Crimpable Hooks Research Articles

Facemask application with fixed orthodontic appliances: 3-dimensional finite element stress analysis.

Facemask(FM) is an orthopedic appliance with extraoral and intraoral anchoring units used in treatment of maxillary retrognathia. Aim of this study was to assess effects of tooth-supported FM application via fixed orthodontic appliances on craniofacial structures with finite element stress analysis. A model was constructed on maxillary teeth with Roth brackets (0.018″slot), 0.018″x0.025″ stainless steel archwire, and crimpable hooks placed distal to upper lateral incisors. The scenario included application of FM with 350 g force, forming 30° angle with occlusal plane. Stress distributions and displacements on craniofacial bones, sutures, intraoral anchoring unit and maxillary teeth were evaluated. High stress distributions were observed in anterior maxilla, pterygomaxillary region, zygomatic arch, and frontal process of zygomatic bone. Zygomaticotemporal, zygomaticofrontal, pterygomaxillary sutures and intraoral anchoring unit showed high stress distributions too. Stresses along maxillary teeth were not uniform, declaring increased stress distributions at the anterior region, but tended to decrease to posterior. Forward displacement was observed in all landmarks and counterclockwise rotation of maxilla and dentition were observed vertically. Narrowing in maxillary dental arch was observed. Tooth-supported FM application over the brackets created stresses on craniofacial bones and sutures. Increased stress distribution were evident at the anterior maxillary region close to the force application points. Displacements were observed in all directions, drawing special attention to transversal narrowing and counterclockwise rotation of maxilla. In this respect, clinical attention should be made during FM application anchored from fixed braces, with either using rigid archwires or supporting mechanics with transpalatal arches.

Three-dimensional evaluation of maxillary tooth movement in extraction patients with three different miniscrew anchorage systems: a randomized controlled trial

ObjectiveTo compare the three-dimensional (3-D) movement of maxillary teeth in response to three common miniscrew anchorage systems in extraction patients with maxillary dentoalveolar protrusion.Materials and methodsThe study employed a randomized controlled single-blinded design with three arms. Thirty extraction patients who required maximum anchorage to retract maxillary anterior teeth were included and randomly allocated into three treatment groups: space closure with direct miniscrew anchorage and low crimpable hooks (DL group), indirect miniscrew anchorage and low crimpable hooks (IL group), and direct miniscrew anchorage and high crimpable hooks (DH group). Cone beam computed tomography (CBCT) images of all included patients were obtained immediately before (T0) and after (T1) space closure. The outcomes were 3-D positional changes of maxillary central incisor, lateral incisor, canine, second premolar, and first molar. The repeated measures analysis of variance with post hoc LSD test was used to evaluate differences among groups.ResultsA significant intrusion (− 1.34 mm; 95% CI, − 1.60 mm, 1.08 mm) and buccal (− 6.92°; 95% CI, − 8.67°, − 5.13°) and distal (4.90°; 95% CI, 3.75°, 6.04°) inclination of the maxillary first molars were observed in the DL group, compared to the other two groups. The mesial movement (− 0.40 mm; 95% CI, − 0.83 mm, − 0.03 mm) of the maxillary first molars was found in the IL group, while the DL (0.44 mm; 95% CI, 0.15 mm, 0.73 mm) and IL (0.62 mm; 95% CI, 0.28 mm, 0.96 mm) groups exhibited distal movement. In the DH group, the lingual inclination changes of maxillary central incisor (5.04°; 95% CI, 2.82°, 7.26°) were significantly lower, which is indicative of good lingual root torque control of the maxillary anterior teeth.ConclusionThree miniscrew anchorage systems produced significantly different 3-D maxillary tooth movement. The maxillary first molars were significantly buccally and distally inclined and intruded in patients using direct miniscrew anchorages with low crimpable hooks. Direct miniscrew anchorages with high crimpable hooks could help to achieve better lingual root torque control of the maxillary incisors.Trial registration The trial was registered at www.chictr.org.cn (ChiCTR1900026960). Registered 27 October 2019.

