Elastomers in

orthodontics

Madhuvanthi Gopalakrishnan
I st year PG
CONTENTS
1. INTRODUCTION 10. FLUORIDE RELEASE FROM
ORTHODONTIC ELASTIC CHAIN
2. HISTORY OF ELASTICS AND
ELASTOMERICS
11. ELASTIC LIGATURE V/S WIRE
3. PROPERTIES OF ELASTICS AND
ELASTOMERICS LIGATURES
4. CLASSIFICATION OF ELASTICS
12.COIL SPRING V/S ELASTIC
5. ANALYSIS OF ELASTIC FORCE
13.ORTHODONTIST’S PART
6. FORCE DEGRADATION
IN PATIENT WEARING ELASTICS
7. ELASTIC ERRORS
14.ARMAMENTARIUM
8.TYPES OF ELASTICS
15.CONCLUSION
9. PRE STRETCHED ELASTICS
16.REFERENCES
INTRODUCTION
 Elastics and Elastomeric are routinely used as a active component of orthodontic therapy.
Elastics have been a valuable adjunct of any orthodontic treatment for many years.

 Their use, combined with good patient cooperation, provides the clinician with the ability
to correct Antero-posterior, Transverse and vertical discrepancies.

 Both natural rubber and synthetic elastomers are widely used in orthodontic therapy.
Naturally produced latex elastics are used in the Begg technique to provide intermaxillary
traction and intramaxillary forces.

 Synthetic elastomeric materials in the form of chains find their greatest application with
edgewise mechanics where they are used to move the teeth along the arch wire.
History of elastics &elastomers
in orthodontics
• With the advent of vulcanization by Charles Goodyear in 1839, uses
for natural rubber greatly increased. Early advocates of using natural
latex rubber in orthodontics were Baker, Case and Angle

• A French man JMA Strange in 1841 claimed that he used a rubber

attached to some hooks on the appliance surrounding the molars for
retention.

• John Tomes in 1848 used the elastics springs with metal plates.
• Celvin Case discussed the use of intermaxillary elastics at the
Columbia Dental Congress. However in 1893 Henry A Baker was
credited with, originating the use of intermaxillary elastics with
rubber bands and named it as Baker Anchorage.
• Angle in 1902 described the technique at the New York institute of
Stomatology.
Natural vs synthetic rubber
 Natural rubber, also called India rubber as initially produced,
consists of polymers of the organic compound isoprene, with minor
impurities of other organic compounds plus water.
 Currently, rubber is harvested mainly in the form of the latex from
the para rubber tree or others. The latex is a sticky, milky
colloid drawn off by making incisions into the bark and collecting the
fluid in vessels in a process called "tapping". The latex then is refined
into rubber ready for commercial processing.
 Synthetic rubber polymers developed from petrochemicals in the 1920’s have a weak
molecular attraction consisting of primary and secondary bonds.

 Rubber like materials which are made from chemicals were called synthetic rubbers
because they were intended as substitutes for natural rubber. Chemists use the word
elastomer for any substances, including rubber, which stretches easily to several times its
length, and returns to its original shape.

 Manufacturers group synthetic rubbers into two classes: General-purpose and special-
purpose.
 Elastomeric chains were introduced to dental profession in the 1960’s and have

become integral part of orthodontic practice. They are used to generate light

continuous forces. They are inexpensive, relatively hygienic, easily applied and required

no patient cooperation.

 Most of the elastics currently used in orthodontics are made up of polyurethane.

 Polyurethane rubbers resist heat and withstand remarkable stresses and pressures.
 The ingredients of polyurethane rubbers include ethylene, propylene, glycols, adipic acid,

and di-isocyanates.

 It has got an excellent strength and resistance to abrasion when compared with natural

rubber. They tend to permanently distort, following long periods of time in the mouth and

often lose their elastic properties. This is mainly used for elastic ligatures
Chemical structure of
elastomers
• Elastomer are any rubbery material composed of long chainlike molecules, or
polymers, that are capable of recovering their original shape after being stretched to
great extents
• Under normal conditions the long molecules making up an elastomeric material are
irregularly coiled.
• With the application of force, however, the molecules straighten out in the direction
in which they are being pulled.
• Upon release, the molecules spontaneously return to their normal compact, random
arrangement.
• Latex (or natural) elastics are composed of cis-1,4 poly-isoprene chains with
preservatives, usually ammonia, added to achieve the unique properties like
elasticity, flexibility, and resilience.

