American Journal of ORTHODONTICS

and DENTOFACIAL ORTHOPEDICS

Founded in 1915 Volume 111 Number 1 January 1997

Copyright 1997 by the American Association of Orthodontists

ORIGINAL ARTICLES

Force decay and deformation of orthodontic

elastomeric ligatures
Louis J. Taloumis, DMD, a Terrence M. Smith, DMD, b Steven O. Hondrum, DDS, MS, c and
Lewis Lorton, DDS, MSD d
Fort George G. Meade, Md., and Washington, D. (2.

This study evaluated commercially available molded gray elastomeric ligatures from seven
companies for force decay, dimensional change, and the relationship between ligature dimension
and force. The initial wall thickness, inside diameter, outside diameter, and force levels of each
ligature were measured. Three of four test groups of ligatures were stretched over stainless steel
dowels with a circumference approximating that of a large orthodontic twin bracket. Test group 1
was kept at room temperature and humidity for 28 days and test group 2 in a synthetic saliva bath
at 37 C, pH 6.84 for 28 days. The residual forces and dimensional changes were measured. The
third test group was placed in a synthetic saliva bath at 37 C, pH 6.84, and force levels recorded
at initial, 24 hours, 7 days, 14 days, and 28 days. The fourth test group of unstretched samples
was placed in a synthetic saliva bath at 37 C, pH 6.84 for 28 days to evaluate dimensional
changes due solely to moisture sorption. The results for stretched samples in a simulated oral
environment revealed the following: (1) Moisture and heat had a pronounced effect on force decay
and permanent deformation, (2) a positive correlation existed between the wall thickness and force,
(3) a negative correlation existed between the inside diameter and force, (4) a weak correlation
existed between outside diameter and force, (5) the greatest force loss occurred in the first 24
hours and the decay pattern was similar for all ligatures tested, and (6) unstretched ligatures
absorbed moisture in the range of 0.060% to 3.15%. The ligatures tested appear to be suitable for
use during initial aligning and leveling. However, the rapid force loss and permanent deformation of
these products may preclude their use for rotational and torque corrections. (Am J Orthod Dentofac
Orthop 1997;111:1-11 .)

