Source: AJO-DO on CD-ROM (Copyright 1998 AJO-DO), Volume 1981 Sep (237 - 255): Why edgewise?

Hocevar
-------------------------------Why edgewise?
A compendium of means to gentle resilient fixed appliances
Richard A. Hocevar, D.M.D.
Dunedin, New Zealand
There are many ways to approach the popular goal of less forceful, more elastic fixed appliances. Ribbon
arch wires can be used in ''edgewise brackets'' instead of excessively rigid edgewise wires. A 0.022 by
0.016 inch ribbon arch wire is less than one third as stiff as a 0.022 by 0.028 inch edgewise arch, yet can
provide the same precise control in all directions; a 0.020 by 0.016 inch ribbon arch compares similarly
with a 0.019 by 0.026 inch edgewise arch. As a 0.5 mm. deflection of the latter to engage a bracket can
result in a force of several pounds, the ribbon arch alternatives deserve consideration. Interbracket span
is one of the most important determinants of the force and range levels inherent in an appliance.
Narrow single brackets with 0.022 by 0.028 inch slots may be the most versatile and may help to
minimize force and maximize working range. Contrary to popular opinion, they provide ample potential
for control of rotations. Elastics, elastomeric threads and ligatures, and sectional and auxiliary wires can
produce light continuous force and facilitate its distribution to specific teeth or groups of teeth. New
arch wire alloys hold great promise, but in currently available dimensions they are not worth while.
Compared with steel ribbon arch wires, the advantages of beta titanium in conventional edgewise
dimensions may be negligible. Ribbon and square arch wires of beta titanium that were, for example,
0,020 by 0.016 inch, 0.020 inch square, 0.021 by 0.016 inch, 0.022 by 0.016 inch, and 0.022 inch square
could offer orthodontists a new range of force and resiliency. Such a selection could provide a series of
very gentle transitions to a progressively more precise fit.
One of the most consistent trends in contemporary orthodontics has been an attempt to decrease the
level of force employed for tooth movement and increase the elastic range of fixed appliances. Many
leading orthodontists are of the opinion that the development of appliances providing still greater range
and lower working force levels is desirable. The purpose of this paper, with this goal in mind, is to review
some of the properties of arch wires and their interactions with brackets, to consider some of the
relevant adaptations of the edgewise appliance, and to make comparisons and offer suggestions. The
most important point, perhaps, is to question the use of rectangular arch wires oriented edgewise and
to make a case for the use of smaller square and ribbon arch wires.
Historical perspective
Compared to the massive rigid expansion arches and jackscrews in use at the turn of the century,1
Angle's 0.036 by 0.022 inch ribbon arch was indeed "very delicate."2 The edgewise mechanism
introduced a still lighter (0.022 by 0.028 inch) wire, used edgewise to gain ''greater power in widening

the arches."3 Strang4 reported that Angle, shortly before his death, had been working with 0.022 inch
square wires that allowed greater elasticity for engaging severely malposed teeth, but were perhaps too
pliable to be used in widening mature dental arches. Arch wires of that era were usually gold, with a
modulus of elasticity that was one half to two thirds that of modern stainless steel.5-8
In 1953, Steiner9 stated, "The greatest demand for force from an archwire is in a lateral direction to
create expansion or contraction of the dental arches," but earlier that same year Halderson, Johns, and
Moyers10 wrote, "No more do orthodontists attempt massive expansions of the dental arches, for we
now know that the teeth inevitably find a position of balance between the tongue and the buccal wall."
Speaking of "extremes of force used in the edgewise mechanism" they said, " . . . the further our
appliance forces deviate from these theoretically desired conditions [very light forces, producing
pressures less than capillary blood pressure], the more likely is the tooth movement to be accompanied
by pathosis. . . . Clinicians using the edgewise mechanism have learned to start their cases with a series
of light round wires. This is sound therapy for two reasons: (a) it takes as much advantage of tipping
movements as is possible and (b) it utilizes forces much lighter than are possible with a standard
edgewise wire."10 Steiner,9 being concerned more with the elasticity of the appliance itself, said that
arch wires "many times lighter [than 0.022 by 0.028 inch] would be of advantage'' for torque, tipping,
and rotations, and that '' . . . edgewise appliance principles may someday be applied by using an arch
wire of extremely elastic metal of a diameter which may be only a small fraction of that of the cross
section of the present one." He felt that reduced dimensions might be called for in stainless steel arch
wires and found that the use of 0.018 inch slot brackets with steel wires resulted in a reduction in
treatment time of approximately 2 months per case in his practice. In the ensuing years steel has
supplanted gold and many orthodontists have changed to 0.018 inch brackets.
