Journal of Orthodontics

ISSN: 1465-3125 (Print) 1465-3133 (Online) Journal homepage: http://www.tandfonline.com/loi/yjor20

Analysis of reversed L-loops as closing loops with

anterior intrusive force

Paiboon Techalertpaisarn & Antheunis Versluis

To cite this article: Paiboon Techalertpaisarn & Antheunis Versluis (2018): Analysis of
reversed L-loops as closing loops with anterior intrusive force, Journal of Orthodontics, DOI:
10.1080/14653125.2018.1490872

To link to this article: https://doi.org/10.1080/14653125.2018.1490872

Published online: 27 Jun 2018.

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JOURNAL OF ORTHODONTICS
https://doi.org/10.1080/14653125.2018.1490872

Analysis of reversed L-loops as closing loops with anterior intrusive force

Paiboon Techalertpaisarna and Antheunis Versluisb
a
Department of Orthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; bDepartment of Bioscience Research, College
of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA

ABSTRACT ARTICLE HISTORY

Objective: Intrusive forces on anterior brackets are preferable for avoiding overbite deepening. Received 13 February 2018
Reversing plain L-loops may create such advantageous force system during space closure. Accepted 11 June 2018
Design: Force systems of reversed L-loops were compared with T-loops at three interbracket
KEYWORDS
distances (IBD). Force system; loop
Setting: Computational study. mechanics; reversed L-loop;
Methods: Using finite element analysis, loop response during simulated loop-pulling was T-loop; intrusive force; finite
determined for plain reversed L- and T-loop configurations at three IBDs and two sizes. Force element analysis
systems were calculated on both loop ends for two activation forces.
Results: The 12 mm IBD reversed L-loops had almost equal M/F ratios in opposite directions at both
ends. A small intrusive force was found at the canine bracket (CB). The 6 mm IBD reversed L-loops
showed larger M/F ratios and extrusive forces at the premolar bracket (PB) and smaller M/F with
intrusive forces at CB. The force system of 12 mm IBD T-loops showed the similar force systems
as off-centered V-bends with extrusive force at CB, whilst plain 6 mm IBD T-loops showed
properties similar to centered V-bends with less extrusive force at CB.
Conclusions: Reversed L closing loops placed no extrusive force on the CB end at various IBDs,
indicating that reversed loops will generate an intrusive force at anterior teeth during space closure.

Introduction adjustment to the force system will affect both ends

(Techalertpaisarn and Versluis 2016).
Forces and moments for controlled movement of teeth
L-loops have demonstrated intrusive forces at the PB
into open spaces can be induced with closing loops.
end for all loop positions between brackets (Techalertpai-
The force system for such loops depends on their
sarn and Versluis 2013a, 2013b). Reversing the L-loop
shape and how they are positioned between the brack-
direction (Figure 1) can create a closing loop configur-
ets. As spaces are closed, loop activation is prolonged
ation that allows a long period of activation whilst main-
by cinching a wire end at subsequent visits. However,
taining an intrusive force throughout. Since there is little
this will gradually move a closing loop along the
information on reversed L-loops in the literature, the aim
inter-bracket span, which will affect the original force
of this study was to investigate the force system of
system on both loop ends. For example, a T-loop
reversed L-loops. Previously force systems of closing
moving closer to the canine bracket (CB) will increase
loops have been calculated with finite element analysis
the moment-to-force (M/F) ratio at the CB
(Techalertpaisarn and Versluis 2016). Using the same
accompanied with a vertical extrusion force. Mean-
numerical method, space closure during anterior teeth
while, at the premolar bracket (PB) end, the M/F ratio
retraction will be simulated in this study by calculating
will decrease in combination with an intrusive vertical
the force systems at various inter-bracket distances
force (Burstone and Koenig 1976; Techalertpaisarn
(IBDs). T-loops were also modelled for comparison.
and Versluis 2013a, 2013b). The vertical forces gener-
ated in this situation can deepen the overbite. In
order to reduce the extrusion force, some suggest an
Material and methods
anterior step bend for off-centered T-loops (Tayer
1981; Hilgers and Farzin-Nia 1992). This may be the Finite element models of reversed L- and plain T-loops
easiest way to avoid extrusion at the CB end. models were created and analyzed using Marc/Mentat
However, such procedure can dramatically affect the software (MSC Software, Santa Ana, CA). The dimensions
force system on the other side of the loop, since any of the loops are shown in Figure 2(A). Loop sizes (height x