C l i n i c i a n s may use either 0.008 to 0.0i4-
inch stainless steel ligature wire, self-ligating spring
clips, or circular synthetic elastomers to secure arch
The views and opinions of the authors experienced herein do not neces-
sarily support or reflect those of the Department of the Army or the
Department of Defense.
aMajor, U.S. Army Dental Corps, Senior Orthodontic Resident, U.S. Army
Orthodontic Residency Program.
bLieutenant Colonel, U.S. Army Dental Corps, Assistant Director, U.S.
Army Orthodontic Residency Program.
cColonel, U.S. Army Dental Corps, Chief, Dental Materials Section,
Dental Research Detachment, Walter Reed Army Institute of Research,
Washington, D.C.
~Consultaut, Statistics and Research Design, U.S. Army Orthodontic
Residency Program.
Reprint requests to: Dr. Louis J. Taloumis, Wfirzburg Dental Clinic, CMR
475, Box 873, APO AE 09036.
8/1/58553
wires to orthodontic brackets. Elastomeric ligatures
are manufactured in two basic forms: injection
molded and cut. The injection molded ligature is
made by injection of liquefied elastomeric material
into a mold and curing, whereas the cut ligature is
sliced from previously processed elastomeric tubing.
Advertised characteristics about elastomeric liga-
tures include: continuous gentle forces, consistent
long-lasting arch wire seating, water sorption resis-
tance, and shape memory properties.
The advantages of elastomeric ligatures are that
they can be applied quickly, are comfortable to the
patient, and are available in a variety of colors.
Disadvantages are that the dentition and soft tissues
may be adversely affected by microbial accumulation
on the tooth surfaces adjacent to brackets ligated
2 Taloumis et aL
Table I. Manufacturer, brand name, and m e a s u r e m e n t s wall thickness (WT), inside diameter (ID), outside diameter (OD) provided
by the manufacturers
Manufacturer Brand name
"A" Company (ACO) Patient Sticks ligature ties
American Orthodontics (AMR) Unistick ligatures
GAC International (GAC) Sani-ties
ORMCO (ORM) Power "0" modules 120
Rocky Mountain Orthodontics (RMO) Designer ligature sticks
TP Orthodontics (TPO) Dispense-A-tie
Unitek (UNI) Alastik A1 module
with elastomeric ligatures, arch wires may not com-
pletely seat during torquing or rotational correc-
tions, and binding may occur with sliding mechan-
ics. 1-4
The force exerted by an elastomeric ligature
appears dependent on the magnitude of the initial
force, the duration that the force may be applied,
and the decay rate of the ligature. The clinician has
control over the initial force with the selection of the
appropriate sized ligature for the clinical situation
and the duration of use. However, the force decay
rate, the amount of force decay, and the dimen-
sional changes of elastomeric ligatures has not re-
ceived exclusive review.
Elastomeric ligatures are polyurethanes whose
exact composition is a commercial secret. Polyure-
thane is a generic term given to elastic polymers that
contain the urethane linkage. Polyurethanes are not
direct polymers of urethane, but are synthesized
through a process of reactions of either polyesters or
polyethers with isocyanates to produce a complex
structure with a urethane linkage, s These products
are not ideal elastics and are affected by duration of
force and environment. 5
Few studies have evaluated the behavior of
single elastomeric ligatures. Studies published on
elastomeric products have evaluated threads and
chains of two or more links for the effects of time,
temperature, salivary pH, and water sorption on
force loss, permanent deformation, and strength. 5-2
Although elastomeric ligatures are made of the
same material as elastomeric chains, the clinical
applications are different. Therefore the clinical
response may be different. Elastomeric materials are
altered in the presence of moisture by water sorp-
tion that facilitates slippage of molecules or polymer
chains past one another accelerating the force decay
process of these materials. 5'6'a'9'13 Exposure of elas-
tomeric chains to a test solution (pH 7.26) produced
significantly greater force decay than an acidic solu-
tion (pH 4.95)} a Many authors have reported per-
manent deformation and rapid force loss of these
products, s2 These products lose 50% to 70% of
their force in the first 24 hours. Some studies noted
American Journal of Orthodontics and Dentofacial Orthopedics
January 1997
Measurements provided
WT ID OD
0.035 ~+0.002 0.050 -+ 0.002 0.120 _+0.002
0.0350 0.045 0.115
0.032 0.055 0.120
0.035 0.050 -+ 0.004 0.120
0.040 0.045 0.125
0.0375 0.050 0.125
0.035 0.050 0.120
no difference in force decay between gray and clear
elastomeric chains, 5,7,12 however, a recent study re-
ported a difference in forces between gray and clear
elastomeric chains. 16
Forces exerted by elastomeric ligatures on arch
wires and for use in space closure have been report-
ed. 4'18'm'22 Forces that elastomeric ligatures exert on
fully engaged arch wires are not as high as those for
stainless steel ties. 21-23 However, elastomeric liga-
tures fastened to the largest twin brackets initially
approach the strength of stainless steel ties. 21 Mo-
ments produced during rotational corrections are a
function of bracket design, wire properties, and
properties of the elastomeric ligature. 3 Echols 4
found that elastomeric ligatures bind tooth move-
ments in sliding mechanics; however, the lubricating
effect of oral fluids was not considered in this study.
In a clinical study, forces of elastomeric ligatures
used to close space dropped to zero after 5 to 8
weeks, is
The purpose of this study was to evaluate force
decay, permanent deformation, and the relationship
between the ligature dimension and the force of
commercially available gray molded elastomeric lig-
atures in a simulated oral environment.
MATERIALS AND METHODS
Commercially available gray molded elastomeric liga-
tures were selected from seven companies (Table I).
Samples from each company were divided into four test
groups. Thirty samples from each company were studied
at room temperature and humidity (test group 1) and in a
simulated oral environment (test group 2) for permanent
deformation and force decay. Twelve samples from each
company were evaluated for force changes at specific time
intervals (test group 3). Lastly, 22 samples from each
company were evaluated for dimensional changes due to
moisture sorption alone (test group 4). The sample size in
test group 3 was reduced, based on the consistent results
found in test groups 1 and 2. The sample size for test
group 4 represents the number of samples supplied to us
on ligature trees by the manufacturer.
Before testing, the initial wall thickness (WT), inside
American Journal of Orthodontics and Dentofacial Orthopedics Taloumis et aL 3
Volume 111, No. l

_ /OD Hook 1 !
Width ~ ID

WT
Hook 2
Fig, 1. Ligaturein threedimensions,
Fig. 2. Close-upof stretchedligaturewithhookssep-
aratedand lineardistance(X) measuredin inches

T a b l e II. Test group 1 dimensions, mean percentage change for WT, ID, OD at constant stretch in mean air temperature of 23 C
with A N O V A comparing percentages of dimensional changes between companies