When Begg introduced the forerunner of his technique he stated that "Stainless steel is so much more
powerful and rigid when made in such large dimensions as the edgewise arch that it is unsuitable" and
recommended 0.018 inch round steel arch wires for their "light gentle force over a long range of
distance.''11 In later papers Begg recommended 0.016 inch or smaller steel wires, opining, "the
orthodontic force values that are used cause least discomfort to patients, least loosening of teeth, and
least damage to tooth-investing tissues, while at the same time they are also the forces that move teeth
the most rapidly and are the most easily controlled forces.''12,13
Schudy and Schudy14 advocated 0.016 by 0.022 inch arch wires with 90 degree twists between their
anterior and posterior portions so as to fit 0.016 inch brackets on anterior teeth edgewise and 0.022
inch brackets on the posteriors ribbonwise. They stated: "By placing the 0.016 inch dimension vertically
in the anterior portion of the dental arches, we have a resilient, gentle, and effective torquing force." In
their experience with over 300 cases, they found 0.022 by 0.016 inch arch wire to provide adequate
strength and molar control.
Andreasen introduced nitinol wire as "another improvement which has emerged from the orthodontist's
search for lighter forces and greater working range.''15 According to Burstone and Goldberg,8 beta
titanium offers greater working range and lower stiffness than steel wire of the same dimensions and
has none of the faults of nitinol.

The call for more resilient wires and lighter forces has come from many of our most respected
colleagues.5,8-16 Thurow has written, " . . . stainless materials in a 22-mil size are too stiff for any
application other than stabilization . . . In larger sizes (over 18-mils) . . . gold is the material of choice"5;
Burstone and Goldberg wrote, ''For common applications, edgewise steel wires invariably deliver more
force than is required"8; and Creekmore said, "In orthodontics we need less force with greater tooth
movements."16
Wires
Stainless steel vs. gold. The working range (the degree to which a wire can be deflected without
permanent distortion) is approximately the same for gold and stainless steel wires of the same
dimensions,5,8,9 but for a given deflection a steel wire delivers one and one half to two times as much
force as one of gold.5-8 Thus, in one respect the introduction of steel wires could be considered
retrogressive; full-sized edgewise steel wires used in the same 0.022 by 0.028 inch brackets produce
more force than the gold wires they supplanted. The 0.018 inch bracket was a logical development to
maintain the status quo with the use of steel wires. Steel 0.018 by 0.025 inch wires produce forces
similar to those of 0.022 by 0.028 inch gold wires in horizontal and vertical bending and in torsion.
Because of its smaller size, the steel wire offers slightly greater working ranges, but this is clinically
irrelevant since the force produced in deflecting it to its elastic limit would be grossly excessive for tooth
movement. Stainless steel 0.018 by 0.025 inch brackets and arch wires offer no progress from the
rigidity of the original 0.022 by 0.028 inch gold appliance.
Ribbon arch wires in ''edgewise brackets." Reduction of the bracket slot is only one of many means to
reduce force levels. Table I affords comparison of the stiffness and range of a number of sizes of steel
wires. It shows that, in corresponding dimensions, 0.016 by 0.022 inch wire is approximately one third as
stiff (i.e., for a given deflection it delivers one third as much force) as 0.022 by 0.028 inch wire and has
from 28 to 37 percent greater working range. This same wire can be used as a 0.022 by 0.016 inch
ribbon arch in a 0.022 by 0.028 "edgewise bracket" (Fig. 1). Then, having its 0.022 inch dimension in the
vertical plane, if it is ligated fully into the bracket it fits just as precisely and can provide the same
accurate control in all directions as a 0.022 by 0.028 inch edgewise wire. Table II lists various types of
rectangular arch wires in order of increasing ridigity, comparing them in range and stiffness in torsion
and horizontal and vertical bending to a 0.022 by 0.016 inch ribbon arch.
