©1980 JCO, Inc. May not be distributed without permission. www.jco-online.

com

Common Sense Mechanics

THOMAS F. MULLIGAN , DDS

Extraction Mechanics

Earlier, in the "Fallacy of Visual

Inspection in Force Analysis",
it was shown that a wire with a
bend off center is clearly dif-
ferent than one with a bend in
the center, since one produces net forces
at the bracket, while the other does not.
A center bend involves no net forces,
but only equal and opposite moments
with full wire/ bracket engagement in
any plane of space.
The tipback bend is an off-center
bend. The long segrnent indicates the
direction of the force produced, while
the short segment points in the opposite
direction to the force it produces (Fig .
107). In the tipback, two moments are Fig. 107 Tipback bend is an off-center bend, with
the long segment pointing in the direction of the
also produced, but they are unequal. force produced and the short segement pointing
The larger moment lies at the bracket or in the opposite direction to the force produced.
tube containing the short segment (Fig.
108). The smaller moment lies at the
bracket or tube containing the long
segment. This smaller moment may, at
times, be clockwise; and at other times
counterclockwise; and even disappear,
producing the cantilever effect, because
only a pure force would exist at that
bracket (Fig. 109). These various results
are dependent on the angle at which the
wire crosses the bracket.
The important thing to remember is
simply that regardless of the presence,
absence, or direction of the smaller mo-
ment the two moments are unequal and Fig. 108 The larger moment lies at the bracket or
tube containing the short segment.

336 © 1980 JPO. Inc . JeO/ MAY 1980

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B / --
- -
7

G
c

G
Fig. 109 Depending on the angle at which the wire with an off-center bend crosses the bracket, and the
length of the long segment, the smaller moment (produced by the longer segment) can be clockwise
(A), counterclockwise (B), or nonexistent (C). In all three instances, the net effect is counterclockwise,
dominated by the short segment.

therefore, result in differential torque still counterclockw ise . If the smaller

dominated by the larger moment. Even
if we do not recognize the smaller mo-
ment as being clockwise, counterclock-
wise, or absent, it is still the larger mo-
ment that produces the net resu lt. If, for
example, the larger moment is counter-
clockwise and the smaller moment is
clockwise (Fig. 109A), the net effect is
moment is counterclockwise (Fig.109B),
the net effect is also counterclockwise,
although more strongly so. If no moment
is present (Fig. 109C), the obvious net
effect is, likewise, counterclockwise.
The resilient characteristics of the
wire can complicate our interpretations,
as archwire activation often produces a

VOLUME XIV NUMBER 5 337

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c;n'---=-==---
E::::3-,....
.... ................
---
Fig. 110 Engaging a tip back bend in the molar
tube, initially produces a wire/bracket relation-
ship different than the ultimate mechanics.
different wire/bracket relationship, ini-
tially, than might be anticipated (Fig .
110).
Practical Interpretation of
Forces and Moments
Thus far, most examples used for
center and off-center bends have in-
volved only two teeth or two units of
teeth. Since we are going to be dealing
with many teeth during the treatment of
various malocclusions, it might be won-
dered how complicated all of this is go-
ing to become. Well, it doesn't have to
become any more complicated than
working with only two teeth.
There are techniques today that
create a "single tooth" by segmenting a
number of individual teeth. In a sense,
this was demonstrated when the canti-
lever principle was discussed. Four inci-
sors were treated as a single unit by the
placement of an anterior segment of
wire, and then an overlay archwire was
used to apply the desired force. How-
ever, we are not going to be using seg-
ments for treatment. As a practical mea-
sure, we will be treating the two teeth on
either side of the bend, even though we
are using a continuous archwire and
multiple banding/bonding . Often, we
will be discussing "segmented tooth
movement", but on a continuous arch-
wire. When dealing with multiple teeth,
the teeth adjacent to the bend will be
338
discussed, while teeth farther away from
such bend will be temporarily ignored.
=.z:
/
Naturally, all of the teeth are ultimately
"
--,"'" affected, as the forces and moments are
transmitted along the wire. But, initially,
the force system acts on the adjacent
teeth most effectively. Therefore, as a
practical matter, we will not discuss the
system in an unnecessarily complex
manner.
Please understand clearly - the
technique shown in this discussion will
depart from exactness; but, in a practical
sense, it works. It is simple, easy, orderly,
hygienic, reduces the need for patient
cooperation, and will make your work
more enjoyable, because you can think
ratherthan follow a "cookbook", and va-
ry your procedures to fit your schedule
- planned and unplanned. I am not ad-
vocating this technique, but will simply
be using one treatment approach to
demonstrate the application of princi-
ples of mechanics in a practical way.
Naturally, you are free to apply such
principles in any way you feel will be
better or enjoy doing more. The " fun" in
orthodontics, I believe, lies in treating
common or similar problems in a variety
of ways.
Cuspid Retraction
Figure 111 shows a crowded condi-
tion in which four first bicuspids were
removed. We are not discussing whether
or not teeth should be removed, and we
are not discussing cephalometrics. This
series will concentrate on a practical
clinical approach in which principles of
mechanics will help us to predict and in-
terpret tooth movement. Complete or-
thodontic records, including cephs are
taken and studied for all full treatment
procedures, but we are attempting to
discuss only the mechanics following
treatment decision and statement of
objectives.
JCO/ MAY 1980
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MULLIGAN