• The production of latex on an industrial scale involves the mixture of natural

rubber with stabilizers such as zinc oxide and other chemicals, which are
heated to specific temperatures to promote a homogeneous final product.

• There is no standardization in the composition of latex elastics, resulting in

products with different properties.
• During the initial stages of Rubber manufacturing it was soon found to have two
serious disadvantages:
• it becomes soft and sticky when warm, because it is really a viscous liquid ,

• it becomes hard when cold, because it crystallizes slowly below about 5 °C (40
°F).

• They were overcome in 1839 by the discovery of vulcanization by the American

inventor Charles Goodyear

• Goodyear found that a mixture of rubber with some white lead and about 8 percent
by weight of sulphur was transformed, on heating, to an elastic solid that remained
elastic and resilient at high temperatures and yet stayed soft at low temperatures.
• Moreover, addition of a small amount of sulfur in various forms makes the rubber
molecules sufficiently irregular that crystallization (and, hence, hardening at low
temperatures) is greatly impeded.
• The linking process is often called curing or, more commonly, vulcanization (after
Vulcan, the Roman god of fire).
• More accurately, the phenomenon is referred to as cross-linking or interlinking,
because this is the essential chemical reaction.
• It is now known that sulphur reacts with unsaturated hydrocarbon elastomers:
• Nonlatex elastics are composed of synthetic rubber, which is any type of artificial polymer

that reproduces, to a higher or lower degree, the physical properties of natural rubber,

namely silicone, polyurethane plastic, and styrene-butadiene rubber (SBR) ethylene

propylene monomer (EPM)

• SBR is a mixed polymer, or copolymer consisting of two different monomer

units, styrene and butadiene, arranged randomly along the molecular chain.

• EPM also consists of a random arrangement of two monomers—in this case, ethylene and

propylene.

• In SBR and EPM, close packing and crystallinity of the monomer units are prevented by their

irregular arrangement along each molecule.

• Styrene butadiene styrene (SBS), a “tri-block” copolymer composed of butadiene
repeating units in the centre portion of the chain and styrene units at the ends.

• Polystyrene and polybutadiene are incompatible, so that the polystyrene end-groups

associate together to form domains of glassy polystyrene in a sea of elastic
polybutadiene.

• The polybutadiene centre portions thus form a connected elastomeric network held
together by rigid domains of polystyrene end-blocks, which are relatively stable up to
the glass transition temperature of polystyrene (about 100 °c, or 212 °f).

• Thus, the material is a rubbery solid at normal temperatures, even though there are no
chemical bonds interlinking the molecules.
 CLASSIFICATION OF
ELASTICS

According to According to According to

material availability clinical use

Latex Force Intraoral Extraoral

elastic
Synthetic Colour Size
elastic
(natural )
 ACCORDING TO THE MATERIAL
Latex Elastics:
These are made up of natural rubber materials, obtained from plants, the chemical
structure of natural rubber is 1, 4 poly-iso-prene.

Synthetic elastics:
These are polyurethane rubber contains urethane linkage. This is synthesized by
extending a polyester or a polyether glycol or polyhydrocarbon with a di-isocynate. These
are mainly used for elastic ligatures.
 ACCORDING TO THE AVAILABILITY
Different makers have different sizes and force, and the colour coding and the name
is also different
size inches Size mm 3 x lumen Use (heavy force)
Based on size
1/8” 3.2mm 9.5mm Triangular elastics

3/16” 4.8mm 14.3mm Crossbite elastics

1/4” 6.4mm 19.1mm Extraction class 2 / 3

elastics

5/16” 8.0mm 23.8mm Non- extraction class

2 / 3 elastics

3/8” 9.5mm 28.6mm Posterior box elastics

Based on FORCE

◦ High Pull
Ranges from 1/8” (3.2mm) to 3/8” (9.53mm). It gives 71 gm force (2 ½ oz)
◦ Medium Pull
Ranges from 1/8” (3.2mm) 3/8” (9.53 mm) it gives 128gm or 4 ½ oz force.
◦ Heavy pull
Ranges from1/8”(3.2mm) 3/8”(9.53 mm) It gives 184gm or 6 1/2oz force.
COLOUR DIAMETER FORCE
INCH MM GRAMS OUNCE

