In vitro friction assessment in

orthodontics* 5
T. Eliades, W. Brantley

5.1 Introduction
Recent developments in science and technology have permitted the introduction of a
plethora of new orthodontic products at a dramatically increasing rate starting in the
early 1980s, an event which inevitably provoked the necessity for the orthodontist
to have a relatively comprehensive exposure to the eld of dental materials science.
Lately, the progression of research in this eld has led to the development of some
new products that are distinguishable from their predecessors based on novel compo-
sitions. Even though training in the eld of orthodontic dental materials is part of the
accreditation standards of graduate orthodontic curricula for European and US pro-
grams, the advanced education seems to have largely failed to follow the rapid pace
of advances in this eld, essentially depriving the orthodontist of the required funda-
mental background knowledge in this area. In the words of an industry leader quoted
by Matasa,1 . for the manufacturer it is always amazing to see how noncritical the
orthodontist can be .
During the last 25 years an abundance of information has been reported on both
the static and kinetic frictional forces developed in the bracket-wire complex during
in vitro studies simulating orthodontic tooth movement with varying levels of reli-
ability. Despite the availability of relevant information, there is a notable lack of
consensus concerning the uctuations of friction during sliding of wires on bracket
slot surfaces. This discrepancy may derive from the multiplicity and inefciency of
research protocols adopted for the study of the phenomenon. The objective of this
chapter is to summarize the criticism of laboratory friction protocols appearing in
the last two decades through a critique of the research protocols employed, assess-
ment of the clinical relevance of the results reported, and analysis of the main fac-
tors. From this summary, use of the in vitro approach is precluded as a reliable
method for clarication of the impact of research ndings at the clinical level.
To this end, an analysis of the methodological approaches employed for the inves-
tigation of frictional effects during bracket sliding on wires raises a number of
issues.

*
Based on material previously published in Orthodontic Materials: Scientic and Clinical Aspects (Brantley
WA and Eliades T, editors), Thieme 2001, as well as several publications by the authors.

Orthodontic Applications of Biomaterials. http://dx.doi.org/10.1016/B978-0-08-100383-1.00005-9

Copyright 2017 Elsevier Ltd. All rights reserved.
98 Orthodontic Applications of Biomaterials

5.2 Factors affecting friction variation

5.2.1 Testing environment
An overview of the experimental conditions reported varies from the use of a dry envi-
ronment to utilization of water and articial saliva baths. The results obtained for these
conditions present substantial variability. In one study the dry state was found to be
associated with increased friction,2 whereas another study reported elevated friction
when a liquid interfacial medium was used.3 The conicting evidence derived from
these studies may be assigned to dynamic viscosity variations as well as to thixotropic
properties possessed by non-Newtonian liquid media. In these latter materials the vis-
cosity decreases as the shear rate increases. Therefore the use of liquids of undeter-
mined viscosity impacts the extrapolation of the results accordingly.
It is essential to include the in vivo aging patterns of orthodontic materials when
considering friction in orthodontics. During the past 15 years work from our groups
at the University of Athens, Ohio State University, and the University of Manchester
has described the pattern of intraoral aging for a number of orthodontic materials. The
reader can nd a brief report of this multitechnique investigation of surface, structural,
mechanical, chemical, and biocompatibility effects of aging in a review article.4 This
pattern is basically characterized by the precipitation of proteinaceous matter, which at
later stages undergoes calcication by adsorption of Ca and P. Thus the laboratory
investigation of as-received materials taken out of their packages fails to consider
the surface prole changes occurring during clinical service. This surface alteration
may be stipulated to have a varying effect depending on the maturation of the adsorbed
compounds. Apparently, calcied integuments could act as obstacles to sliding; how-
ever, the involvement of noncalcied lms is unknown and has been considered by
some investigators to have a lubrication effect. Because articial saliva lacks the mul-
tiplicity of factors present in the actual oral environment (enzymes, elements such as
Ca and P, and most importantly time variantsdconsidering that each cycle of sliding
in the laboratory may take some minutes), the prole of in vitroeaged materials should
be vastly different from that of their counterparts in routine clinical conditions.
The development of oxides on the surface of the alloy as a result of exposure to wa-
ter or articial saliva, may retard the movement rate, especially when the association of
velocity and frictional force is considered. Some investigators have also conjectured an
adhesive behavior of saliva to explain the consistently increased friction noted in the
presence of a wet environment,5 whereas evidence from retrieval analyses6 empha-
sizing the important role of the intraoral pH on the corrosion of orthodontic wires sup-
ports this association.