Custom-made acrylic beads for Forsus reactivation

The usage of the fixed functional appliances has increased over the years, mainly on the account of minimal demand for patient cooperation with these appliances. Though Forsus appliance provides sufficient activation for skeletal and mandibular correction with crimpable hooks, additional activation may be required in few cases. This clinical tip presents with a efficient and cost effective way for Forsus activation using customized acrylic beads.

Comparison and Measurement of Molar Anchorage Loss during En-Masse Retraction Using Mini-Implant and Conventional Mechanics

Aim: To compare and measure molar anchorage loss during en-masse retraction using mini-implant and conventional mechanics. Objectives: 1) To evaluate the molar anchorage loss during en-masse retraction of anterior teeth by using conventional mechanics. 2) To evaluate the molar anchorage loss during en-masse retraction of anterior teeth by using the orthodontic mini-implant as absolute anchorage. 3) To measure and compare the molar anchorage loss during en-masse retraction using mini-implant and conventional mechanics. Methods: The study was carried out on 10 patients requiring extraction of four first premolars and maximum retraction. On the right side (experimental side) mini-implants were placed between the second premolar and first molar and an e-chain was engaged from the head of the implant to the crimpable hook. On the left side (control side) an e-chain is given from crimpable hook to molar hook for en masse retraction. The retraction space closure was calculated using vernier caliper on the study model after 28weeks of retraction. Lateral cephalogram was taken before and after orthodontic retraction for calculating molar anchor loss. Results: The retraction space closure after 28 weeks showed a mean value of 3.59+0.68mm on the mini-implant side and 3.98+0.62mm on the conventional mechanics side, which was statistically significant. The anchor loss of 0.17+0.3 mm was observed on the mini-implant side and 1.32+0.62 mm was observed in the conventional mechanics after retraction, which was found to be statistically significant. Conclusion: In this study, the molar anchor loss of 0.17+ 0.3mm was seen on the mini-implant side and 1.32+0.6mm on the conventional mechanics side which was significantly more by 1.15mm than the mini-implant side. The closure of extraction space on the mini-implant side was done by retraction of anterior teeth and minimal anchorage loss, while in the conventional mechanics side there was anchor loss of anterior as well as posterior teeth.

Efficacy of Infrazygomatic Crest Implants for Full-arch Distalization of Maxilla and Reduction of Gummy Smile in Class II Malocclusion

The purpose of the study was to evaluate the efficacy of infrazygomatic (IZ) implants along with mini-implants for full-arch distalization of maxilla and reduction of gummy smile in patients with class II division I malocclusion. Ten orthodontic patients were taken from the department of orthodontics and dentofacial orthopedics. Each patient required distalization and intrusion of the complete maxillary arch as a part of the treatment plan. Patients were of class II malocclusion with gummy smile. Initial leveling and alignment were done by using 0.22″ slot Mclaughlin Bennett Trevisi (MBT) prescription. Fav Anchor infrazygomatic crest (IZC) implants of 2 mm of head diameter and 14 mm length were inserted between first and second molar and 2 mm above the mucogingival junction in the alveolar mucosa and in the anterior region, two titanium mini-implants of 1.4 mm head diameter and 6 mm length. The screws were loaded immediately with e-chain with a minimal force from mini-implants in the anterior region to crimpable hook placed between lateral and canine and continuing the same till the IZ implants. To measure the amount of distalization and reduction of gummy smile, pre- and postlateral cephalograms were taken and assessed. Pre- and postdistalization and intrusion readings of all patients were obtained and calculated statistically for quantifying the amount of distalization of maxillary arch and intrusion for reduction of gummy smile. The distalization of the maxillary arch achieved was 4.6 mm which is clinically and statistically significant. The anterior teeth in the study were intruded with a minimum of 3.8 mm which is clinically and statistically significant; the gingival smile line was reduced with a mean of 3.4 mm which is clinically and statistically significant. Overbite correction of 4 mm was done with the mean difference of 4 mm which is also statistically significant. The IZ bone screws can be effectively used as an absolute anchorage to correct class II skeletal discrepancy with gummy smile devoid of premolar extraction with noninvasive procedure. The use of IZC implants along with anterior implants, a biomechanical approach is effective in achieving full-arch distalization of maxilla and intrusion as the force vectors allow that the line of action passes through the center of resistance (Cr) of the entire maxillary arch, facilitates the distalization and intrusion of the maxillary arch, establishes ideal occlusion, and improves the smile esthetics.

