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Three-dimensional comparison of continuous and segmented arch techniques in the traction of palatally impacted
Stephanie Bou Malhab1, Richard Karam2, Fouad Kaddah2
1Department of Orthodontics, School of Dental Medicine, Saint Joseph University, Beirut, Lebanon.
Objective:
To compare the three-dimensional (3D) effects of canine traction on the maxillary teeth when using two different traction methods, the continuous and the segmented arch wire techniques; then to test whether adding a transpalatal arch (TPA) would affect their response to traction.
Design:
Finite element analysis.
Methods:
A cone-beam computed tomography (CBCT) scan of a patient with bilateral palatally impacted canines was chosen, from which a 3D model was derived and imported into ABAQUS. Two arch wires were modelled, a continuous round one and a segmented rectangular one. Four models were obtained by adding a TPA to both techniques. A 100° imposed rotation was then applied at the intersection between the vertical loop and the horizontal segment of each wire. Initial displacement of the maxillary tooth in the labio-lingual and in the vertical directions was measured. The absolute maximum principal stress of the periodontal ligament (PDL) was also assessed.
Results:
Traction using a continuous arch wire led to different movement patterns of all teeth, some of them were tipped in a labial direction while others were lingually tipped. Traction using a segmented arch wire resulted in a retroclination of the posterior teeth and a proclination of the anterior teeth with a high level of stress on the premolars' PDL. Adding the TPA only affected the displacement of the first molars. The right side showed a maximum displacement of the first premolar, while the left side showed it on the lateral. The total displacement on the right side was higher than the left side.
Conclusion:
The segmented technique caused a uniform displacement of all teeth while the continuous one showed a non-uniform displacement. The angulation and position of the vertical loop affected the displacement of the maxillary teeth. The addition of a TPA acted only on the first molars.