It is important to recall that the torsional force (or "torque") that an arch wire delivers depends on the
length of span, the degree of deflection, and the polar moment of inertia of the wire5 and not on its
orientation. A 0.022 by 0.016 inch ribbon arch activated to give 10 degrees of torque in a 0.022 inch
edgewise bracket delivers exactly the same force to the tooth as does a 0.016 by 0.022 inch edgewise
arch activated to give 10 degrees of torque in a 0.016 inch bracket. Twisting the same wire through the
same arc requires the same force and produces the same range of movement whether the wire is
oriented ribbonwise or edgewise.
It is hardly surprising that Schudy and Schudy14 found 0.016 by 0.22 wire to be adequately rigid. In
cross-sectional area (0.22 mm.2) it falls between 0.020 (0.20 mm.2) and 0.022 inch (0.24 mm.2) round

wires. Even 0.018 inch round wires are used only as "base arch wires'' in the Begg technique; active
wires are 0.016 inch or smaller.
Table II shows that 0.018 inch square wire is very similar in its properties to 0.022 by 0.016; it could be
used in 0.018 inch edgewise brackets with effect similar to that of 0.022 by 0.016 inch wire in 0.022 inch
brackets. A 0.018 inch square arch wire is heavier than a 0.020 round one. It is considerably lighter and
more resilient than a 0.018 by 0.025 or even a 0.017 by 0.022 inch wire, yet provides a precision fit in an
0.018 bracket that the latter does not.
Precision fit vs. loose fit. Schudy and Schudy14 presented logical criticism of the use of finishing wires
that do not fit the brackets precisely. The use of undersized edgewise wires in 0.022 by 0.028 inch
brackets is quite common. The popular 0.019 by 0.026 inch size may serve as a case in point in
examining the rationale of this practice. Schwaninger17 pointed out that 0.019 by 0.025 inch wire has an
actual deviation angle of 15 degrees; 0.019 by 0. 026 inch wire with rounded corners has a real
deviation angle of approximately 20 degrees, i.e., the wire can rotate freely through an arc of 40
degrees within a 0.022 inch bracket (Table III) . However, very firm ligation might restrict this freedom
somewhat.
Deflecting the midsection of a 14 mm. long beam of 0.019 by 0.026 inch steel arch wire (as, for example,
when a wire engaging brackets on a second premolar and a canine must be distorted to engage a first
premolar bracket) just 1 mm. requires nearly 4 pounds of force in the plane of its lesser dimension and
over 6 pounds in the plane of its greater dimension. Deflections of only 0.5 mm. require nearly 2 pounds
and more than 3 pounds, respectively, in those planes. What logical reason can there be for routine use
of such a rigid edgewise wire when it does not even provide precise engagement in the brackets? In
many instances round wires would serve just as well.
The main advantage of rectangular arch wires is that they can offer torque control. A 0.019 by 0.026
inch wire offers this only if pronounced torque enough to take up the play between wire and
bracket is bent meticulously into it. Even then the wire "controls" each tooth in only one direction,
allowing up to 40 degrees of play the other way. This is sometimes acceptable because the operator is
concerned only with a particular type and direction of movement. Thurow5 pointed out that unless all
teeth in an arch need torqueing in the same direction and degree there should be some play between
the arch wire and brackets. If there is not, as the wire is activated in engaging a bracket on a tooth
requiring torque, adjacent teeth are torqued in the opposite direction first and then complete the
unnecessary ''round trip" as the wire returns to its passive state. Any activation for torque should be less
than the degree of play in the opposite direction at adjacent teeth.
Where this sort of loose control is desired a 0.020 by 0.016 inch ribbon arch deserves consideration. It is
less than one half as forceful as a 0.019 by 0.025 inch edgewise arch (Table I) but, because its vertical
dimension is greater, it provides a similar deviation angle for torque (Table III) and a closer fit for
mesiodistal tipping. Square 0.020 inch wire provides somewhat closer torque control (deviation angle
approximately 12 degrees), while still showing less stiffness and more range than 0.019 by 0.025 inch
wire (Table I). Precise control for each tooth, as for stabilization of an arch or fine finishing, can be

obtained more accurately and easily with a 0.022 by 0.016 inch ribbon arch. There is also far less force
and more working range than with 0.019 by 0.025 inch edgewise, whether the control is built into the
bracket or bent into the arch wire.
