Introduction
The optimal force delivery system in orthodontics should be able to deliver the desired force without frequent visits or change, be hygienic and be affordable. A force delivery system should be possible with minimum patient compliance and least operator indulgence.
Orthodontic forces are generated by:
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1.
Wires and their configurations, including springs
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2.
Elastics and rubber bands
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3.
Forces from muscles/functional spaces
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4.
Force from clear aligners
In fixed appliances, wires and their various configurations serve as the primary force delivery system, working in tandem with brackets or similar attachments on the teeth. This force system is a complex interplay of the wire’s alloy composition, physical properties, dimensions, shape and appliance design.
As the idiom goes, ‘an orthodontist is as good as the arch wire he uses’. The orthodontic arch wire is one of the most important active elements of the orthodontic armamentarium and thus requires special consideration.
Definition: What is a wire?
In engineering terms, a wire is a flexible structural or machine component having a working length many times that of its cross-sectional dimension and has the capability of transmitting force along that length.
In orthodontic language, an arch wire refers to a piece of wire secured to two or more teeth, and the dental arch is secured through fixed attachments to cause, guide or control orthodontic tooth movement.
American Dental Association specification no. 32 includes orthodontic wires, excluding precious metals and ligature wires. The desirable properties of the orthodontic wires are summarised in Table 45.1 . Since most wires are made with metals and alloys, several engineering terms are used for the materials. These are summarised in Table 45.2 .
TABLE 45.1
Properties of metal orthodontic wires
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TABLE 45.2
Some common terms and their definitions related to metals used in orthodontics
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Wire dimensions
The wire dimension expressed in terms of thousands of an inch/mm, mil or gauge. Dimensions of wire are judged by its cross-sectional dimensions. The most popular international standards for adhering to this specification are mentioned in International Organisation for Standardisation (ISO/CD) 15841.
The ISO 15841:2014 standard, last reviewed in 2020, specifies requirements and test methods for preformed orthodontic arch wires, excluding springs or other preformed components.
The Deutsches Institut für Normung e.V. (DIN) standard, published in January 1998 by the German Institute for Standardization, specifies measurement tolerances for orthodontic wires (NA 014-00-19 AA). This standard is more stringent than the tolerance zones in ISO 15841:2014/Amd 1:2020.
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•
Round wires are available in the dimensions of 0.010, 0.012, 0.014, 0.016, 0.018, 0.020 and 0.022 in. ( Tables 45.3 and 45.4 ).
TABLE 45.3
Wires cross-section/types and material ( Fig. 45.1 )
Wire cross-section Wire strands Wire material Round Single-stranded Metals and alloys Square Multistranded Shape-memory polymers (SMPs) Rectangular Twisted or braided Polymers (composite) Combination of round and rectangular Co-axial Metals with synthetic coatings TABLE 45.4
Round wires
Advantages Disadvantages -
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Larger deflection; hence, can be engaged in teeth with discrepancy of alignment
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•
Easy to bend and create shapes and loops
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•
Increased play allows tipping movement
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Reduced friction
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Rolling of wire in the bracket slot
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It cannot effectively cause torque
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•
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•
Square wires are available in the dimensions of 0.016 × 0.016 in.
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•
Rectangular wires are available in the dimensions of 0.016 × 0.022, 0.017 × 0.025, 0.018 × 0.025, 0.019 × 0.025 and 0.0215 × 0.0275 in. A rectangular wire, therefore, has a thickness and width which corresponds to the bracket slot. The standard size of bracket slots is 0.022 × 0.028 or 0.018 × 0.025 in. ( Table 45.5 ).
