Novel approach for characterizing clinical load application of superelastic orthodontic wires.

Current standardized in vitro bending experiments for orthodontic archwires cannot capture friction conditions and load sequencing during multi-bracket treatment. This means that clinically relevant forces exerted by superelastic wires cannot be predicted. To address these limitations, this study explored a novel test protocol that estimates clinical load range. The correction of a labially displaced maxillary incisor was simulated using an in vitro model with three lingual brackets. Deflection force levels derived from four different protocols were designed to explore the impact of friction and wire load history. These force levels were compared in nickel-titanium (NiTi) archwires with three commonly used diameters. The unloading path varied between protocols, with single or multiple sequences and different load orders and initial conditions. Deflection forces from the new protocol, employing multiple continuous load/unload cycles (CC incr), consistently exceeded those from the conventional protocol using a single continuous unloading path (CU decr). Mean differences in plateau force ranged from 0.54 N (Ø 0.014" wire) to 1.19 N (Ø 0.016" wire). The CC inr protocol also provided average force range estimates of 0.47 N (Ø 0.012" wire), 0.89 N (Ø 0.014" wire), and 1.15 N (Ø 0.016" wire). Clinical orientation towards CU decr carries a high risk of excessive therapeutic forces because clinical loading situations caused by friction and load history are underestimated. Physiological tooth mobility using NiTi wires contributes decisively to the therapeutic load situation. Therefore, only short unloading sequences starting from the maximum deflection in the load history, as in CC incr , are clinically meaningful. • Friction and load history affect deflection forces of orthodontic NiTi wires. • Conventional in vitro 3-bracket bending tests underestimate clinical force levels. • Physiological tooth movement must be considered to derive clinically relevant loads. • Reactive forces from wire deflection may vary because of physiological conditions. • Sequential short unloading sequences allow characterization of clinical load range. [ABSTRACT FROM AUTHOR]