CONTACT Antheunis Versluis antheun@uthsc.edu Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science
Center, 875 Union Avenue, Memphis 38163, TN, USA
© 2018 British Orthodontic Society
2 P. TECHALERTPAISARN AND A. VERSLUIS
Figure 1. Reverse L-loop used as a closing loop for anterior teeth
space closure.
width) were 8 × 8 and 10 × 10 mm. The horizontal loop
lengths (b), representing the IBD, were 12, 9 and 6 mm.
On the CB end, the distance from the center of the ver-
tical legs to the wire end was kept constant at 2.5 mm
to simulate space closure by shortening the PB end. Con-
sequently, the distances (a) from the center of the verti-
cal legs to the PB end were 9.5, 6.5 and 3.5 mm,
respectively. The a:b ratios were 0.79, 0.72, 0.58, respect-
ively. The distances from the midpoint of the apical
portion were 6, 3 and 0 mm for the reversed L-loop
and 9.5, 6.5 and 3.5 mm for the T-loop, respectively.
The directions of the vertical force and moment are
defined in Figure 2(B). Positive values of the vertical
force are forces directed away from the loop (extrusion),
whilst negative values are forces in the loop direction
Figure 2. (A) Reverse L- and T-loop dimensions for 8 × 8 mm and
10 × 10 mm loop sizes. Different loop distances (a) represent
various stages during space closure with corresponding locations
of the midpoint of the apical portions (s and t). The original inter-
bracket distance (b) is 12 mm. (B) Definition of forces and
moments. Positive vertical forces move bracket in direction
opposite of the loop (extrusion), negative forces move bracket
in loop direction (intrusion). Positive moments rotate bracket
clockwise, negative moments rotate bracket counterclockwise.
(intrusion). Positive moments turn the loop clockwise,
negative moments turn it counterclockwise.
The loops were modelled using three-dimensional
linear-interpolation beam elements with rectangular
cross-sections (0.016 × 0.022 inch). The reversed L-loops
consisted of 440 beam elements and the T-loops of
520. The loop ends (PB and CB), and thus loops, were
placed in the same plane. Properties of stainless steel
(elastic modulus 157.6 GPa, Poisson’s ratio 0.3) were
applied to the beam elements (Hayashi et al. 2004).
The loops were activated by moving the PB and CB
ends apart with a 100 or 200 g horizontal activation
force. The ends were fixed in 6 degrees of freedom (3 dis-
placements and 3 rotations) except at the PB, where hori-
zontal displacement was allowed to facilitate the
activation force application. Vertical forces and
moments at both ends as well as the horizontal deflec-
tion at the PB end were recorded.
Results
Results are shown in bar diagrams (Figure 3). The values
are listed in Table 1 for the 8 × 8 mm loops and Table 2
for the 10 × 10 mm loops.
Load/deflection of the reversed L-loops increased
substantially with decreasing IBD, whilst it remained
almost constant for the T-loops. Increasing the horizontal
force from 100 to 200 g slightly decreased the load/
deflection values, but the response to IBD reduction
remained similar. Load/deflection values of the larger
10 × 10 mm loops were approximately half of those of
the 8 × 8 mm loops, but their response to IBD reduction
was the same.
The reversed L-loops showed intrusive forces at the
CB end and an equal amount of extrusive force on the
PB end (Figure 4). The off-centered T-loops generated
extrusion at the CB end with an equal amount of intru-
sion at the PB end (Figure 4). In the reversed L-loops
vertical forces increased when IBD was reduced,
whereas vertical forces in the T-loops decreased with
IBD reduction. Increasing the horizontal force from 100
to 200 g increased vertical forces. For the larger 10 ×
10 mm reversed L-loops, vertical forces were higher
than for the 8 × 8 mm loops, whereas they were gener-
ally slightly lower for the T-loops. The directions of verti-
cal forces were the same between the two loop sizes.
The M/F ratio at the CB end of a reversed L-loop placed
12 mm off-center was slightly lower than at the PB end
and in opposite direction. When the IBD decreased by
reducing the PB segment length, the difference
between the CB and PB M/F ratios became larger
because the M/F ratio at the CB end decreased slightly
whilst at the PB end the M/F ratio stayed relatively
 JOURNAL OF ORTHODONTICS 3

