Journal Article
Meta-Analysis
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Materials-induced variation in the torque expression of preadjusted appliances.

The purpose of this article is to comprehensively investigate the sources of variation in the expression of torque in preadjusted appliances. Variables related to properties of materials were systematically analyzed, including (1) the inability to fill the slot because of the size difference of archwires and bracket slot, (2) irregularities from the manufacturing process of brackets precluding proper engagement, (3) differences in the stiffness of wire alloys engaged to the bracket slot, (4) variations between actual and reported bracket torque values, and (5) ligation modes, all of which might account for increased third-order clearance or bracket-archwire "play." The effect of these variations on the expression of torque is discussed, and the net buccolingual inclinations are provided as a function of wire size and composition for common bracket slot-archwire combinations. Most reports published on this issue indicate a loss of torque control as high as 100% of the prescribed value. Furthermore, the fallacy of transferring the ideal crown inclination to the torque prescribed in the bracket is illustrated, along with the underestimation of the prescribed torque relative to the proper tooth crown. The realistically required torque is analyzed to its constituent components, involving tooth inclination, compensation for the slot-wire play, and incomplete ligation with elastomeric ligatures. Based on the evidence available, it is proposed that a high-torque prescription should be selected to account for the lack of full expression of the prescribed torque that occurs clinically.

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