It is particularly practical and efficient to work up through arch wires, providing progressively more
precise engagement with pretorqued and angulated brackets. A logical sequence of wires yielding gentle
transitions for finishing and stabilization of arches requiring no gross root movement would be 0.016
inch round, 0.018 inch round, 0.020 by 0.016 inch ribbon, 0.020 inch square, and 0.022 by 0.016 inch
ribbon arch wires. (Perhaps a 0.021 by 0.016 inch ribbon arch would be preferable to 0.020 inch square,
but I have not been able to find any wire of that size and so have not been able to ascertain its deviation
angle.) It is often possible to skip one or more of the intermediate wires; with narrow single brackets it is
not unusual to be able to proceed directly from 0.018 inch round wire to the final 0.022 by 0.016 inch
ribbon arch wires. New alloys in appropriate dimensions could, in theory, provide still greater flexibility
and gentleness, allowing the omission of transitional wires much more frequently. When certain teeth
require relatively extensive root movement, auxiliaries independent of the main arch wire may be the
best solution (Fig. 2).
New alloys. Nitinol wire,15 having approximately one fifth the stiffness and four and one half times the
range of stainless steel,8 offered hope of a resilient, gentle, precisely fitting arch wire that could
accomplish all root positioning and finishing movements. Indeed, 0.021 by 0.025 inch nitinol does, in my
experience, yield excellent range and force levels, but it does not provide a precision fit. However, I have
found working with it to be very awkward; its "formability"8 is difficult. Beyond its elastic limit nitinol is
brittle and modifications that are achieved tend to diminish with time and/or activation.19 I have had no
success with torsional bending (i.e., adjusting ''torque"). Nitinol can not be soldered or welded.
Andreasen20 recently reported a trial of 0.019 inch thermal nitinol wire used to straighten malaligned
lower anterior teeth in 5 months. The wire was not fully engaged in the brackets for at least 3 months.
Light steel wires with elastomeric ligatures could have accomplished the same movement as easily and
quickly (Figs. 3, 4, and 5) at much lower cost (without needing to be embedded in plaster and heat
treated at 450 C. for 10 minutes) .
Burstone and Goldberg8 provide a variance in information on the resilience of beta titanium wire,
stating that it ''can be deflected approximately twice as far [as steel] without permanent deformation, "
while their figures show its elastic range to be only 1.64 times that of steel. Nevertheless, even the
lower figure indicates a significant advantage for the beta titanium in some circumstances. Even more
important is the fact that its stiffness is only four tenths that of steel.
Table I shows that round or undersized nitinol or beta titanium wires provide little or no advantage over
steel wires of smaller dimensions (or, by implication, of twisted, braided, or coaxial configurations) . For
example, 0.018 inch round beta titanium is similar in stiffness to 0.014 inch steel (i.e., for a given
distortion, they produce the same force), as is 0.018 inch nitinol to 0.012 or twin 0.010 inch steel wires.
It is my opinion that the steel wires produce forces as high as, or higher than, those desirable for
alignment when deformed to their elastic limits; the increment in range of the newer alloys is

superfluous for tooth movement. When deflected further than would be possible for steel wires they
would produce excessive force. The somewhat closer fit of 0.018 inch wire in 0.022 inch brackets might
be a slight advantage in limiting tipping, but would be contraindicated where tipping was desired. The
greater elastic range of the new alloys might, in theory, mean they would be less liable to permanent
distortion from mastication in some situations.
