated. The forces recorded when using the 0.014-in archwires ranged from 1.7 ± 0.1 to 5.0 ± 0.3 N in the x-axis direction, and from 1.2 ± 0.1 to 5.5 ± 0.3 N in the z-axis direction. When we used the 0.016-in archwires, the forces ranged from 2.6 ± 0.1 to 6.0 ± 0.3 N in the x-axis direction, and from 2.0 ± 0.2 to 6.0 ± 0.4 N in the z-axis direction. Overall, the increases ranged from 16.0% to 120.0% in the x-axis and from 10.4% to 130.0% in the z-axis directions. Increasing the cross section of the wire increased the force level invariably with all brackets. Wires of size 0.014 in produced relatively high force levels, and the force level increased with 0.016-in wires. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
    American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 04/2015; 147(4 Suppl). DOI:10.1016/j.ajodo.2014.11.024 · 1.44 Impact Factor
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    ABSTRACT: The force systems during multiband treatment are influenced by the selection of the bracket-archwire combinations. Resin models replicated from casts reflecting the pretreatment intraoral situation of a patient's mandible were used to explore how different bracket systems and archwire qualities would affect the force systems developing during simulated orthodontic leveling of several malaligned teeth. Leveling movements of the malaligned teeth 32, 33, and 34 were simulated using the orthodontic measurement and simulation system (OMSS). Two bracket types and three archwire qualities were compared, the former featuring a slot width of 0.022" (0.56 mm) and including one conventional (Freedom MIM Roth by ODS) and one passive self-ligating (Carriere MBT by ODS) design. Both were combined with three NiTi round 0.014" (0.36 mm) archwire products, two of them standard products (CuNiTi by Ormco; EuroArch by ODS) and one being a low-cost (NiTi Superelastic by Modern Arch) product. Measured parameters included force, torque, translation, and rotation. Archwire qualities are critical to the force systems developing in the leveling stage. On the other hand, the finding that lower force/torque values result in less tooth movement is not primarily due to wire selection. Our most striking result was that the ODS EuroArch wire resulted in very low force and torque values both with the conventional and with the self-ligating brackets. Almost identical patterns with these two bracket designs were found, and none of the measured parameters revealed a significant advantage for any of the bracket-archwire combinations over the others. In our experimental simulations of tooth leveling, wire-quality selection was found to be a key modifier of force, torque, translation, and rotation. Clearly, however, neither the wire qualities nor the bracket designs made a decisive difference to the amounts of leveling movement induced to malaligned teeth; other factors like tooth class or nature of the malalignment seem to be more important in this regard. A therapeutic benefit of self-ligating over conventional brackets was not demonstrable.
    Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 03/2015; 76(2). DOI:10.1007/s00056-014-0276-y · 0.82 Impact Factor
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    ABSTRACT: Analysing the influence of implant splinting and its relation to different framework materials is a complex issue. The stiffness of framework materials and the overload of the implant system directly affect the final transferred load of the bone around implants.A finite element model of a long-span cementable implant-supported fixed prosthesis was created. Three materials were analysed for the framework: Titanium, gold alloy, and zirconia. The connection screws were first preloaded with 200. N. Two loading conditions were studied: The implant at the molar region was first loaded without splinting to the framework, and in the second condition, the implant was splinted to the framework. A total force of 500. N and 1000. N in 30° from the long axis of the framework were applied in buccal or distal direction on the implant system.The stresses and strains within the framework materials, implant system, and bone bed around the supporting implants were analysed. Loading the implant distally was associated with high stresses within the implant system in comparison to buccal loading. By splinting the implant, the stress in the implant system was reduced from 5393. MPa to 2942. MPa. Buccal loading of the implant was more critical than the distal loading. In the splinted condition of the implant, the stresses in the cortical bone were reduced from 570. MPa to 275. MPa.
    Annals of Anatomy - Anatomischer Anzeiger 01/2015; 199. DOI:10.1016/j.aanat.2014.12.001 · 2.08 Impact Factor
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    ABSTRACT: Self-ligating brackets are widely believed to be more effective in clinical use and to involve less friction and force. Thus, the goal of this in vitro investigation was to experimentally assess the effectiveness of different bracket-archwire combinations and the force levels exerted in two-dimensional direction during correction of tooth malalignment. An important aspect of this objective was to determine whether the behaviors of conventional bracket systems with an elastic or steel ligature differ from that of self-ligating brackets.
    Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 11/2014; 75(6):459-470. DOI:10.1007/s00056-014-0238-4 · 0.82 Impact Factor
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    ABSTRACT: Objectives Nickel (Ni) is one of the main metal elements in orthodontic and prosthetic devices. Different effects of Ni are described ranging from an induction of local inflammation to allergy and cancerous/mutagenic properties. Inflammatory reactions are frequently observed in the oral cavity, but the interrelationship of Ni with those events is still unknown. Therefore, we focused on the impact of Ni on inflammation in vitro. Methods In accordance to previous immersion tests of our lab, human gingival fibroblasts (HGFs) (n = 6) were exposed to a pro-inflammatory environment using interleukin-1 beta (IL-1β) and additionally stimulated with different Ni(II) concentrations (400 and 4000 ng/ml). At varying time points the expression of pro- and anti-inflammatory as well as matrix degeneration proteins, i.e. MMPs, were analyzed. Furthermore, proliferation assays, wound healing tests and the detection of NF-κB activation were conducted. Unstimulated HGFs served as control. Results Our experiments showed that low clinical average Ni(II) levels did not alter pro-inflammatory cytokines significantly compared to control (p > 0.05). Instead, a 10-fold higher dose up-regulated these mediators significantly in a time-dependent manner (p < 0.01). This was even more pronounced combining both Ni(II) concentrations with an inflammatory condition (p < 0.001), MMP expressions were in line with our findings (p < 0.001). The mRNA data were supported by proliferation and wound closure assays (p < 0.001). However, the combination of both stimuli induced contradictory results. Analyzing NF-κB activation revealed that our results may be in part attributed to NF-κB. Significance Our in vitro study implicated that Ni(II) has various modifying effects on IL-1β-induced inflammatory processes depending on the concentration.
    Dental Materials 10/2014; DOI:10.1016/ · 4.16 Impact Factor
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    ABSTRACT: Structured AbstractObjective To evaluate the efficacy of tooth alignment achieved by various small cross-section archwire/bracket combinations using the orthodontic measurement and simulation system.Materials and Methods The study comprised three types of orthodontic brackets 1) conventional ligating (Victory Series and Mini-Taurus), 2) self-ligating (SmartClip a passive self-ligating bracket and Time3 an active self-ligating bracket), and 3) a conventional low-friction bracket (Synergy). All brackets had a nominal 0.022″ slot size. Brackets were combined with 1) 0.012″ stainless steel, 2) 0.012″ Orthonol, 3) 0.012″ Thermalloy, and 4) 0.0155″ coaxial archwires. Archwires were tied to the conventional brackets with stainless steel ligatures and elastomeric rings. The malocclusion simulated represented a central upper incisor displaced 2 mm gingivally (x-axis) and 2 mm labially (z-axis).ResultsThe inciso-gingival correction achieved by the different archwire/bracket combinations ranged from 15 to 95%, while the labio-lingual correction ranged from 10 to 95%. The smallest correction was achieved by coaxial, Orthonol, and thermally archwires when ligated with the elastomeric rings to conventional brackets. Stainless steel archwires achieved from 65 to 90% of inciso-gingival correction and from 60 to 90% of labio-lingual correction.Conclusion The resultant tooth alignment was the product of interaction between the archwire type, bracket type, and bracket design including ligature type. Small cross-sectional archwires might produce up to 95% correction if combined properly with the bracket system. Elastomeric rings when used with conventional brackets limit the efficacy of malalignment correction.
    Orthodontics and Craniofacial Research 09/2014; 18(1). DOI:10.1111/ocr.12057 · 1.29 Impact Factor
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    ABSTRACT: The aim of this work was to investigate whether electrochemical surface treatment of nickel-titanium (NiTi) and titanium-molybdenum (TiMo) archwires (OptoTherm™ and BetaTitan™; Ortho-Dent Specials, Kisdorf, Germany) reduces friction inside the bracket-archwire complex. We also evaluated further material properties and compared these to untreated wires.
    Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 07/2014; 75(4). DOI:10.1007/s00056-014-0225-9 · 0.82 Impact Factor
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    ABSTRACT: Background The aim of this study was to investigate the efficacy of orthodontic treatment using the Invisalign® system. Particularly, we analyzed the influence of auxiliaries (Attachment/Power Ridge) as well as the staging (movement per aligner) on treatment efficacy. Methods We reviewed the tooth movements of 30 consecutive patients who required orthodontic treatment with Invisalign®. In all patients, one of the following tooth movements was performed: (1) Incisor Torque >10°, (2) Premolar derotation >10° (3) Molar distalization >1.5 mm. The groups (1)-(3) were subdivided: in the first subgroup (a) the movements were supported with the use of an attachment, while in the subgroup (b) no auxiliaries were used (except incisor torque, in which Power Ridges were used). All tooth movements were performed in a split-mouth design. To analyze the clinical efficacy, pre-treatment and final plaster cast models were laser-scanned and the achieved tooth movement was determined by way of a surface/surface matching algorithm. The results were compared with the amount of tooth movement predicted by ClinCheck®. Results The overall mean efficacy was 59% (SD = 0.2). The mean accuracy for upper incisor torque was 42% (SD = 0.2). Premolar derotation showed the lowest accuracy with approximately 40% (SD = 0.3). Distalization of an upper molar was the most effective movement, with efficacy approximately 87% (SD = 0.2). Conclusion Incisor torque, premolar derotation and molar distalization can be performed using Invisalign® aligners. The staging (movement/aligner) and the total amount of planned movement have an significant impact on treatment efficacy.
    BMC Oral Health 06/2014; 14(1):68. DOI:10.1186/1472-6831-14-68 · 1.15 Impact Factor
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    ABSTRACT: Introduction The exact force systems as well as their progressions generated by removable thermoplastic appliances have not been investigated. Thus, the purposes of this experimental study were to quantify the forces and moments delivered by a single aligner and a series of aligners (Invisalign; Align Technology, Santa Clara, Calif) and to investigate the influence of attachments and power ridges on the force transfer. Methods We studied 970 aligners of the Invisalign system (60 series of aligners). The aligners came from 30 consecutive patients, of which 3 tooth movements (incisor torque, premolar derotation, molar distalization) with 20 movements each were analyzed. The 3 movement groups were subdivided so that 10 movements were supported with an attachment and 10 were not. The patients' ClinCheck (Align Technology, Santa Clara, Calif) was planned so that the movements to be investigated were performed in isolation in the respective quadrant. Resin replicas of the patients' intraoral situation before the start of the investigated movement were taken and mounted in a biomechanical measurement system. An aligner was put on the model, the force systems were measured, and the calculated movements were experimentally performed until no further forces or moments were generated. Subsequently, the next aligners were installed, and the measurements were repeated. Results The initial mean moments were about 7.3 N·mm for maxillary incisor torque and about 1.0 N for distalization. Significant differences in the generated moments were measured in the premolar derotation group, whether they were supported with an attachment (8.8 N·mm) or not (1.2 N·mm). All measurements showed an exponential force change. Conclusions Apart from a few maximal initial force systems, the forces and moments generated by aligners of the Invisalign system are within the range of orthodontic forces. The force change is exponential while a patient is wearing removable thermoplastic appliances.
    American Journal of Orthodontics and Dentofacial Orthopedics 06/2014; 145(6):728–736. DOI:10.1016/j.ajodo.2014.03.015 · 1.44 Impact Factor
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    ABSTRACT: The rigidity of framework materials and overload of the implant system directly affect the final transferred load of the bone around implants. The aim of the present study has been to analyse the influence of framework materials on the transferred load to the implant system and the surrounding bone. A finite element model of a long-span cementable implant-supported fixed prosthesis was created with two coping layers (gold and hybrid composite) to optimise the fitting of the prosthesis to the abutments. Three framework materials were analysed: Titanium, gold alloy, and zirconia. The connection screws were first preloaded with 200 N. The framework was then loaded with 500 N vertically and at 30° to the framework long axis. Two loading conditions were considered: At the mesial and distal boundaries of the framework and at the centre of the framework. The stresses and strains within the framework materials and bone bed around the supporting implants were analysed. The region and angle of load applications showed an obvious effect on the values of the stresses and strains within the framework itself and, consequently, their distribution in the implant system and surrounding bone. A correlation of the framework material and stresses of the coping materials was observed as well. The gold framework showed acceptable values of stress within the cortical bone (92 MPa and 89 MPa with 30° loading at two points and at the centre, respectively) in comparison to titanium (92 MPa and 113 MPa) and zirconia (88 MPa and 115 MPa).