TABLE 45.5
Rectangular and square wires
Advantages Disadvantages -
It can allow bodily tooth movement
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Precise 3D control
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Better orientation to bracket
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Better control of tooth movement
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Can initiate and produce effective torque
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Difficult to bend and give shape, rarely free of torque
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High friction
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Difficult to engage in clinical situations where teeth are positioned in discrepancy
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The thickness (height) of a rectangular wire is usually the smaller dimension, and it fills the height of the slot of the bracket. It is the dimension in the plane of the bend. The width of a rectangular wire is usually the larger dimension, and it fills the depth of the slot of the bracket. Hence, in edgewise mode, a 0.017 × 0.025 in. rectangular wire has a thickness of 0.017 in. and a width of 0.025 in. ( Fig. 45.1 ).
Wires in cross-sections:
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i.
Round wire
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ii.
Square wire
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iii.
Rectangular wire: (iiia) rectangular wire in edgewise bracket and (iiib) rectangular wire in ribbon mode.
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iv.
Triangular wire
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v.
Braided round wire (3 strands)
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vi.
Braided wire (8 strands)
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vii.
Coaxial round wire
A rectangular wire can be bent in ribbon mode (flat wire), with a thickness greater than the width ( Fig. 45.1iiib ).
Modes of rectangular wire are as follows ( Fig. 45.2 ):
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Edgewise/conventional mode
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Ribbon arch mode
Bi-dimensional wires.
(A) Anterior segment (B) Posterior segment.
Triangular wires
In 2001, Broussard and Graham introduced the use of a stainless steel (SS) wire with a triangular cross-section. The equilateral triangle has a mean dimension of 0.030 in. and rounded-off edges in cross-section. Compared to round or rectangular wires, triangular wires offer superior adaptation in interproximal areas, better patient comfort, improved periodontal health and excellent appliance stability. Triangular wires are used in various clinical applications, including bonded and removable retainers ( Fig. 45.1iv ).
Dual geometry wires
The SPEED (298, Shepherd Avenue Cambridge Ontario, N3C 1V1, Canada) self-ligating appliance system uses a dual geometry arch wire that is optimised for efficient sliding mechanics in the posterior region due to its round cross-section and effective torque control in the anterior segments, thanks to the square segment. The arch wire is made of SS and has a high tensile strength ( Fig. 45.2 ).
The 0.018 in. slot bracket uses a dual geometry wire to achieve precise torque control in the anterior segment, with a square 0.018 × 0.018 in. arch wire. The buccal segments, on the other hand, employ round 0.018 in. arch wire for efficient sliding mechanics. For use in 0.022 in. bracket slot size, the anterior segment of the arch wire has square 0.021 × 0.021 in. dimensions and the buccal segments have a round wire of 0.020 in.
Properties of ideal arch wire are tabulated in Table 45.6 .
TABLE 45.6
Properties of ideal arch wire
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Evolution of orthodontic wires
The orthodontic arch wires have evolved over time, mainly with the development of metallurgy and the science of alloys and the testing of their properties inside and outside the mouth.
Early era: The correction of dental irregularities dates back to 400 BC by Hippocrates with some kind of tying. Catgut and silk thread were also used. But gold ligatures are the first ever reported wires in orthodontics. Noble metals such as gold, platinum and silver were used to manufacture wires because of their ductility, formability, biological safety and inertness in the oral environment.
Wires in the 1880s: The precursor of the orthodontic wire used in treatment in the late 1800s was the ‘arch bow’. The typical arch bow was a round, threaded stiff wire drawn from a nickel–silver or platinum–gold alloy to a diameter of 0.032–0.036 in. attached to the bands using nuts. Angle’s ribbon arch appliance utilised a gold–platinum alloy combination as the arch wire.
Dr. Edward H. Angle (1887) introduced ‘Neusilber’ or nickel–silver alloys, also called German silver, in the United States. These were alloys of Cu 47–65%, Ni 10–25% and Zn 15–42% that did not contain any silver. He was able to obtain favourable clinical properties by cold working to various degrees. But this was strongly opposed as they tend to discolour in the mouth.
