Dentists often search for a way to control the torque of an individual tooth or a group of teeth. This can happen at the start of treatment, during or at the end of treatment. Torque management starts at treatment planning when the diagnosis and treatment plan is elaborated. Initial root position can influence the choice of bracket torque as our mechanics like the use of Cl II elastics or the choice of a specific appliance. Imagine a Herbst appliance in your treatment protocol and the side effects it will have on the lower incisors torque. For any orthodontic procedure that will have a torque effect on the teeth, choosing a specific bracket torque could be of use to the clinician. If we think of mechanics that will flare the lower incisors, the initial choice of negative torque brackets can be useful in controlling the side effects. If the clinician plans to use Cl II elastics for a few months, the upper incisors can also benefit for positive torque brackets, often called super torque brackets. Prefabricated differential torque wires with a 20 deg anterior torque can also be useful. The clinician can also choose to put the torque in the wire manually instead of buying a prefabricated wire. We can also use auxiliary torque accessories like the ART for torquing, even more, the upper or lower incisors as a group. Upper posterior teeth often need buccal root torque (BRT) after transverse arch development. BRT may be applied manually in a progressive form by putting gradual torsion in the wire with pliers. Figure1 and 2 show the application of progressive palatal root torque.
Figure 1. Figure 2.
Individual tooth position can also need torque in the final phase of treatment. In this indication, the clinician can either bend the wire at the tooth position with Rose torquing pliers or add a single root torque auxiliary (search categories and torque). In the coming info letters we will describe in more details the application of torque in these different situations.