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Role of Friction in
Orthodontics
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INDIAN DENTAL ACADEMY
Leader in continuing dental education
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Contents
Introduction
Static & dynamic friction
Laws of friction
Sliding mechanics
effect of bracket
archwire
ligation
biological factors
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What is FRICTION ?
A force resisting the relative displacement
of two contacting bodies in a direction
tangent to the plane of contact .
Because of friction ,part of the mechanical
energy intended for movement of the two
bodies relative to each other is dissipated
as thermal energy
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Static friction is the component of
frictional force that has to be overcome to
initiate motion
Dynamic (kinetic) friction is the component
of frictional force that has to be overcome
to maintain motion .
static frictional force is usually higher
than dynamic frictional force
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It is the force that resists the movement
of one surface past another and acts in a
direction opposite the direction of
movement.
Friction may exist between :
- Two solid surfaces
- Solid fluid interface
-Liquid/fluid layers
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Types of friction
1. Rolling or sliding
2. Static or dynamic
When two surfaces in contact slide
or tend to slide against each other,
two components of total force arise
Frictional component
Normal force
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Normal force :-
• Perpendicular to one or both contacting
surfaces and also to the frictional
component.
• Fixed surface on which the block rests
responds only to the weight of the block
with an upward force, perpendicular to the
plane contact area.
• This force is symbolized by N.
Also signifies the force pushing two
surfaces together
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Frictional force :-
• Parallel in the direction to the
intended or actual sliding motion and
opposes the motion.
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2. Static and Dynamic Friction :-
- Resistance that precludes actual
motion is termed static friction.
- That which exists during motion
is called Dynamic friction.
Both static and dynamic forms of
sliding friction are of orthodontic
interest.
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Frictional coefficient(µ ) –the law of friction
theorized by coulomb states that the magnitude
of the frictional force F is equal to the product of
normal force N acting perpendicular to the
contact surface multiplied by frictional
coefficient
The frictional coefficient depends on the surface
roughness of the combination of the materials
involved .it does not depend on the area of
contacting surfaces and varies only slightly with
velocity of movement
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Coefficient of static friction :
Reflects the force necessary to
initiate movement.
Coefficient of Kinetic friction :-
Reflects the force necessary to
perpetuate the motion.
It takes more force to initiate
motion than to perpetuate it.
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. LAWS OF FRICTION :
As early 17th and 18th centuries, Amontons
and coulomb were formally investigating frictional
forces. From their efforts, fundamental laws of
friction evolved :-
a) Frictional force (f) is proportional to the
applied normal force (N) multiplied by the
coefficient of friction (µ) i.e f = µ N.
b) Frictional force (f) is independent of the
apparent area of contact b/n two sliding surfaces.
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This is because all surfaces, no
matter how smooth, have
irregularities that are large on a
molecular scale and real contact
occurs only at a limited number of
small spots at the peaks of surface
irregularities
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ASPERITIES :
spots called Asperities, Carry all the
load b/n two surfaces. Even under light
loads,, local pressure at the asperities may
cause appreciable plastic deformation of
small areas bcoz of this the true contact
area is to a considerable extent deter­
mined by the applied load and is directly
proportional to it
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Surfaces with relatively large asperity wavelengths may
be considered smooth but not flat, whereas, surfaces
with relatively short asperity wavelengths may be
considered flat but not smooth. With preparation
methods such as machining, milling, grinding, or
lapping, peak height and wavelength may vary
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Frictional force is independent of the
sliding velocity (v) i.e the so called
coulomb’s 3rd law.
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Orthodontic tooth movement
during space closure is achieved
through two types of mechanics :-
 
Friction
FrictionFree
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Friction Mechanics (Sliding Mechanic)
Involves either
- Moving the brackets along an
archwire
- Sliding the archwire through
brackets and tubes.
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ROLE OF FRICTION IN SLIDING
MECHANICS :
Most fixed appliance techniques involve
some degree of sliding between bracket
and archwire.
When sliding mechanics are used,
friction occurs at the wire bracket
interface. Some of the applied force is
therefore dissipated as friction and the
remainder is transferred to supporting
structures of the tooth to mediate tooth
movement.
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maximum biological tissue response
occurs only when the applied force is
of sufficient magnitude to adequately
overcome friction and lie within the
optimum range of forces necessary
for movement of the tooth
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in vitro resolution of static and kinetic
frictional resistance into separate and
distinct phases is arbitrary and
potentially misleading because at low
velocity, such as exists in orthodontics,
static and kinetic frictional resistances
are dynamically related.
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The first two laws are usually obeyed in
orthodontics whereas the third usually is
not.
In wire/bracket couples of stainless
steel/stainless steel and NiTi/ stainless
steel, the third law is obeyed; however for
Co-Cr/SS and B-Ti/SS couples, the values
of u slightly increase and markedly
decrease respectively with velocity.
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if a stationary mass (M) is at equilibrium (at
rest with zero velocity V0) on a solid flat
surface (S), the contact between the mass
and the surface is the result of a normal force
(F) acting on the mass
The normal force F may be the net system
force or the weight of mass M. The interfacing
area between mass M and surface S may be
approximated as the nominal area by the
macroscopic surface area of M in contact with
S www.indiandentalacademy.com
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To overcome the static frictional resistance from the
rest position, a minimum pulling or shear force (f),
which is parallel to the contact surface of the nominal
area, is required to move mass M at velocity V. This
static frictional resistance (fs) is equal to the normal
force or load (F) multiplied by a coefficient of static
friction .Once a steady sliding motion of a constant
velocity (Vc) is achieved, then a minimum force to
overcome the kinetic frictional resistance (fk) is
required to maintain velocity Vc of mass M. The
kinetic frictional resistance is equal to the normal
force or load (F) multiplied by a coefficient of kinetic
friction (fk).
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Static friction (occurring instantaneously up to
the onset of sliding) and kinetic friction
(occurring continuously after the onset of
sliding) are two distinct phases that by
definition cannot coexist. The classic
Amontons-Coulomb laws relate static and
kinetic friction as follows:
1. s and k are independent of F and area;
2. s and k are materials dependent; and
3. usually k< s.
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The two distinct frictional
phases (ie, fs and fk are
defined by zero velocity Vo and
constant sliding velocity Vc,
respectively.
the transition from zero velocity
Vo to constant sliding velocity
Vc must involve an
acceleration of mass M. The
acceleration phase is of
particular interest when Vc
approximates Vo (ie, low
velocity friction).
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Refinement of the Amontons-Coulomb
principles is required especially when it
becomes evident that Vc approximates Vo.
Apparent deviation from the Amontons-
Coulomb principles includes
time-dependency of the static coefficient S(t)
(ie, static coefficient as a function of time) and
velocity-dependency of the kinetic coefficient
K(V) (ie, kinetic coefficient as a function of
velocity).
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The Stick-Slip Phenomenon
At low speeds a “Stick - slip
phenomenon” may occur as enough force
builds up to shear the junctions and a jump
occurs, then the surfaces stick again until
enough force again builds to break them.
A single stick-slip cycle involves a stick state
associated with elastic loading of the system,
followed by a sudden slip corresponding to
stress relaxation.
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Static Coefficient as a Function of Time {s (t)}
the static coefficient of friction varies as a
function of increasing time t before the onset
of sliding.
Increases in the coefficient of static friction,
as a function of stick time vary over a wide
time interval range
the longer a mass M is at rest on a flat
surface S (or an archwire at rest on a
bracket) the greater the resistance to pulling
force f parallel to the contact surface of
nominal area.
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Age strengthening of localized point contacts
among the asperities of mass M and surface
S is correlated with experimental observation
of slow plastic deformation occurring at the
stressed asperities, leading to an increasing
effective interface area as a function of time
When plastic deformation occurs at the level
of the softer asperities, the frictional force
becomes a function of shear stress localized
to point contacts among surface asperities of
mass M and surface S As a result, increases
in both area and shear produce a
proportionate increase in f.www.indiandentalacademy.com
. Assuming that the normal force F (ie,
load) remains constant, the coefficient
of static friction increases as a function
of time
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Kinetic Coefficient as a Function of Velocity
The second refinement of the Amontons-
Coulomb principles is that constancy of the
kinetic frictional coefficient is dependent on
maintenance of a steady sliding velocity Vc.
Different materials exhibit unique kinetic
frictional characteristics as a function of
velocity
within very low velocity ranges, most
materials exhibit decreasing coefficients of
kinetic friction as the low-velocity range
increases (ie, velocity weakening).
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subsequent velocity strengthening as
velocity progressively increases beyond
the low-velocity range.
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At low velocity, such as occurs with in vivo
tooth movement, steady sliding instability may
lead to oscillations of motion characterized by
cycles of sticking and slipping.
Stick-slip motion, as observed over a broad
velocity range in frictional sliding, can
potentiate consequences resulting in noise
(chatter), energy loss (friction), surface
damage (wear), and component failure
(breakage).
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Stick-slip processes are caused when the
frictional force does not remain constant as a
function of some other variable such as
distance, time, or velocity
Orthodontic evidence of repetitive stick-slip
oscillations at the archwire-bracket interface
may be inferred from scanning electron
micrographs that reveal permanent
deformation of archwires subjected to
intermittent binding and sliding at bracket
surfaces.
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Loss of Applied Force
Orthodontic tooth movement is dependent on
the ability of the clinician to use controlled
mechanical forces to stimulate biologic
responses within the periodontium.
it has been concluded that the rate of tooth
movement increases proportionally with
increases in applied force up to a point, after
which additional force produces no
appreciable increase in tooth movement.