Compa ~y Samples Initial Dimensions (inches) Dimensions(inches) at 28 days Mean%Change

i
N WT ID OD OD
-15%~ ID " OD
ACO 30 .034.001 .052.001 ,122.001 .029.002 .089,009 i .150_.008
+ i 71% 23%
I
AMR 32 .034.001 Z047.00' .116.O01 .032.002 .069.005 .133-+,003 77% I 47% 15%
I
GAC 32 .033.001 .056.001 .121.001 .028.002 .088.006 .140+,005 i -15% 57% 115%
I
ORM 31 .037.001 .046.001 .119.001 .032.001 .080.002 I .143+.002 -14% 74% 20%
RMO 31 .039.002 .044.002 .126.001 .030.002 .090.006 !. 154+.004 -23% !04%!22%
' I
I
TPO 33 .038.001 .048.001 .125.002 .031.002 .096.006 158+.006 I -18% O0%!26%
I i
!

UNI 33 .033.001 ,058.002 .125.003 .026.002 .105.005 157.004 i -21% 81% 26%

A summary of significant findings at 95% using the Scheffe F-Test appear below each table in order of least
percent change to most percent change between companies at 28 days. Spaces between companies denote
statistical significance and the companies that are underlined denote no statistical difference.

Wall Thickness
Source: DF: Sum of Squares: Mean Squares: F-Test:
Between Groups 6 5059.9 843.3 26
Within Groups 215 6973.6 32.4 )=.0001
Total 221 i 12033.5
Least % WT Change >>>>>>>>: >>>>>>>>: Most % WT Change
AMR GAC ORM ACO TPO UNI RMO

Inside Diameter
Source: DF: Sum of Squares: Mean Squares: F-Test:
Between Groups I 6 180560.5 I ~;,296,8 84.5
Within Groups 215 34165.2 p=,0001
Tota 221 114726
Least % ID Change >>>>>>>>: >>>>>>>>: Most % ID Change
AMR GAC ACO ORM UNI TPO RMO

Outside Diameter
Source: DF: Sum of Squares: Mean Squares: F-Test:
BetweenGrups I 6 I 4418S
Within Groups 21 5
3438.9
36'4 1461
p=.O001
Tota 221 7857.4
Least % OD Change >>>>>>>>: >>>>>>>>: Most % OD Change
AMR GAC ORM RMO ACO TPO UNI
4 Taloumis et aL American Journal of Orthodontics and Dentofacial Orthopedics
January 1997

Fig, 3. Ligatures stretched over stainless steel doweL.

Fig. 4. From left to right, Ligatures before testing, after storage (stretched) for 28 days at
room temperature and humidity, and after storage (stretched) for 28 days in simulated oral
environment. (Magnification x4.)

diameter (ID), and outside diameter (OD) (Fig. 1) of all
ligatures in test groups 1, 2, and 4 were measured to the
nearest thousandth of an inch with an optical comparator
(Nikon, model V-12A, Kogaku, Japan) with a digital
display (Quadra-Check 2000, Excell Technologies, En-
field, Conn.).
Groups 1, 2, and 3 were tested for initial force on a
universal testing machine (Instron model 1011, Instron
Corp., Canton, Mass.). Ligatures were stretched at the
rate of 0.2 inches per minute as described by Kovatch 15 to
a predetermined length (x) (Fig. 2). Initial force readings
were recorded in grams, with a 5 Kg load cell scaled down
to 1 to 2 Kg, depending on the ligature tested. The
measurement error of the load cell was 1%.
The amount of extension was calculated in the follow-
ing manner. The diameter (D 1 of the ligature stretched
over an object of known diameter (a maxillary central
incisor twin bracket) was related to the diameter (D2) of
the ligature stretched on the testing apparatus by using the
following equation:
D1 = D 2
~ D 1 = 2x + ~ D 2
(Diameter of simulated bracket) = 2(x) + (a/a Diameter
of hook 1 + 1/2 Diameter of hook 2)
Ligatures were stretched over stainless steel dowels
(0.155 0.0002 inches in diameter D1) to simulate the
American Journal of Orthodontics and Dentofacial Orthopedics Z a l o u m i s et al. 5
Volume 111, No. 1

Table IlL Test group 2 dimensions, mean percentage change for WT, ID, OD kept in a saliva bath at 32 C for 28 days with
ANOVA comparing percentage of dimensional changes between companies

Company Samples Initial Dimensions (inches) Dimensions(inches) at 28 days Mean % Change

