PRE,FACE

Because the literature is abundant with case reports with

complete orthodontic records, it must be explained that this book
will avoid presenting records including models, cephalometric
headfilms and tracings.

This book will deal strictly with biomechanics. The orthodontist

will discover many factors not contained within the typical
orthodontic records such as the neutral zone for teeth. Without
progress films, the orthodontist will discover that the type,
direction, and amount of tooth movement achieved ean very
often be determined by mechanics alone. Likewise, it will be
shown that much of the orthodontic treatment for patients today
can be treated on a noncompliant basis without the various
appliances now utilized which so frequently displace lower
incisors as well as invading the neutral zone which can best be
determined by muscles and function.

In spite of what has just been said, my practice requires the

taking of complete records - not only for legal purposes, but
because patients may possibly move elsewhere and transfer to a
practice where such records are required for treatment planning
and reference. I certainly do not wish to leave the impression
that such orlhodontic records are not required in my practice, but
rather that in spite of such records, much of the treatment
planning for each patient is based on knowledge gained from
mechanics in which force systems are applied in a unique and
individual manner for the patient. Such procedures will become
apparent in the chapters to follow.

vlll
 l.-erefore, as each chapter is read, understand that cephalometric
: :"-ings will not be shown. Photographs of the patient will be
, , -- \\-r1 only when appropriate to the discussion at hand.

*"! in the previous edition of "Comtnon Sense Mechanics in

: .,¡1,'cloy Orthodontics," at the end of each chapter, a synopsis
" - :rre material called, "The Short Storyti' will be presented. This
-
-:s prroven to be an excellent introduction to each chapter for
t - se u'ho prefer an insight beforehand as to what each chapter

1 :tains. It provides, as well, a summary of what has already

rt ::l re &d and makes an excellent reference for later reviews.
!
')
v s hoped that this book will provide each individual a
re - . ::nletelynew look at the mechanics that can be applied to
v ;:--r of our patients today. The orlhodontist will find a greater
*:riest and appreciation for the cause-effect relationships
}S that
3r :,:; place in orthodontic tooth movement and may very well
)e -':rde that it is a mistake to rely on the many commercial
:::caches being offered to the profession today. Rather than
.'.srant1y changing brackets, wires, etc., it will be rediscovered
he i - the fundamentals in mechanics have not changed.
rut r --,,, -\-er, appreciation for such fundamentals seems to have
)a -':r seriously declining with the use of appliances being
'-',', il)' promoted by orthodontic companies and
ng the speakers
on ,'" ,-, represent them.
rut
ent :.:llr. I would like to warn you about a possibility which I
0m
--:"
":.r
; ieamed from my experience with others. you just might
ind ofihodontics much more exciting than in the past and decide
me -,Jd vears to your practice as well as years to your life.

v111 1X
 CONTENTS
Chapters Page

1. Introduction 1

2. Understanding Forces and Moments t2

3. Static Equilibrium and its Importance 29

-1. Forces and Relative Magnitudes 43

5. IJnderstanding and Applying Wire/Bracket Angles 54

6. Molar Control - A Unique Approach 77

7. Applying the Off-Center Bend in Molar Control 89

8. Applying the Step Bend in Molar Control 111

9. Applying the Center Bend in Molar Control 130

10. An Illustrated Review of Molar Control Bends l4t

11. Increasing Force Magnitudes with Overlays 152

12. Mintmtzing Side-Effects During Bracket Alignment 167

13. The Advantages of Differential Moments 180

x X1
 COI{TENTS
Chapters Page

14. Differential Moments in Overbite Treatment 19r

15. Differential Moments for Arch Length Increases 201

16. Differential Moments in Class II Correction - Part I 213

17. Differential Moments in Class II Correction - Part 2 22s

18. When Differential Moments Fail 240

19. Molar Rotations Present Opporfunities 253

2A.Diastemas - Is Retention Necessary? 267

21. Innovative Biomechanics - Extractions 277

22.lJnusual Extractions - Pqrt I 298

23. Unusual Extractions - Part 2 311

24. Open Bites - A Real Challenge 32r

25. Concluding Remarks 336

 Introduction 1

INTRODUCTIOI{

REMARKS:

Many things will be said in this book that you may never have
heard before - not even in your graduate education. Having
been interested in cause-effect relationships since my childhood,
it has always been my nature to constantly ask the question,
"WHY?" Often, I did not receive answers that satisfied my
curiosity, so from the time I began my practice in August 1962,I
began searching for the answers myself. Having a deep interest
in the clinical aspects of orthodontic treatment, I closely
observed both expected and unexpected tooth movements. I
enjoy the academics in orthodontics, but find it disappointing
I rvhen the academic and clinical aspects are not in agreement. I
sincerely hope that everyone who reads this book will find both
their personal and professional lives enhanced.