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With orthodontic mechanotherapy, a biologic
tissue response with resultant tooth
movement will occur only when the applied
forces adequately overcome the friction at the
bracket wire interface.
mechanotherapy to move a tooth via a
bracket relative to a wire results in friction
localized at the bracketwire interface that may
prevent the attainment of an optimal force in
the supporting tissues.
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The portion of the applied force lost because
of the resistance to sliding can range from
12% to 60%.
If frictional forces are high, the efficiency of
the system is affected, and the treatment time
may be extended or the outcome
compromised because of little or no tooth
movement and/or loss of anchorage.
the amount of frictional resistance will impact
on the moment to- force ratios of the teeth
and, consequently, their centers of rotation.
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When the archwire and the bracket have
clearance, classical friction exists as the only
component to the resistance to sliding.
When clearance disappears and an
interference fit occurs between the bracket
and the arch wires, binding arises as a
second component to the resistance to sliding
superimposed on the classical friction.
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Movement of the crown mostly
precedes displacement of the root
because a tipping moment is placed on
the crown of the tooth
This tipping leads to increased friction
from binding between the archwire and
bracket restricting movement of the
entire tooth.
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Friction is influenced by
- the nature of contacting surface ,but is
independent of area of contact,this is due to the
interlocking of surface irregularities
-the extent to which asperites on the harder
material plough into the surface of the softer
material
Total frictional resistance is the sum of
-Force necessary to shear all junctions
-Resistance caused by interlocking roughness
-Ploughing component of total frictional force
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Orthodontic Model of friction - BETWEEN
ARCHWIRE AND BRACKET
Sliding friction is generated between arch
wire and bracket when
-       The wire “guides” the bracket during
M-D movement of an individual tooth.
-       the wire is slipped through posterior
crown attachment in, e.g:- Retrac­tion of
anterior dental segment.
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Possible Components of this force are :-
-       Engagement of arch wire in brackets
that are out alignment.
Ligatures pressing the wire against base of
slot
-      Active torque in rectangular wire
-      Bodily tooth movement in which tipping
tendency is resisted by two point contact
between the bracket and archwire.
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The relative magnitudes of these
components of frictional force vary
according to the clinical situation
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VARIABLES AFFECTING FRICTIONAL
RESISTANCE DURING TOOTH MOVEMENT
A) PHYSICAL :-
1) Archwire a. Material
b. Cross sectional
shape/size.
c. Surface texture.
d. Stiffness.
2) Ligation of archwire to bracket
Ligature wires.
Elastomerics
Method of ligation : Method of tying, bracket
designs to limit force of ligation, self ligating
brackets
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) Bracket:
a.    Material
b.     Manufacturing process : Cast or
sintered stainless steel.
c.    Slot width and depth
d.    Design of bracket : Single or twin
e.    First order bend ( in - out)
f.     Second order bend (angulation)
gThird order bend (torque
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4. Orthodontic appliance
a. Interbracket distance.
b.Level of bracket slots between adjacent
teeth.
c. Forces applied for retraction.
B. BIOLOGICAL
1. Saliva
2.Plaque.
3.Acquired pellicle.
4. Corrosion
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With so many variables affecting frictional
force, it is difficult to accurately
determine them in a clinical situation. the
problem is further complicated by wide
array of brackets, wires and ligatures
available that provide a multitude of
combinations for use during various stages
of orthodontic treatment.
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EXPERIMENTAL METHOD USED TO STUDY
FRICTION :
1. SIMULATED TOOTH MOVEMENT :
Most of studies within orthodontic literature
have carefully simulated different clinical
conditions b/n bracket and archwire to measure
sliding frictional resistance.
2. SURFACE ROGHNESS :
Some studies have quantified surface
roughness of various bracket and archwire
materials.
Most common method of estimating surface
roughness – SPECULAR REFLECTANCE
Involves determination of amount of light that
is reflected back from a surface.
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Smooth surface :- Reflects much of light shone
on it in a narrow pattern.
Rough surface :- Scatters light and reflects it
back in amore dispersed pat­tern.
3. CONTACT FLATS :-
Coefficients of friction have also been
evaluated using orthodontic wire held between two
parallel plates (Contact flats) made of material
similar to that used in orthodontic brackets such
as SS, polycrystalline alumina or Teflon various
levels of normal force were applied to plates and
wire is pulled through them to measure friction
generated.
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4. DESCRIPTIVE STUDIES :-
These have involved discussion of
frictional resistance of brackets and wires
based on clinical experience and anecdotal
information.
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EFFECT OF BRACKET MATERIAL, DESIGN
AND MANUFACTURING PROCESS ON
FRICTION :-
Various Bracket materials today available are
:-
1. Stainless steel Cast
Sintered
2. Ceramic brackets Polycrystalline
alumina
Single Crystalalumina (SCA) (i.e Sapphirc)
3. Zircoma brackets
4. Plastic brackets
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1. Stainless Steel Brackets :-
Most popular bracket material
Stainless steel brackets are
associated with lowest frictional
force values amongst the available
bracket materials
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Kapila et al (1990)
Evaluated friction b/n Edgewise
SS brackets and orthodontic wires of
4 alloys (SS, Co- Cr, NiTi and B-Ti)
Mean frictional forces with
conventional cast stainless steel
brackets ranges between 40-336 g.
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Level of frictional forces observed in :-
0.018inch SS brackets – Ranged from 49g with
0.016 inch SS wires in narrow single brackets to
336g with 0.017 x 0.025 inch B-Ti wires wide twin
brackets.
0.22 inch SS brackets – Friction ranged from
40g 0.018 inch SS wires in narrow brackets to
222g with 0.019 x 0.025 inch NiTi wires in wide
brackets.
Several SS bracket wire combinations
generated low levels of frictional forces less than
100g.
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SINTERED STAINLESS STEEL BRACKETS
Sintering : Process of fusing individual particles
together after compacting them under heat and
pressure.
Sintering allows individual bracket to be
premolded in a smooth stream­lined manner. The
SS particles are compressed in a contoured
smooth rounded shape as apposed to older casting
procedure in which milling or cutting pro­cess left
sharp angular brackets that were bulky and rough.
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Sintered edgewise brackets
RMO Mini Taurus.
RMO Mini Taurus Synergy
Unitek Mini Twin.
Sintered SS brackets produce
significantly lower friction than cast
stainless steel brackets overall friction of
sintered SS brackets is approx 40% - 45%
less than friction of conventional cast
stainless steel brackets
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2) CERAMIC BRACKETS :
With ceramic brackets, most of
wire size and alloy combinations with
both 0.018 and 0.022 inch slot sizes
demonstrate significantly higher fric­
tional forces than with SS brackets.
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Characteristics of Ceramic Bracket
Material or Slot Surface Texture:
Highly magnified views have revealed
numerous generalized small indentations in
the ceramic bracket slot while the SS
bracket appeared relatively smooth.
Hardness of the material
All currently available ceramic brackets
are composed of Aluminium oxide.
Aluminium oxide is extremely hard.
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The rough but hard ceramic material is
likely to penetrate the surface of even a
steel wire during sliding, creating a
considerable resistance and this is worse
with titanium wires
The interaction of metal wire - ceramic
slot interface leads to leveling of ceramic
slot. This results in drop in friction as
ceramic peaks are removed and valleys
become clogged with metal
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Types of Ceramic brackets :
-      Single Crystal alumina (SCA)
-      Polycrystalline alumina (PCA)
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monocrystalline alumina :- Single crystal
ceramic brackets are derived from large
single crystals of Alumina which are milled
into desired shape and dimensions by
ultrasonic cutting, diamond cutting or
combination of two techniques. Because
Alumina is third hardest known material,
this procedure is difficult and may explain
granular and putted surface of ceramic
brackets seen in SEM
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Polycrystalline brackets - have also been
observed under SEM to possess very rough
surfaces which actually scribed grooves into the
archwire
Monocrystalline brackets were observed to be
smoother than PCA brackets but their frictional
properties were comparable.
The most apparent difference b/n polycrystalline
and single. crystal brackets is their optical clarity.
Single crystal brackets are noticeably clearer
than PCA brackets which tend to be translucent
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Clinical significance :-
Combination of metal archwires
and Ceramic brackets produce high
magnitudes of frictional force;
therefore greater force is needed to
move teeth with ceramic brackets
compared to SS brackets in sliding
mechanics.
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Since ceramic brackets on anterior teeth
are often used in combination with SS
brackets and tubes on premolar and molar
teeth, retracting canines along archwire
may result in greater loss of anchorage
because of higher frictional force
associated with Ceramic than SS brackets.
To reduce frictional resistance Ceramic
brackets with smoother slot surfaces and
consisting of metallic slot surface are
avaliable
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) ZIRCONIA BRACKETS :
Besides high friction, Ceramic brackets
have very low fracture resistance Due to
their brittle nature even smallest crack or
flaw can propagate rapidly through the
material.
Zirconia brackets have been offered as
an alternative to ceramic brackets since
surface hardening treatments to increase
fracture toughness are available for
Zirconium oxide.
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Frictional coefficients of Ziconia
brackets were found to be greater
than or equal to those of poly
crystalline alumina brackets in both
dry and wet states (Keith et al ,
1994). Surface changes consisting of
wire debris and surface damage in
Zirconia brackets after sliding of
archwires were also observed.
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) PLASTIC BRACKETS :
In an attempt to create an
esthetic bracket with lower frictional
resistance and easier debonding
features than ceramics a varity of
new, ceramic reinforced plastic
brackets with or without metal slot
inserts have been introduced.