Figure 3. Bar diagrams showing the force systems of 8 × 8 mm and 10 × 10 mm reversed L- and T-loops for three interbracket distances
(IBD 12, 9 and 6 mm) and two horizontal force values (100 and 200 g). Positive vertical load is extrusion and negative vertical load is
intrusion at the anterior or canine bracket end. Moment-to-force unit is mm; positive is clockwise, negative is counterclockwise.

Table 1. Force system of 8 × 8 mm reversed L- and T-loops for three interbracket distances (12, 9 and 6 mm) and two horizontal force
values (100 and 200 g).
100 g 200 g
IBDa (mm) Shape L/dc (g/mm) Ld at CBe (g) M/F ratiof PB/CBe L/d (g/mm) L at CB (g) M/F ratio PB/CB
12 RL-loop b
120.0 −5.6 4.3/−3.6 109.8 −7.4 4.2/−3.6
T-loop 156.5 43.8 0.1/−5.6 153.4 85.5 0.1/−5.7
9 RL-loop 149.3 −34.9 5.9/−2.5 131.6 −66.7 6.0/−2.5
T-loop 157.9 36.2 2.0/−5.5 154.3 71.8 1.9/−5.6
6 RL-loop 228.5 −57.6 5.7/−2.1 212.3 −117.4 5.9/−1.9
T-loop 174.1 10.2 4.3/−5.0 167.7 21.2 4.3/−5.0
a
IBD is interbracket distance.
b
RL-loop is reversed L-loop.
c
L/d is load/deflection.
d
L is vertical force; +is extrusion, – is intrusion at anterior or CB end.
e
CB is at canine bracket end, PB is at premolar bracket end.
f
M/F ratio is moment-to-force ratio, unit is mm; +is clockwise, – is counterclockwise.

constant. For the T-loops, the M/F ratios at the CB and PB between both ends became smaller as the loop position
ends were also in opposite direction but were higher on became more centered during IBD reduction because the
the CB end than at the PB end. The differences were M/F ratio slightly decreased at the CB end whilst it
highest at the largest IBD. The difference in M/F ratios increased at the PB end. The M/F ratio was hardly
4 P. TECHALERTPAISARN AND A. VERSLUIS

Table 2. Force system of 10 × 10 mm reversed L- and T-loops for three interbracket distances (12, 9 and 6 mm) and two horizontal force
values (100 and 200 g).
100 g 200 g
IBD (mm) Shape L/d (g/mm) L at CB (g) M/F ratio PB/CB L/d (g/mm) L at CB (g) M/F ratio PB/CB
12 RL-loop 61.8 −22.0 7.0/−3.9 46.4 −33.6 6.9/−3.9
T-loop 80.0 42.3 1.1/−7.2 77.0 86.4 1.0/−7.4
9 RL-loop 80.3 −47.9 7.9/−3.1 59.9 −92.9 8.4/−2.9
T-loop 81.4 30.7 3.5/−6.9 78.0 65.1 3.3/−7.1
6 RL-loop 126.6 −62.0 7.1/−3.0 111.3 −128.4 7.6/−2.7
T-loop 90.7 8.3 5.8/−6.4 84.9 18.0 5.8/−6.5

affected by horizontal forces (100 or 200 g), whereas
increasing the loop sizes slightly increased M/F ratios.
Discussion
This study investigated if a reversed L-loop could
prolong activation whilst maintaining an intrusive
force at the CB without a step or Gable bend. The
force systems were analysed using the same numerical
method as has been used in other studies, where they
have been extensively discussed (Techalertpaisarn and
Versluis 2013a, 2013b, 2016). The results of this study
showed that reversed L closing loops maintained an
intrusive force at the CB whilst M/F ratio remained rela-
tively constant throughout the shrinking activation
distance.
The choice clinicians must make for a closing loop
does not only concern the M/F ratio, but also the vertical
forces on both sides of a loop. Plain vertical and T-loops
have a V-bend-like force system, which generates an
extrusive force on the shorter end. Such extrusive
forces could result in a deep overbite. Various procedures
have been used to create an intrusive force at the shorter
loop ends, such as step bends (Tayer 1981; Hilgers and
Farzin-Nia 1992) or V-bends at the longer ends (Martins
et al. 2008). Step bends in off-centered T-loops increase
the intrusive force, but they also erase the higher
moment associated with off-centered T-loops, resulting
in more tipping movement at the CB and more bodily
movement at the PB (Techalertpaisarn and Versluis
2016). Off-centered V-bends at the PB long end have
been suggested as another strategy to avoid deepening

