The biomechanics of posterior maxillary arch expansion using fixed labial and lingual appliances

Objective: To compare the biomechanics of straight labial, straight lingual, and mushroom lingual archwire systems when used in posterior arch expansion. Materials and Methods: An electro-mechanical orthodontic simulator allowing for buccal-lingual and vertical displacements of individual teeth and three-dimensional force/moment measurements was instrumented with anatomically shaped teeth for the maxillary arch. In-Ovation L brackets were bonded to lingual surfaces, and Carriere SLX brackets were bonded to labial surfaces to ensure consistency of slot dimensions. Titanium molybdenum archwires were bent to an ideal arch form, and the teeth on the orthodontic simulator were set to a passive position. Posterior teeth from the canine to second molar were moved lingually to replicate a constricted arch. From the constricted position, the posterior teeth were simultaneously moved until the expansive force decreased below 0.2 N. Initial force/moment systems and the amount of predicted expansion were compared for posterior teeth at a significance level of alpha = 0.05. Results: Archwire type affected both the expected expansion and initial force/moment systems produced in the constricted position. In general, the lingual systems produced the most expansion. The archwire systems were not able to return the teeth to their ideal position, with the closest system reaching 41% of the intended expansion. Conclusions: In general, lingual systems were able to produce greater expansion in the posterior regions when compared with labial systems. However, less than half of the intended arch expansion was achieved with all systems tested.