Development and biomechanical investigation of a new compound palatal arch

Abstract

Background and aim: There are many advantages in using a transpalatal arch in orthodontic treatment. In addition to the active movement of individual teeth, such an arch can be used to provide additional anchorage. The aim of this study was to further develop and improve both the clinical and the biomechanical properties of the conventional transpalatal arch.

Material and methods: Currently available compound material components form an established part of orthodontic therapy. The Compound palatal arch broadens the scope of this treatment system. The biomechanical effects of the newly developed Compound palatal arch were verified by comparing them with those of commercially available conventional transpalatal arches. The recently developed Compound palatal arch is made of one compound element: nickel-titanium/stainless steel. The specific dimensions and design of the nickel-titanium element are aimed at exploiting its superelasticity, even during active molar movement. The biomechanical investigation was carried out using six-component measuring sensors to register the forces and moments in the three spatial dimensions (x, y and z) at 37 degrees C. The following appliances were investigated: Goshgarian transpalatal arch, quad-helix appliance, Arndt memory expander, and Compound palatal arch.

Results: Transpalatal arches could not be inserted without the arch being under tension. This is particularly important when the arch is being used for anchorage purposes. The Goshgarian arch had to be classified as problematic for the movement of single teeth as the load/deflection rate was high. However, this can be utilized for anchorage purposes. The clinical advantage of a quad-helix appliance is the option for asymmetric tooth movement.

Conclusions: This study showed that the quad-helix was effective for both unilateral and bilateral derotation as well as for transversal tooth movement. However, expansions should be confined to < or = 4 mm, and derotations to < 10 degrees, as forces and moments are otherwise not within the physiologic range. The Arndt memory expander displayed no advantages over either the quad-helix appliance or the Goshgarian transpalatal arch. Nor did it display any superelastic properties. The linear relationship, the relatively high forces and moments, and the lack of clinical adjustability cast doubts on the benefits of this appliance. The newly developed Compound palatal arch showed substantial advantages in molar derotation compared with conventional transpalatal arches. Superelastic properties were achieved through the design and positioning of the nickel-titanium element. Expansion with the Compound palatal arch was comparable with that with conventional transpalatal arches. The clinical advantage is in the fact that this appliance can be reactivated and that dental asymmetries can be treated.