966 Indian Journal of Forensic Medicine & Toxicology, January-March 2021, Vol. 15, No. 1 DOI Number: 10.37506/ijfmt.v15i1.

13541

Retraction in Orthodontics – A Short Review

R. Vighnesh1, Ashith M.V2, Siddarth Shetty3, Supriya Nambiar4, Nidhin Philip Jose5, Shravan Shetty6,
Asavari Desai7
1
Post graduate Student, 2Associate Professor, 3Professor, 4Head of the Department and Professor, 5Associate
Professor, 6Assistant Professor, 7Associate Professor, Department of Orthodontics, Manipal College of Dental
Science, Mangalore, Affiliated to Manipal Academy of Higher Education

Abstract
Aim- The aim of this review is to discuss about the retraction mechanism in orthodontics and to discuss in
detail regarding the mechanism of action and their application in orthodontics.

Objective- To list out the difference types of retraction mechanics used and their merits and demerits

Background- The basic principle of retraction mechanism can be used in orthodontic space closure
involving retracing the canine initially followed by remaining anterior teeth or entire anterior teeth can be
retracted at once using intra or extra oral anchorage. They are broadly classified into friction and frictionless
mechanism. Once the extraction of the teeth has been done, the orthodontist must choose the procedure to
retract the teeth based on the demand of the case. This article provides the basic information of both the
mechanics and their application in orthodontics.

Reason- This review mainly done for better assessment and benefits of retraction mechanics and its
appliances

Keywords- Two step retraction, loop mechanics, enmass retraction, space closure

Introduction as anchorage by tying back the arch and using a coil

spring arch to retract the cuspids back with the help
The different methods to close spaces, reduce
of 0.016 round archwire. In 1980, rickets employed
procumbency, overjet, and eliminate extraction sites
closed coil springs to obtain sectional cuspid retraction.
by antero-posterior therapy is generally categorized as
Several studies have been made on the amount of force
Retraction mechanics. Whether retracting the anterior
required for specific tooth movements. Storey and
or protracting the posterior or a combination of both
Smith’ reported that 150 to 200 grams is the optimum
principles of retraction mechanics apply for space
force range for retraction of the lower canine tooth.
closure remains the same 1
Reitan’ has reported that the maximum force needed
As extraction was done in late 19th century finger for continuous bodily movement of canine teeth is 250
springs or other methods were employed for simple grams. Burstone and Groves found the optimum force
pushing back of canine teeth. This often resulted in for the retraction of anterior teeth to be 50 to 75 grams.
tipping and elongation of teeth. Tweed used the molars Lee in 1966 showed optimal force for distal movement
of maxillary canine with tipping was 15 to 260 cm.
Burstone in 1982 developed composite TMA spring for
Corresponding author: canine retraction 2. Poul gjessing in 1985 developed a
Dr Ashith M.V sectional arch technique that produces optimal force
Associate Professor, Department of Orthodontics system for controlled canine retraction.
Manipal College of Dental Science, Mangalore
Affiliated to Manipal Academy of Higher Education Determining the anchorage value while retracting
Pin code-576104, Email: [email protected] the teeth is of major concern no matter the technique used.
 Indian Journal of Forensic Medicine & Toxicology, January-March 2021, Vol. 15, No. 1 967