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Trade Name
Company Type
E.g: Silkon American Orthodontics Plastic reinforced with ceramic
Spirit Ormco Plastic with metal insert
Image GAC Plastic reinforced with glass
Clarity Unitek Ceramic with metal insert
Cermaflex TP Metal with plastic base
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Plastic brackets can deform because of compression
from ligation and thus binding of the wire, and higher
frictional resistances were recorded than stainless
steel brackets. Recently introduced composite
brackets with and without metal slots faired better in
friction studies showing lower frictional resistance
than both ceramic and stainless steel brackets in one
of the studies.
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EFFECT OF BRACKET WIDTH ON FRICTION
Effect of bracket width on friction has been
controversial
- Some studies have found that altering bracket
width made no difference in friction (Peterson et
al 1982, Andereasen et al, 1970).
- Frictional resistance has been reported to
increase with increase in bracket width (Tidy
1989, Drescher et al, 1989).
- Whereas others found that frictional
resistance decrease as bracket width increased.
• Franks and Nikolai (1980) :- Related greater
friction with wider brackets to the fact that
binding occurs frequently with wider brackets.
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Omana et al suggested that with a narrow
bracket the tooth could tip considerably
before binding could occour,and once
binding occurs it was of severe nature
Kapila et al (1990 and Ogata et al (1996) :
Suggested that with a wider bracket
the elastomeric ligature used was
stretched more than with a narrower
bracket which exerted a greater normal
force on the wire
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Bracket Width and Interbracket Distance (IBD)
Bracket width is closely related to IBD
Narrower the bracket
↓
Greater the length of interbracket wire
↓
Greater the flexibility of wire
↓
Decrease in stiffness of wire
↓
Greater chance of binding with more flexible wire.
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Bracket slot size may not influence the
frictional resistance,
some studies suggested that frictional
resistance decreased as slot size
increased from 0.018 inch to 0.022 inch
because of reduced binding probably
from increased wire stiffness. And also
because of the increased play in the
slot with final archwirewww.indiandentalacademy.com
ADDITIONAL DESIGN FEATURES IN
BRACKETS TO REDUCE FRICTION
Bumps on the bracket
slot walls and floor
which decreased
surface contact with
the wires, help
decreased friction in
bracket wire interface.
(Ogata etal)
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Begg brackets—haveachieved low friction by
virtue of an extremely loose fit betweena round
archwire and a very narrow bracket, but this is at
thecost of making full control of tooth position
correspondinglymore difficult. Some brackets
with an edgewise slot have incorporatedshoulders
to distance the elastomeric from the archwire
and,thus, reduce friction, but this type of design
also producesreduced friction at the expense of
reduced control.
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EFFECT OF SECOND ORDER DEFLECTION OF
FRICTION
Second order defection of wire b/n
brackets held in series can have significant
effects on brackets wire friction.
- Several studies have found that
increasing the angulation between bracket
and wire produced greater friction.
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Frank and Nikolai (1980) :- Found that
frictional resistance increased in a
nonlinear manner with bracket angulation.
With brackets out of alignment
archwire stiffness, strongly influences
forces normal to the points of contact and
hence friction.
In a well aligned arch forces that result
from archwire deflection are not important
and friction is largely independent of
archwire stiffness
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Ogata et al (1986)Evaluated the effects
of different bracket wire combinations and
2nd order deflections on kinetic friction.
The brackets were offset deflecting wire
in increments of 0.25 mm
As 2nd order deflection increased
frictional resistance increased for every
bracket wire combination - With lower
deflections a smooth sliding phase
appeared in which friction increased in
approximate a linear manner.
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As deflection increased further a binding phase
occured in which friction increased at a much
greater rate and was not necessarily linear.
Binding generally occured between 0.75 and 1.00
mm of 2nd order deflection.
The relationship between frictional resistance
and second order angulation may not be linear and
may become more important as the angulation
increases. The active configuration for binding
occurred between 3 to 7°.
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When tipping occurs the frictional
resistance of nickel-titanium has been
reported to be less than stainless steel,
Because of the lower modulus of
elasticity of nickel-titanium compared
with stainless steel, lower normal force
that was induced by binding occurred
resulting in less resistance to sliding.
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Active third order torque with rectangular
wires would increase the friction even more.
Similarly, greater friction with larger
rectangular wires results from the possible
introduction of torque because an 0.021x
0.025” wire has 3.9° of play compared with an
0.018 x0.025” wire that has 14.8° of play
when engaged into an 0.022” bracket slot
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Effect of ARCHWIRE
) WIRE ALLOY:-
The role of wire alloy in frictional
characteristics of sliding mechanics has
been extensively studied.
most studies have found SS wires to be
associated with the least amount of
friction and Beta titanium with the most.
from lowest to highest friction SS, Co - Cr,
NiTi and B-Ti.
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Frank and Nikolai (1980) :- Found
that SS wires had less friction than
nickel titanium at non binding
angulations, but as the angulation
increased and binding was present
reverse was true.
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SURFACE TEXTURE :-
Specular reflectance studies have
shown that SS wires have the smoothest
surface followed by Co-Cr, B-Ti and NiTi
wires in order of increasing surface
roughness
Since B-Titanium had the most friction but
was not the roughest Kusy and Whitly
concluded that one cannot use surface
roughness as an indicator of frictional
characteristics in sliding mechanics.
www.indiandentalacademy.com
NiTi has greater surface roughness Beta Ti has
greater frictional resistance.
as the titanium content of an alloy increased its
surface reactivity increases and surface
chemistry is a major influence on frictional
behaviour.
β-Ti at 80% Titanium has higher coefficient of
friction than NiTi at 50% titanium
there is enough titanium reactivity for wire to
“COLD WELD” itself to steel bracket and
therefore β-Ti wire exhibits more of stick slip
phenomenon.
www.indiandentalacademy.com
ION IMPLANTATION :-
- Alteration of the surface of titanium wires by
implantation of ions into the surface.
- Gas ions (Nitrogen and Oxygen) are implanted
in to the wire surface resulting in a surface that is
extremely hard.
- Ion implantation produces no interface b/n
the coating and the wire neither does it alter the
dimensions of the wire.
Burstone and Farzin Demonstrated that ion
implanted β-Ti wires produced about the same
level friction as SS wires.
www.indiandentalacademy.com
Braided arch wires
Berger (1990) Studied friction produced by
0.0175 inch braided archwire in a 0.022 slot and
found very high friction levels.
-      1.5 times compared to 0.018 inch round SS
wire with elastomeric ligation. 5 times with
stainless steel ligation
This can be attributed to interwoven pattern and
irregular surface of Braided arch wire.
Mechanical interlocking of the archwires with the
edges of the bracket slot increase friction as the
wire moves relative to the bracket.
,efforts to reduce friction with teflon coating are
being made
www.indiandentalacademy.com
WIRE SIZE
- Several studies have found that an increase in
wire size is to be associated with increased
bracket wire friction .
The main reason for the increase in friction as
the wire size increased can be attributed to an
increase in the stiffness of the wire.Wires of
greater stiffness will create a greater normal
force with binding of the archwire with the edges
of the bracket. .
.
www.indiandentalacademy.com
Rectangular wires produce more friction than
round wires. At nonbinding angulations the contact
area between bracket and archwire is important
factor in friction and would therefore expect
more friction with rectangular wire.(nanda)
placement of a rectangular wire can dramatically
increase the friction because of the concomitant
increase in wire stiffness.(tidy)
At greater angulation of the bracket, the
determining factor is the point at which the wire
contacts the edge of the bracket
www.indiandentalacademy.com
With round wires bracket slot can “bite” into the
wire at one point ,causing an indentation in the
wire
With rectangular wire the force is distributed over
a large area i.e the entire faciolingual dimension
of the wire, resulting in less pressure and therefore
less resistance to movement
Frank and Nikolai (1980) Found that an 0.020
inch wire was associated with more friction than
0.017 x 0.025 inch wire
www.indiandentalacademy.com
) ROLE OF WIRE STIFFNESS AND
CLEARENCE
Mechanically speaking orthodontic archwires
are elastic beams supported at either one or both
ends.
WIRE STIFFNESS DEPENDS UPON :-
- Diameter or cross section of the wire
- Length of beam.
e.g Doubling length of cantilever beam decreases
stiffness by 8 times.
- By altering interbracket distance stiffness of
wire can be altered.During canine retraction in a
premolar extraction case the increased inter­
bracket span of the unsupported wire over the
extraction site decreases the stiffness of wire.
www.indiandentalacademy.com
Retraction force therefore has a greater chance
of deflecting the wire resulting in buckling.
-      To prevent such deflections of the wire that
may increases friction and chances of bracket
binding, diameter of wire should be increased to
compensate for decrease in stiffness when
interbracket span is greater than normal.
-       Another reason for not using flexible small
size archwires during sliding canine retraction is
that flexible small size archwires can deflect as
canine crown tips distally which can lead to incisor
extrusion.
www.indiandentalacademy.com
CROSS SECTIONAL DIMENSION IN DIRECTION OF
BENDING
0.017 x 0.022 inch wire placed edgewise is more springy in
vertical dimension than when placed in ribbon mode
Drescher et al (1989)Stated that vertical dimension of the
wire was an important factor in frictional resistance
. Nature of end supports of a beam
Rigidly supported beam at both ends has stiffness 4 times
as compared to cantilever beam.Therefore During sliding
space closure the wire therefore should be tied into the
supporting brackets tightly to increase stiffness.
eg During canine retraction premolar and lateral incisor
brackets should be tied tightly to the archwire
www.indiandentalacademy.com
Clearance of arch Wire:-
Adequate clearence should be provided
between bracket and wire to prevent binding.