WHITE 1/8 3.2 56.8 2.0

RED 3/16 4.6 99.4 3.5

GREY 3/16 4.6 127.8 4.5

BLUE 1/ 4 6.4 99.4 3.5

ORANGE 1/ 4 6.4 127.8 4.5

YELLOW 5/16 7.9 56.8 2.0

GREEN 5/16 7.9 99.4 3.5

TAN 5/16 7.9 127.8 4.5

PINK 3/8 9.5 99.4 3.5

LAVENDER 3/8 9.5 127.8 4.5

 ACCORDING TO THE USES.
1) Intra oral 2) Extra oral
Intra Oral Elastics

1) Cl I Elastics/ Horizontal Elastics/ Intramaxillary Elastics/ Intra-arch Elastics

◦ The force recommended is 1 ½ to 2 ½ oz for non extraction cases and 2 to 4 oz. in
extraction cases.
2) CL II Elastics / intermaxillary elastics / interarch elastics
The force recommended is 1 ½ to 2 ½ oz. in non extraction case
2 to 4 in extraction cases.
• Why: To correct Class II malocclusion
• When: Finishing arch wires .
 3) Class III elastics
Recommended force is ¼” elastic with 3 ½ oz
1.To prevent advancement of the mandibular anterior teeth in a crowded
non-extraction arch during the Initial archwire in the mandibular arch
2. To provide maximum anchorage in a bimaxillary protrusion extraction
case done during the activation of the mandibular closing loops (wearing
combination facebow)
3. Worn Throughout treatment to correct class 3 malocclusion
4) Zigzag Elastics
Aras A et al 2001 in the study “The effect of zig zag elastics in the treatment of
CL II div 1 malocclusion subjects with hypo and hyper divergent growth pattern”. -

• Zig zag elastics thus was used in the last stage of fixed appliance treatment of
CL II malocclusion in growing patient were effective in the correction of molar
relationship. Establishing a good intercuspation as well as improving sagittal skeletal
relationship.
• the use of such elastics does not cause an unfavourable effect on vertical jaw base
relationship.
Force recommended is 2.5 oz.
 5) CROSS BITE ELASTICS

 Buccal surface of one molar to lingual surface of opposing molar (all molar bands have
lingual hooks attached)
 Force: 3/16 inch; 6 oz

 Done To correct posterior crossbites

 When: Early and/or late in treatment

 Time: 24 hours per day

 6) Cross Palate Elastics

• This is to correct the undesired expansion of the upper molars, during third stage.
• This is placed between the lingual aspects of the upper molar
• Upper molar expansion during the 3rd stage is usually bilateral, the cross palate elastics is
appropriate because the force it exerts in pulling one molar lingually is equal and opposite
to the force it exerts in pulling the other lingually.
7) Diagonal Elastics (Midline elastics)
Force used is 1 ½ to 2 ½ ounces.
 8) Open Bite Elastics
 These are used for the correction of open bite.

 It can be carried out by a vertical elastic, triangular or box elastic.

9] Box Elastics

Box elastics have a box shape configuration and can be used in variety of
situations to promote tooth extrusion and improve intercuspation.

Force used ¼” 6 oz or 3/16” 6 oz.

 Maxillary central incisor brackets to mandibular lateral incisor brackets
 Force: 3/16 inch; 6 oz
 Given To close the bite in a Class II malocclusion
 Given In intermediate and finishing archwires
 Maxillary lateral incisor and canine brackets to mandibular canine and premolar
brackets
 Force: 3/16 inch; 6 oz
 Helps To increase the overbite and improve the canine relationships
 Given during Finishing archwires, Class II malocclusion
 Extends from Maxillary canine and premolar brackets to mandibular premolar brackets
 Force: 3/16 inch; 6 oz
 helps level the mandibular arch and improve cusp-fossa interdigitation
 Given during Maxillary finishing archwire, mandibular intermediate or final archwire,
Class II malocclusion
10.Triangular elastics:
 Where: Maxillary canine bracket to mandibular canine and premolar area (plus other possible
configurations)
 Force: 1/8 inch; 3,5 oz
 Why: Apply direct force to a single tooth in Class I cases
 When: Stabilized opposing archwire and a flexible archwire for the tooth to be moved
 Time: 24 hours per day
 Type 2 triangle elastics usually connect from the lower back molar hook to a
hook on the front upper tooth. (Just like the Type 2 elastics) But they will also
go to a hook on another lower tooth to form a triangle.
Type 3 triangle elastics usually connect from the upper back molar to a hook
on the lower tooth But they will also go to a hook on another upper tooth
to form a triangle.
12)Vertical Elastics(Spaghetti)
Force used is 3 ½ oz.
•Vertical elastic runs between the upper and lower brackets of each tooth.