Fig. 111 Crowded case to be treated with four-bicuspid extraction.

The typical extraction strapup in-
volves the banding/ bonding of cuspids,
second bicuspids, and first molars (Fig .
112). Many prefer to band second mo-
lars for anchorage purposes as well as
for gnathological considerations.
Others band second molars for
alignment and control. As we move
along, I will discuss some of my reasons
for not routinely banding second mo-
lars . Obviously, there are situat ions
when they MUST be banded. Remem-
ber, that as far as intraoral anchorage is
concerned, we will be talking about the
effectiveness of differential torque as a
means of control. Keep in mind, there is
no such thing as PERFECT intraoral an-
chorage, so we are seeking a method
which offers the optimum for control.
Those who band second molars to
increase anchorage are saying, in effect,
that three teeth (considering total root
area, etc.) will tend to resist moving as
much as a single opposing tooth will
tend to move, and therefore, during cus-
pid retraction, the cuspid will undergo
the greatest movement. However, expe-
rience has taught that this is not always
reliable. Sometimes, the anchor unit
serves well, while at other times it rea-
dily seems to move forward .
Since the forces during retraction
are equal and opposite on the two units
- anchor unit and non-anchor unit-
the multibanded unit actually receives
the lesser amount of force per unit area
(stress) along the periodontal mem-
brane while the non-anchor unit (cus-
pid) receives the greater. This could be
one of the causative factors in the varia-
tions that occurs. We will be discussing
moments (differential torque) as a
means of controlling the anchor unit in-
stead of purely by force distribution.
Aga in, this is not meant to imply that dif-
ferential torque is an ideal means of
anchorage control. Extraoral means are
always available, but not always desired.

Fig. 112 Typical extraction strapup, with cuspids, second bicuspids, and molars banded.

VOLUME XIV NUMBER 5 339

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COMMON SENSE MECHANICS
In the cases being demonstrated,
the appliance happens to be edgewise
with .022 x .028 slots and .045 headgear
tubes. The initial wires are only .016 (oc-
casionally .018). But this is not a discus-
sion of appliances, so mentally convert
the various applications to the appliance
and wire sizes of your choice, but don't
lose sight of the principles.
I n Figure 112, you can see that anti-
rotational ties are placed next to the ex-
traction sites, unless such rotations are
indicated. The malocclusion usually re-
sults in initial archwire activation, due to
the fact the brackets are not yet aligned.
The periodontal response that occurs is
permitted to improve bracket alignment
and level, prior to placing any bends in
the archwire. If total arch length is to be
reduced in the final result, the 360 0 tie-
back loops are placed "short" of the
molar tubes as shown. Also, anytime
teeth are being retracted, there is a me-
sial force at the molar tubes. Toe-in
bends should be placed early, so as to
initiate a counterrotation, so that we do
not produce a mesiolingual rotation of
the molars when retraction is begun. Re-
member the "Cue Ball Concept". Of
course, many will offset this rotational
tendency with lingual elastics. However,
I do not use ANY lingual attachments.
Next (Fig. 113), we see the place-
ment of bends intraorally. If bends are
placed intraorally, they cannot be placed
against the brackets completely, due to
the width of the Tweed loop plier that is
Flg.113 Bends placed intraorally with Tweed plier.
340
used. Therefore, the differential torque
produced on the teeth adjacent to the
extraction spaces is reduced. This is be-
cause, as mentioned numerous times
now, the closer a bend gets to the center,
the more equal become the moments;
and when placed directly in the center,
the moments are equal and opposite.
Again, these statements are not exactly
precise, as the molars are included in the
partial strapup. But, as emphasized be-
fore, exactness is sacrificed so that we
can utilize a "workable" clinical ap-
proach . Likewise, regardless of how far
we place bends off center, smaller inter-
bracket distances result in bends being
relatively close to center. I n fact, second
bicuspids are sometimes temporarily
not banded to increase the distance and
therefore the differential torque. Re-
member the importance of the toe-in
bends or lingual elastics to offset the
tendency for mesiolingual rotation of
the molars.
Figure 114 shows the retracting
elastics in place. I now utilize power
chains and tie the cuspid directly to the
molar, while the second bicuspid is tied
individually with an "0" Ring. This
allows a greater range of force. In order
to eva'luate the effectiveness of anchor-
age control, on a clinical basis, observe
the two units. The anchor unit should
remain relatively upright, while the non-
anchor unit should undergo tipping until
archwire binding occurs. Once binding
occurs, the roots will respond to the
JCO / MAY 1980
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MULLIGAN