Versatile Uses of Crimpable Hooks

The crimpable hook is a widely accepted tool onto which active elements can be fixed to aid in orthodontic tooth movement. This clinical pearl aims at showing the different ways in which crimpable hooks can be used to better orthodontic treatment mechanics, which are Crimpable hooks used for buccolingual force mechanics and Crimpable hooks used in conjunction with orthodontic miniscrews. The above-mentioned simple methods aim to facilitate and make easy the attachment of force elements for various kinds of tooth movements. It can help the operator to save time, prevent unwanted side effects of forces, as well as reduce the need for ligature wires for the attachment of force systems onto implant heads or lingual sheaths.

Pulpal blood flow changes and pain scores related to using Superelastic 0.018-inch Nickel Titanium as the first orthodontic alignment archwire: a prospective clinical trial.

Background Optimal orthodontic force results in maximum rate of tooth movement without tissue damage. Even though starting orthodontic treatment with a thicker archwire may shorten treatment duration, the evidence on the effect of using 0.018-inch NiTi as the first alignment archwire on pulpal blood flow (PBF) status is still scarce.Objectives to record PBF changes and pain scores associated with using 0.018-inch NiTi as the first alignment archwire during fixed orthodontic treatment.Methodology Patients were selected from subjects attending postgraduate orthodontic teaching clinics at Jordan University of Science and Technology. In total, forty healthy patients who exhibited mild lower arch crowding were included. A split-mouth trial design was used. Each patient received two archwire sizes at one time joined in the midline by crimpable hook and applied in the lower arch. Patients were assigned into one of two groups based on archwire sizes used. Group 1: 0.014-inch and 0.018-inch NiTi (Six males, 14 females aged 19.4±1.33 years) and Group 2: 0.016-inch and 0.018-inch NiTi (Seven males, 13 females aged 19.6±1.45 years). The archwire size group was randomly allocated with a 1:1 allocation ratio. A Laser Doppler Flowmeter was used to measure PBF at different time intervals (T0-T5). Pain scores were recorded using a visual analogue scale (VAS). A repeated measures ANOVA and a post-hoc Bonferroni comparison tests were conducted to examine differences at the different time points before and during orthodontic alignment.Results For all studied archwire sizes, PBF decreased 20 minutes after their placement. Most PBF changes occurred within 24hours and continued to decrease until 72 hours after archwire placement where the maximum reduction was reached. Eventually, normal values were reverted within 1 month. PBF changes were similar between all alignment – groups.Conclusions Initial orthodontic alignment with 0.018-inch NiTi does not cause irreversible changes to pulpal vasculature or produces higher pain scores.

