Source: AJO-DO on CD-ROM (Copyright 1998 AJO-DO), Volume

1998 Feb (237 - 241): Understanding orthodontic loop preactivation

Demetrios J. Halazonetis,DMD, MS

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Understanding orthodontic loop preactivation

Demetrios J. Halazonetis, DMD, MS

Control of the force system that is applied to teeth is one of the main
problems in the field of biomechanics. Straight archwires seldom
produce forces and moments that are of the appropriate direction
and magnitude. For this reason, orthodontic loops have been used
extensively, either in order to decrease force magnitude or to
produce a force system compatible with desired tooth movement. A
major use of loops is in the retraction of canines, where a correct
moment to force ratio is essential for bodily movement.1,2
Unfortunately, achieving force magnitudes within the considered
biologic range, in combination with appropriate moment to force
ratios over a large range of activation, has not proven easy. The
design of the loop influences both the force levels and the moment
to force ratio (M/F) in such a way that it is difficult to change the one
without adversely affecting the other.

The purpose of this article is to demonstrate how computers can be

used to gain a better understanding of the principles of orthodontic
loop design. Various factors that determine force magnitude and
moment to force ratio will be discussed, with emphasis on loop
preactivation.

Computer-aided loop design

A computer loop-simulation program has been presented in a
previous article.3 It runs under Microsoft Windows and can simulate
almost any orthodontic loop that connects two brackets. With the
use of this program, we will attempt to design a T-loop that can be
used for canine retraction. The loop will connect the first molar to
the canine and will be used as a sectional retraction loop, positioned
centrally between the two teeth. To keep matters as simple as
possible, we will assume that posterior anchorage is perfect so that
we need not care about forces and moments on the molar tooth. To
achieve bodily translation of the canine we will assume that the
appropriate moment to force ratio (M/F) is 10 mm. For those readers
with Internet access, the program and the example loops described
here can be downloaded from my web page. Specific program
commands for activating the loop, bending the wire, and obtaining
the correct preactivated shape are also found there.

Fig. 1A shows a T-loop, constructed out of 0.017 0.025 inch TMA

wire. The same loop, activated 3 mm to engage into the canine
bracket is shown in Fig. lB. The distal force is approximately 175 gf
and the M/F ratio 4.4 mm. Such a loop would result in distal tipping
of the canine because the M/F ratio is too low. How can the M/F
ratio be increased? To answer this question it is helpful to
understand how the uprighting moment on the canine bracket is
produced.

When the loop is not engaged in the canine bracket and is passive,
the free end of the wire is parallel to the bracket slot. As we activate
the loop by bringing the free end toward the canine bracket, the loop
opens. This opening results in a progressive angulation of the free
end of the wire. When the wire reaches the canine bracket, the
angulation of the free end of the wire relative to the bracket
becomes approximately 10. Fig. 2 shows the loop after it has been
activated to the canine bracket but before inserting it into the slot. In
order to engage the wire into the slot, a clockwise moment must be
exerted on the wire. The reaction to this moment will be an
uprighting moment on the canine.

From the above, two methods that will increase the uprighting
moment come to mind. One is to decrease the height of the loop.
This will move the opening part of the loop closer to the interbracket
axis and will result in larger angulation of the free end, as the loop is
opened. Using the computer simulation we can change the height of
the loop and assess the angulation of the free end of the wire
relative to the canine bracket, when the loop is activated but not
inserted into the bracket slot. What is observed is that for each
millimeter of loop height change, the angulation changes by
approximately 1. One would, therefore, expect a shorter loop to
produce a larger M/F ratio. However, exactly the opposite is found,
as is shown in Fig. 3, where, although the loop has been shortened
by 1 mm, the M/F ratio is also reduced, by approximately 0.5 mm.
The reason becomes obvious when we look at the force levels. As the
loop becomes shorter, the total force needed to activate it increases.
Although the angulation changes by 10% for each millimeter of loop
height change, force levels change by more than 30%. The net effect
is that the M/F ratio decreases as the height of the loop is decreased.
Because the force effect is opposite to the moment effect, this
method of changing the M/F ratio is not very efficient. By trying
different loop heights, it is found that we need a 20 mm high T-loop
to achieve an M/F ratio of 10 mm. Obviously this is not very practical.