5.2.2 Methodology of testing

In general the methods employed for the quantitative determination of friction may be
classied into two categories:
1. measurement of the roughness of stainless steel, ceramic, or plastic bracket slot surfaces com-
plemented by morphological study of the wire surfaces prior to and following sliding on the
bracket surface and
In vitro friction assessment in orthodontics 99

2. actual simulation of sliding at a given distance with the use of a mechanical testing machine
or custom-made assemblies, under various bracket-wire engagement modes.
The rst category involves the use of scanning electron microscopy or laser spec-
ular reectance spectrometry. Despite the accuracy and sensitivity furnished by these
analyses the study of the surface prole is limited to the vicinity of the relatively small
area examined. In general, microscopic techniques lack a quantication scale to facil-
itate the estimation of surface roughness, which imposes a barrier to elucidating the
variability of friction relative to the surface smoothness. However, studies have sup-
ported the lack of a relationship between the surface texture and frictional forces,
revealing the presence of unanticipated interactions among the variables involved in
this complex phenomenon.7,8
In the second mode of investigation, multiple aws associated with the process of
simulating clinical conditions appear to render its use invalid. There are several com-
ponents to be considered at length:
1. The movement rate is chosen ad lib, resulting in a nonstandardized parameter in several
studies that makes comparison of the results impossible. Nonetheless, when a standard
rate is chosen, fundamental discrepancies between the clinical situation and the research envi-
ronment arise. As Reitan has shown in his pioneering work the plot of tooth movement (mm)
against time (days) is a highly individualized, complex curve that is generally characterized
by a wide plateau at 15e30 days, followed by a peak at days 35e 40.9 Therefore the incor-
poration of movement rates indiscriminately described by rst order kinetics is inappropriate.
In as much, examining the implicated parameters in this phenomenon, Kusy and Whitley have
noted a dependence of friction on the velocity gradients.10 This observation contradicts the
elementary laws of friction, whereby frictional forces depend only on the vertical component
of the applied force, the properties of the surface involved, and the medium in contact with
the moving element. These investigators explained the striking discrepancy by postulating a
dynamic relationship between the formation and detachment of oxides during movement and
arising from the wear of the surfaces involved. Hence, at low sliding velocity the formation of
oxides prevails and, as a result, the rate of frictional changes over time increases. When the
velocity exceeds a critical value the detachment of oxides from the surface per time unit sur-
passes the rate of their formation, leading to a decrease in friction. The fact that decreased
friction has been associated with increased number of sliding repetitions for the same spec-
imens strongly supports the validity of the hypothesis proposed by these authors. Additional
evidence related to the structure and morphology of retrieved nickeletitanium archwires, and
indicating the presence of adsorbed KCl crystals along with prominent island-like formations
arising from the dissolution of nickel,6 provides further substantiation to the model suggested
by Kusy and Whitley.
2. An inherent aw associated with the described experimental approaches is the measurement
of force magnitude over some distance, presumably to derive information about the extent of
the obstacles to movement.11,12 An alternative strategy would be to determine the energy
dissipated during the movement under the conditions studied. Because the magnitude of
force does not remain constant over the distance set in the experiments, it is difcult to mea-
sure force uctuations under real time conditions. Therefore the rate of movement is techni-
cally accelerated to facilitate the extrapolation of values.
3. The complexity of this issue is further increased when the interference of the force decay
occurring in the applied load is considered. Application of retracting forces with the use
of elastomeric modular chains is associated with force relaxation that occurs at a varying
extent. This degradation may reach levels of up to 50% during the rst 24 h.13 Thus the
100 Orthodontic Applications of Biomaterials