N WT ID OD WT ID OD WT ID OD

AC0 30 .035.001 .051.001 .122.001 .023.002 .126.004 .172.003 -35% 146% 42%

AMR 32 .035.001 ,046.001 .116.001 .024.003 .114.007 .162.005 -32% 147% 40%

GAC 32 .034.001 ,053.001 .121.001 .025.002 .111.007 .151.006 -27% 108% 25%

ORM 31 .036.001.046.001 .119.001 .026.001 .112.002 .165.001 -28% 143% 38%

RMO 31 ,042.001.042.001 .126.001 .029.002 .122.005 .179.002 -32% 192%!42%

TPO 33 .039.002 .048.001 .125.002 .024,002 .131.002 .179.002 -38% 171% 43%

UNI 34 .033.001 .059.002 ,125.003 .023.002 .131.004 .177.003 -29% 123% 42%

A summary of significant findings at 95% using the Scheffe F-Test appear below each table in order of least
percent change to most percent change between companies at 28 days. Spaces between companies denote
statistical significance and the companies that are underlined denote no statistical difference.

Wall Thickness
Source: DF: Sum of Squares: Mean Squares: F-Test
Between Groups 6 3097.3 516.2 14.3
Within Groups 216 7805.3 36.1 p=.0001
Total 222 10902.6 I
Least % WT C h a n g e >>>>>>>>> >>>>>>>-- Most % WT Change
GAC ORM UNI RMO AMR ACO TPO

Inside Diameter
Source: DF: Sum of Squares: Mean Squares: F-Test:
Between Groups 6 15208325347.1 179
TotaIWithinGroups 216222 30518.6182601 I 141.3 p=.O001

Least % ID Change >>>>>>>>> >>>>>>>.- Most % ID Change

GAC UNI ORM ACO AMR TPO RMO

Outside Diameter
Source: DF: Sum of Squares: Mean Squares: F-Test:
Between Groups 6 8077.1 [ 1346.2 171 I
i
Within Groups 216 1702.6 7.9 p=.0001
Total 222 9779.7 I
Least % OD C h a n g e >>>>>>>>> >>>>>>>: Most % OD Change
GAC ORM ARM ACO RMO UNI TPO

stretch necessary to apply an elastomeric ligature over a
maxillary central incisor twin bracket (0.022 slot) and arch
wire (Fig. 3). One end of the stainless steel dowel was
tapered to facilitate the application and the removal of the
ligatures. We realize that ligatures stretched over arch
wires and brackets do not make perfect circles and that
brackets, arch wires, and ligatures come in a variety of
sizes. Substituting the tapered dowels for brackets elimi-
nates the effect of bracket design and the potential for
overstretching the ligature on application and removal.
The diameter of the hooks on the force measuring instru-
ment was 0.018 inch (D2). Substituting the known vari-
ables into the equation and solving for (x) found that the
distance necessary to stretch the ligatures was 0.217 inch
or 5.5 ram.
Group 1 samples stretched over dowels were kept in
ambient conditions ( - 2 3 C). Groups 2 and 3 sample s
stretched over dowels were immersed in synthetic saliva
(fluoride and dye-free Oralube, Oral Disease Research
Laboratory, VA Medical Center, Houston, Texas) main-
6 TaIournis et aL American Journal of Orthodontics and Dentofacial Orthopedics
January 1997

Table IV. Test group 1 force in grams and mean percentage force loss at constant stretch for 28 days in mean air temperature of
23 C with ANOVA comparing percentage of force changes between companies

Number of
Company Observations Force (Mean+sd) Percent Change
Initial I 28 Days
ACO 30 569 +_ 35 425 + 20 25%
GAC 32 483+40 353+17 27%
AMR 32 649_+32 4 4 6 + 11 31%
ORM 31 804+_ 9 512+_11 36%
RMO 31 1029 + 31 660 + 23 36%
TPO 33 698 + 35 422 + 22 40%
UNI 33 654 + 57 339 + 30 48%

A summary of significant finN'ngsat 95% using #70Scheffe F-Test appear below each ANOVA table in order of
least percent change to most percent change between companies at 28 days. Spaces between companies
denote statistical significance and the companies that are underlined denote no statistical difference.