Clearance or play in 2nd order i.e tipping depends
upon Slot size, Bracket width ,
Archwire size
3rd order play in rectangular arch wires.
In 0.018 slot→ 16.7° for 0.016 x 0.016 wire 4.5°
for 0.017 x 0.025 wire.
0.022 27.4° for 0.016 x 0.022 inchwire.
2° for 0.0215 x 0.028 wire.
www.indiandentalacademy.com
EFFECT OF LIGATION TECHNIQUE ON
FRICTION:-
The normal force exerted by ligature has a
significant influence in determining the frictional
resistance developed within an orthodontic
appliance.
Ligation technique signifies the force that
pulls the wire into the bracket.
Elastomeric modules:
-      Affected by the oral environment.
-      Demonstrate stress relaxation with time
Stainless steel ligatures:
Can be tied either too tight or too lose.
www.indiandentalacademy.com
Properties of an ideal ligation system
 be secure and robust;
ensure fullbracket engagement of the archwire;
exhibit low friction betweenbracket and
archwire;
be quick and easy to use;
permit highfriction when desired;
permit easy attachment of elastic chain;
assist good oral hygiene;
be comfortable for the patient
www.indiandentalacademy.com
Edwards et al (1995) : Compared the effect of 4
ligation techniques.
-      E modules tied conventionally and in figure 8
pattern.
-      Stainless steel ligatures.
-      Teflon coated ligatures.
static frictional resistance greatest in figure of 8
emodules-      No significant differences between
frictional resistance offered by conventionally
tied E-modules and steel ligature.teflon coated
ligatures produce lowest friction
www.indiandentalacademy.com
Shivapuja et al (1994) : E-modules
produced greater frictional resistance as
compared to steel ligature ties. This
combined with rapid rate of decay for
these E-modules and their predliction for
harboring large quality of plaque suggests
little merit in their use especially in sliding
mechanics
www.indiandentalacademy.com
NEW SLICK ELASTOMERIC MODULE SYSTEM:
A new slick elastomeric module system
incorporating metafasix technology (TP
orthodontics) has recently been introduced claims
to combine ease of use with low friction.
The new slick E - modules reduced friction by
upto 60% compared with their regular
counterparts when tied normally
www.indiandentalacademy.com
BRACKET DESIGNS LIMITING FORCE OF
LIGATION:
Three brackets were introduced to restrict
the amount of force placed on wire by the
ligature.
-      American friction free bracket (Am. Orthod)
-      GAC shoulder bracket (GAC central I slip NI)
-      RMO synergy bracket (RMO)
These brackets generated lower mean
frictional forces at 2nd order deflections of 0.00
& 0.25 mm than conventionally ligated brackets
www.indiandentalacademy.com
eg.Synergy bracket:
Includes 6 wings 3 on each side of
bracket slot. The lateral wings may be
included in ligation for correction of
rotation of teeth but only center wings may
be ligated during sliding mechanics to
reduce force of ligation.
www.indiandentalacademy.com
SELF LIGATING BRACKETS:
Orthodontic brackets are now
available that possess the feature of
self ligation.First Edgewise self
ligating bracket Russelhock (1946).
www.indiandentalacademy.com
SELF LIGATING BRACKET SYSTEMS:
LIGATIONS SYSTEM
* Edgelok bracket (Ormco) – 1972
Sliding cap
* Speed bracket (Strite industries) - 1980
Spring clip
* Activa bracket (A company) - 1986
Lever arm.
Damon – 1994 vertical slide
www.indiandentalacademy.com
www.indiandentalacademy.com
BERGER (1990) Compared between speed bracket
and stainless steel bracket revealed that friction
with self ligating bracket was between 12% and
23% that of stainless steel bracket irrespective
of wire shape and ligation technique.
The unique anatomic characteristic associated
with speed bracket - highly resilient and flexible
spring clip was determined to be causative factor
in critically lowering level of applied force.
www.indiandentalacademy.com
Shivapuja et al (1994)
Self ligating brackets displayed significantly
lower level of friction both static and dynamic as
compared to conventional ligating system.
Significantly less chair side time was required
for archwire removal and insertion with self
ligating system as compared to conventional
ligating systems.
Kapur found dramatically lower frictionwith both
stainless steel and nickel-titanium wires for
Damonbrackets compared to conventional
brackets
www.indiandentalacademy.com
Advantages of self
ligating system
more certain fullarchwire
engagement;
low friction between bracket and
archwire;
less chairside assistance;
faster archwire removal and
ligation
www.indiandentalacademy.com
Gac in ovation bracket
similar in design to speed
bracket with sliding spring
clip,
Damon sl 2 with vertical
slide
www.indiandentalacademy.com
the clip places a diagonally directed lingual force on the wire, which
does not contribute to any third order interaction between the wire
corners and the walls of the bracket slot, which is the origin of
torquing force
This increases the ‘slop’ between the rectangular wire and the slot, and
also reduces the moment arm of the torquing mechanism
www.indiandentalacademy.com
Activa bracket with clip Clip retaining groove is visible on the
gingival surface.
www.indiandentalacademy.com
With low friction, the net tooth-moving
forces are morepredictablylow and the
reciprocal forces correspondingly smaller
Lower net forces deflect archwires less
and, therefore, facilitaterelease of binding
forces between wire and bracket,
enhancingsliding of brackets along a wire.
www.indiandentalacademy.com
BIOLOGICAL FACTORS:
I. Effect of saliva on kinetic friction:
It has been suggested that saliva substitute serves as
an excellent lubricant in sliding of the bracket along the
wire.
BAKER ET AL (1987):
Using an artificial saliva substitute found a 15% - 19%
reduction in friction.
KUSY ET AL (1991):
Found that saliva could have lubricious as well as
Adhesive behaviour depending on which archwire bracket
combination was under consideration
www.indiandentalacademy.com
SSWIRES: Showed an adhesive behaviour with
saliva and a resultant increased in coefficient of
friction in wet state.
β-TI wires: In wet state kinetic coefficients of
friction were 50% of the values in dry state.when
sliding through SS brackets ,the titanium rich
oxide layer in β-Ti archwire breaks
down,reacts,adheres and breaks away ,resulting in
a stick-slip phenomenon
Hypothesis: Saliva probably acts by preventing
solid to solid contact.
www.indiandentalacademy.com
CLINICAL SIGNIFICANCE:
In an adult patient: H/O of Xerostomia or
decreased salivary, Oral radiation therapy,
Anticholinergic medication.
Should be noted as possible factors in varying
force levels necessary to move teeth.
www.indiandentalacademy.com
Surface Characteristics Affecting Friction
Most metals are subject to oxidation and an
associated oxide layer growth. Friction between
specific sliding metallic surfaces significantly
decreases with proportionate increases in oxide layer
thickness, although sliding characteristics in the
presence of an oxide layer vary from material to
material.
.bioflims may reduce the coefficient of friction by
producing a boundary lubrication effect through
salivary protein adsorption and plaque accumulation
www.indiandentalacademy.com
CLINICAL SIGNIFICANCE OF FRICTION
Based on information gathered from studies of
friction several points of clinical significance can
be identified.
An appreciation of magnitude of friction is crucial
for the orthodontist who employs sliding
mechanics during treatment -      With best of wire
bracket combinations atleast 40g of friction must
be included in force applied to initiate tooth
movement.
www.indiandentalacademy.com
New bracket designs and manufacturing
techniques have been introduced to decreased
the amount of friction generated between wire
and bracket slot.
-      Sintered SS brackets.
-      Bracket designs limiting force of ligation
Self ligating brackets
Clinicians using esthetic tooth colored brackets
- important to know the level of friction
generated by these brackets before initiating
tooth movement
www.indiandentalacademy.com
Selection of wire shapes and sizes:
e.g.: 0.018 inch SS steel best choice for canine
retraction in 0.022 slot.
- If overall torque control is required:
0.016x 0.022 inch - 0.018 slot.
0.019x0.025 inch - 0.022 slot.
Archwire can also be thinned down in region distal to
canine so as to further facilitate movement.
Care must be taken not to over reduce the wire
dimensions which could decreased strength of
wire
www.indiandentalacademy.com
Complete leveling of arch - important factor in
reducing friction during tooth movement.
e.g.: Space closure using 0.019 x 0.025 wire in
0.022 slot.
Before starting space closure rectangular wires need
to be place for atleast 1 month.
-       To ensure proper leveling and freedom from
posterior torque pressure.
Sliding mechanics can proceed smoothly
www.indiandentalacademy.com
To optimize use of sliding mechanic sufficient time
must be allowed for distal root movement to
occur.