bracket-wire biomechanical model constructed in vitro is far from simulating the clinical
analogue.
4. In addition the majority of the published reports lacks the modeling of the bracket-wire
play. Research in this eld has shown14 that this variable depends on the slotearchwire
dimensional relationship, reaching values of the order of I4 . This parameter also derives
from the manufacturing processes for the brackets and wires. It has been estimated that
the discrepancy between the theoretically derived and measured play differs considerably
because of precautions taken by the manufacturers to ensure the engagement of terminal-size
archwires in the bracket slot. For example the actual size of archwires differs from the re-
ported one in that they are actually smaller, and slot sizes are usually marginally larger to
facilitate proper engagement in spite of dimensional variations arising from the
manufacturing processes. Research with predetermined inclination variants has veried the
adverse effect on the rate of simulated tooth movement.15 Nonetheless, others have found
that the relative dimensions of the bracket slot and archwire cross section have no effect
on friction.16
5. In most studies the use of stainless steel or cobaltechromium, beta-titanium, and NiTi wires,
coupled with ceramic brackets, were found to be associated with increased friction in the
described order.17e19 However, a limited number of investigations adopting identical
research protocols has shown that this sequence may be reversed.10,20 In the wet state the
use of stainless steel wires on stainless steel slot surfaces presented higher friction compared
to beta-titanium wires,5 while multistrand wires consistently presented decreased friction.16

5.2.3 The ligation

The methods of ligation used in friction research have employed elastomeric modules,
steel ligature ties, and Teon-coated ligatures.
The problems encountered with elastomeric ring use pertain to the enigmatic tem-
poral characteristics of material degradation. As pointed out by a publication, the force
relaxation patterns of these materials vary signicantly, with the consensus being that
the estimated 24-h force loss may exceed 40% under laboratory conditions.21 Addi-
tional decay is expected to occur in the intraoral environment due to complex surface
adsorption phenomena altering the mechanical properties of the material. The
decreased time frame employed in the in vitro approaches relative to the clinical con-
dition, the absence of enzymatic activity, plaque accumulation and temperature varia-
tions, as well as the oral microbiota elevation induced by the placement of appliances,
contribute to a much more severe environment compared to the dry condition or arti-
cial saliva used in vitro, adding another source of variation. The presence of lipids has
also been found to impose degradation of elastomers in vivo. Specically, lipids
adsorbed onto elastomers induce a shift of the glass transition temperature to the crys-
talline stage, increase brittleness, and decrease elastic range.22
In relevant studies the use of steel ligature ties has been shown to increase friction
through a dual mechanism involving a higher engagement force and additional friction
generated by the contact of the ligature surface with the wire,16 although elastomers
have been also found capable of inducing the same effect.23 The methodological prob-
lem associated with this issue is the lack of a reliable means to maintain accuracy and
repeatability in the ligation force, resulting in high variability that precludes the
In vitro friction assessment in orthodontics 101

extrapolation of statistical signicance. A method proposed to bypass this obstacle

involving the incorporation of a standard number of twisting cycles determined ad
lib24 cannot withstand scientic scrutiny. Thus the information from such studies is
limited to the conformity of hypothetical inferences proposed by investigators and,
as such, is considered highly subjective. As a general conclusion, self-ligating brackets
showed less frictional forces, while the ligature gure-of-eight conguration increased
friction signicantly.25
Generally the study of bracket-wire friction produced by a wide variation of bracket
surfaces (conventional and sintered stainless steel, zirconia, polycrystalline or single-
crystal alumina, polycarbonate with and without metallic slots, and composite mate-
rials), and archwire alloys (ordinary and ion-implanted nickeletitanium and beta-
titanium, cobaltechromium, stainless steel and polymeric in standard and multistrand
forms with multiple series of cross sections), yields an enormous number of pairs and a
cumbersome design to test the working hypothesis. Moreover, the clinical usefulness
of many of these models is seriously questioned since, by denition, sliding mechanics
necessitates the presence of free play between bracket and wire at the expense of tip
and torque control. The purpose of this retraction mechanics mode is to obtain ef-
ciently and quickly the proper tooth position in the arch in order to achievedat a later
stagedthe required spatial orientation of the crown.
Finally the lack of null hypotheses for testing a myriad of applianceearchwire com-
binations may further confuse this issue from a statistical perspective. For example, the
test of miscellaneous wire alloy compositions (variable 1), possessing various cross
sections (variable 2), in contact with different bracket slot surfaces (variable 3), and
engaged in brackets with two modes of ligation (variable 4) requires the use of com-
plex multifactorial analysis of variance and a post hoc multiple range statistical test. A
power analysis should be performed after initial pilot experiments to determine
adequate sample sizes for demonstrating potential statistical signicance among test
groups. This would be expected to result in an enormous number of specimens to
examine the effects of the four variables.