Maximum anchorage is indicated when only anterior is on the long axis of the tooth for single rooted tooth
teeth are retracted. Minimum anchorage is used if only and probably between one third and one half of the root
posterior teeth is protracted and when combination of length apical to alveolar crest for a multirooted teeth.
both is used moderate anchorage is used.
A body appears to rotate around its center of rotation.
Retraction is the most frequently used technique in The more translational the moment of the tooth the
space closure. The strategy used in retraction mechanics farther apically the centre of rotation would be placed.
must be based on a careful diagnosis and treatment plan Moment is defined as tendency to rotate 5. If the line of
made according to the specific needs of the individual. action of force does not pass through centre of resistance
Two step retraction and en mass retraction are two it will produce some rotation which can be calculated as
most used mechanics in anterior retraction. In two step force multiplied by perpendicular distance from centre
retraction retraction of canine teeth is done followed of resistance to point of application of force. When two
by retraction of all four incisors and en mass retraction forces of equal magnitude act in opposite direction it
involves retraction of all six teeth 3. Two step retraction will produce a couple. This will produce pure rotation,
involves retraction of canine teeth in one step later spinning the object around its centre of resistance. The
retracting followed by retracting the remaining teeth in way an object is rotates while its being moved can be
next step. This will reduce the tendency of anchorage changed by different combination of force and couple.
loss by incorporating more teeth in the anchorage unit.
The ratio between magnitude of couple and the
However, this will take longer time to complete the
amount of force applied at the bracket determines the
treatment. In addition when the entire anterior unit is
type of tooth movement exhibited by the tooth. A single
retracted compared to canine retraction they tend to
force produces a uncontrolled tipping so in order to
tip and rotate less, thus requiring less time and effort
produce a controlled tipping or translation a single force
when compared to canine retraction. En mass retraction
is insufficient, a rotational tendency (moment) must also
occurs when incisors and canines are retracted together.
be applied at the bracket.
In clinical situation it is difficult to maintain anchorage
in clinical situation. Anchorage can be derived from A force of 100 grams produced at a distance of
segment of the teeth or the entire arch. In some difficult 10mm from the centre of resistance produces a clockwise
situations the requirement for extra oral anchorage such moment of 1000gm-mm which will cause tipping of the
as headgear, face mask, intermaxillary elastics and mini tooth. we must generate counter balancing moment of
implants is needed. 1000 grams-mm so that bodily moment can be achieved
since the tipping is undesirable. This can be done by
The principles for retraction currently used can be
twisting the anterior segment of rectangular wire and
explained as either frictional system in which teeth is
fitting it into a rectangular slot. After the wire is engaged
allowed to slide distally and it’s guided by continuous
in a bracket slot it generates an inherent moment of
arch wire or a non-frictional system with couples and
couple which is a couple produced within the wire itself
force built into the loops of an arch section 4.
and now it will result in bodily movement of the teeth 6.
Mechanics of Tooth Movement
RETRACTION MECHANICS IN EDGEWISE
Every free body or an object can be perfectly
balanced on one point which is known as centre of Once the extraction of the teeth is done orthodontist
gravity. The relationship between line of action of force have to plan how to close the space. There are two
to the center of the body determines the movement of the schools of thoughts of retraction mechanism:
free body. In a tooth which is a restrained body, a point i. Two step canine retraction [Friction or
similar to the centre of gravity is used which is known as frictionless mechanics)
centre of resistance.
ii. En-mass retraction [Friction or frictionless
If the force passes through the center of resistance mechanics)
an object undergoes translation. The centre of resistance
968 Indian Journal of Forensic Medicine & Toxicology, January-March 2021, Vol. 15, No. 1

FRICTION MECHANICS approaches the center.

A tooth can be moved bodily only when force is METODS OF CANINE RETRACTION IN
applied such that it can pass through center of resistance. SLIDING MECHANICS:
When a bracket is placed on a tooth and the force is
1. Elastic module with ligature
applied at it, both force and moment is experienced
by the tooth. The tooth moves in two planes due to 2. Elastomeric chain or power chain
this moment of force. The canine moves mesial out as
force is applied buccal to center of resistance due to one 3. Intra or inter maxillary elastics to kobayashi
moment. The second moment produces distal tipping ligature
of tooth is caused because force is applied occlusal to
4. Coil springs (stainless steel or NiTi)
centre of resistance. A moment in opposite direction
is produced due to interaction between the bracket and 5. J-hook head gear
wire which counteracts this moment. When the tooth tips
in distally it glides along the archwire till binding occur 6. Sliding jig and traction
between the archwire and the bracket. This produces a 7. Mulligans v bend sliding mechanics
couple at the bracket which results in distal root moment
and hence uprighting of the tooth. As it uprights the ELASTIC MODULE WITH LIGATURE
moment decreases until the wire can no longer bind 7.
This method of retraction has been popularised
Then the canine retracts along the archwire till distal
by Bennett and McLaughlin (Fig A). A single elastic
crown tipping again causes binding. Until the force gets
module is used to secure the arch wires to brackets which
depleted this continuous to take place which is known
is attached to canine by a ligature wire extending from
as walking of canine because of initial tipping of crown
the molar. These elastic tie backs are activated 2-3 mm
followed by root uprighting. The major advantage of
or to twice then original size to generate approximately
friction mechanism is it provides comfort to the patients
100 – 150 grams 9.
and less time consuming as complicated wire bending is
not required.