    Annals of Anatomy - Anatomischer Anzeiger 05/2014; 199. DOI:10.1016/j.aanat.2014.03.005 · 2.08 Impact Factor
  • Zahnmedizin up2date 01/2014; 8(01):87-107. DOI:10.1055/s-0033-1346682
  • Biomedizinische Technik/Biomedical Engineering 01/2014; DOI:10.1515/bmt-2014-0008 · 2.43 Impact Factor
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    ABSTRACT: Once periodontitis has been completely resolved, one common follow-up method is to carry out orthodontic treatment to take advantage of the residual bone, i.e., via tooth intrusion. In this study, the biomechanical behavior of teeth in a reduced periodontium was studied by numerically simulating upper-incisor intrusion accomplished with various orthodontic mechanics. Using the finite element method, a patient-customized 3D model of a periodontally reduced dentition was generated in order to simulate tooth movement. The morphology of this upper-jaw model was derived from cone-beam computed tomography (CBCT) datasets of four patients. Material parameters were adopted from previous investigations, including teeth (E=20 GPa), periodontal ligament (PDL) (bilinear elastic; E1=0.05 MPa; E2=0.20 MPa; ε12=7%), and bone (homogeneous, isotropic; E=2 GPa). Two intrusion scenarios were used, the first drawing from Burstone's segmented-arch technique to intrude four splinted incisors at a time, and the second one using cantilevers to intrude single incisors. The aforementioned PDL material parameters were varied in several ways to simulate different biological and biomechanical states of PDL. All simulations were recalculated with an idealized, periodontally intact model to assess the effect of bone loss by way of comparison. Single-tooth intrusion via cantilever mechanics was accompanied by less rotation than the segmented-arch approach. Both intrusion systems involved significantly greater degrees of tooth displacement and PDL load in the periodontally reduced model. Periodontally reduced dentitions are associated with an increased load on periodontal tissue. This can be counteracted by reducing orthodontic force levels and by selecting mechanics that do not harm the tissue. In so doing, the use of numerical methods may greatly facilitate individualized computer-aided treatment-planning strategies.
    Fortschritte der Kieferorthopädie 11/2013; 74(6). DOI:10.1007/s00056-013-0182-8 · 0.82 Impact Factor
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    ABSTRACT: The force applied to the teeth is a variable of orthodontic treatment that can be controlled. Poor control of the applied force can lead to adverse biologic effects as well as undesirable tooth movements. The selected archwire-bracket combination is a primary determining factor in the force level applied to a tooth during orthodontic treatment. The aim of this research was to use an experimental biomechanical setup to measure forces generated during complex orthodontic tooth movements with various archwire-bracket combinations. The materials consisted of 3 types of 0.022-in slot orthodontic brackets: (1) conventional brackets (Victory Series [3M Unitek, Monrovia, Calif] and Mini-Taurus [Rocky Mountain Orthodontics, Denver, Colo]), (2) self-ligating brackets (SmartClip [3M Unitek] and Time3 [American Orthodontics, Shegoygan, Wis]), and (3) a conventional low-friction bracket (Synergy [Rocky Mountain Orthodontics]); and 4 archwire types: (1) 0.012-in stainless steel (3M Unitek), (2) 0.0155-in coaxial (Advanced Orthodontics [Näpflein, Düsseldorf, Germany]), (3) 0.012-in Orthonol (Rocky Mountain Orthodontics), and (4) 0.012-in Thermalloy (Rocky Mountain Orthodontics). Stainless steel ligatures and elastomeric rings were used. The materials were used in different combinations in a simulated malocclusion that represented a maxillary central incisor displaced 2 mm gingivally (x-axis) and 2 mm labially (z-axis). The lowest forces were measured when the brackets were combined with either the coaxial or the Thermalloy archwires; the forces ranged from 3.4 ± 0.2 to 0.7 ± 0.1 N in the x-axis direction, and from 4.5 ± 0.3 to 0.5 ± 0.1 N in the z-axis direction. The highest forces were measured in combination with stainless steel archwires; the forces ranged from 6.3 ± 0.3 to 3.0 ± 0.1 N in the x-axis direction, and from 6.3 ± 0.3 to 1.7 ± 0.1 N in the z-axis direction. We recommend 0.0155-in coaxial and 0.012-in Thermalloy archwires for leveling and alignment. Elastomeric rings, when used with conventional brackets, increased the force applied to the teeth.
    American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 04/2013; 143(4):507-14. DOI:10.1016/j.ajodo.2012.11.020 · 1.44 Impact Factor
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    ABSTRACT: OBJECTIVES: To develop an in vitro assay for quantitative analysis of the degradation to which a bone substitute is exposed by osteoclasts. The aim of establishing this method was to improve the predictability of carrying out tooth movements via bone substitutes and to provide a basis for verification in exemplary clinical cases. METHODS: After populating a bone substitute (NanoBone®; ArtOss, Germany) with osteoclastic cells, inductively-coupled mass spectrometry was used to evaluate changing calcium levels in the culture medium as a marker of resorption activity. RESULTS: It was observed that calcium levels increased substantially in the culture medium with the cells populating the bone substitute. CONCLUSIONS: This in vitro assay is a valid method that can assist clinicians in selecting the appropriate materials for certain patients. While tooth movements occurring through this material were successful, uncertainty about the approach will remain as long-term results are not available.