5.3 The clinical signicance

Currently the scientic orthodontic literature lacks a clear-cut proof demonstrating that
signicant differences exist between low intraslot-friction tooth sliding and the incor-
poration of a high-friction biomechanical system on the contralateral side of the same
patient participating in a clinical study on treatment efcacy and duration. On the con-
trary, there have been many randomized clinical trials where materials, which demon-
strated lower friction in vitro, were not associated with decreased treatment duration
in vivo. Apart from the factors discussed in the previous sections of this chapter, an
important factor potentially canceling out variations in friction is the pattern of tooth
movement. Whereas in vitro approaches essentially slide a wire on a bracket slot along
a horizontal path to extrapolate the frictional force developed, in reality the bracket
slides along an archwire, and the path consists of a series of tipping movements, which
102 Orthodontic Applications of Biomaterials

Summary of friction results from published studies

Table 5.1
(Specic articles are listed in Reference 27.)
Friction increased with increasing force for all wire materials. Stainless steel
and beta-titanium showed the lowest friction for the dry state. Articial saliva
increased friction for all wires pulled on metallic surfaces but not for Teon surfaces.
Friction rank: beta-titanium > nickeletitanium > stainless steel for all wire cross sections
tested.
Surface roughness of the wire was a major factor for friction. Narrow brackets increased
friction. The ligature may affect friction signicantly. Multistrand wires presented the
lowest friction.
Higher friction was found for narrow brackets. Archwireeslot relative dimensions had
little effect on friction. Rank for friction was beta-titanium > nickeletitanium > stainless
steel.
Stainless steel wires showed the lowest friction, and beta-titanium showed the highest
friction. Friction was affected by changes in sliding velocity.
Ceramic brackets and rectangular wires resulted in increased friction. Rank: beta-titanium
and nickeletitanium > stainless steel and cobaltechromium.
Single-crystal alumina brackets > polycrystalline alumina brackets > metallic brackets.
Smoother surface observed for single-crystal alumina brackets than polycrystalline
alumina brackets.
Nickeletitanium wires > stainless steel wires. Articial saliva > air. Ceramic brackets >
metallic brackets.
Wide brackets presented more friction than narrow brackets. The applied-to-effective load
ratio was 2.3.
Coefcients of friction do not always follow surface roughness. Mass transfer from
beta-titanium wire to stainless steel at and abrasion of wire from polycrystalline alumina
surface may occur.
Friction depends on ligation mode rather than dimension of archwire. Multistrand
wires present the least friction. Steel ligatures present greater friction than elastomeric
ligatures.
Increased archwire angulation and size presented higher friction. No relationship
between roughness and friction was found. Ceramic brackets with beta-titanium showed
highest friction. Extrapolation of in vitro friction values to in vivo condition is
inappropriate.
Stainless steel wires presented the lowest friction in the dry state. In the wet state, stainless
steel combinations increased friction, while beta-titanium combinations decreased friction
up to 50%. Saliva may promote adhesive behavior.
Wire surfaces were scratched more obviously by ceramic brackets whose slot surfaces
were rougher than metallic slots. Ceramic brackets showed higher friction than metallic
brackets.
Elastomeric ligation presented higher friction. Ceramic brackets presented more friction
than metallic brackets. Self-ligation did not show lower friction.
Larger diameter rectangular wires and stainless steel wires presented lower friction.
Ceramic brackets showed higher friction with small diameter wires.
Occlusal loads may result in decreased frictional forces in vivo.
In vitro friction assessment in orthodontics 103