-      A common mistake is to change the E-chain too
often thus maintaining high force levels and a
M/F ratio that produces distal tipping only.
www.indiandentalacademy.com
                      Thank you
For more details please visit 
www.indiandentalacademy.com
www.indiandentalacademy.com

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Role of friction in orthodontics /certified fixed orthodontic courses by Indian dental academy

  • 1. Role of Friction in Orthodontics www.indiandentalacademy.com INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com
  • 2. Contents Introduction Static & dynamic friction Laws of friction Sliding mechanics effect of bracket archwire ligation biological factors www.indiandentalacademy.com
  • 3. What is FRICTION ? A force resisting the relative displacement of two contacting bodies in a direction tangent to the plane of contact . Because of friction ,part of the mechanical energy intended for movement of the two bodies relative to each other is dissipated as thermal energy www.indiandentalacademy.com
  • 4. Static friction is the component of frictional force that has to be overcome to initiate motion Dynamic (kinetic) friction is the component of frictional force that has to be overcome to maintain motion . static frictional force is usually higher than dynamic frictional force www.indiandentalacademy.com
  • 5. It is the force that resists the movement of one surface past another and acts in a direction opposite the direction of movement. Friction may exist between : - Two solid surfaces - Solid fluid interface -Liquid/fluid layers www.indiandentalacademy.com
  • 6. Types of friction 1. Rolling or sliding 2. Static or dynamic When two surfaces in contact slide or tend to slide against each other, two components of total force arise Frictional component Normal force www.indiandentalacademy.com
  • 7. Normal force :- • Perpendicular to one or both contacting surfaces and also to the frictional component. • Fixed surface on which the block rests responds only to the weight of the block with an upward force, perpendicular to the plane contact area. • This force is symbolized by N. Also signifies the force pushing two surfaces together www.indiandentalacademy.com
  • 8. Frictional force :- • Parallel in the direction to the intended or actual sliding motion and opposes the motion. www.indiandentalacademy.com
  • 9. 2. Static and Dynamic Friction :- - Resistance that precludes actual motion is termed static friction. - That which exists during motion is called Dynamic friction. Both static and dynamic forms of sliding friction are of orthodontic interest. www.indiandentalacademy.com
  • 10. Frictional coefficient(µ ) –the law of friction theorized by coulomb states that the magnitude of the frictional force F is equal to the product of normal force N acting perpendicular to the contact surface multiplied by frictional coefficient The frictional coefficient depends on the surface roughness of the combination of the materials involved .it does not depend on the area of contacting surfaces and varies only slightly with velocity of movement www.indiandentalacademy.com
  • 11. Coefficient of static friction : Reflects the force necessary to initiate movement. Coefficient of Kinetic friction :- Reflects the force necessary to perpetuate the motion. It takes more force to initiate motion than to perpetuate it. www.indiandentalacademy.com
  • 12. . LAWS OF FRICTION : As early 17th and 18th centuries, Amontons and coulomb were formally investigating frictional forces. From their efforts, fundamental laws of friction evolved :- a) Frictional force (f) is proportional to the applied normal force (N) multiplied by the coefficient of friction (µ) i.e f = µ N. b) Frictional force (f) is independent of the apparent area of contact b/n two sliding surfaces. www.indiandentalacademy.com
  • 13. This is because all surfaces, no matter how smooth, have irregularities that are large on a molecular scale and real contact occurs only at a limited number of small spots at the peaks of surface irregularities www.indiandentalacademy.com
  • 14. ASPERITIES : spots called Asperities, Carry all the load b/n two surfaces. Even under light loads,, local pressure at the asperities may cause appreciable plastic deformation of small areas bcoz of this the true contact area is to a considerable extent deter­ mined by the applied load and is directly proportional to it www.indiandentalacademy.com
  • 15. Surfaces with relatively large asperity wavelengths may be considered smooth but not flat, whereas, surfaces with relatively short asperity wavelengths may be considered flat but not smooth. With preparation methods such as machining, milling, grinding, or lapping, peak height and wavelength may vary www.indiandentalacademy.com
  • 16. Frictional force is independent of the sliding velocity (v) i.e the so called coulomb’s 3rd law. www.indiandentalacademy.com
  • 17. Orthodontic tooth movement during space closure is achieved through two types of mechanics :-   Friction FrictionFree www.indiandentalacademy.com
  • 18. Friction Mechanics (Sliding Mechanic) Involves either - Moving the brackets along an archwire - Sliding the archwire through brackets and tubes. www.indiandentalacademy.com
  • 19. ROLE OF FRICTION IN SLIDING MECHANICS : Most fixed appliance techniques involve some degree of sliding between bracket and archwire. When sliding mechanics are used, friction occurs at the wire bracket interface. Some of the applied force is therefore dissipated as friction and the remainder is transferred to supporting structures of the tooth to mediate tooth movement. www.indiandentalacademy.com
  • 20. maximum biological tissue response occurs only when the applied force is of sufficient magnitude to adequately overcome friction and lie within the optimum range of forces necessary for movement of the tooth www.indiandentalacademy.com
  • 21. in vitro resolution of static and kinetic frictional resistance into separate and distinct phases is arbitrary and potentially misleading because at low velocity, such as exists in orthodontics, static and kinetic frictional resistances are dynamically related. www.indiandentalacademy.com
  • 22. The first two laws are usually obeyed in orthodontics whereas the third usually is not. In wire/bracket couples of stainless steel/stainless steel and NiTi/ stainless steel, the third law is obeyed; however for Co-Cr/SS and B-Ti/SS couples, the values of u slightly increase and markedly decrease respectively with velocity. www.indiandentalacademy.com
  • 23. if a stationary mass (M) is at equilibrium (at rest with zero velocity V0) on a solid flat surface (S), the contact between the mass and the surface is the result of a normal force (F) acting on the mass The normal force F may be the net system force or the weight of mass M. The interfacing area between mass M and surface S may be approximated as the nominal area by the macroscopic surface area of M in contact with S www.indiandentalacademy.com
  • 25. To overcome the static frictional resistance from the rest position, a minimum pulling or shear force (f), which is parallel to the contact surface of the nominal area, is required to move mass M at velocity V. This static frictional resistance (fs) is equal to the normal force or load (F) multiplied by a coefficient of static friction .Once a steady sliding motion of a constant velocity (Vc) is achieved, then a minimum force to overcome the kinetic frictional resistance (fk) is required to maintain velocity Vc of mass M. The kinetic frictional resistance is equal to the normal force or load (F) multiplied by a coefficient of kinetic friction (fk). www.indiandentalacademy.com
  • 26. Static friction (occurring instantaneously up to the onset of sliding) and kinetic friction (occurring continuously after the onset of sliding) are two distinct phases that by definition cannot coexist. The classic Amontons-Coulomb laws relate static and kinetic friction as follows: 1. s and k are independent of F and area; 2. s and k are materials dependent; and 3. usually k< s. www.indiandentalacademy.com
  • 27. The two distinct frictional phases (ie, fs and fk are defined by zero velocity Vo and constant sliding velocity Vc, respectively. the transition from zero velocity Vo to constant sliding velocity Vc must involve an acceleration of mass M. The acceleration phase is of particular interest when Vc approximates Vo (ie, low velocity friction). www.indiandentalacademy.com
  • 28. Refinement of the Amontons-Coulomb principles is required especially when it becomes evident that Vc approximates Vo. Apparent deviation from the Amontons- Coulomb principles includes time-dependency of the static coefficient S(t) (ie, static coefficient as a function of time) and velocity-dependency of the kinetic coefficient K(V) (ie, kinetic coefficient as a function of velocity). www.indiandentalacademy.com
  • 29. The Stick-Slip Phenomenon At low speeds a “Stick - slip phenomenon” may occur as enough force builds up to shear the junctions and a jump occurs, then the surfaces stick again until enough force again builds to break them. A single stick-slip cycle involves a stick state associated with elastic loading of the system, followed by a sudden slip corresponding to stress relaxation. www.indiandentalacademy.com
  • 30. Static Coefficient as a Function of Time {s (t)} the static coefficient of friction varies as a function of increasing time t before the onset of sliding. Increases in the coefficient of static friction, as a function of stick time vary over a wide time interval range the longer a mass M is at rest on a flat surface S (or an archwire at rest on a bracket) the greater the resistance to pulling force f parallel to the contact surface of nominal area. www.indiandentalacademy.com
  • 31. Age strengthening of localized point contacts among the asperities of mass M and surface S is correlated with experimental observation of slow plastic deformation occurring at the stressed asperities, leading to an increasing effective interface area as a function of time When plastic deformation occurs at the level of the softer asperities, the frictional force becomes a function of shear stress localized to point contacts among surface asperities of mass M and surface S As a result, increases in both area and shear produce a proportionate increase in f.www.indiandentalacademy.com
  • 32. . Assuming that the normal force F (ie, load) remains constant, the coefficient of static friction increases as a function of time www.indiandentalacademy.com
  • 33. Kinetic Coefficient as a Function of Velocity The second refinement of the Amontons- Coulomb principles is that constancy of the kinetic frictional coefficient is dependent on maintenance of a steady sliding velocity Vc. Different materials exhibit unique kinetic frictional characteristics as a function of velocity within very low velocity ranges, most materials exhibit decreasing coefficients of kinetic friction as the low-velocity range increases (ie, velocity weakening). www.indiandentalacademy.com