Removal Torque Analyses of Two Self-drilling Orthodontic Temporary Anchorage Devices (TADs)

Stability of miniscrews or Temporary Anchorage Devices (TADs) is an essential factor for successful application in orthodontics. Miniscrews removal torque can be used as an indicator of miniscrews stability. The objective of this work was to compare removal torque between self-drilling tapered mini-screws and cylindrical miniscrews. Materials and Methods: Two groups of TADs were inserted in the maxillae of orthodontic patients to provide stationary anchorage for front teeth retraction. Group 1: 20 tapered self-drilling miniscrews, Group 2: 20 cylindrical self-drilling miniscrew. Split mouth technique was used. All of the TADs were inserted parallel to the occlusal plane, between roots of the 2nd maxillary premolar and 1st maxillary molar. The TADs were immediately loaded with constant and continuous load using 8 mm long heavy short Nickel Titanium coil spring. The coil spring was stretched between the heads of the two types of TADs and crimpable hooks that fixed on arch wire just distal to the anterior six maxillary teeth. After complete retraction of the anterior maxillary teeth, TADs were removed using torque adjustable screw-removal. At the moment of movement of the TAD the torque was recorded in Newton Centimeter (Ncm). Results: Mann Whitney U Test resulted in a significant difference between the two groups, indicating that cylindrical TADs had significantly higher removal torque than tapered TADs (means were 3.20 Ncm ± 0.20 and 2.70 Ncm ± 0.10 respectively). Conclusion: Physical properties have a considerable influence on the stability of the TADs. Cylindrical TADs are showed more mechanical interlock into the bone.

Implant Anchorage in Orthodontic Retrusion: A Case Report

Mini screws represent a new treatment modality in orthodontic biomechanics. They provide absolute anchorage, no secondary movements and reduced orthodontic treatment time. Futhermore, the surgical procedure for mini implants placement is quite simple and this type of treatment requires no patient compliance. We selected a clinical case in order to emphasize one of the most important indications of the mini implants: retrusion of the upper incisors for a incresed overjet case in a young patient. Two mini implants were placed in order to obtain the correction of the overjet and the retrusion of the anterior teeth. The retrusion was obtained in a reduced period of time using retraction devices on crimpable hooks.

Self-customized Crimpable Hook

Self-customized Crimpable Hook

Self-customized Crimpable Hook

Universally, hooks are meant for application of a force delivery system. Recently, hooks bent into the archwire/soldered hooks were replaced with crimpable archwire hooks in clinical practice. An alternative to crimpable hooks, a simpler, cost-effective method to reduce the chairside time was thought, which leads to innovation. This article describes the stepwise fabrication and application of simple self-customized crimpable hooks onto the archwire. These self-customized crimpable hooks are very economical and extremely useful for practitioners and can be easily fabricated at the chairside. They can be positioned where ever required and also can be used as an alternative to crimpable hooks without welding. It has added advantage of easy removal with a crimpable hook removal plier without causing distortion of the main archwire.

Forsus™ Reactivation by Blu Bite™: Clinical Tip

The usage of the fixed functional appliances has increased over the years, mainly on the account of minimal demand for patient cooperation with these appliances. Though Forsus™ appliance provides sufficient activation for skeletal and mandibular correction with crimpable hooks, additional activation may be required in few cases. This clinical tip can be helpful in the reactivation of Forsus™ with the utilization of Blu Bite™.

Comparison of Rate of En masse Retraction and Anchorage Loss in Conventional Labial Appliance with Labial and Lingual Force: A Clinical Study

Aims: The rate of en masse retraction and anchorage loss were compared between labial appliance with lingual force and conventional labial appliance. Subjects and Methods: The sample consists of 14 patients and they were divided into two groups. In Group 1 – labial appliance with lingual force, elastomeric chain was placed from the palatal surface of the canines to the palatal surface of the molars. In Group 2 – labial appliance with labial force, elastomeric chain was placed from the crimpable hook distal to lateral incisor to the molar tube hooks. The rate of en masse retraction and anchorage loss was calculated for both the groups during retraction in dental casts (R 0 , initial; R 1 , 4 weeks; R 2 , 8 weeks; and R 3 , 12 weeks). Statistical Analysis Used: Student's paired t -test. Results: The rate of retraction was faster and anchorage loss was lower with labial appliance with lingual force, i.e., Group 1. The difference of anchorage loss in Group 1 and Group 2 shows t = 4.824 and P value= 0.000, which is statistically highly significant. The difference of rate of retraction in Group 1 and Group 2 shows t = 3.573 and P value = 0.004, which is statistically signifcant. Conclusions: The rate of retraction was faster and anchorage loss was lower with labial appliance with lingual force, thus indicating that this new technique of space closure utilizes biomechanical advantage of lingual force in conventional labial appliance.