ANOVA Table
Source: DF: Sum of Squa~s: Mean Squa~s: F-Te~:
Between groups 12486.5 2081.1 126.3
Within groups 215 3542.6 16.5 p=.O001
Total 221 16029.2

Least % Force Change )) )) )) )) )))>)) )) Most % Force Change

ACO GAC AMR ORM RMO TPO UNI

tained in glass containers, covered to prevent evaporation
and kept in a 37 C oven (Fisher Scientific Oven model
818F, Fisher Scientific, Pittsburgh, Pa.). The pH was
measured periodically and the mean for the test period
was pH 6.84,
All samples in groups 1, 2, and 3 remained stretched
over the dowels for a 28-day period (the amount of time
that ligatures are typically applied to hold arch wires in
brackets). After 28 days, the ligatures from groups 1 and
2 were removed and the dimensions WT, ID, and OD
were measured. The ligatures were then tested for force
decay on the universal testing machine. The mean per-
centage of deformation for WT, ID, and OD and the
mean percentage of loss of force were calculated.
Samples from group 3 were removed for force testing
at the following intervals: 24 hours, 7 days, 14 days, and 28
days. The results were expressed as the mean percentage
of loss of force for each time period.
After the initial measurements, group 4 samples were
placed into the synthetic saliva bath at 37 C for 28 days.
At 28 days, the samples were removed, and the WT, ID,
and OD were measured to evaluated to effect of water
sorption on the dimensions of the ligatures. The results
were expressed as mean percentage of changes for each
ligature dimension.
Mean dimensional and mean force differences from
initial measurements to final measurements for each
company were compared with paired t tests. One-way
analysis of variance (ANOVA) was used to compare the
mean percentage of dimensional and mean percentage of
force changes between companies. Correlation coeffi-
cients were calculated to determine the relationship of
ligature dimensions to initial force.
RESULTS
T h e dimensions (WT, ID, O D ) of the ligatures
in groups 1 and 2 at test periods are presented in
Tables II and III. T h e initial dimensions of all
ligatures were within the m e a s u r e m e n t s provided by
the companies with the exception of the ligatures
f r o m Unitek, which m e a s u r e d larger in I D and O D
than the m a n u f a c t u r e r ' s specifications.
T h e m e a n initial and final dimensional measure-
ments for groups 1 and 2 showed that all ligatures
were significantly different after testing (Tables II
and I I I with A N O V A comparisons). Fig. 4 shows
the ligatures before and after testing. Initial and
final force levels for groups 1 and 2 are shown in
Tables I V and V with A N O V A comparisons. O r m c o
ligatures showed the most consistent initial and final
force levels.
M a n y of the ligatures had varying amounts of
excess material (flash) at their inner and outer edges
(Fig. 5). T h e amounts ranged f r o m no flash to flash
covering the entire inner and outer circumference.
American Journal of Orthodontics and Dentofacial Orthopedics Taloumis et al. 7
Volume 111, No. 1

Table V. Test group 2 force in grams and mean percentage force loss at constant stretch for 28 days in saliva bath at 32 C with
A N O V A comparing percentages of force changes between companies

Number of
Company Observations ~ Force (Mean+sd) Percent
Initial 28 Days
GAC 32 585 _+45 342 + 24 42%
AMR 32 697 + 36 377 + 25 46%
ACO 30 615 + 51 294 + 27 52%
ORM 31 798_+ 9 365 + 10 54%
RMO 31 1036+24 4 6 6 + 18 55%
TPO 33 679 + 24 301 _+ 10 56%
UNI 34 591 + 51 198 + 2P 66%

A summary of significant findings at 95% using the Scheffe F- Test appear below each ANOVA
table in order of least percent change to most percent change between companies at 28 days.
Spaces between con cenies denote statis~cal significance and the companies that are underlined
denote no statistical difference.

ANOVA Table
Source: DF: Sum of Squares: MeanSquares: F-Test:
Between groups 6 12849.7 2141.6 353.6
Within groups 216 1302.1 6.06 p=.O001
Total 222 14151.8