    Fortschritte der Kieferorthopädie 03/2013; DOI:10.1007/s00056-012-0136-6 · 0.82 Impact Factor
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    ABSTRACT: OBJECTIVE: The significance of friction inside the bracket-wire-ligature interface remains controversial despite having been investigated for four decades. Numerous approaches have been proposed to reduce friction via any of the elements of the interface, key among them being recently developed bracket modifications and the introduction of surface-modified wires. The present study explored whether archwires treated by a novel electrochemical process of surface refinement influence first-order couples generated inside self-ligating and conventionally ligated brackets during tooth rotation. MATERIALS AND METHODS: A surface-refined nickel-titanium archwire (OptoTherm/LoFrix™) was compared ex vivo to a non-refined archwire of the same production lot (OptoTherm™), the nominal dimensions being 0.014×0.025'' in both cases. Three bracket designs were included to assess the role of the ligation mechanism: (1) Carrière SLB™ passive self-ligating brackets, (2) BioQuick® active self-ligating brackets, and (3) Classic Series® conventionally ligated brackets. The brackets were bonded to leveled tooth elements on a resin mandibular arch. To simulate rotation, the lower left first premolar was removed and connected to a biomechanical measuring system. The simulation procedures were performed at 37°C. RESULTS: The various bracket designs yielded characteristic torque curves mainly reflecting the play of the archwire specimens inside their slots. While the passive self-ligating brackets exhibited 2-3° of play in either direction, both the active self-ligating brackets and the conventional brackets with elastic ligatures did not reveal any play. Torque levels ranged from 8 Nmm inside the conventional brackets to 13 Nmm inside the passive self-ligating brackets. The surface-refined archwires induced significantly (up to 35%) lower torque levels and were slightly reduced in cross-section. CONCLUSION: Electrochemical surface refinement can significantly reduce first order couples induced by archwires. This effect is caused by less friction, but also by the slightly reduced cross-section of these wires.
    Fortschritte der Kieferorthopädie 03/2013; DOI:10.1007/s00056-012-0133-9 · 0.82 Impact Factor
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    ABSTRACT: This study aimed to investigate the differences in the force loss during simulated archwire-guided canine retraction between various conventional and self-ligating brackets. Three types of orthodontic brackets have been investigated experimentally using a biomechanical set-up: 1. conventional ligating brackets (Victory Series and Mini-Taurus), 2. self-ligating brackets (SmartClip: passive self-ligating bracket, and Time3 and SPEED: active self-ligating brackets), and 3. a conventional low-friction bracket (Synergy). All brackets had a nominal 0.022″ slot size. The brackets were combined with three rectangular 0.019×0.025″ archwires: 1. Remanium (stainless steel), 2. Nitinol SE (nickel-titanium alloy, NiTi), and 3. Beta III Titanium (titanium-molybdenum alloy). Stainless steel ligatures were used with the conventional brackets. Archwire-guided tooth movement was simulated over a retraction path of up to 4mm using a superelastic NiTi coil spring (force: 1 N). Force loss was lowest for the Victory Series and SmartClip brackets in combination with the steel guiding archwire (35 and 37.6 per cent, respectively) and highest for the SPEED and Mini-Taurus brackets in combination with the titanium wire (73.7 and 64.4 per cent, respectively). Force loss gradually increased by 10 per cent for each bracket type in combination with the different wires in the following sequence: stainless steel, Nitinol, and beta-titanium. Self-ligating brackets did not show improved performance compared with conventional brackets. There was no consistent pattern of force loss when comparing conventional and self-ligating brackets or passive and active self-ligating brackets.
    The European Journal of Orthodontics 02/2013; DOI:10.1093/ejo/cjs110 · 1.39 Impact Factor

Publication Stats

419 Citations
129.67 Total Impact Points


  • 1999–2015
    • University of Bonn
      • Poliklinik für Kieferorthopädie
      Bonn, North Rhine-Westphalia, Germany
  • 2007
    • University of Padova
      • Center of Mechanics of Biological Materials
      Padova, Veneto, Italy
  • 2006
    • Tel Aviv University
      • Department of Orthodontics
      Tell Afif, Tel Aviv, Israel