A key to the understanding of extraoral forces

Numerous commercially marketed extraoral assemblies are available for use

by orthodontists to assist in effecting orthopedic jaw correction and/or orthodontic tooth
movement. Selecting a suitable appliance can be confusing. However, an understanding
of the basic functional mechanical principles of the appliance and a knowledge of the force
actions involved in their respective designs readily obviate this shortcoming.
From a clinicians standpoint, the usual questions asked are: What are the orthodontic
effects of various headgear assemblies on molar teeth? Will the specific type of assembly
used intrude teeth, and to what degree? Will the headgear tip the roots or crowns of
molars, and how can such movements be controlled? Which type of head- or neckgear
assembly is best suited to moving molars distally without extruding them? Which asymmetric
face-bow design is most effective in unilateral molar movement? This article will
try to answer such questions. The article will not include fully banded arches, only upper
molars. Fully banded arches may change the position of the center of resistance.
Extraoral orthodontic appliances generally comprise an inner and an outer bow soldered
together near their respective centers. When eccentric forces are desired, the inner
and outer bows of the headgear appliances are attached to each other asymmetrically.
Extraoral force is delivered by means of springs, elastics, or stretchable material, attached
to a neck or headgear assembly usually constructed of pliable material.
The ends of the inner bow engage in tubes attached buccally to bands on the teeth to
which force is applied. Stops are placed on the inner bow mesial to the buccal tubes. The
force applied to the outer bow is transferred to the attached inner bow, which acts upon the
molar teeth. Ideally, the metal section (solder or bar) attaching the inner and outer bows
should be located comfortably in the embrasure between the upper and lower lips.
The length of the outer bow varies and may be conveniently described as (1) short, in
which the outer bow is shorter than the inner bow; (2) medium, in which the outer bow is
approximately the same length as the inner bow; or (3) long, in which the outer bow is
longer than the inner bow (Fig. 1).
Before we proceed toward an understanding of the effects of extraoral forces on molar
teeth, certain mechanical principles need to be understood and defined. This is essential
since the key to an understanding of the effects of extraoral forces on a molar tooth is an
appreciation of the relationship of the line of action of a,force to the center of resistance of
a tooth.
The mechanical principles that need to be defined include the following:
A force. A force is that which changes or tends to change the position of rest of a body
or its uniform motion in a straight line. The forces used in orthodontics are created by
elastic or spring traction.
Center of resistance. Teeth may be moved by tipping or translation. In tipping, the
center of rotation for any tooth must be located between the neck of the tooth and its apex,
its exact position being unknown.3 Most investigators. I3 agree that the fulcrum of the
tipping movements is in the region between the middle and apical thirds of the root portion
of the tooth. In discussions of tipping or translatory tooth movements, the terms center of
rotation and center of resistance are sometimes not clearly differentiated4 and tend to be
used loosely. Since one is a fixed point and the other movable: the points warrant
definition.
The center of resistance of a body is that point through which the resultant of the
constraining forces acting upon it may be considered to act. The center of resistance of a
single-rooted tooth with a parabolic shape is at a point 0.4 times the distance from the
alveolar crest to the apex.* In the maxillary first molar the center of resistance is estimated
to be in the middle third of the root near the junction of the cervical third, or approximately
at the trifurcation of the roots. The center of resistance of a tooth cannot be
changed by external force application.
Center of rotation. The center of rotation of a body is a point around which the body
will rotate or tip. The center of rotation, unlike the center of resistance, can be changed,
the latter being dependent upon external force application. When a force is applied to a
tooth and its line of action does not pass through the center of resistance, then tipping of
the tooth will occur around a center of rotation which may be located anywhere between
the center of resistance of the tooth and infinity. No tipping wili occur when the forc

coinciding.
Force resolution. Forces may be resolved into component vectors which, in a single
plane of space, are at right angles to each other. The extraoral force application to molars
is considered to be the resultant force which, in the discussion, are resolved into its
components in the various planes of space.
Line ofaction. The line of action of a force is usually represented by an arrow and is
the direction in which the force acts.
Clinical application of above principles