Least % Force Change )))))))))))))))) Most % Force Change

GAC AMR ACO ORM RMO TPO UNI

This experiment did not explore any relationship Table VI, Correlation coefficients
between the amount of flash present and any mea-
Dimension I Correlation(r2)
sured characteristic. It was noticed that the manu-
facturer (Ormco) with the most consistent force Test group 1 (n = 222)
measurements also had consistently the least Wall thickness 0.765 (0.584)
amount of flash. Inside diameter -0.712 (0.505)
Outside diameter 0.175 (0.026)
Fig. 6 showed the correlation between WT, ID, Test group 2 (n = 223)
OD, and initial force for test group 2. The samples Wall thickness 0.803 (0.645)
of Rocky Mountain Orthodontics (RMO) were Inside diameter -0.793 (0.629)
tightly clustered and had a high mean force. Table Outside diameter 0.184 (0.034)
VI shows the correlation coefficients. Retrospec-
tively, the widths (Fig. 1) of 30 samples from each
company were measured to determine the relation-
ship between initial force and width. The correlation sorption, showed that the dimensional changes for
coefficient was high at (r = 0.768). the seven companies ranged between 0.06% to
Group 3 data, the forces measured at initial, 24 3.15% for WT, ID, and OD.
hours, 7 days, 14 days, and 28 days, are presented in
Table VII with ANOVA comparisons. The percent- DISCUSSION
age of loss of force for each company was plotted The null hypothesis that elastomeric ligatures
against initial, 24 hours, 7 days, 14 days, and pre- remain dimensionally stable and do not lose force is
sented in Fig. 7. rejected on the basis of the results in this experi-
Group 4, the effects on dimension of moisture ment. The results in this study may help the clinician
8 Talournis et aL
Fig. 5. Example of ligature with material flash.
scrutinize manufacturer claims of minimal loss of
force and dimensional stability of elastomeric liga-
tures. The reader must understand the results in this
study pertain to gray ligatures of different dimen-
sions tested in a simulated oral environment. These
results should be viewed with understanding that
with any specific person at any specific time, the
elastomeric ligatures may not behave in a similar
manner on force decay and dimensional change, as
seen here. Therefore the results of this study should
not be used to judge one product superior to
another.
This study supports the finding by others that
moisture and heat decrease the dimensional stability
and force levels of elastomeric materials. 1'13
Huget 1~ found that ligatures exposed to moisture
first leads to weakening of noncovalent forces and
then to degradation of the ligature. The samples of
unstretched ligatures reveal that dimensional
changes are at least partially a result of moisture
sorption. The percentage of changes were highly
variable and the ranges were broad, especially for
thickness and inside diameter.
The correlation between the initial forces, WT,
and ID combined with the weak correlation between
OD and the initial forces generated may change the
way elastomeric ligatures are marketed. Although
ligature sizes are manufactured on the basis of the
sizes of the brackets used, it may be more accurate
for the industry to relate the ID of the ligature to the
applied bracket. Of the seven companies tested,
American Journal of Orthodontics and DentofaciaI Orthopedics
January 1997
American is the only company to market their
ligatures according to ID.
The mean percentage of loss of force at 28 days
for the samples in group 3 was greater than that for
group 2. An explanation for this may be that the
ligatures in group 2 were allowed to relax before
testing forces, whereas the ligatures in group 3 were
measured immediately. Fig. 7 showed that force
decay pattern for all the ligatures in this test ap-
peared to be similar. The mean percentage of force
loss for 24 hours was 53% to 68% for the seven
companies tested and was comparable to that re-
ported in the published studies for elastomeric
chains.5-20
DeGenova et al. 1 found that elastomeric chains
producing higher initial forces displayed less force
loss than did chains with lower initial forces and Lu
et al? 6 found that the greater the initial force the
greater the force decay. This study did not support
these findings. A possible explanation is that this
study evaluated elastomeric ligatures and that the
models used to study elastomeric chains do not
necessarily apply to elastomeric ligatures. The forces
exerted after 28 days in this study did not drop to
zero as found in a clinical study by Samuels et al. 18
In the Samuels study, forces were tested between 5
to 8 weeks, whereas in this study, forces were tested
at 28 days after exposure to a simulated oral envi-
ronment.
Logical extensions of this study could include
testing ligatures in vivo, testing different colors,
American Journal o f Orthodontics and Dent@cial Orthopedics Taloumis et aI. 9
Volume 111, No. 1

y = 38918.182x - 702.048, R-squared: ,645

1100 t . . . . . . . . . i' ' ' i' ' '

1000 . . . . . . .

t
1
.

,o0t ..... :

,ooi/." "-''- '.

4001 . . . . . . . . . . . . . . . 1
.03 .032 .034 .036WALL .038
THICKNESS.04 .042 .044 .046

y = -22037.961x + 1802.258, R-squared: .629

10004
"i"+:
o(, l,
: :

u.

700/ ~;% ~- " "

] *t'L + , ,++~-L.". "

2
0375 .04 .0425 .045 .0475 .05 .0525 .055 .0575 .06 .0625 .065
INSIDE DIAMETER

y = 7565,858x - 211,01, R-squared: .034

11001 . . . . . . . . . . . . " .,,~, . t, . , ., ~ .