•This is useful in whom there is difficulty in closing the bite, whether anteriorly or
posteriorly.

• This type of elastic is contraindicated in malocclusions that were originally characterized

by a deep bite
12] M and W Elastics
Force is ¾” 2 ounce.
 13.Lingual Elastics
 This can be used as a supplement or a counter balancing
agent to buccal elastic force, there by increasing the
efficiency of force distribution.
 Lingually tipped lower molars can be up righted by the use of class II elastics attached
between lingual hook of the lower molar and intermaxillary hook of upper arch wire on the
same side.

 Lingual elastics can be used as a substitute for buccal elastics like CL I and CL II elastics,
provided the arch wire should be tied back to the cuspid bracket
14. Check Elastics
• For overbite reduction and buccal segment interdigitation being preserved.
• Relapse of overbite in Stage III will most often be the result of inadequate bite opening. This should
obviously be avoided, but may require ‘Class II check’ elastics to rectify
• Check elastics can provide a potent mechanism for overbite reduction, causing extrusion of maxillary and
mandibular molars and counteracting the tendency of the anchor bends to tip the molars distally plus
aiding incisor intrusion.
15 Sling Shot Elastics( Molar distalizing)

Two hook on buccal and lingual side of the molar to be incorporated in the
acrylic plate to hold the elastic. The elastic is stretched at the mesial aspect of
molar to distalize it.
 16 Other elastics:
Asymmetrical elastics:
They are usually class II on one side and class III on the other side.
They are used to correct dental asymmetries. If a significant dental midline deviation is
present (2 mm or more), an anterior elastic from the upper lateral to the lower
contralateral lateral incisor should also be used
Finishing elastics:
• Are used at the end of the treatment for final posterior settling.
• Force recommended ¾” or 2 oz
Elastics in removable appliance
• Elastics in conjunction with the removal appliance
are used for the movement of single and groups of
teeth, and for intermaxillary traction.
• They can be used to move the impacted canine to a
proper place along with the Hawley appliance.
• They are used in moving the canine distally along
with screw appliances.
• The acrylic plates cover the premolars and molars
and tuberosities for bodily anchorage
EXTRA ORAL ELASTICS:

Heavy elastics and plastic chain are used with the head gear
Elastic separators
 a) Elastomeric ring
 b) Safe-T-Separators
 c) Dumbell Separators
 d) Stick Separators
 e) Durasep Separators
 LIG-A-RING:
It is used for individual ligation of the tooth. It can be used in
place of conventional ligature ties in straight wire therapy and for cuspid
ties in Begg. It is of 1.5 – 2 mm in diameter.
ELASTIC LIGATURES Vs WIRE LIGATURES

◦ Elastic ligature may be a substitute for the wire ligatures in most

situations
◦ Elastic ligatures will give an easy work to the doctor and since no sharp
ends it will be more acceptable by the patient.
◦ In rotation control, higher force levels than elastomeric materials is
required. The brackets in rotation cases the partial engagement of the
arch wire will be difficult with elastic ligature, so in these cases wire
ligature are advised.
◦ When the sliding of a bracket on the arch wire is needed, it is advisable to
use elastic ligature because of its smoothness.

◦ The strength and inflexibility of wire ligatures may also provide more secured
ligation. The relatively low strength of the elastic ligature is its major
disadvantage.
COIL SPRINGS Vs ELASTICS
◦ To overcome the drawbacks of elastomeric material, Andrew L. Souis in 1994 conducted a study NiT
coil springs and elastics.
◦ This study shows the following:-
- NiTi coil springs have been shown to produce a constant force over varying length with no decay.
- NiTi coil spring produced nearly twice rapid a rate of tooth movement as conventional elastics.
- No patient co-operation needed.
- Coil springs can stretch as much as 500%

without permanent deformation.

◦ The force delivered is 90 to 100gm.
• Cox C et al “The wide use of NiTi coil springs for canine retraction can be attributed to their
relatively constant force delivery hence, reducing the number of appliance reactivations.