The second method to increase the wire/bracket angulation is to

bend the wire so that the free end of the loop is not parallel to the
bracket slot even before the loop is activated. This is called
preactivating the loop.
Where do we bend the wire? The activation bends should be placed
in the center of the interbracket distance, otherwise, vertical forces
will be introduced. This can be achieved by bending at the legs of the
loop as shown in Fig. 4, where a 20 bend has been placed at each
leg, giving a total of 40 preactivation. What values of force and
moment do you think that this loop will produce on the canine
bracket, relative to Fig. 1? Will the moment be larger, smaller, or the
same? Will the force be larger, smaller, or the same? Before reading
further, can you guess the M/F value, considering that the 10
angulation that was automatically produced by the nonpreactivated
loop resulted in an M/F ratio of 4.4 mm?

Fig. 5 shows the activated loop. The M/F ratio has increased by only
1 mm. Why was this disappointing result observed? Again, a hint to
the answer can be found by looking at the absolute force and
moment values. The moment almost tripled, from 770 to 2000
gf.mm. This alone should increase the M/F ratio from 4.4 to more
than 11 mm. However, the force also increased from 175 to 370 gf,
effectively counteracting most of the positive effect of preactivation.

What is the cause of the force increase? It is exactly the opposite

phenomenon to that which produces the wire-to-bracket angulation
shown in Fig. 2. As the free end of the loop is rotated in order to
engage it into the bracket slot, the loop closes at the T and the free
end of the wire moves away from the canine. This is shown in Fig. 6,
where only a moment has been applied to the loop. The moment is
exactly sufficient to bring the end of the loop parallel to the bracket
slot. Observe that the loop has contracted, and the end of the loop is
now at a distance of more than 6 mm from the canine bracket. The 3
mm extra activation necessary to engage the loop into the bracket
increases the force and counteracts most of the gain from the 40
preactivation. The loop of Fig. 6, where, only a moment is applied in
order to bring the free end parallel to the bracket slot, is said to be in
the neutral position. The moment necessary to bring the free end of
the wire parallel to the bracket slot is called the activating moment4
or the residual moment.2

Is there a way to avoid loop contraction? The answer lies in the way
that the preactivation bends are placed. What we need is a loop that
assumes the shape of Fig.1A not when passive, but when in its
neutral position, i.e., when the activating moment is applied. When
such a loop is engaged into the canine bracket, it should produce a
force and moment equal to that of Fig. 1B, plus an additional
moment equal to the activating moment. Using the numbers found
above, we can calculate that the activating moment should be
approximately 980 gf.mm. This, added to the 770 gf.mm moment
produced in Fig.lB, will give a total moment of 1750 gf.mm. Because
the force is 175 gf, an M/F ratio of 10 mm should result.

What is the passive shape of such a loop? To arrive at the

preactivated shape of the T-loop, we apply a moment equal in
magnitude but opposite in direction to the activating moment. This
moment was applied to the loop of Fig. 1 and the result is shown in
Fig. 7. The loop has now assumed the correct preactivated shape but
is still under the influence of the moment. It is a simple matter to
make the wire passive, by selecting the appropriate program
command that removes the moment but retains the shape of the
wire. Observe that activation is not localized at two points on the
wire but is spread out along the entire loop. This results in an
opening of the loop that counteracts the contraction produced by
the activating moment. As expected, the shape of the new
preactivated loop at the neutral position is identical to Fig. 1. The
loop engaged in the canine bracket is shown in Fig. 8. Forces and
moments are as predicted.
Conclusions

Computer simulation of orthodontic loops can help us visualize

various factors of loop design that interact to produce the
force/moment properties of loops. The computer program used here
has special features that allow calculation of the neutral position of
loops and of the preactivated shape of the wire.

Assessment of the neutral position of preactivated loops is important

in predicting loop properties.

Preactivation may need to involve the whole loop, rather than a few
points on the wire.