  • 34. subsequent velocity strengthening as velocity progressively increases beyond the low-velocity range. www.indiandentalacademy.com
  • 35. At low velocity, such as occurs with in vivo tooth movement, steady sliding instability may lead to oscillations of motion characterized by cycles of sticking and slipping. Stick-slip motion, as observed over a broad velocity range in frictional sliding, can potentiate consequences resulting in noise (chatter), energy loss (friction), surface damage (wear), and component failure (breakage). www.indiandentalacademy.com
  • 36. Stick-slip processes are caused when the frictional force does not remain constant as a function of some other variable such as distance, time, or velocity Orthodontic evidence of repetitive stick-slip oscillations at the archwire-bracket interface may be inferred from scanning electron micrographs that reveal permanent deformation of archwires subjected to intermittent binding and sliding at bracket surfaces. www.indiandentalacademy.com
  • 37. Loss of Applied Force Orthodontic tooth movement is dependent on the ability of the clinician to use controlled mechanical forces to stimulate biologic responses within the periodontium. it has been concluded that the rate of tooth movement increases proportionally with increases in applied force up to a point, after which additional force produces no appreciable increase in tooth movement. www.indiandentalacademy.com
  • 38. With orthodontic mechanotherapy, a biologic tissue response with resultant tooth movement will occur only when the applied forces adequately overcome the friction at the bracket wire interface. mechanotherapy to move a tooth via a bracket relative to a wire results in friction localized at the bracketwire interface that may prevent the attainment of an optimal force in the supporting tissues. www.indiandentalacademy.com
  • 39. The portion of the applied force lost because of the resistance to sliding can range from 12% to 60%. If frictional forces are high, the efficiency of the system is affected, and the treatment time may be extended or the outcome compromised because of little or no tooth movement and/or loss of anchorage. the amount of frictional resistance will impact on the moment to- force ratios of the teeth and, consequently, their centers of rotation. www.indiandentalacademy.com
  • 40. When the archwire and the bracket have clearance, classical friction exists as the only component to the resistance to sliding. When clearance disappears and an interference fit occurs between the bracket and the arch wires, binding arises as a second component to the resistance to sliding superimposed on the classical friction. www.indiandentalacademy.com
  • 41. Movement of the crown mostly precedes displacement of the root because a tipping moment is placed on the crown of the tooth This tipping leads to increased friction from binding between the archwire and bracket restricting movement of the entire tooth. www.indiandentalacademy.com
  • 42. Friction is influenced by - the nature of contacting surface ,but is independent of area of contact,this is due to the interlocking of surface irregularities -the extent to which asperites on the harder material plough into the surface of the softer material Total frictional resistance is the sum of -Force necessary to shear all junctions -Resistance caused by interlocking roughness -Ploughing component of total frictional force www.indiandentalacademy.com
  • 43. Orthodontic Model of friction - BETWEEN ARCHWIRE AND BRACKET Sliding friction is generated between arch wire and bracket when -       The wire “guides” the bracket during M-D movement of an individual tooth. -       the wire is slipped through posterior crown attachment in, e.g:- Retrac­tion of anterior dental segment. www.indiandentalacademy.com
  • 44. Possible Components of this force are :- -       Engagement of arch wire in brackets that are out alignment. Ligatures pressing the wire against base of slot -      Active torque in rectangular wire -      Bodily tooth movement in which tipping tendency is resisted by two point contact between the bracket and archwire. www.indiandentalacademy.com
  • 45. The relative magnitudes of these components of frictional force vary according to the clinical situation www.indiandentalacademy.com
  • 46. VARIABLES AFFECTING FRICTIONAL RESISTANCE DURING TOOTH MOVEMENT A) PHYSICAL :- 1) Archwire a. Material b. Cross sectional shape/size. c. Surface texture. d. Stiffness. 2) Ligation of archwire to bracket Ligature wires. Elastomerics Method of ligation : Method of tying, bracket designs to limit force of ligation, self ligating brackets www.indiandentalacademy.com
  • 47. ) Bracket: a.    Material b.     Manufacturing process : Cast or sintered stainless steel. c.    Slot width and depth d.    Design of bracket : Single or twin e.    First order bend ( in - out) f.     Second order bend (angulation) gThird order bend (torque www.indiandentalacademy.com
  • 48. 4. Orthodontic appliance a. Interbracket distance. b.Level of bracket slots between adjacent teeth. c. Forces applied for retraction. B. BIOLOGICAL 1. Saliva 2.Plaque. 3.Acquired pellicle. 4. Corrosion www.indiandentalacademy.com
  • 49. With so many variables affecting frictional force, it is difficult to accurately determine them in a clinical situation. the problem is further complicated by wide array of brackets, wires and ligatures available that provide a multitude of combinations for use during various stages of orthodontic treatment. www.indiandentalacademy.com
  • 50. EXPERIMENTAL METHOD USED TO STUDY FRICTION : 1. SIMULATED TOOTH MOVEMENT : Most of studies within orthodontic literature have carefully simulated different clinical conditions b/n bracket and archwire to measure sliding frictional resistance. 2. SURFACE ROGHNESS : Some studies have quantified surface roughness of various bracket and archwire materials. Most common method of estimating surface roughness – SPECULAR REFLECTANCE Involves determination of amount of light that is reflected back from a surface. www.indiandentalacademy.com
  • 51. Smooth surface :- Reflects much of light shone on it in a narrow pattern. Rough surface :- Scatters light and reflects it back in amore dispersed pat­tern. 3. CONTACT FLATS :- Coefficients of friction have also been evaluated using orthodontic wire held between two parallel plates (Contact flats) made of material similar to that used in orthodontic brackets such as SS, polycrystalline alumina or Teflon various levels of normal force were applied to plates and wire is pulled through them to measure friction generated. www.indiandentalacademy.com
  • 52. 4. DESCRIPTIVE STUDIES :- These have involved discussion of frictional resistance of brackets and wires based on clinical experience and anecdotal information. www.indiandentalacademy.com
  • 53. EFFECT OF BRACKET MATERIAL, DESIGN AND MANUFACTURING PROCESS ON FRICTION :- Various Bracket materials today available are :- 1. Stainless steel Cast Sintered 2. Ceramic brackets Polycrystalline alumina Single Crystalalumina (SCA) (i.e Sapphirc) 3. Zircoma brackets 4. Plastic brackets www.indiandentalacademy.com
  • 54. 1. Stainless Steel Brackets :- Most popular bracket material Stainless steel brackets are associated with lowest frictional force values amongst the available bracket materials www.indiandentalacademy.com
  • 55. Kapila et al (1990) Evaluated friction b/n Edgewise SS brackets and orthodontic wires of 4 alloys (SS, Co- Cr, NiTi and B-Ti) Mean frictional forces with conventional cast stainless steel brackets ranges between 40-336 g. www.indiandentalacademy.com
  • 56. Level of frictional forces observed in :- 0.018inch SS brackets – Ranged from 49g with 0.016 inch SS wires in narrow single brackets to 336g with 0.017 x 0.025 inch B-Ti wires wide twin brackets. 0.22 inch SS brackets – Friction ranged from 40g 0.018 inch SS wires in narrow brackets to 222g with 0.019 x 0.025 inch NiTi wires in wide brackets. Several SS bracket wire combinations generated low levels of frictional forces less than 100g. www.indiandentalacademy.com
  • 57. SINTERED STAINLESS STEEL BRACKETS Sintering : Process of fusing individual particles together after compacting them under heat and pressure. Sintering allows individual bracket to be premolded in a smooth stream­lined manner. The SS particles are compressed in a contoured smooth rounded shape as apposed to older casting procedure in which milling or cutting pro­cess left sharp angular brackets that were bulky and rough. www.indiandentalacademy.com
  • 58. Sintered edgewise brackets RMO Mini Taurus. RMO Mini Taurus Synergy Unitek Mini Twin. Sintered SS brackets produce significantly lower friction than cast stainless steel brackets overall friction of sintered SS brackets is approx 40% - 45% less than friction of conventional cast stainless steel brackets www.indiandentalacademy.com
  • 59. 2) CERAMIC BRACKETS : With ceramic brackets, most of wire size and alloy combinations with both 0.018 and 0.022 inch slot sizes demonstrate significantly higher fric­ tional forces than with SS brackets. www.indiandentalacademy.com
  • 60. Characteristics of Ceramic Bracket Material or Slot Surface Texture: Highly magnified views have revealed numerous generalized small indentations in the ceramic bracket slot while the SS bracket appeared relatively smooth. Hardness of the material All currently available ceramic brackets are composed of Aluminium oxide. Aluminium oxide is extremely hard. www.indiandentalacademy.com
  • 61. The rough but hard ceramic material is likely to penetrate the surface of even a steel wire during sliding, creating a considerable resistance and this is worse with titanium wires The interaction of metal wire - ceramic slot interface leads to leveling of ceramic slot. This results in drop in friction as ceramic peaks are removed and valleys become clogged with metal www.indiandentalacademy.com
  • 62. Types of Ceramic brackets : -      Single Crystal alumina (SCA) -      Polycrystalline alumina (PCA) www.indiandentalacademy.com
  • 63. monocrystalline alumina :- Single crystal ceramic brackets are derived from large single crystals of Alumina which are milled into desired shape and dimensions by ultrasonic cutting, diamond cutting or combination of two techniques. Because Alumina is third hardest known material, this procedure is difficult and may explain granular and putted surface of ceramic brackets seen in SEM www.indiandentalacademy.com
  • 64. Polycrystalline brackets - have also been observed under SEM to possess very rough surfaces which actually scribed grooves into the archwire Monocrystalline brackets were observed to be smoother than PCA brackets but their frictional properties were comparable. The most apparent difference b/n polycrystalline and single. crystal brackets is their optical clarity. Single crystal brackets are noticeably clearer than PCA brackets which tend to be translucent www.indiandentalacademy.com
  • 65. Clinical significance :- Combination of metal archwires and Ceramic brackets produce high magnitudes of frictional force; therefore greater force is needed to move teeth with ceramic brackets compared to SS brackets in sliding mechanics. www.indiandentalacademy.com