• On the other hand, elastomeric chains deliver an interrupted force that provides periods of
rest allowing for regeneration and better tolerance of the supporting tissues. Ziegler P et al
and Dixon V

• Barsoum HA et al There was no clinical or statistical difference in canine retraction rate,

tipping, rotation, or root resorption between the NiTi closed coil spring and the elastomeric
chains to recommend one method over the other.

•Significantly fewer days with pain were reported for the NiTi closed coil spring. Further studies
are needed to investigate this finding.
• A clinical study of space closure with nickel-titanium closed coil springs and an elastic
module R. H. A. Samuels, .
• Sentalloy nickel-titanium closed coil springs produce more consistent space closure than an
elastic module.
• 150- and 200-gram springs produce a faster rate of space closure than either the elastic
module or the 100-gram spring.
• No significant difference was found in the rates of space closure caused by the 150-gram
and 200- gram springs
 E-LINK :
It is used as intermaxillary class II and class III applications. It
is available in different lengths
TIP EDGE RINGS:
It can control and hold the desired degree of mesiodistal inclination. The
cross bar can give up-righting forces.
E-CHAIN:
It is used for continuous ligation and consolidation etc. It is available in 3 types.
Small (continuous)
Medium (short)
Large (long)
Small or continuous chain
• Recommended for lower incisor space closure

• Interlink distance of 3 mm

• They provide higher initial force and retain force longer than long chains

• Bell recommends stretching the elastics 3 times its length in order to obtain the
desired force level
Medium or short chain
• Recommended for lower dental arch space closure

• Interlink distance 3.5 mm

Long chain or large

• Recommended for upper dental arch space closure

• Interlink space is 4 mm
Extra long chain

• This chain has the advantage of having less holes where food can loge
into resulting in less caries and periodontal problem

• Interlink distance 4.5 mm

POWER THREAD: (ELASTIC LIGATURE)
This is polyurethane thread, used for rotating, extruding, losing minor
spacing and to consolidate
 ELAST -O CHAIN:
• It is used for consolidation of arches. It gives a light continuous traction force.
• Elimintaes the solid bar between modules and permits each modules to be
used for engagement
• Available in .029 ‘thickness
ELASTIC THREAD:
• This is an elastic ligature covered with silk or nylon. The nylon fibers is there to protect
the latex core.
• It is used for rotation correction, traction etc, both with fixed and removable appliance.
• It is available in 3 types
Light
Medium
Heavy
ROTATION WEDGES :

• It acts as a fulcrum between wire and bracket to correct the rotation.

• It is ligated to the tie wing of the bracket.
 De-rotation
 Correction of Individual Tooth Rotations with Elastomeric Ligatures

To rotate a tooth distolingually, tie an elastomeric ligature in a figure-8 to the distal wing of the bracket
(Figs. A).
After placing the archwire, tie the mesial wing of the bracket to the archwire with a ligature wire or an
80
 PLASTIC CHAIN:

It is used extra orally along with head gear, for the orthopedic correction using
heavy forces.
 Factors affecting orthodontic elastics and chains
1) FORCE DEGRADATION

 Relaxation is defined as a decrease in force value carried or transmitted over time

with the element maintained in a fixed activated state of constant strain.
 The force decay under constant force application to latex elastic, polymer chains
and tied loops showed that the greatest amount of force decay occurred during the
first three hours in water bath.
 The force remained relatively the same throughout the rest of the period.
 Liu Yang et al in his study Force degradation of orthodontic latex elastics analyzed in
vivo and in vitro stated that –”The force degradation of latex elastic in vivo is much
greater than that in both air and artificial saliva. In vivo, the force value of the
orthodontic latex elastics decreased sharply in the first hour. The larger the inner
diameter and smaller the setting force value were, the slower the force decay.”

