Novel universal system for 3-dimensional orthodontic force-moment measurements and its clinical use

• A customized measuring platform for 3D orthodontic loads detection is proposed.
• The device is suitable for any kind of fixed orthodontic appliances.
• Two cases of malocclusion, treated with wire-brackets and an invisible aligner, were analyzed.
• Lowifriction wires exert optimal loads.
• Invisible aligners with a divot provided better rotation control.
• This platform can be used to train clinicians to exert lower loads and thus avoid irreversible damage.

IntroductionOrthodontic treatment is an important part of dental health care in Europe: the percentages of the population undergoing therapy vary from 10% to 55%. Therefore, quantifying effective orthodontic loads is a challenging topic with regard to the predictability of tooth movements and the reduction of traumatic side effects.MethodsA customized measuring platform was developed and used for detecting orthodontic forces in a range between 0.1 and 2 N. The system consists of 6 load cells, each equipped with 6 strain gauges. The tests were conducted on a 3-dimensional printed malocclused mouth model and on a plaster cast. Four types of superelastic ligation and 2 types of invisible aligners were tested to analyze, respectively, a malocclusion with a high maxillary canine, and the effects on the axial rotation of a maxillary central incisor with and without a divot in the invisible aligners.ResultsOptimal treatment forces are exerted by low-friction wires, especially if they are partially engaged. Moreover, by reducing the treatment force, there is less necessity of anchoring to surrounding teeth, thus decreasing the side effects. The efficacy of using invisible aligners with a divot was validated.ConclusionsThis platform allowed measurement, at the radicular level, of the resultant forces of orthodontic treatments performed with different orthodontic appliances. In addition to customizing and calibrating the therapy for each patient, this platform could be used to develop new specific instruments able to exert lower treatment forces, thus preventing irreversible damages.

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