  • 66. Since ceramic brackets on anterior teeth are often used in combination with SS brackets and tubes on premolar and molar teeth, retracting canines along archwire may result in greater loss of anchorage because of higher frictional force associated with Ceramic than SS brackets. To reduce frictional resistance Ceramic brackets with smoother slot surfaces and consisting of metallic slot surface are avaliable www.indiandentalacademy.com
  • 67. ) ZIRCONIA BRACKETS : Besides high friction, Ceramic brackets have very low fracture resistance Due to their brittle nature even smallest crack or flaw can propagate rapidly through the material. Zirconia brackets have been offered as an alternative to ceramic brackets since surface hardening treatments to increase fracture toughness are available for Zirconium oxide. www.indiandentalacademy.com
  • 68. Frictional coefficients of Ziconia brackets were found to be greater than or equal to those of poly crystalline alumina brackets in both dry and wet states (Keith et al , 1994). Surface changes consisting of wire debris and surface damage in Zirconia brackets after sliding of archwires were also observed. www.indiandentalacademy.com
  • 69. ) PLASTIC BRACKETS : In an attempt to create an esthetic bracket with lower frictional resistance and easier debonding features than ceramics a varity of new, ceramic reinforced plastic brackets with or without metal slot inserts have been introduced. www.indiandentalacademy.com
  • 70. Trade Name Company Type E.g: Silkon American Orthodontics Plastic reinforced with ceramic Spirit Ormco Plastic with metal insert Image GAC Plastic reinforced with glass Clarity Unitek Ceramic with metal insert Cermaflex TP Metal with plastic base www.indiandentalacademy.com
  • 71. Plastic brackets can deform because of compression from ligation and thus binding of the wire, and higher frictional resistances were recorded than stainless steel brackets. Recently introduced composite brackets with and without metal slots faired better in friction studies showing lower frictional resistance than both ceramic and stainless steel brackets in one of the studies. www.indiandentalacademy.com
  • 72. EFFECT OF BRACKET WIDTH ON FRICTION Effect of bracket width on friction has been controversial - Some studies have found that altering bracket width made no difference in friction (Peterson et al 1982, Andereasen et al, 1970). - Frictional resistance has been reported to increase with increase in bracket width (Tidy 1989, Drescher et al, 1989). - Whereas others found that frictional resistance decrease as bracket width increased. • Franks and Nikolai (1980) :- Related greater friction with wider brackets to the fact that binding occurs frequently with wider brackets. www.indiandentalacademy.com
  • 73. Omana et al suggested that with a narrow bracket the tooth could tip considerably before binding could occour,and once binding occurs it was of severe nature Kapila et al (1990 and Ogata et al (1996) : Suggested that with a wider bracket the elastomeric ligature used was stretched more than with a narrower bracket which exerted a greater normal force on the wire www.indiandentalacademy.com
  • 74. Bracket Width and Interbracket Distance (IBD) Bracket width is closely related to IBD Narrower the bracket ↓ Greater the length of interbracket wire ↓ Greater the flexibility of wire ↓ Decrease in stiffness of wire ↓ Greater chance of binding with more flexible wire. www.indiandentalacademy.com
  • 75. Bracket slot size may not influence the frictional resistance, some studies suggested that frictional resistance decreased as slot size increased from 0.018 inch to 0.022 inch because of reduced binding probably from increased wire stiffness. And also because of the increased play in the slot with final archwirewww.indiandentalacademy.com
  • 76. ADDITIONAL DESIGN FEATURES IN BRACKETS TO REDUCE FRICTION Bumps on the bracket slot walls and floor which decreased surface contact with the wires, help decreased friction in bracket wire interface. (Ogata etal) www.indiandentalacademy.com
  • 77. Begg brackets—haveachieved low friction by virtue of an extremely loose fit betweena round archwire and a very narrow bracket, but this is at thecost of making full control of tooth position correspondinglymore difficult. Some brackets with an edgewise slot have incorporatedshoulders to distance the elastomeric from the archwire and,thus, reduce friction, but this type of design also producesreduced friction at the expense of reduced control. www.indiandentalacademy.com
  • 78. EFFECT OF SECOND ORDER DEFLECTION OF FRICTION Second order defection of wire b/n brackets held in series can have significant effects on brackets wire friction. - Several studies have found that increasing the angulation between bracket and wire produced greater friction. www.indiandentalacademy.com
  • 79. Frank and Nikolai (1980) :- Found that frictional resistance increased in a nonlinear manner with bracket angulation. With brackets out of alignment archwire stiffness, strongly influences forces normal to the points of contact and hence friction. In a well aligned arch forces that result from archwire deflection are not important and friction is largely independent of archwire stiffness www.indiandentalacademy.com
  • 80. Ogata et al (1986)Evaluated the effects of different bracket wire combinations and 2nd order deflections on kinetic friction. The brackets were offset deflecting wire in increments of 0.25 mm As 2nd order deflection increased frictional resistance increased for every bracket wire combination - With lower deflections a smooth sliding phase appeared in which friction increased in approximate a linear manner. www.indiandentalacademy.com
  • 81. As deflection increased further a binding phase occured in which friction increased at a much greater rate and was not necessarily linear. Binding generally occured between 0.75 and 1.00 mm of 2nd order deflection. The relationship between frictional resistance and second order angulation may not be linear and may become more important as the angulation increases. The active configuration for binding occurred between 3 to 7°. www.indiandentalacademy.com
  • 82. When tipping occurs the frictional resistance of nickel-titanium has been reported to be less than stainless steel, Because of the lower modulus of elasticity of nickel-titanium compared with stainless steel, lower normal force that was induced by binding occurred resulting in less resistance to sliding. www.indiandentalacademy.com
  • 83. Active third order torque with rectangular wires would increase the friction even more. Similarly, greater friction with larger rectangular wires results from the possible introduction of torque because an 0.021x 0.025” wire has 3.9° of play compared with an 0.018 x0.025” wire that has 14.8° of play when engaged into an 0.022” bracket slot www.indiandentalacademy.com
  • 84. Effect of ARCHWIRE ) WIRE ALLOY:- The role of wire alloy in frictional characteristics of sliding mechanics has been extensively studied. most studies have found SS wires to be associated with the least amount of friction and Beta titanium with the most. from lowest to highest friction SS, Co - Cr, NiTi and B-Ti. www.indiandentalacademy.com
  • 85. Frank and Nikolai (1980) :- Found that SS wires had less friction than nickel titanium at non binding angulations, but as the angulation increased and binding was present reverse was true. www.indiandentalacademy.com
  • 86. SURFACE TEXTURE :- Specular reflectance studies have shown that SS wires have the smoothest surface followed by Co-Cr, B-Ti and NiTi wires in order of increasing surface roughness Since B-Titanium had the most friction but was not the roughest Kusy and Whitly concluded that one cannot use surface roughness as an indicator of frictional characteristics in sliding mechanics. www.indiandentalacademy.com
  • 87. NiTi has greater surface roughness Beta Ti has greater frictional resistance. as the titanium content of an alloy increased its surface reactivity increases and surface chemistry is a major influence on frictional behaviour. β-Ti at 80% Titanium has higher coefficient of friction than NiTi at 50% titanium there is enough titanium reactivity for wire to “COLD WELD” itself to steel bracket and therefore β-Ti wire exhibits more of stick slip phenomenon. www.indiandentalacademy.com
  • 88. ION IMPLANTATION :- - Alteration of the surface of titanium wires by implantation of ions into the surface. - Gas ions (Nitrogen and Oxygen) are implanted in to the wire surface resulting in a surface that is extremely hard. - Ion implantation produces no interface b/n the coating and the wire neither does it alter the dimensions of the wire. Burstone and Farzin Demonstrated that ion implanted β-Ti wires produced about the same level friction as SS wires. www.indiandentalacademy.com
  • 89. Braided arch wires Berger (1990) Studied friction produced by 0.0175 inch braided archwire in a 0.022 slot and found very high friction levels. -      1.5 times compared to 0.018 inch round SS wire with elastomeric ligation. 5 times with stainless steel ligation This can be attributed to interwoven pattern and irregular surface of Braided arch wire. Mechanical interlocking of the archwires with the edges of the bracket slot increase friction as the wire moves relative to the bracket. ,efforts to reduce friction with teflon coating are being made www.indiandentalacademy.com
  • 90. WIRE SIZE - Several studies have found that an increase in wire size is to be associated with increased bracket wire friction . The main reason for the increase in friction as the wire size increased can be attributed to an increase in the stiffness of the wire.Wires of greater stiffness will create a greater normal force with binding of the archwire with the edges of the bracket. . . www.indiandentalacademy.com
  • 91. Rectangular wires produce more friction than round wires. At nonbinding angulations the contact area between bracket and archwire is important factor in friction and would therefore expect more friction with rectangular wire.(nanda) placement of a rectangular wire can dramatically increase the friction because of the concomitant increase in wire stiffness.(tidy) At greater angulation of the bracket, the determining factor is the point at which the wire contacts the edge of the bracket www.indiandentalacademy.com
  • 92. With round wires bracket slot can “bite” into the wire at one point ,causing an indentation in the wire With rectangular wire the force is distributed over a large area i.e the entire faciolingual dimension of the wire, resulting in less pressure and therefore less resistance to movement Frank and Nikolai (1980) Found that an 0.020 inch wire was associated with more friction than 0.017 x 0.025 inch wire www.indiandentalacademy.com