 K.A. Russell et al 2001 in his study the assessment of mechanical properties of latex
and non latex orthodontic elastics stated that breaking force there was trend towards
non latex elastics having lower breaking force than the latex elastics
Kamisetty SK et al -Non latex elastics have greater cross sectional area than
latex elastics in all types of elastics. Forces generated by the elastics decreased
over 48 hours to an average load approximating 65-75% of the manufacturer's
values. Force degradation was greater in non latex elastics compared to latex
elastics.
Force degradation was higher in the heavy elastics when compared with the
medium and light elastics.
Qodcieh SM et al
• Fifty percent of force degradation occurred in the first 4 to 5 hours, followed by
continuous and gradual force degradation for the remaining time intervals.
• Because of breakage and for oral hygiene purposes, orthodontic elastics should be
changed every 24 hours. Otherwise, elastics can be used for 48 hours.
• Force decay of the elastics was correlated with lateral distance between the
maxillary canine and the mandibular first molar at centric occlusion.
• The amount of anterior mouth opening had a significant effect on force
degradation of the elastics. Ie Maximum mouth opening anteriorly had a significant
effect on force decay but not on the lateral distance.
 2) FLUORIDES

• Plaque accumulation around the fixed orthodontic appliance will cause dental and
periodontal decease.
• Decalcification can be avoided by mechanical removal of plaque or by topical fluoride
application or with a mechanical sealant layer.
• Controlled fluoride release device has been in use since the 1980s. In such device a
copolymer membrane allows a reservoir of fluoride ions to migrate into oral
environment rate.
• The delivery of stannous fluoride by means of power chain would presumably
reduce count and inhibit demineralization.
• An average of 0.025 mg of fluoride is necessary for remineralization.
• But this protection is only temporary and of a continued exposure needs; the elastic
should be replaced at weekly intervals.
• The force degradation property will be higher with the fluorinated elastic chain.
 Storie DJ et al in his study Characteristics of a fluoride-releasing elastomeric chain concluded that
 The physical properties and fluoride releasing capabilities of a fluoride-containing elastomeric
chain (Fluor-I-Chain) have been evaluated and compared to those of a standard gray elastomeric
chain.
 The fluoride chain required significantly more displacement to achieve the same force level.
 When maintained at a constant distraction of 100%, Fluor-I-Chain was unable to deliver a force
within the optimal range for tooth movement after one week. In contrast, the force delivery level
of the standard gray chain remained adequate over the entire three-week test period.
 Fluoride was released by the fluoride-containing chain over a three-week period at a level that
could inhibit demineralization and promote remineralization.
3. Air
 Exposure of latex to air was found to cause a loss of force.

4. Ozone
 The most significant limitation of natural latex is its enormous sensitivity to the effects of ozone
or other free radical generating systems such as sunlight or ultraviolet light that produces cracks.
 The ozone breaks down the unsaturated double bonds at the molecular level as the water
molecule is absorbed → weakens the latex polymer chain.
 Swelling and staining → due to the filling of the voids in the rubber matrix by fluids and bacteria
debris.
 In clinical use the latex elastics are replaced before this stage is reached.
 The exposure to free radicals results in a decrease in the flexibility and tensile
strength of the polymer.

 Manufacturers have added antioxidants and antiozonates to retard these effects and
extend the shelf life of elastomerics.
5. Disinfection and sterilization

 Disinfection (short-term exposure) and/or sterilization (long-term exposure) may become

a common procedure for elastomeric chains.
 Exposure to gluteraldehyde solution affected the strength and the distention required to
deliver a force of 500g of certain elastomeric chains. However, the resultant changes were
relatively small and are probably insignificant in the clinical setting.
 Discoloration of some chains occurred in the sterilizing solutions but this change appeared
to have no effect on the chain properties. The findings suggest that cold disinfection
and/or sterilization via gluteraldehyde solutions (Sporicidin and Cidex-7) may be an
effective and convenient approach for elastomeric chains.
7. Ph

 Oral pH almost certainly has a significant influence on the decay rate of orthodontic
polyurethane chain elastics.

 Ferriter JP et al “ All the test products yielded a significantly greater force-decay rate
in the basic (pH 7.26) solution than in the acidic (pH 4.95) solution over 4 weeks.
 A hypothesis is presented that the decay rate of orthodontic polyurethane chain
elastics is inversely proportional to the oral pH, with that basic pH levels (above
neutral) are most hostile to polyurethane chain elastics, thus increasing their
force-decay rates.”
  Clinically, it would seem that an oral pH lower than 7.26 would retard the force-
decay rate of the chain elastics. Before this study, we did not expect to find that
decreased pH associated with dental plaque in the presence of carbohydrates may
actually decrease the force-decay rate of the chain elastics and thus potentially
enhance their effectiveness.