When illustrations are showr, some will be used only as visual

titles andlor enhancements to the subject and will not be labeled
r1 as Figure 1-1, Figure 1-2, etc. However,
illustrations that apply to treatment will
2l receive such labels. Therefore, I will
begin this entire discussion on "Common
36 Sense Mechanics" by initiating the very
basic first level. Do not consider it
offensive if seemingly basic subjects are [Jnderstand!!!

x11
 Introduction 1

included. When completely understood, it will be seen what

biomechanics can really do for the individual who is interested
in clinical applications that are effective as well as excitittg.

Dissonance
Cognitive Dissonance Changing Your Beliefs

Looking at cognitive dissonance above, the definition and

statement that follow should clarify the intent behind the
material published in this book.

Why Do Teeth Often Move in [Jnexpected Directions?

Frequently, teeth are expected to move in one direction, but

often move in completely unexpected directions. Unfortunately,
this often leads to the use of rigid appliances to prevent such

-3t¡
 Introduction 1

undesirable responses. TranspaLatal and lingual arches may find

:hLemselves being used routinely in order to avoid undesirable
üúnsequences. It will later be shown that such appliances can
rTr,-rst often be avoided. In fact, in over 45 years of practice, the
¡uthor has never used either.

Let's now take a look at some of the so-called visual problems

:hat are encountered in mechanics. These visual interpretations
ane quite common in the profession and are largely responsible
tor the failure to predict and recognize correct force systems.
The first examples will deal with the characteristic known as
--rt' c ltw ir e r e s il i ency .

rd
IC

but
rly,
¡ch Figure 1-3 Figure 1-4
 Introduction 1 4

In observing Figures 1- I thru

1-5, it can be seem that the
actual moment on the cusPid
creates a force sYstem which
can be very beneficial for many
types of treatment, such as
anchorage control and Class II
correction. Note that teeth in
the buccal segments have been
bt'-passed. The greater the inter- Figure 1-5
bY anY
bracket distance, the gteatet will be the resiliencY created
given archwire.

Now, let,s take a look at the occlusal view of archwire bends.

makes
whether resiliency occurs in the sagittal or occlusal plane
no difference. The confusion usually remains the same'

Planes of SPace Figure 1-6

Note in Figures 1-6 thru 1-8 that the archwire has been activated
by bending the wire lingual to the molars. Determine onlY the
forces present and disregard the moments for these examPles.

-:

-
 Introduction 1 5

Figure 1-7 Figure 1-8

*:: ,i, :re in each case is bent in the same direction with forces

1y cornpletely different. It will be seen later that the

of tlre bend is significant.

1s.
. et' s look at a
somewhat different sifuation, but stiil
:CS
t* :ng resiliency and its effects. In this case, consider only
::--,ments and not the forces for Figure 1-9.

Figure 1-9 Figure 1-10

' , -u1d appear that the resulting moments in Figure 10 are
rted - *;": because of the arc through which the wire must travel
" : ;:gagement with the molar tubes. Wires are normally
the
: ,: ; i into the molar tubes first, thereby eliminating the visual
: *: - . ;,i resiliency.
 Introduction 1 6

The moments shown in Figure

1- 1 1
are correct. These are
simple examples of the effects
of archwire resiliency. More
dramatic effects will be seen
later when the Wire/Bracket
relationships are discussed in
detail.
Figure 1-11

Next, a discussion will take place involving the problems

associated with visual inspection it the sagtttal plane of space.

1-13 Figure l-I4

In Figures I-I2 thru 1-15, it
can be seen that although the
wires are bent in the same
direction, it is the different
location of each of the bends
responsible for the entirely
different forces produced on
the molars and the cuspids.
Figure 1-15
 Introduction I 7
\*rgft. the same
illustrations will be shown, but only the moments
::* to be determined. Disregard an forces resent.