V – BEND SLIDING MECHANICS

This was developed by Thomas F Mulligan, this

approach is used for closing space by moving each teeth
(canine retraction or molar protraction). He gave the
concept of differential torque as a means of effective
intraoral anchorage. It is obtained by applying unequal
alpha and beta moments. An off center V- bend is used
in a wire to create unequal moments with higher moment Figure A: Elastic modules
applied to the anchorage teeth. The closer the bend is to ELASTOMERIC CHAIN OR POWER CHAIN
the bracket shorter the wire and shorter wire has a higher
E chain were introduced into the dental profession
bending moment than a longer wire. Therefore, a higher
in 1960 for canine retraction, diastema closure, rotation
moment acts on the bracket which is closer to the V bend
correction and arch constriction. (Fig B) They are
than the more distant bracket 8.
available in configuration of closed loop, short filament,
In case of canine retraction using the V-bent and long filament chains. It has many advantages such as
mechanics the tooth located closure to the bend is the being inexpensive, relatively hygienic and can be easily
anchor side and the opposite is the non-anchor side. applied without arch wire removal and do not depend
As the cuspids continue to move distally, the bend is on patient cooperation. Most of elastomeric chains lose
centered and the differential torque begins to gradually 50% - 70% of their initial force during the 1st day of
disappear. Root parallelism begins to effect as the bend force application and at three weeks retain only 30% -
 Indian Journal of Forensic Medicine & Toxicology, January-March 2021, Vol. 15, No. 1 969

40% of their original force. Elastomeric chains should It can be used for distal movement of canines
be changed every 4 – 6 weeks 10. without causing loss of posterior anchorage. It involves
the use of headgear with j hooks where the hooks attach
along a continuous arch wire mesial to the canines and
exert a force over them so that they will slide along the
arch wire. Since it incorporated extra oral anchorage in
canine retraction, it should be effective in maximum
anchorage cases 11.

SLIDING JIG AND TRACTION

0.022 round wire or 0.017 x 0.022 rectangular wires

are used in making this jig and it is slide on to the arch
wire in addition to a short piece of open coil spring of
about 4mm in length. The coil spring lies in contact with
Figure B: Elastomeric chain
mesial end of canine bracket and circle of jig lies on
COIL SPRINGS mesial end of coil spring. The traction can be applied to
the jig either intra or inter maxillary elastics or by extra
Coil springs were introduced in the year 1931.
oral traction.
The various materials that have been used in making
springs are stainless steel and NiTi. Stainless steel are MULLIGANS V BEND SLIDING MECHANICS
more efficient because they apply more predictable level
of force compared to elastic based system. However It was introduced by mulligan 1970’s. The basic
stainless-steel springs have relatively higher load principle was to apply differential moments to the teeth
deflection rate so as space starts to close there is some via bends in the continuous arch wire while force for
force degradation due to lessening activation. Nickel retraction was applied by auxiliaries like E chain, coil
titanium coil springs were introduced by Samuels and springs etc. during cupid retraction 12. The 45 degrees v
Rudge in 1979 (Fig C). They are indicated if large spaces bend are added to the wire and 200 grams of force are
need to be closed. The force degradation is very less due applied without removing the archwire using calibrated
to low load deflection rate. They are available in lengths optic pliers.
of 9mm and 11mm. The advantage of springs is that they
The v bend helps in differential medio distal
can easily be placed and removed without removal of
movements on the canines and molars. If the bend is
arch so patient cooperation not much needed but it is
placed off center it creates a short and a long segment.
relatively unhygienic compared to elastic system.
The shorter segment is more rigid and hence applies
greater moments. So, if maximal canine retraction is
required the bend is placed very close to molar and
bicuspid. This causes a strong distal crown moment on
the molar which counteracts the auxiliary force tending
to move the molar crown forward.