  • 93. ) ROLE OF WIRE STIFFNESS AND CLEARENCE Mechanically speaking orthodontic archwires are elastic beams supported at either one or both ends. WIRE STIFFNESS DEPENDS UPON :- - Diameter or cross section of the wire - Length of beam. e.g Doubling length of cantilever beam decreases stiffness by 8 times. - By altering interbracket distance stiffness of wire can be altered.During canine retraction in a premolar extraction case the increased inter­ bracket span of the unsupported wire over the extraction site decreases the stiffness of wire. www.indiandentalacademy.com
  • 94. Retraction force therefore has a greater chance of deflecting the wire resulting in buckling. -      To prevent such deflections of the wire that may increases friction and chances of bracket binding, diameter of wire should be increased to compensate for decrease in stiffness when interbracket span is greater than normal. -       Another reason for not using flexible small size archwires during sliding canine retraction is that flexible small size archwires can deflect as canine crown tips distally which can lead to incisor extrusion. www.indiandentalacademy.com
  • 95. CROSS SECTIONAL DIMENSION IN DIRECTION OF BENDING 0.017 x 0.022 inch wire placed edgewise is more springy in vertical dimension than when placed in ribbon mode Drescher et al (1989)Stated that vertical dimension of the wire was an important factor in frictional resistance . Nature of end supports of a beam Rigidly supported beam at both ends has stiffness 4 times as compared to cantilever beam.Therefore During sliding space closure the wire therefore should be tied into the supporting brackets tightly to increase stiffness. eg During canine retraction premolar and lateral incisor brackets should be tied tightly to the archwire www.indiandentalacademy.com
  • 96. Clearance of arch Wire:- Adequate clearence should be provided between bracket and wire to prevent binding. Clearance or play in 2nd order i.e tipping depends upon Slot size, Bracket width , Archwire size 3rd order play in rectangular arch wires. In 0.018 slot→ 16.7° for 0.016 x 0.016 wire 4.5° for 0.017 x 0.025 wire. 0.022 27.4° for 0.016 x 0.022 inchwire. 2° for 0.0215 x 0.028 wire. www.indiandentalacademy.com
  • 97. EFFECT OF LIGATION TECHNIQUE ON FRICTION:- The normal force exerted by ligature has a significant influence in determining the frictional resistance developed within an orthodontic appliance. Ligation technique signifies the force that pulls the wire into the bracket. Elastomeric modules: -      Affected by the oral environment. -      Demonstrate stress relaxation with time Stainless steel ligatures: Can be tied either too tight or too lose. www.indiandentalacademy.com
  • 98. Properties of an ideal ligation system  be secure and robust; ensure fullbracket engagement of the archwire; exhibit low friction betweenbracket and archwire; be quick and easy to use; permit highfriction when desired; permit easy attachment of elastic chain; assist good oral hygiene; be comfortable for the patient www.indiandentalacademy.com
  • 99. Edwards et al (1995) : Compared the effect of 4 ligation techniques. -      E modules tied conventionally and in figure 8 pattern. -      Stainless steel ligatures. -      Teflon coated ligatures. static frictional resistance greatest in figure of 8 emodules-      No significant differences between frictional resistance offered by conventionally tied E-modules and steel ligature.teflon coated ligatures produce lowest friction www.indiandentalacademy.com
  • 100. Shivapuja et al (1994) : E-modules produced greater frictional resistance as compared to steel ligature ties. This combined with rapid rate of decay for these E-modules and their predliction for harboring large quality of plaque suggests little merit in their use especially in sliding mechanics www.indiandentalacademy.com
  • 101. NEW SLICK ELASTOMERIC MODULE SYSTEM: A new slick elastomeric module system incorporating metafasix technology (TP orthodontics) has recently been introduced claims to combine ease of use with low friction. The new slick E - modules reduced friction by upto 60% compared with their regular counterparts when tied normally www.indiandentalacademy.com
  • 102. BRACKET DESIGNS LIMITING FORCE OF LIGATION: Three brackets were introduced to restrict the amount of force placed on wire by the ligature. -      American friction free bracket (Am. Orthod) -      GAC shoulder bracket (GAC central I slip NI) -      RMO synergy bracket (RMO) These brackets generated lower mean frictional forces at 2nd order deflections of 0.00 & 0.25 mm than conventionally ligated brackets www.indiandentalacademy.com
  • 103. eg.Synergy bracket: Includes 6 wings 3 on each side of bracket slot. The lateral wings may be included in ligation for correction of rotation of teeth but only center wings may be ligated during sliding mechanics to reduce force of ligation. www.indiandentalacademy.com
  • 104. SELF LIGATING BRACKETS: Orthodontic brackets are now available that possess the feature of self ligation.First Edgewise self ligating bracket Russelhock (1946). www.indiandentalacademy.com
  • 105. SELF LIGATING BRACKET SYSTEMS: LIGATIONS SYSTEM * Edgelok bracket (Ormco) – 1972 Sliding cap * Speed bracket (Strite industries) - 1980 Spring clip * Activa bracket (A company) - 1986 Lever arm. Damon – 1994 vertical slide www.indiandentalacademy.com
  • 107. BERGER (1990) Compared between speed bracket and stainless steel bracket revealed that friction with self ligating bracket was between 12% and 23% that of stainless steel bracket irrespective of wire shape and ligation technique. The unique anatomic characteristic associated with speed bracket - highly resilient and flexible spring clip was determined to be causative factor in critically lowering level of applied force. www.indiandentalacademy.com
  • 108. Shivapuja et al (1994) Self ligating brackets displayed significantly lower level of friction both static and dynamic as compared to conventional ligating system. Significantly less chair side time was required for archwire removal and insertion with self ligating system as compared to conventional ligating systems. Kapur found dramatically lower frictionwith both stainless steel and nickel-titanium wires for Damonbrackets compared to conventional brackets www.indiandentalacademy.com
  • 109. Advantages of self ligating system more certain fullarchwire engagement; low friction between bracket and archwire; less chairside assistance; faster archwire removal and ligation www.indiandentalacademy.com
  • 110. Gac in ovation bracket similar in design to speed bracket with sliding spring clip, Damon sl 2 with vertical slide www.indiandentalacademy.com
  • 111. the clip places a diagonally directed lingual force on the wire, which does not contribute to any third order interaction between the wire corners and the walls of the bracket slot, which is the origin of torquing force This increases the ‘slop’ between the rectangular wire and the slot, and also reduces the moment arm of the torquing mechanism www.indiandentalacademy.com
  • 112. Activa bracket with clip Clip retaining groove is visible on the gingival surface. www.indiandentalacademy.com
  • 113. With low friction, the net tooth-moving forces are morepredictablylow and the reciprocal forces correspondingly smaller Lower net forces deflect archwires less and, therefore, facilitaterelease of binding forces between wire and bracket, enhancingsliding of brackets along a wire. www.indiandentalacademy.com
  • 114. BIOLOGICAL FACTORS: I. Effect of saliva on kinetic friction: It has been suggested that saliva substitute serves as an excellent lubricant in sliding of the bracket along the wire. BAKER ET AL (1987): Using an artificial saliva substitute found a 15% - 19% reduction in friction. KUSY ET AL (1991): Found that saliva could have lubricious as well as Adhesive behaviour depending on which archwire bracket combination was under consideration www.indiandentalacademy.com
  • 115. SSWIRES: Showed an adhesive behaviour with saliva and a resultant increased in coefficient of friction in wet state. β-TI wires: In wet state kinetic coefficients of friction were 50% of the values in dry state.when sliding through SS brackets ,the titanium rich oxide layer in β-Ti archwire breaks down,reacts,adheres and breaks away ,resulting in a stick-slip phenomenon Hypothesis: Saliva probably acts by preventing solid to solid contact. www.indiandentalacademy.com
  • 116. CLINICAL SIGNIFICANCE: In an adult patient: H/O of Xerostomia or decreased salivary, Oral radiation therapy, Anticholinergic medication. Should be noted as possible factors in varying force levels necessary to move teeth. www.indiandentalacademy.com
  • 117. Surface Characteristics Affecting Friction Most metals are subject to oxidation and an associated oxide layer growth. Friction between specific sliding metallic surfaces significantly decreases with proportionate increases in oxide layer thickness, although sliding characteristics in the presence of an oxide layer vary from material to material. .bioflims may reduce the coefficient of friction by producing a boundary lubrication effect through salivary protein adsorption and plaque accumulation www.indiandentalacademy.com
  • 118. CLINICAL SIGNIFICANCE OF FRICTION Based on information gathered from studies of friction several points of clinical significance can be identified. An appreciation of magnitude of friction is crucial for the orthodontist who employs sliding mechanics during treatment -      With best of wire bracket combinations atleast 40g of friction must be included in force applied to initiate tooth movement. www.indiandentalacademy.com
  • 119. New bracket designs and manufacturing techniques have been introduced to decreased the amount of friction generated between wire and bracket slot. -      Sintered SS brackets. -      Bracket designs limiting force of ligation Self ligating brackets Clinicians using esthetic tooth colored brackets - important to know the level of friction generated by these brackets before initiating tooth movement www.indiandentalacademy.com
  • 120. Selection of wire shapes and sizes: e.g.: 0.018 inch SS steel best choice for canine retraction in 0.022 slot. - If overall torque control is required: 0.016x 0.022 inch - 0.018 slot. 0.019x0.025 inch - 0.022 slot. Archwire can also be thinned down in region distal to canine so as to further facilitate movement. Care must be taken not to over reduce the wire dimensions which could decreased strength of wire www.indiandentalacademy.com
  • 121. Complete leveling of arch - important factor in reducing friction during tooth movement. e.g.: Space closure using 0.019 x 0.025 wire in 0.022 slot. Before starting space closure rectangular wires need to be place for atleast 1 month. -       To ensure proper leveling and freedom from posterior torque pressure. Sliding mechanics can proceed smoothly www.indiandentalacademy.com
  • 122. To optimize use of sliding mechanic sufficient time must be allowed for distal root movement to occur. -      A common mistake is to change the E-chain too often thus maintaining high force levels and a M/F ratio that produces distal tipping only. www.indiandentalacademy.com