Objective: To investigate the influence of a rotational second-order bracket-archwire misalignment on the loads generated during third-order torque procedures. Specifically, torque in the second- and third-order directions was considered.
Materials and methods: An orthodontic torque simulator (OTS) was used to simulate the third-order torque between Damon Q brackets and 0.019 × 0.025-inch stainless steel archwires. Second-order misalignments were introduced in 0.5° increments from a neutral position, 0.0°, up to 3.0° of misalignment. A sample size of 30 brackets was used for each misalignment. The archwire was then rotated in the OTS from its neutral position up to 30° in 3° increments and then unloaded in the same increments. At each position, all forces and torques were recorded. Repeated-measures analysis of variance was used to determine if the second-order misalignments significantly affected torque values in the second- and third-order directions.
Results: From statistical analysis of the experimental data, it was found that the only statistically significant differences in third-order torque between a misaligned state and the neutral position occurred for 2.5° and 3.0° of misalignment, with mean differences of 2.54 Nmm and 2.33 Nmm, respectively. In addition, in pairwise comparisons of second-order torque for each misalignment increment, statistical differences were observed in all comparisons except for 0.0° vs 0.5° and 1.5° vs 2.0°.
Conclusion: The introduction of a second-order misalignment during third-order torque simulation resulted in statistically significant differences in both second- and third-order torque response; however, the former is arguably clinically insignificant.
Keywords: Biomechanics; Orthodontic torque simulator; Orthodontics; Third-order torque.