EN-MASS RETRACTION

It literally means retracting group of teeth together

as a single unit. The anterior teeth are intruded and
retracted simultaneously and also maintaining the torque
control however, demand on the anchorage should be
Figure (Fig C): Nickel titanium coil spring evaluated carefully 13. It can be effectively employed in
J-HOOK HEADGEAR moderate and minimum anchorage cases. In frictionless
mechanics retraction is done with a continuous wire with
970 Indian Journal of Forensic Medicine & Toxicology, January-March 2021, Vol. 15, No. 1

one closing loop each side distal to cupid. Various loop with loops or springs which offer more controlled tooth
design are available for retraction and all are having pre- movement than sliding mechanism. In frictionless
determined vertical heights ranging from 7-10 mm in mechanism when the loops are activated, they distort
vertical direction to keep it closer to centre of resistance from their original shape as the tooth moves and then
of tooth. it gradually returns to its undistorted (preactivated)
position, delivering the energy stored at the time of
In 1990s, a method of controlled space closure was
activation. It is activated by by pulling the arms of the
described using sliding mechanics. Rectangular archwire
loop away and cinching them back at the molar tubes.
0.019 x 0.025 wires are recommended with the 0.022 slot.
Thus, this approach is friction free, so can be used to
This wire size had good overbite control while allowing
move group of teeth more accurately with more precise
free sliding through the buccal segment 14. Thicker wires
anchorage control to achieve treatment goals more
sometimes restrict free sliding of molars and premolars
readily than methods in which friction plays a role 16.
and thinner wires have less control. Thinner wires along
with the heavy forces of E- chain can give rise to roller The Gable bend and Neutral Position
coaster kind of effect.
A simple loop when activated is unable to
Soldered hooks of 0.7 brass hooks can be used and generate adequate counter moment required to achieve
alternatively soft stainless steel (SS) 0.6 soldered hooks the desired tooth movement so preactivation bends also
can also be used. The most common hook length are 36 known as gable bends are given which increases the M/F
– 38 mm in upper and 26 mm in the lower arch. ratio. To maintain the neutral position of the loop which
has been altered by the introduction of gable bends,
Active tiebacks refer to use of stainless-steel ligatures
appropriate magnitude and occlusogingival location of
threaded through an elastic module that goes directly
the gable bends are vital. Because of the gable bends,
from the terminal molar to the canine bracket. They are
the closing loop functions as V- bend in the arch wire.
stretched to their original size during activation, without
Practically, this means that during canine retraction
pre stretching the force levels range between 200-300
with the vertical loop placed closed to a canine, a higher
grams. If large spaces are to be closed Niti coil spring
ratio M/F ratio would be present on the canine which
are used instead of elastomeric module. The force decay
could better control the apex. The undesirable effect is
in the Niti coil spring is very much less as compared to
extrusion of the canine.
elastomeric modules.
Preactivation bends or gable bends can be placed
FRICTION ISSUE IN SLIDING MECHNICS
within the archwire or where loop meets the archwire
Using the friction mechanism has few disadvantages which are placed to increase M/F ratio. For anterior
during retraction because of mainly two components retraction loops should be placed closer to the canine
friction and binding, due to which applied force should than to the molar and a gable bend should be added near
be higher than the required optimum force because of the molar. A gable bend that is larger in the posterior
decay in force. When E chain is used for retraction if dimension will produce a larger beta moment thus
excessively stretched leads to breakdown of internal increasing posterior anchorage. For both retraction of
bond leading to permanent deformation. It also absorbs anterior and protraction of anterior segment the loop
water and saliva when exposed to oral environment should be placed midway between posterior and anterior
causing degradation of force by 50%-70% by 1st day. segments. A gable bend of equal dimension should
Due to these drawbacks in friction or sliding mechanism, be used so that alpha and beta moments are equal and
frictionless mechanism is in better position for retraction, reciprocal space closure occurs 17. When only posterior
as monitoring of optimum force can be done effectively, protraction is desired, the loop should be located closer to
and it is active for longer duration of time 15. the posterior segment and anterior gable bend should be
placed with a greater alpha moment than beta moment,
FRICTIONLESS MECHANICS making the anterior teeth the anchorage segment.