1900s: The SS alloys were used for orthodontic appliance fabrication in 1919. The wires of noble metal were replaced by SS wires, which were much less expensive and yet exhibited the desired properties of corrosion resistance in the oral environment, excellent strength and desired springback on activation. These indeed replaced noble metals primarily because of their desirable properties such as corrosion resistance, excellent strength and low-cost, springback.
In 1950, the Elgin Watch Company (United States) developed Elgiloy (Co–Cr–Ni), which has useful properties of excellent formability and exhibits the necessary strength after heat treatment. The alloy was adapted for use in orthodontic arch wires. These wires were corrosion resistant and inexpensive.
In 1963, William Buehler developed the nickel–titanium alloy. It was introduced into dentistry by George Andreasen because of its property of shape memory effect (SME). This alloy could regain its original preset shape when heated. These wires are much more advanced now and remain the mainstay wires in the initial alignment stages.
Burstone and Goldberg (1980) introduced wires made of a new alloy called ‘Titanium–molybdenum alloy’ (TMA). TMA wires have been found to have significant uses in clinical orthodontics because these alloy wires have useful mechanical properties for enhanced performance compared to steel.
Twenty-first century: To improve the aesthetics of orthodontic appliances, tooth-coloured wires like Optiflex wires and Teflon-coated wires have been introduced. These wires, which have a non-metallic appearance, are indicated in combination with aesthetic ceramic or plastic brackets ( Tables 45.7–45.9 ).
TABLE 45.9
The shape of wire (round, square or rectangular) vis-à-vis wire properties
| Round wire in bending | Round wire in torsion | Rectangular wire in bending | Helical spring in axial tension or compression |
|---|---|---|---|
| Stiffness • r 4 /l 3 | Stiffness • r 4 /l | Stiffness • (thickness) 3 width/l 3 | Stiffness • 1 ( coil diameter ) 3 ( no . of coils ) Not dependent on cross-section |
| Strength • r 3 /l |
Strength • r
3
.
Not dependent on the length |
Strength • (thickness) 2 width/l | Strength • 1 coil diameter Not dependent on cross-section and no. of coils |
| Range • l 2 /r 3 | Range • l/r |
Range • l
2
/thickness.
Not dependent on width |
Range • (coil diameter)
2
× (no. of coils).
Not dependent on cross-section |
r, diameter; l, length.
TABLE 45.7
Metal composition and properties of orthodontic wires
| Wire composition | Stiffness | Springback | Load–deflection rate | Biocompatibility | Resiliency | Joinability | Friction | Formability | Cost |
|---|---|---|---|---|---|---|---|---|---|
|
High | Low | Highest | Good | Low | Good but the welded joint needs to be soldered | Very low | Good | Lowest |
|
High | Low | Comparable to SS | Good | Low | Good, but welded joint needs to be soldered | Low to moderate | Very good | Low |
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Low | High | 1/4 of SS | Some corrosion noted | High | Not solderable or weldable | Higher than SS | Poor | Moderate |
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Average | Average | 1/2 of SS | Very good | Good but lower than NiTi | Truly weldable and solderable | Very high | Good | High |
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Low | Four times of SS and higher than M-NiTi | Lower than M-NiTi | Better than M-NiTi | Better than M-NiTi | Not solderable or weldable | Higher than SS | Poor | Very high |
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Lowest | Higher than all | Lowest | Better than M-NiTi | Better than M-NiTi | Not solderable or weldable | Higher than SS | Poor | Very high |
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Low | High | Comparable to A-NiTi | Good | High | Good but the welded joint needs to be soldered | Very low | Poor | Low |
A-NiTi, austenitic/nickel–titanium; B-Ti, beta-titanium; Cu-NiTi, copper/nickel–titanium; M-NiTi, martensitic nickel–titanium.
The field of wire technology has advanced with the introduction of shape-memory polymers (SMPs) . These polymers are a type of ‘actively moving’ materials that can change from one shape to another. They can be temporarily shaped through mechanical deformation and then fixed to obtain a new shape. This unique property of SMPs opens up many possibilities for their application in orthodontics.