Table 5.1 Continued

Friction rank was polycarbonate brackets > ceramic brackets > metallic brackets.
Increasing the angulation generally resulted in increased friction. The presence of saliva
reduced friction.
Archwire alloy inuenced friction more than bracket type. Multiple sliding of nickeleti-
tanium wires against same ceramic surfaces resulted in decreased friction.
Increased bracket angulation resulted in higher friction. Epoxy-coated stainless steel wires
presented the highest friction, while multistrand stainless steel wires showed the lowest
friction. Fiber optic wires presented relatively low friction.
Friction increased with increasing wire size. Underestimation of friction occurs due to the
lack of ligation.
Beta-titanium wires produced higher friction than stainless steel and nickeletitanium
wires in stainless steel brackets. Beta-titanium wires had coarse surface texture compared
to stainless steel and nickeletitanium wires. Increasing archwire dimensions increased
friction.
Self-ligating brackets showed the least friction. Increasing tip and torque resulted in almost
linear increases in friction for all brackets used. Increasing the tip caused a greater effect on
friction.
Highest friction coefcients were found for zirconia brackets. Beta-titanium wires
produced the highest friction, except for the wet state with zirconia brackets. Saliva only
slightly changed the friction values with zirconia brackets.
Articial saliva increased friction for brackets and did not appear to act as a lubricant.
Smallest increases in friction for wet versus dry state occurred with beta-titanium wires
compared to stainless steel and nickeletitanium wires.
Figure of eight elastomers presented the highest friction in both dry and wet states. No
difference was found between steel ligatures and elastomers. Teon-coated wires showed
the least friction. Teon-coated ligatures produced the lowest friction for all groups.
Ceramic brackets presented higher friction than their metallic counterparts.
Composite brackets presented the lowest friction regardless of wire size, alloy type, and
ligation mode. Friction rank: nickeletitanium > beta-titanium > stainless steel. Steel
ligation produced higher variability in friction than elastomeric ligation.
Friction rank was beta-titanium > nickeletitanium > ion-implanted beta-titanium > ion-
implanted nickeletitanium. However, stainless steel presented the highest variability
among the wires tested. Overall, the two as-received titanium-containing wire alloys
presented higher friction than their ion-implanted counterparts.

is vastly different from maintaining continuous contact between the wire and the
bracket slot walls. Thus the development of friction is exaggerated in laboratory set-
tings. Moreover, during routine clinical conditions, patients masticate or speak, and
the bolus of food or opposing teeth come in contact along with the movement of
the tongue. In orthodontically treated teeth, this may generate an important factor,
namely vibrational forces during movement. As these have mainly a vertical direction,
perpendicular to the path of movement, they disturb the effect of friction between the
bracket and archwire. Evidence supporting this notion has been provided by a study
projecting a notable decrease of frictional forces in vivo as a result of the interference
of complex occlusal loads.26
104 Orthodontic Applications of Biomaterials

Lastly, since the tooth movement rate presents an upper limit determined by biolog-
ical variables, the clinical impact of accelerating the rate of a canine retraction by a
fraction of the biologically optimum is doubtful.
The Table 5.1 summarizes the reported ndings from a large number of friction
studies.27 It can be seen that there were many conicting observations, further casting
doubt on in vitro investigations of friction.