10004 4. ~ +,,~-

9OO4

L=. 800-1 " ~+*'~- "

J #+
V- 7oo4 , "~!~ " .b ~ " ;-*"
,++ , ~, ,. . ,t
6004 ..... ~ ~ +,~ ~, ~t

5oo4
4001 . . . . . . . . . . . . . . . . . 3
.114 .116 .118 .12 .122 .124 .126 .128 .13 .132
OUTSIDE DIAMETER

Fig. 6. S i m p l e regression analysis b e t w e e n initial force and TH, ID, OD.

increasing the time interval of the applied force, and cian's loyalty to a particular company, cost of the
testing various sizes of ligatures in combination with ligatures, the variety of sizes and colors available,
application to various sizes of brackets. and, possibly, the clinical feel of the ligatures. This
The results of this article give the clinician article presents other reasons to consider when
additional information to make choices about prod- selecting elastomeric ligatures such as dimensional
ucts they use. The virtual reality, when it comes to stability, forces generated, and force decay. The
selecting elastomeric ligatures, may be the clini- elastomeric ligatures tested in this study appear to
10 Taloumis et al. American Journal of Orthodontics and Dentofacial Orthopedics
January 1997

10

20 + ACO

30 AMR

40 GAG

5O ORM

,o
70
i
i
- - ~ RMO

TPO

80 ------el-- UNI

90
IOO I - - I --{
INITIAL 24 HOURS 7 DAYS 14 DAYS 28 DAYS
TIME

Fig, 7. Percentage of loss of force at initial, 24 hours, 7 days, 14 days, and 28 days.

Table VII. Test group 3 mean force (grams) initial, 24 hours, 7 days, 14 days, and 28 days with ANOVA comparing percentage of
force changes between companies

Company Number MEAN + standa(d deviation (grams)

Initial I 24 hours I 7 days I 14 days I 28 days
'ACO 12 606 +- 32 234 + 15 179+11 171+ 9 153 + 13
ANR 12 630+-25 265+-19 212+-23 204+ i 6 185+18
GAC 12 520+-70 239+-33 189 + 22 189 +- 22 172+-26
ORM 12 767+22 270+-16 193+ 9 188+ 8 173+ 10
RNO 12 942+27 334+17 252+-12 238+- 16 224+ 16
TPO 12 629 +- 25 232 + 9 182+ 7 175+-13 157 +- 15
UNI 12 548 + 39 172 + 18 133+13 127+14 118+11

A summaryof significantfindingsat 95% usingthe ScheffeF-TestappearbeloweachANOVAtablein ordero~leastpercentchangeto

mostpercentchangebetweencompaniesat 28days. Spacesbetweencompaniesdenotestatisticalsignificanceand the companiesthatare
underlineddenotenostatisticaldifference.

ANOVA Table
Source: DF: Sum of Squares: Mean Squares: F-Test:
IBetween group; 6 1214 202 33
i Within groups 77 469 6 p=.O001
Total 83 14152