Figure 4. Force system of the 8 × 8 mm reversed L-loop and T-loop with 12, 9 and 6 mm interbracket distance (IBD). Axial strains are
shown under 200 g activation load according to a linear color scale; the dashed line shows the unactivated loop. For the reversed L-
loop, when IBD decreases the intrusive forces increase from 7.4 to 117.4 g whilst the M/F ratios decrease at the CB end. Throughout the
simulated space closure process, only intrusive forces were found at the CB end. For the T-loop, when IBD decreases the extrusive forces
decrease from 85.5 to 21.2 g whilst the M/F ratios change little. Throughout the simulated space closure process, only extrusive forces
were found at the CB end.
 JOURNAL OF ORTHODONTICS 5

Figure 5. Example of anterior space closure treatment of a bimaxillary protrusion in a 28-year female patient over a period of 7 months.
First, the canines were retracted completely, followed by the anterior retraction phase, using a planar reversed L closing loop archwire
(approximately 8 × 8 mm). When the archwire ends were cinched and activated, the posterior horizontal portion was in the extrusive
position compared to the anterior portion. Space between the anterior and posterior part was gradually closed. After seven months, the
space was closed and overbite improved. There was no sign of drop down of the anterior part during the space closure.

of an overbite (Techalertpaisarn and Versluis 2016).
However, when a step or Gable bend is added to a
closing loop, the M/F ratio changes rapidly along the
activation distance or force. Therefore, during each acti-
vation, teeth that are moved may encounter various
types and degrees of tooth movement, from crown
tipping to root movement.
This study demonstrates another option, using a
reversed L-loop as a plain closing loop with intrusive
force at the CB from the horizontal activation. The
reverse L-loop showed a similar force system as a (12
IBD) centered T-loop (Techalertpaisarn and Versluis
2013a). When the IBD decreased, the reversed L-loop
decreased the M/F ratio at the CB end and increased
the M/F ratio at the PB end, whilst the moments main-
tained their directions. Increasing the loop length and
height from 8 to 10 mm increased the M/F ratio and
decreased the load/deflection value, but the intrusive ver-
tical forces at the CB end were preserved in all three IBDs.
This observation confirms a previously reported attribute
of the apical portion of a loop for determining the force
system where it acts like a V-bend (Techalertpaisarn and
Versluis 2017). At the beginning of the space closure pro-
cedure, the midpoint of the apical portion of the reversed
L-loop is approximately at the center between the two
brackets. When the space is closing, the midpoint of the
apical portion moves toward the PB end. Therefore, intru-
sive forces on the CB can be maintained throughout the
space closure. Figure 5 shows a clinical example of
space closure with a reversed L-loop, showing no sign
of extrusion at the anterior part.
M/F ratios on the PB end were higher than those of
the CB at all IBDs. Although the reversed L-loops did
not have M/F ratios as high as 8–10 on both sides, they
still had relatively high and constant ratios to produce
controlled tipping. Moreover, when teeth move, the
initial M/F will tip the teeth on both sides and the M/F
ratio will become higher from the angulation of
the bracket on both wire ends. How and how much
the M/F ratio would change from bracket angulation
would need further study. Adding a gable bend may
also increase the M/F ratio to reach the bodily movement
value. Although the theoretical analysis of the force
system showed that a reversed L-loop generated intru-
sive force throughout the space closure movement, clini-
cal verification is still needed.
Conclusions
Reversed L closing loop placed no extrusive force on the
CB end at various IBDs, indicating that reversed loops will
generate an intrusive force at the anterior teeth during
space closure.
Disclosure statement
No potential conflict of interest was reported by the authors.
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