References
1. Matasa CG. Is some orthodontists thinking antiquated? Orthod Mater Insid 1997;I0:8.
2. Pratten DH, Popli K, Germane N, Gunsolley JC. Frictional resistance of ceramic and
stainless steel orthodontic brackets. Am J Orthod Dentofac Orthop 1990;98:398e403.
3. Stannard JG, Gau JM, Hanna MA. Comparative friction of orthodontic wires under dry and
wet conditions. Am J Orthod 1986;89:485e91.
4. Eliades T, Bourauel C. Intraoral aging of orthodontic materials: the picture we miss and its
clinical relevance. Am J Orthod Dentofac Orthop 2005;127:403e12.
5. Kusy RP, Whitley JQ, Prewitt MJ. Comparison of the frictional coefcients for selected
archwire-bracket slot combinations in the dry and wet states. Angle Orthod 1991;61:
293e302. Erratum in: Angle Orthod 1993;63(3):164.
6. Oshida Y, Sachdeva RC, Miyazaki S. Microanalytical characterization and surface modi-
cation of Ti-Ni orthodontic archwires. Biomed Mater Eng 1992;2:51e69.
7. Kusy RP, Whitley JQ. Coefcients of friction for arch wires in stainless steel and poly-
crystalline alumina bracket slots. I. The dry state. Am J Orthod Dentofac Orthop 1990;98:
300e12. Erratum in: Am J Orthod Dentofacial Orthop 1993;104(4):26.
8. Ho KS, West VC. Friction... Friction resistance between edgewise brackets and archwires.
Aust Orthod J 1991;12:95e9.
9. Graber TM, Swain BF. Orthodontics d current principles and techniques. St Louis:
Mosby; 1985. p. 199e201.
10. Kusy RP, Whitley JQ. Effects of sliding velocity on the coefcients of friction in a model
orthodontic system. Dent Mater 1989;5:235e40.
11. Garner LD, Allai WW, Moore BK. A comparison of frictional forces during simulated
canine retraction of a continuous edgewise arch wire. Am J Orthod Dentofac Orthop 1986;
90:199e203.
12. Drescher D, Bourauel C, Schumacher HA. Frictional forces between bracket and arch wire.
Am J Orthod Dentofac Orthop 1989;96:397e404.
13. von Fraunhofer JA, Coffelt MTP, Orbell GM. The effects of articial saliva and topical
uoride on the degradation of the elastic properties of orthodontic chains. Angle Orthod
1992;62:265e74.
14. Sebanc J, Brantley WA, Pincsak J, Conover JP. Variability of effective root torque as a
function of edge bevel on orthodontic archwires. Am J Orthod 1984;86:43e51.
15. Tselepis M, Brockhurst P, West VC. The dynamic frictional resistance between orthodontic
brackets and arch wires. Am J Orthod Dentofac Orthop 1994;106:131e8.
16. Schumacher HA, Bourauel C, Drescher D. The effect of the ligature on the friction between
bracket and arch. Fortschr Kieferorthop 1990;51:106e16 [In German].
17. Angolkar PV, Kapila S, Duncanson Jr MG, Nanda RS. Evaluation of friction between
ceramic brackets and orthodontic wires of four alloys. Am J Orthod Dentofac Orthop 1990;
98:499e506.
In vitro friction assessment in orthodontics 105

18. Tanne K, Matsubara S, Shibaguchi T, Sakuda M. Wire friction from ceramic brackets
during simulated canine retraction. Angle Orthod 1991;61:285e90. Discussion 291e2.
19. Downing A, McCabe J, Gordon P. A study of frictional forces between orthodontic brackets
and archwires. Br J Orthod 1994;21:349e57.
20. Ireland AJ, Sherriff M, McDonald F. Effect of bracket and wire composition on frictional
forces. Eur J Orthod 1991;13:322e8.
21. Taloumis LJ, Smith TM, Hondrum SO, Lorton L. Force decay and deformation of ortho-
dontic elastomeric ligatures. Am J Orthod Dentofac Orthop 1997;11:1e11.
22. Adams Jr WP, Robinson Jr JB, Rohrich RJ. Lipid inltration as a possible biologic cause of
silicone gel breast implant aging. Plast Reconstr Surg 1998;101:64e8.
23. Bednar JR, Gruendeman GW, Sandrik JL. A comparative study of frictional forces between
orthodontic brackets and arch wires. Am J Orthod Dentofac Orthop 1991;100:513e22.
24. Bazakidou E, Nanda RS, Duncanson Jr MG, Sinha P. Evaluation of frictional resistance in
esthetic brackets. Am J Orthod Dentofac Orthop 1997;112:138e44.
25. Sims AP, Waters NE, Birnie DJ, Pethybridge RJ. A comparison of the forces required to
produce tooth movement in vitro using two self-ligating brackets and a pre-adjusted bracket
employing two types of ligation. Eur J Orthod 1993;15:377e85.
26. Jost-Brinkmann P, Miethke RR. The effect of physiological tooth mobility on the friction
between the bracket and the arch. Fortschr Kieferorthop 1991;52:102e9 [In German].
27. Eliades T, Brantley WA. Friction: on the edge of ction. A critique of bracket-archwire
friction research protocols and their clinical signicance. Hel Orthod Rev 1999;2:17e29
[Greek and English].