Stainless steel wires
By the late 1930s, thorough research and efficacy in clinical applications established SS as the mainstay orthodontic wire material, replacing noble metals. Steels are iron-based alloys that usually contain less than 1.2% carbon. SS contains a minimum of 10%–13% chromium and 8% nickel, which gives it ‘rust-free properties’ and so the name. SS consists of mainly three types:
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Ferritic SS (400 series)
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Austenitic SS (300 series)
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Martensitic SS (400 series)
Austenitic stainless steels (300 series)
Austenitic steels are used for orthodontic wires and bands. This family of alloys was named after the British metallurgist Roberts Austen. All American Iron and Steel Institute (AISI) numbers in the series of 300 are austenitic. Due to the presence of a significant amount of nickel and chromium, these alloys are the most corrosion resistant of all the SS.
AISI 302 is the primary type of steel containing 18% chromium, 8% nickel and 0.15% carbon.
AISI 304 has a similar composition, but its carbon content is 0.08%. Both 302 and 304 may be designated as 18–8 SS.
Low carbon AISI Type 316L and nickel-free ASTM Type F2229 wires are also available.
Round orthodontic wires are manufactured by a proprietary drawing sequence that involves several stages with intermediate annealing heat treatments.
Rectangular orthodontic wires are manufactured from round wires by a drawing process utilising a Turk’s head apparatus. Therefore, the edges of the rectangular wires may be somewhat rounded which limits their torque expression.
Properties of SS wires , are briefly tabulated in Table 45.10 .
TABLE 45.10
Properties of stainless steel (SS) wires ,
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High tensile australian wires
A.J. Wilcock (AJW) Sr., an engineer and entrepreneur, in collaboration with Dr. P.R. Begg, an orthodontist in Adelaide, developed pre-heat-treated cold-drawn steel wires that were more resilient than SS and had higher tensile strength.
These wires (AJW) were designed exclusively for use with Begg’s light wire technique. They are graded according to the increasing order of resiliency and yield strength. The resilient wires are highly brittle and break easily, and they are relatively more expensive than SS wires. As these wires developed in Australia were to be used with Begg’s technique, they are popularly called Australian wires, Begg wires or AJ Wilcock wires.
AJW wires are available according to the straightening processes ( Table 45.8 , Figs 45.3 and 45.4 ), spinner or pulse.
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Spinner straightening is a mechanical process of straightening resistant materials, usually in cold-drawn conditions. The wire is pulled through rotating bronze rollers, which twist it into a straight shape. This process has disadvantages, including permanent deformation and a decrease in yield strength value as the wires are strain softened.
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Pulse straightening is a recent and more accepted method of wire straightening. Here, the wire is pulled in a special machine, which permits lower diameters of high-tensile wires to be straightened. The surface has a smoother finish and, therefore, lower friction. Pulse-straightened wires are better in properties regarding ultimate tensile strength, high load–deflection rate, significantly higher working range and lower frictional resistance.
TABLE 45.8
Grades and wire dimensions of AJ Wilcock Australian wires
| A. AUSTRALIAN (AJW) ORTHODONTIC WIRES ARE AVAILABLE IN DIFFERENT GRADES AND DIAMETERS | |
|---|---|
| Wire grade | Size (diameter), inches |
| Regular | 0.012–0.024 |
| Regular + | 0.012–0.020 |
| Special | 0.012–0.020 |
| Special + | 0.012–0.024 |
| Premium | 0.012–0.020 |
| Premium + | 0.010–0.018 |
| Supreme | 0.008–0.011 |
| B. AUSTRALIAN (AJW) PULSE-STRAIGHTENED WIRES | |
| Grade | Diameter in inches |
| Special + | 0.014, 0.016, 0.018 |
| Premium | 0.020 |
| Premium + | 0.010, 0.011, 0.012, 0.014, 0.016, 0.018 |
| Supreme | 0.008, 0.009, 0.010, 0.011, 0.012 |
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