Figure 1-18 Figure 1-19

-{gain, look at the completely different directions
and
rnagnitudes of the moments involved
i:l Fi_qures 1- 16 thru I-19.
ru\
ith forces and moments having been
¡etermined individu alIy, the entire
:ürce systems can now be seen in
Frqure 1-20. This is not easy for many
rndir"iduals to predict.
Figure l-20
 Introduction 1

Figure l-21 Figure l-22

Figures l-2T and l-22 offer very simple rules to predict the
foices and moments previously discussed. This is not exactly a
scientific method for identification, but it is a good rnemory
method until such time as immediate recognition of forces and
moments takes place. This will occur with a thorough
understanding of equilibrium requirements.

With afr understanding of the above rules, it

can be seen in
Figures I-23 thru l-29 that all the bends shown are really off-
center bends. Later, when the center bend is discussed, it will
be seen that it can be considered to be a vañation of the
center bend. These similarities will be extremely helpful"ff-
in
predicting force systems.

Figure I-23 Figure l-24 Figure I-25

 Introduction I 9

1e
a
t))
nd
gh

Figure l-28 Figure l-29

1n : .-.-rt has been discussed thus far has been an elementary
,Jf- :::l,Cuction to force systems. The pu{pose is to illustrate the
r,ill
- .:lrability of using visual inspection. Contrary to what is
,Jf-
in

Figure 1-30 Fig 1-31

 Introduction 1

THE, SHORT STORY

Orthodontic treatment involves the use of many appliances used

for control. Transpalatal and lingual arches are in common use
today because of unexpected tooth movements. With the use of
such additional appliances, rigidity interferes with the need for
teeth to be placed into the neutral zone, as rigidity overcomes
the nafural forces produced by the muscles and function.

An approach has been presented to atd the orthodontist in

recognizing why these forces seem somewhat difficult to
rccognize. Archwire resilience and archwire shape can be very
misleading in the prediction of force systems. Because the
typical orthodontist has been taught to read force systems by
visualizing the relationship of the archwire to the bracket slot
prior to insertion, incorrect force systems are often anticipated.
No force system is produced until an archwire is placed securely
into the bracket, at which time chancteristics such as resilience
come into play. Resilience is an important factor to recognize as
it will increase or decrease with changing interbracket distances.
Wire shape has also been shown to create force systems other
than what might be anticipated.

Explanations and solutions to the above problems have been

presented at a relatively elementary level at this point. With the
material to follow, the orthodontist will be able to predict force
systems in a more sophisticated manner. What will be presented
may be far different than what you have learned in the past, but
it will offer new opportunities for the clinician.
 Introduction 1 11

SUGGESTED READINGS
)d
IA
I\/

Df illulligan TF. Common sense mechanics. Phoenix: CSM, 1040 East

Df Osborn Road, 1982.
ES
Smith RJ, Burstone CJ. Mechanics of tooth movement. Am J Orthod
1984;85:294-307 .

in
to
;ry
he
by
lot
ed.
ely
nce
)as
)es.
her

€en
the
)rce
nted
but

:
G
 lJnderstanding Forces and Moments 2

TJNDE,RSTANDII{G
FORCES AND MOME,I{TS
2
For some reason, the terms forces and momenls do not always
seem to be thoroughly understood. It is true that the English
language seems to suffer over a period of time, but in the area
of
mechanics it is important to understand exactly what each term
means and to use these terms properly. The terminology which
follows will be used in a practical manner. There afe exacting
definitions that may be confusing to many while there are
déscriptions that may convey a practical meaning to most
clinicians.
Orthodontic clinicians know from
personal experience that a specific
force system does not necessarilY
produce the same response for
different patients. Nothing in life
happens without a reason. Force
magnitude can be very significant.
as stated in Figure 2-1.
Figure 2-1

With an intrusion arch molars might erupt andlor incisors may

intrude. Bicuspids are more likely to undergo an equal and
opposite rotati,onal response with powerchain elastics. These
responses are illustrated in Figures 2-2 thru 2-4.
 Understanding Forces and Moments 2 13