In frictionless mechanism retraction is accompanied METHODS OF CANINE RETRACTION IN

 Indian Journal of Forensic Medicine & Toxicology, January-March 2021, Vol. 15, No. 1 971

FRICTIONLESS MECHANICS initial load of 100 grams. It is critical to avoid over

activation of the spring because a few mm of over
1. Ricketts retraction spring
activation can result in anchor loss. Since the average
2. Poul gjessing spring distance from the centres of the brackets to the CR
are identical for the upper and lower canines, the PG
3. Burstone T loop retraction and attraction spring retraction spring works equally well for canine retraction
in either arch.
4. Marcotte spring

5. Drum spring

6. Opus loop

7. Kalkra simultaneous intrusion retraction spring

8. Wave spring

9. A statistically determined retraction system

10. Niti canine retraction spring

RICKETTS RETRACTION SPRING

Maxillary cuspid retractor is a combination of a

double vertical closed helix and an extended crossed Figure E: Poul gjessing spring
T closing loops spring which contains 70mm of wire. BURSTONE T LOOP RETRACTION AND
(Fig D) It produces 50 grams per mm of activation. ATTRACTION SPRING
The additional wire in its design helps in activation of
the spring by contracting the loops and 3 – 4 mm of The burstone composite ‘T’ loop retraction spring
activation for upper cuspid is sufficient for retraction. is made from 0.017 x 0,025-inch TMA wire. T loop
Mandibular cuspid spring is a compound spring with a retraction spring can be used in group A arches. The
double vertical helical closing loop. It contains 60 mm of attraction springs are used in group B and group C
wire and produces approximately 75 grams of force per arches. The difference lies in rotational control of the
mm of activation 18. Activation of 2 – 3 mm is required canine, which is achieved with a non-sliding mechanism.
to produce the desired force. Antirotational bends are placed in the retraction
assemblies to prevent the canine from rotation as it
retracts. It is also possible to use an arch wire to prevent
rotation. It is engaged into auxiliary tube of first molar
and the vertical tube on the burstone canine bracket.
Initially after preactivation controlled tipping occurs
Figure D: Ricketts retraction spring (M/F 8:1), as space closes and spring deactivates, the
POUL GJESSING SPRING force level decreases so translation occurs (10:1), further
deactivation leads to root movements (12:1) 19.
The Poul Gjessing maxillary canine retraction spring
was described by Poul Gjessing in 1985. Essentially the MARCOTTE SPRING
spring consist of a double ovoid helix with a smaller
This is a type of minor cuspid retraction spring and is
occlusally places helix and is in the preformed version is
small, light 0.016 closing loop. This spring extends from
available commercially constructed in 0.016 x0.022 inch
the auxiliary tube of 1st molar brackets to the bracket on
stainless steel wire. The spring is activated by pulling
the cuspid and it is activated by being pulled through the
distal to molar tube until the two loops separate (Fig E).
auxiliary tube and cinched. The buccal segment feels,
The amount of activation produces the recommended
then a protractive force and a positive moment, while
972 Indian Journal of Forensic Medicine & Toxicology, January-March 2021, Vol. 15, No. 1