At the time of this writing the only sizes in which beta titanium wire is available are 0.018 (round), 0.017
by 0.025, and 0.019 by 0.025 inch. Comparisons in Table I suggest that this selection may not be as
rational as it could be. The 0.017 by 0.025 inch may offer negligible advantage over round wire in 0.022
brackets, as it can rotate through an arc of up to 50 degrees17 depending on the type and firmness of
ligature used. It fits 0.018 inch brackets more closely, but 0.018 inch square wire would fit precisely and
be less stiff and more elastic. Part of the case against 0.019 by 0.025 inch beta titanium wire
corresponds to that made earlier against 0.019 by 0.026 inch steel wire; both 0.020 by 0.016 inch ribbon
and 0.020 inch square (or 0.021 by 0.016 inch ribbon) beta titanium arch wire would be less forceful and
more elastic, the former fitting similarly, the latter more precisely. Furthermore, 0.020 by 0.016 inch
steel wire (ribbonwise) is nearly identical in stiffness and fit to 0.019 by 0.025 inch beta titanium
edgewise. Similarly, there would be little point to using 0.022 by 0.028 inch beta titanium; it would be
stiffer than 0.022 by 0.016 inch steel ribbon wire. However, 0.022 inch square beta titanium would be
more gentle and elastic than 0.022 by 0.016 inch steel ribbon wire, and 0.022 by 0.016 inch beta
titanium still more so, surpassing the excellent combination of low stiffness and close fit of 0.021 by
0.025 inch nitinol.
Brackets
Arch wire slot size. There are many things to be considered in choosing an arch wire slot size. The 0.022
by 0.028 inch slots may be the most versatile, in that they: (1) can allow teeth to tip considerably on
undersized wires (Figs. 2, 4, 6, and 7) which can be advantageous in certain circumstances as explained
by Begg13 and many others; 0.016 inch wires can be used in the manner that has proved to be so highly
effective in the Begg technique (Figs. 4, 6, and 7); (2) allow ample play for easy, gentle engagement of
light wires for alignment; (3) permit engagement of two undersized wires at once; [for example, a 0.016
inch round wire can control molars and open the bite while an 0.010 inch wire aligns severely
malpositioned teeth (Figs. 4 and 5); a 0.014 inch auxiliary can torque incisors while the arch is controlled
by an 0.018 inch base arch wire (Fig. 2)]; (4) allow the operator to choose from the greatest selection of
practical arch wire sizes; (5) accept very rigid wires for the special cases fixation for surgery,
maintaining arch form while moving impacted canines, arch expansion, etc. in which these may be
desirable; (6) offer the choice in these cases between precisely fitting 0.022 inch square or 0.022 by
0.028 inch edgewise wires and loosely fitting but still rigid 0.020 inch square or 0.019 by 0.025 inch
wires; (7) offer the control of precision fit with relatively light (0.022 by 0.016 inch) ribbon arch wires;
and (8) allow the use of a series of arch wire sizes gradually increasing in precision of fit to provide
gentle transitions. This may be particularly advantageous with bracket systems having all first-, second-,
and third-order control built into them.

Smaller arch wire slots, such as 0.016 or 0.018 inch, offer less play even on very light wires. They do not
provide as much freedom for tipping, nor do they accept ultrarigid wires when these are desirable.
Larger slots, e.g., 0.030 inch, require very large, rigid wires, and consequently very high forces and
limited range, for precise control.
Width: Narrow single vs. twin. The introduction of wide and twin brackets could, like that of stainless
steel wires, be considered a retrogressive step; it resulted in a far more rigid appliance. Bracket width is
an important determinant of the interbracket force level inherent in an appliance system and affects
both the span of unsupported wire between teeth and the degree of freedom for mesiodistal tipping.
Maximizing the interbracket span minimizes force levels and maximizes the working range of the arch
wire. In bending, range is proportional to the square of the span length and stiffness is inversely
proportional to the cube of the length. In torsion, range is directly proportional and stiffness inversely
proportional to length. The effect of various bracket widths obviously varies with the sizes of the
particular brackets and teeth involved, but can be illustrated by considering replacing typical twin
brackets (3.2 mm. width) with narrow single (1.3 mm. width) brackets on ''typical" 7 mm. wide teeth,21
thus increasing interbracket span by one half. Stiffness in bending would be reduced by 70 percent, and
in torsion by 33 percent by using the single brackets and bending range would be increased by 125
percent and torsional range by 50 percent. Creekmore16 has pointed out that 0.016 inch wire in narrow
single brackets can be less stiff than 0.012 inch wire in twins and that, for bending, 0.018 by 0.025 inch
wire in single brackets can be one half as stiff as 0.016 by 0.022 inch in twins (although they are equal in
torsion). He and Schudy and Schudy14 have presented thorough explanations of the advantages of
narrow brackets; I would add only that they can allow maximum tipping when this is desired, and can
also allow the involvement of minimal tooth surface in direct bonding.