FiEure 2-2 Figure 2-3 Figure 2-4

)'s - - --,-'\\ 1I19 illustrations may help to clarify some of the

Sh , :.;3rtions the orthodontic rofession.
of
rTn
Lch
ing
are
ost

om
ific Figure 2-5 Figure 2-6
rily
for .:r- used in reference to a free body such as a golf ball or
life ::i::¡11. When the same force is applied through the center of
)rce i: ::ached body - such as a tooth - the term used is center of
ant. "- ,i:'tnce. This is nothing new to the orthodontist, but building
: . : r"s ii ill slowly be established so that confusion does not
r,*:i nater when discussing biomechanics.

may - -; definition of a force could properly be defined as MxA

and -'-,:-*-rtimes Acceleration), but what meaning would this have
hese ' : : :}re clinical orthodontist? If we describe rather than define a
:-e. it can be seen in Figure 2-6 that aforce acts in a straight
:.¿ and may consist of a push or pull.
 Understanding Forces and Moments 2 1-[

Retracting cuspids with an open coil spring does not result in

forces actlng in a curve. If we push from the lingual surface of a
tooth with a lingu al arch, ot pull from the buccal surface of a
tooth with an archwire, the force acts in a straight line as it
passes through the tooth.

Frgure 2-7 demonstrates this by using descriptions rather than

definitions which so often confuse the issue. Depending on
eiactly where these forces act, moments may or may not be
produóed. This will be discussed later during the subject of
forces and moments.

Figure 2-7
11 Understanding Forces and Moments 2 l5

in
fa
la
it

ran
on
be Figure 2-8 Figure 2-9
of
ur-}en a force acts on a body, but away from the center of
'.:;i-;[tttTce (or center of mass), there is a perpendicular distance
:.:bhshed between the applied force and the center of the
;:"¿ct as shown in Figure 2-8. It is the product of this distance
:*i the force that produces a moment. In other words, if either
,.-- ibrce or the distance doubles, the moment produced would
:: -rble. This is significant because in Figure 2-9 it can be seen
;"-:: different force magnitudes can produce the same moment.
: '¡ne force is half the magnitude of the other, but acting at
r;, -'-e the distance, the moments in each case will be equal. This
impoftant to recognize in orthodontirc treat
reatment as it affords
-: opportunity to produce desirable moments without the
::s¿dvantage of high force magnitudes, particul arly in the
:rtical plane of space where vertical dimension of the patient
:.lght be compromised.

l::sonal experience in our lives can be of great help in

-;ognizing forces and moments produced in orthodontic tooth
n,,-r\ efirert. Most of us have probably played the game of pool -
.:ien referred to as billiards - sometime in our lives or at least
- rserved it being played by others. It is quite popular on TV.
 Understanding Forces and Moments 2 16

So, let's take a look at the game

of pool and see how it maY be
of help in learning. For those
who may not be aware' the ball
in question is known as the cue-
ball and is the white one seen in
Figure 2-10. KeeP this in mind
so as not to become confused
Figure 2-I0 with conservation of momentum
are
rvhich involves the other balls. The following examPles
those we have experienced or can experience in our
daily lives'

Figure 2-ll Figure 2-12

The first step involved is to visualize the crown of the tooth

as a

cue-ball as seen in Figure 2-rL rhe next step will be to

identiff
the point of forru opplication shown in Figur e
2-12 ' The cue
stick used in the gá-. of pool will represent the source of
the
applied force. Th¿ next question is: "In what direction will
the
cue-ball move and how wil it rotate?" Keep in mind that
the
rotation will be clockwise or counterclockwise - in pool this
is

referred to as left or right Engtish. Naturally, the ball will

ro11

down the tabl. án. to friction, but disregard this rotation'

 6 Understanding Forces and Moments 2 t7

1e
)e
SE

111

.e-
in
nd
ed
tm Figure 2-13 Figure 2-14
lre There aÍe three possible
;.
movements that may occur, just
as in the real world of
orthodontics. The first movement
we observe is pure translation as
seen in Figure 2-I3. The force
has been applied through the
center of the bodies shown.
Figure 2-15
l:enslation and rotation may occur as shown in Figure 2-14
," nere the force has been applied away from the center of the