the tooth being “walked back” on the wire. Hence are range on activation 5.
used in group B and group C arches. Activation should
RAPID CANINE RETRACTION THROUGH
be limited to 1-2 mm.
DISTRACTION OF PERIODONTAL LIGAMENT
OPUS LOOP
Liou and huang in 1998 proposed a concept in
This new design can be fabricated from 16 x 22 or which first premolar of the patient is extracted then
18 x 25 or 17 x 25 TMA wire. The loop is positioned off the interseptal bone distal to canine is undermined by
center about 1.5mm from the mesial canine bracket. It is a bone bur. After debridement of that area tooth born
activated by tightening it distally behind the molar tube custom made distraction device is placed which helps
and can be adjusted to produce maximum, moderate, or in retraction of canine within three weeks into the
minimum incisor retraction. It also delivers a nonvarying extraction space. No complications were also observed
target M/F within the range of 8.0 – 9.1 mm inherently, during or after the treatment 20.
without adding residual moments by twist or bends
CANINE RETRACTION WITH RARE EARTH
anywhere in the archwire or the loop 14.
MAGNETS
KALRA SIMULTANEOUS INTRUSION
In a study conducted by john daskalogiannaskisa
RETRACTION SPRING (K – SIR)
and Kenneth roy in 1996 they hypothesised that a
It is made up of continuous 019 x 025 TMA prolonged constant force provides more effective tooth
arch wire with closed 7 mm x 2mm U – loops at the movement than a impulsive force of a short duration
extraction site for en masse retraction. The u loop has a arylene coated neodymium-iron-boron block magnets
90 degree bend to create equal and opposite moments. A were used in the experiment. The appliance provided
60 degree V – bend is also located posterior to the center a constant force, and this method was two times faster
of interbracket distance producing n increased clockwise than the conventional methods of retraction as they use
moment on the first molar 16. interruptive force which degrade after some time 21.

A STATICALLY DETERMINATE RETRACTION CANINE RETRACTION WITH REMOVABLE

SYSTEM APPLIANCES

This novel system consisted of a single – force Canine retractors are the springs which are used to
cantilever arm of 017 x 025 TMA for active retraction move the canine in distal direction.
and a passive rigid stabilizing unit. A turn of helix is
THE VARIOUS TYPES OF CANINE
placed in front of auxiliary tube for the molar and ended
RETRACTORS ARE AS FOLLOWS:
with a hook on its anterior end. A 90 bend is placed in
middle of spring. The spring is activated 90 at the helix Palatal Canine Retractor: The distal movement of
as well 17. the canine teeth can be brought about by a palatal canine
retractor if the canine is palatably placed which is made
THE WAVE SPRING
out of 0.6mm stainless steel wire with a coil of 3mm
This spring can be used where a closed coil would be diameter, an active arm and a guide arm. The helix is
appropriate for retraction. It is made up of superplastic placed along the long axis of the canine. Activation is
nickel titanium alloy delivering large amount of done by opening the helix 2mm at a time.
activation about 90g of force from extremely a compact
The ‘U’ Loop Canine Retractor: Mechanically it is
spring only 6mm long in its resting state 18.
least effective and used when only minimum retraction
NITI CANINE RETRACTION SPRING of 1-2mm is required. It is made of 0.6mm stainless
steel wire. It consists of a U loop, an active arm and a
The spring is available in 016 x 022 NiTi wire with
retentive arm which is distal. The base of the U loop
antitip and antirotational incorporated. It has an ability
is 3mm below the cervical margin. It is activated by
to deliver continuous force and moments over a broad
closing the U loop. The advantages of this retractor are
 Indian Journal of Forensic Medicine & Toxicology, January-March 2021, Vol. 15, No. 1 973

its simplicity of fabrication and lesser bulk 22. of teeth with minimal time, to produce an aesthetic and
functional and near ideal occlusion as much as possible.
Reverse Loop Buccal or Helical Canine Retractor:
It is used when the sulcus is shallow, as in the lower References
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