Rotation control. There has been some concern about control of rotations with narrow single edgewise
brackets.16,22 A number of additions to the bracket, usually in the form of wings or eyelets, have been
suggested for this purpose. The basic bracket itself, with standard steel or elastomeric ligation, is often
adequate (Figs. 4 and 6); for those instances in which more positive control is desirable a variety of
practical techniques have been shown.23 Some of these require vertical slots in the backs of the
brackets, but some of the simplest do not. Rotations of premolars and canines can be corrected by
placing the brackets off-center toward the side of the tooth that is rotated lingually; ligation to the arch
wire then, depending upon the degree of offset, corrects or overcorrects the rotation. A large
elastomeric ligature or small elastomeric separating ring can overcorrect rotation of any tooth (Figs. 5, 8,
9). It must be slipped onto the arch wire before it is placed in the mouth so when ligating wire to bracket
it will be wedged between wire and tooth on the side to be pushed lingually and will be facial to the
wire on the side of the tooth to be pulled facially. Thick (0.030 inch) elastomeric thread can be tied in
the same manner without removing the arch wire; it may be doubled if more force or more
overcorrection is desired (Figs. 5 and 10).
Elastomers, loops, and sectionals
There are many ways of making fixed appliances gentle and resilient and, while this paper is concerned
mainly with the interactions of brackets and continuous arch wires, some other aspects of force systems

deserve mention. Elastics providing forces as light as 50 Gm. per side have proved highly effective in the
Begg technique for overjet reduction and extraction space closure. Elastomeric ligature rings, threads,
and tubes can augment the resilience of even very light arch wires (Figs. 3 to 5) and can pull malposed
teeth gently into alignment and engagement on arch wires, which need not be deflected fully into
brackets. Force and elasticity come from both wire and elastomer rather than solely from deformation
of an arch wire. Elastomers can also provide light forces for retraction of teeth, individually or in groups.
Looped arch wires can serve well in many situations but bear scrutiny because they can produce very
high forces and do not always act as they are supposed to.24-27 Elastics or elastomers with plain arch
wires may provide a simpler alternative in many cases.
Sectional or segmental wires can offer greater versatility in force distribution than is available with
solitary arch wires. For example, posterior teeth can be stabilized with rigid transpalatal bars28 or
molar-premolar sectionals while resilient 0.016 arch wires and light elastics act on the anterior teeth as
in the Begg technique23 (Figs. 3-7).
Summary and conclusions
Several adaptations of "edgewise" appliances can yield increased working range and reduced force
levels from arch wires. Among the possibilities are the use of (1) ribbon or square rather than edgewise
wires; (2) brackets with smaller, e.g., 0.018 inch, arch wire slots (not recommended) (3) narrow (1.3
mm.) single brackets to increase the span of wire between brackets; (4) undersized wires; (5) sectional
arch wires and auxiliaries; (6) elastics and elastomeric threads and ligatures; and (7) arch wires of alloys
that are superior to stainless steel in elastic range and stiffness.
In light of Angle's prior development of the ribbon arch, his later work with 0.022 inch square wires, and
some trends away from arch expansion and toward lighter forces and smaller arch wire dimensions, it is
amazing that the use of rectangular wires, edgewise, has continued; there is seldom reason to use
stainless steel wires in this manner. A 0.022 by 0.016 inch ribbon arch wire, for example, can provide the
same precise control as a 0.022 by 0.028 inch edgewise arch wire while delivering considerably less
force and greater working range. Similarly, the 0.020 by 0.016 inch ribbon arch compares favorably with
the 0.019 by 0.026 inch edgewise. Not only are ribbon arches more gentle and elastic, but they are also
much easier to work with than edgewise arch wires; horizontal offsets for molars, incisors, and rotation
control lie in the plane in which the wire is most easily bent and arch form can be "wiped" in with fingers
alone.
