Torque expression in stainless steel orthodontic brackets. A systematic review.

OBJECTIVE To evaluate the quantitative effects on torque expression of varying the slot size of stainless steel orthodontic brackets and the dimension of stainless steel wire, and to analyze the limitations of the experimental methods used. MATERIALS AND METHODS In vitro studies measuring torque expression in conventional and self-ligating stainless steel brackets with a torque-measuring device, with the use of straight stainless steel orthodontic wire without second-order mechanics and without loops, coils, or auxiliary wires, were sought through a systematic review process. RESULTS Eleven articles were selected. Direct comparison of different studies was limited by differences in the measuring devices used and in the parameters measured. On the basis of the selected studies, in a 0.018 inch stainless steel bracket slot, the engagement angle ranges from 31 degrees with a 0.016 x 0.016 inch stainless steel archwire to 4.6 degrees with a 0.018 x 0.025 inch stainless steel archwire. In a 0.022 inch stainless steel bracket slot, the engagement angle ranges from 18 degrees with a 0.018 x 0.025 inch stainless steel archwire to 6 degrees with a 0.021 x 0.025 inch stainless steel archwire. Active stainless steel self-ligating brackets demonstrate an engagement angle of approximately 7.5 degrees, whereas passive stainless steel self-ligating brackets show an engagement angle of approximately 14 degrees with 0.019 x 0.025 inch stainless steel wire in a 0.022 inch slot. CONCLUSIONS The engagement angle depends on archwire dimension and edge shape, as well as on bracket slot dimension, and is variable and larger than published theoretical values. Clinically effective torque can be achieved in a 0.022 inch bracket slot with archwire torsion of 15 to 31 degrees for active self-ligating brackets and of 23 to 35 degrees for passive self-ligating brackets with a 0.019 x 0.025 inch stainless steel wire.