Fas Twin Function Plier: A Clinical Innovation

The main objective of this innovation was to ease, minimise the working time at chair side by loading the crimpable hook for retraction/protraction/any other clinical situation demanding placement of the crimpable hook when the archwire is in position. For the same reason a plier routinely used which can be modified to suit the above purpose was thought off. This innovative plier serves dual purpose. As it is a modified distal end cutter, there is an added feature of crimping the hook to the arch wire apart from serving the basic purpose of cutting the distal end. Thus saves time at chairside. The innovative FAS *twin function plier has a high efficiency, ease of use, is economic, for distal end cutting of the arch wire.

Reactivation of NiTi open coil spring using crimpable hook: A clinical pearl

Ni-Ti open coil springs are often used to create space for alignment of malposed teeth. Predetermining the length of open coil spring required to open up the exact amount of space is rather difficult, and occasionally, the length of the open coil spring falls short to open up the entire space required. This article highlights the chairside intraoral method of reactivation of NiTi open coil spring with the use of crimpable hook without removing the base archwire.

A New Technique to prevent Slippage of Crimpable Hooks

A New Technique to prevent Slippage of Crimpable Hooks

V-notch to Prevent Sliding of Crimpable Hook

En-mass retraction of anterior teeth most commonly involves the use of crimpable hooks which often dislodge when retracting force is applied. A V-notch distal to the hook may prevent such sliding when sandblasting and dental adhesives are not available

Easy Ligature Hooks on Archwire

Any where hooks are meant for application of force delivery system. Soldered hooks were replaced with crimpable archwire hooks in everyday clinical practice. However, simple and costeffective method should be available with the clinician, alternate to crimpable hooks. This article describes stepwise fabrication and application of simple ligature hooks to the archwire.

"Attaching crimpable hooks: An easy way out"

With the advent of pre-adjusted edgewise orthodontic bracket systems, archwire fabrication has been considerably simplified. Archwires that are devoid of any loops or customizing bends can be utilized. These include fabricated tie-back loops, soldered brass hooks, pre-posted archwires and crimpable archwire hooks. Soldering requires chairside or laboratory equipment, is time consuming and may lead to annealing of the archwire. Crimpable archwire attachment allows quick and simple placement of the attachment in any desired position along the archwire in or out of the mouth.This clinical pearl aims at showing an easy and effective method of crimpable hook attachment without any compromise on arch wire properties.

Management of incomplete transposition of mandibular lateral incisor using removable appliances: Two case reports

The aim of this case report was to present treatment of two cases involving the incomplete transposition of a mandibular lateral incisor to a canine site using two different removable appliances. The two 8-year-old girls were referred to our clinic from a general dentist with a complaint of a malpositioned permanent mandibular lateral incisor. Based on the clinical and radiographic examination, a treatment plan was devised. The plan was to correct the transposition and the axial inclination and rotation of the lateral incisor with a removable appliance as the patient was in the mixed dentition stage. The appliances were constructed with 2 adams clasps and a modified vestibular arch on which a crimpable hook was welded. A button was attached to the lingual surfaces of the lateral incisors, and a 1/8 light elastics was placed between the button and crimpable hook in both two patients. The patients were evaluated every 2 weeks with an appointment. At the end of the treatment, the ectopically erupted lateral incisors were uprighted and aligned in their normal positions in the dental arch. In early mixed dentition period, if transposition is suspected, with early and correct diagnosis and with sufficient forethought a pediatric dentist may avoid the need for fixed orthodontic treatment.