Least % Force Change >>>>)>))>)>>)> Most o~ Force Change

GAC AMR ACO TPO RMO ORM UNI

behave similarly in a simulated oral environment.
This study indicates that all the ligatures tested had
a residual force after 28 days, which should hold an
arch wire in a bracket slot. Elastomeric ligatures
appear to be useful in the initial aligning and
leveling phase of orthodontics. However, in a bench
study, elastomeric ligatures were not effective in
holding arch wires in bracket slots when large
rotational moments were applied. 3 For mechanics
requiring complete bracket engagement, elasto-
meric ligatures may not be practical because of rapid
force loss and deformation in the oral cavity. Finally,
the amount of force that ligatures exert to secure
arch wires in orthodontic brackets appears to de-
pend on the size of elastomeric ligatures, duration of
activation, decay rate of the product, desired or-
American Journal of Orthodontics and Dentofacial Orthopedics
Volume 111, No. 1
thodontic movement, arch wire selection, as well as
the size and design of the bracket used. 3'2~,22
CONCLUSIONS
1. Elastomeric ligatures are affected by moisture and
heat, exhibit rapid force loss (53% to 68% in 24
hours), and deform permanently when stretched.
2. In a simulated oral environment, the GAC liga-
tures showed the least mean percentage of dimen-
sional changes and the least mean percentage of
force loss.
3. The Ormco ligatures showed the most consistent
initial and final forces.
4. The thicker the ligature and the smaller the inside
diameter, the greater the force the ligature will
produce.
5. The outside diameter correlates poorly with the
forces generated.
6. The inside diameter may be a useful standard to
assist clinicians in selecting ligatures to use with a
particular sized bracket for a desired orthodontic
correction. Of the seven companies tested, Amer-
ican is the only" company to market ligatures by
their inside diameter.
7. The elastomeric ligatures tested are suitable for
use during initial aligning and leveling, however,
the rapid force loss and permanent deformation of
these products appears to preclude their use when
complete arch wire seating is needed.
REFERENCES
I. Forsberg CM, Brattstrom V, Malmberg, Nord CE. Ligature wires and elastomeric
rings: two methods of ligature, and their association with microbial colonization of
Streptococcus mutans and lactobacilli. Eur J Orthod 1991;13:416-20.
Taloumis et al. 11
2. Thurow RC. Elastic ligatures, binding forces, and anchorage taxation (Letter to the
editor). Am J Orthod 1975;67:694.
3. Bednar JR, Gruendeman GW. The influence of bracket design on moment
production during axial rotation. Am J Orthod Dentofac Orthop 1993;104:254-
61.
4. Echols MP. Elastic ligatures, binding forces and anchorage taxation. Am J Orthod
1975;67:219.
5. Young J, Sandrik JL. The influence of preloading on stress relaxation of orthodon-
tic elastic polymers. Angle Orthod 1979;49:104-8.
6. Andreasen OH, Bishara S. Comparison of alastik chains with elastics involved with
intra-arch molar to molar forces. Angle Ortbod 1970;40:151-8.
7. Ash JL, Nikolai RJ. Relaxation of orthodontic elastomeric chains and modules in
vitro and in vivo. J Dent Res 1978;57:685-90.
8. Bishara S, Andreasen GF. A comparison of time related forces between plastic
alastiks and latex. Angle Orthod 1970;40:319-28.
9. Brantley WA, Salander S, Myers LC, Winders RV. Effects of prestretching on
force degradation characteristics of plastic modules. Angle Orthod 1979;49:37-
43.
10. DeGenova DC, McInnes-Ledoux P, Weinberg R, Shaye R. Force degradation of
orthodontic elastomeric chains--a product comparison study. Am J Orthod
1985;87:377-84.
11. Ferriter JP, Meyers CE, Lorton L. The effect of hydrogen ion concentration on the
force degradation rate of orthodontic polyurethane chain elastics. Am J Orthod
Dentofac Orthop 1990;98:404-10.
12. Hershey GH, Reynolds WG. The plastic module as an orthodontic tooth moving
mechanism. Am J Orthod 1975;67:554-62.
13. Huget EF, Patrick KS, Nunez LJ. Observations on the elastic behavior of a
synthetic orthodontic elastomer. J Dent Res 1990;69:496-501.
14. Killiany DM, Duplesis J. Relaxation of elastomeric chains. J Clin Orthod 1985;19:
592-3.
15. Kovatch JS, Lautenschlager EP, Apfel DA, Keller JC. Load extension time
behavior of orthodontic alastiks. J Dent Res 1976;55:783-6.
16. Lu CT, Wang WN, Tarng TH, Chert JW. Force decay of elastomeric chain--a serial
study, part n. Am J Orthod Dentofac Orthop 1993;104:373-7.
17. Rock WP, Wilson HJ, Fisher SE. A laboratory investigation of orthodontic
elastomeric chains. Br J Orthod 1985;12:202-27.
18. Samuels RHA, Rudge SJ, Mair LH. A comparison of the rate of space closure
using a nickel-titanium spring and an elastic module: a clinical study. Am J Orthod
Dentofac Orthop 1993:103:404-7.
19. Von Fraunhofer JA, Coffelt M-TP, Orbell GM. The effects of artificial saliva and
topical fluoride treatments on the degradation of the elastic properties of orth-
odontic chains. Angle Orthod 1992;62:265-74.
20. Wong AK. Orthodontic elastic materials. Angle Orthod 1976;46:196-204.
21. Adams DM, Powers JM, Asgar K. Effects of bracket ties on stiffness of an arch
wire. Am J Orthod Dentofac Orthop 1987;91:131-6.
22. Rock WP, Wilson HJ. The effect of bracket type and ligation method upon forces
exerted by orthodontic archwires. Br J Orthod 1989;16:213-7.
23. Graber RM, Swain BF. Orthodontics: current principles and techniques. St Louis:
CV Mosby, 1985:574-5.