Single 1.3 mm. width brackets with 0.022 by 0.028 inch arch wire slots may offer maximum versatility
and provide numerous advantages. They help minimize forces and maximize working ranges and have
ample potential for controlling rotations, although, as is the case with any bracket, rotated teeth
sometimes require particular attention. Those orthodontists who prefer 0.018 inch slots might well
consider using square rather than edgewise arch wires.
Even with the narrow single brackets of the Begg-Edgewise Diagnosis Determined Totally Individualized
Orthodontic Technique23 system, 0.022 by 0.016 inch steel wire is too stiff for anything other than
stabilization or the most minute movements. Teeth often are allowed to tip on light round wires in this

technique; 0.022 by 0.016 inch ribbon wire will not then engage their brackets. Root movement must be
accomplished with auxiliaries, with a graduated series of arch wires, or with arch wires of different
materials.
Rectangular arch wires that fit brackets with some play allow the torqueing of specific teeth without
"round-tripping" adjacent teeth. Activation for torque should be limited to the degree of play in
neighboring brackets. Ribbon arch wires offer a more gentle, resilient alternative to excessively rigid
edgewise wires in this application. For example, 0.020 by 0.016 inch ribbon arch wires fit like 0.019 by
0.025 inch edgewise, but are less than one half as stiff. A series of arch wires, such as 0.018 inch round,
0.020 by 0.016 inch ribbon, 0.020 inch square (or 0.021 by 0.016 inch ribbon, if it were available), and
0.022 by 0.016 inch ribbon, offer gentle transitions to progressively more precise fit. Such transitions can
produce direct movement to desired positions with little unwanted reciprocal movement in functions
such as finishing and stabilization of intact arches where no gross tooth movement is required.
Situations in which larger movements of crowns and/or roots are required may indicate the use of some
or all of the means whereby specific force levels can be applied and flexibility and rigidity distributed to
particular segments of the dentition sectional and auxiliary wires, elastics, and elastomeric ligatures
and threads.
Since gold, nitinol, and beta titanium arch wires are more expensive than steel, they are practical only if
their properties are clearly superior. Round or undersized nitinol or beta titanium wires may provide
little or no advantage over steel wires or smaller dimensions. The difficult handling of nitinol wire and
the low cost of steel should indicate that use of the new alloys may not be advantageous in 0.018 inch
diameter. Likewise, beta titanium 0.019 by 0.025 and 0.022 by 0.028 inch wire may not have significant
advantage over 0.020 by 0.016 and 0.022 by 0.016 inch steel ribbon arches, respectively.
Wires of beta titanium or similar material could be a great boon to orthodontics, but in currently
available dimensions they offer negligible advantages. The properties and fit of a 0.019 by 0.025 inch
beta titanium edgewise arch, for example, are very similar to those of a 0.020 by 0.016 inch steel ribbon
arch wire. Beta titanium wires, having four tenths the stiffness and 1.6 times the elastic range of steel,
could be a valuable addition to the orthodontic armamentarium if available in a range of sizes offering
significantly lower stiffness and higher resiliency than the lightest steel wires of similar fit, i.e., ribbon
and square arch wires. wires of 0.020 by 0.016 inch, 0.020 inch square (and/or 0.021 by 0.016 inch),
0.022 by 0.016 inch, and 0.022 inch square dimensions would, in theory, make an ideal selection.
The effects of decreasing bracket width and wire size and substituting less stiff, more resilient alloys
would, of course, be multiplicative. A 0.020 by 0.016 inch steel ribbon arch would be 0.45 as stiff and
have 1.2 times the range of a 0.019 by 0.025 inch steel edgewise arch. In narrow single brackets,
compared to the 0.019 by 0.025 inch in twin brackets, the 0.020 by 0.016 inch would be 0.14 as stiff and
have 2.7 times the range in bending, and 0.3 as stiff and have 1.8 times the range in torsion. Beta
titanium 0.020 by 0.016 inch ribbon wire in narrow single brackets, compared to steel 0.019 by 0.025
inch edgewise wire in twin brackets, would be 0.06 as stiff and have 4.4 times the range in bending, and
0.12 as stiff and have 3 times the range in torsion.