:';nd)- as illustrated. The moment in such a case is referred to as

-:e moment of a
force.
asa
rtiry F:gure 2-I5 shows equal and opposite forces (known as a
cue ; -',uple) being applied and producing pure rotation.. The moment
'the -: such a case is referred to as the moment of a couple. A pure
the :iüment always acts around the center of resistance. Regardless
the :: the where the equal and opposite forces are applied, the body
* ril undergo pure rotation around the center of resistance.
is is
roll
*:ri's see where this concept applies at the clinical level.
 Understanding Forces and Moments 2

Translation

Figure 2-16
In Figurc 2-16 upper left, forces have been applied at the crown
level resulting in tipping moments. The force system is always
shown at the center of resistance. Remember that a force
applied away from the center of a body will cause the body to
move in the direction of the applied force and rotate because of
the perpendicular distance. With the addition of a center (gable)
bend shown in the lower part of the illustration, moments
opposite to the tipping moments ate created thereby eliminating
tipping moments measured at the center of resistance. The result
is that only pure forces remain as seen on the right in Figure 2-
16. This is referred to as an equivalent force system. Remember
the so-called powerarms that were introduced to the profession
in order to create a translatory force through the center of
resistance? Where are they now? Does this tell you how
successful or unsuccessful the results have been?

A clinical example of the above application is seen in Figure2-

.
ll Tipping moments are eliminated by equal and opposite
moments resulting from a center bend. As will be explained
Iater, all archwire bends are done intraorally and activated 45
i8 IJnderstanding Forces and Moments 2 19

degrees.All adjustments for

increasing or decreasing
moments for the proper force
system are created by
adjusting whatever closing
mechanism is in use, such as
coil springs or powerchain.

In Figure 2-IB, tipping the

Figure 2-17 incisors together would not
be acceptable. The placement
wn
of a center bend into the wire
ays -
produces moments which
rce
then result in bodil¡'
'to movement as a result of
:of
r1e)
eliminating the tipping
moments produced by the
:nts
ting
closing mechanism which
sult
could be coil springs or
powerchain elastics.
e2-
Figure 2-18
rber
sion
Translation and Rotation
rof
how
Fiqures 2-I9 and 2-20 demonstrate that a force applied away
:iom the center of a body will cause the body to translate and
:ütate. Looking at a rotated bicuspid with space mesial to the
se 2-
iooth, it can be seen that applying a mesial force atthe bicuspid
osite
bracket will produce the necessary force and moment. This
rined
¡bviously simple approach is intended only to illustrate the cue-
d4s '¡a11 concept regarding translation
and rotation.
 Understanding Forces and Moments 2 20

Figure 2-21 Figure 2-22

Figure 2-2I and Figure 2-22 demonstrate the same concept
beautifully as will be seen later when wire/bracket relationships
are discussed. For now however, simply keep in mind that by
excluding the second bicuspid brackets from the archwire, an
off-center bend has been created without the need to remove the
wire. In a full appliance the toe-in bend at the molar would
actually be a center bend when related to the adjacent molar tube
and bicuspid bracket on each side. By not engaging the wire
into the second bicuspid bracket an off-center bend has been
created. Do you remember the rules for off-center bends? An
off-center bend contains a long and a short section. The short
section points opposite to the force produced thereby indicating
abuccal force on the molar. The toe-in bend (short section) also
 Understanding Forces and Moments 2 21

rrühduces a rotational moment. This approach allows both

;c,rrection of the molar rotations and crossbites simultaneously
n:nhout removal of the archwire or use of crossbite elastics.
T:ns is only one of many similar approaches that can minimize
;:¿rrside time for the orthodontist as well as providing a vaiety
:: ntrncompliant and exciting approaches not taught in school.

- :rs might be a good time to mention that in over 46 years of

:rrctise - thus far - never has the author used a crossbite elastic,
:rnspalatal arch, lingual arch, or any other type of lingual
¡::¿chments. Why not? Because there are so many alternative
.:C noncompliant approaches that do not require this. Many
: *rer t),pes of labo ratory appliances which are commonly used
l'.-Cr\ can also be avoided. This will be discussed in the
*ruoming chapters.

Pure Rotation

3pt
l:ie final cue-ball concept relating to pure rotation - moment of a
ips
by
-
-.,:rp/e can now be illustrated. Remember that equal and
: lposite forces produce a couple.
an
the
uld
ube
vire
een
An
hort
ting
also
Figure 2-23 Figure 2-24