Flg. 114 Retraction elastics in place. I now use an " 0" Ring on the bicuspid and power chain from cuspid to
molar.

moments produced by the archwire,
until binding stops and crown move-
ment is resumed . Remember, the anchor
side is located closest to the bend while
the non-anchor side is furthest from the
bend. As cuspids continue to move dis-
tally, the bend automatically " ap-
proaches" the center of the wire, until
finally, when the extraction sites are
closed, the bend is centered . So you can
see that as the off-center bend moves
toward the center during space closure,
the differential torque begins to gradu-
ally disappear, and becomes equal and
opposite torque when the bend is finally
centered . This is interesting , because we
utilize the differential when we need it
most and, since tipping occurs with the
non-anchor unit, the root parallelism
begins to take effect as the bend ap-
proaches center. By center, of course,
we are not referring to the center of the
entire archwire, but to the center of the
wire lying between the bicuspid and
cuspid brackets. Do not expect to see
the anchor unit "tip back" as the mesial
force on this unit from the retraction
elastic will offset the distal crown thrust
that was observed in nonextraction
treatment. However, the net force on the
cuspid is distal in direction.
Since we are considering differen-
tial torque rather than multi banded an-
chor units for " bulk", it may be difficult
to get used to the idea of banding LESS
teeth for anchorage. For example, if the
second bicuspid is not banded (Fig .
115), the off-center bend can be placed

Fig. 115 If the second bicuspid is not banded, the off-center bend is further off-center.

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COMMON SENSE MECHANICS

more distant from center. Remember

that as we move away from center, the
differential torque increases, whereas at
the center point the moments are equal
and opposite and, therefore, there is no
differential torque. The clinical guide to
effective anchor control is to look at the
unbanded bicuspids and observe them
for mesial tipping. They will only tip
mesially, if the molars come forward.
Because of the mesial root torque on the Fig. 116 When extraction space is closed, an intra-
oral bend can be made distal to the cuspid brack-
molars from the off-center bend, the et, countering the tipback bend at the molar and
molar itself will tend to move bodily, producing equal and oppOSite moments for root
while the cuspid is permitted to tip to a paralleling.
limited degree, as it experiences a
smaller moment. Once the spaces are
closed, a centered bend will not be pres-
ent, as the bend has been placed against and opposite and root paralleling oc-
the molar. Therefore, to produce equal curs. Toe-in bends or lingual elastics
and opposite moments for root parallel- should be in useforthe duration of space
ing, it is not necessary to place a new closure and, in fact, should be placed
archwire and relocate the bend, as a prior to initiating space closure, so that a
bend can be placed immediately distal countermoment is produced to prevent
to the cuspid bracket (Figure 116), and mesiolingual rotation of the molars dur-
the moment becomes equal and oppo- ing space closure. Since round wire is
site to the moment on the molar. being used, one must remain conscious
of the "Cue Ball Concept", and not de-
pend entirely on the concept of "rigidity
Summary
for control".
When the initial archwire is placed,
the periodontal response will most often (TO BE CONTINUED)
be initiated by the malocclusion, which
produces brackets that are angulated re-
lative to a straight wire. When reason-
able alignment takes place, the bends
may be placed. If anchorage is required,
then the bend is off-center. The tooth
located closest to the bend indicates the
anchor side. The oppOSite is the non-
anchor side. The anchor side requires a
bodily type movement for displacement,
whereas the non-anchor side tips some-
what due to the lesser moment. As space
closure occurs, the bend becomes more
and more centered, meaning the mo-
ments become more and more equal.
When finally centered, they are equal

342 JCO / MAY 1980