Khaleghi A, et al -This study aimed to assess the effect of citric acid, as a weak acid
commonly used in food industry, on elastomeric chain force decay. Elastomeric chains in
both the citric acid and artificial saliva groups experienced force decay over time. Force
decay was greater in the citric acid group. Thus, citric acid can effectively decrease the
elastomeric chain force.
8. Mastication

 The forces of mastication and the intraoral environment cause natural rubber to
break down by formation of knotty tearing mechanisms.
9. Oral cavity

 Oral cavity → elastics absorb water and saliva → breakdown of the internal bonds
and permanent deformation of the material.

 Elastics swell and stain due to the filling of the voids in the rubber matrix by fluids and
bacterial debris → loss in force delivered to the tooth.

 To minimize such side effects, orthodontists recommend that patients change their
elastics twice daily, but this requires faithful patient adherence.
10. Staining

 The foods appeared to fall into three distinct categories

 A. No staining (Coco-Cola even after 72 hours and, presumably, most colorless
foodstuffs)
 B. Gradual staining (chocolate drink, Lea & Perrins sauce, red wine, tomato
ketchup)
 C. Rapid staining (coffee produced severe staining after only six hours, tea)
• Anil P Ardeshna et al Significant changes in colour, including grey level and chromaticity,
both as a function of colour and company of elastomeric ligature module were found
following exposure to beverages and spices.
• Colour change was most affected by Δb* (yellowness) and most significant in clear
modules.
• Modules made using injection mouldings were more resistant to colour change than
those by extrusion.
• Spice mix had the most effect and cola beverage the least.
11) STORAGE

According to the manufactures the orthodontic elastics should

be stored in the refrigerator, because increased atmospheric temperature for
a long period will decrease the strength. Keeping in refrigerator (cool and
dry) will give long shelf life.
12) PRE STRETCHING OF ELASTICS

• Allen. K. Wong suggested in 1976 that the elastomeric materials need to pre-
stretched 1/3rd of their length to pre stress the molecular polymer chain. This procedure
will increase the length of a material.

• If the material is over stretched a slow set will occur but will go back to original state in
time.
• If the material is over stretched to near breaking point, over and over again, permanent
plastic deformation will occur.

These means that the initial force may come to an effect during an pre stretched process. So
when it is in use it will give more stable force.
13) Latex allergy:

Allergies to the latex proteins are increasing which has implication for
dental practitioners because latex is ubiquitous in dental environment.
K. A. Russel 2001 - reaction to the latex materials have become more
prevalent and better recognized- since 1988 adoption of universal
precautions. Only 3 reports have been cited in the literature relating latex
allergies to orthodontic treatment. 2 of these studies related the allergic
reactions to use of latex gloves, and 3rd report related to the development of
stomatitis with acute swellings and erythematous buccal lesions to the use of
orthodontic elastics
 ARMAMENTARIUM
◦ Dontrix Gauge:-

It is used to determine proper size elastic for each application by

measuring the force. Measuring range is 28gm – 450gm.
◦ Stress Gauge (correx Gauge):-
The measuring range is 25-250gm or 100-500gms or 200 – 1000 gm.
◦ Elastic separator placing pliers:-

Pliers with the limit for excess expansion. Rounded beak protects patient’s soft tissue. It

can be used with large and small rings

Module remover
Double ended instrument for removing modules from the bracket.

Mosquito forces
Having curved delicate serrated tips for applying modules
◦ Mathieu Forceps:-
It is used for placing all types of elastomers. It has got a slip free grasping and quick release
ratchets for fast operation.
◦ Twirl on ligature:-
It is used for placing elastomeric modules and can be preloaded.
Orthodontic wrench
It is a double ended plastic instrument for the use of attaching
elastics by patient himself
ORTHODONTIST’S PART IN PATIENT
WEARING ELASTICS
◦ Educate the patient to wear the elastics continuously except while
brushing and replacing. Occasionally there may be some exceptions.

◦ Instruct the patient carefully where the elastics are to be attached and
have him to do so before you.

◦ Every visit check whether the patient is wearing elastics, properly or

not.

◦ Make sure that the patient can place his elastics easily and that they
remain in place.
◦ Check whether the hooks, pins, tubes, cleats are easily accessible and
remove all sharp edges that may cause breakage of elastics.

◦ Caution the patient not to allow the lower jaw to come forward in
response to the pulling force exerted by CL II elastics. Be sure that the
patient closes in the proper retruded position.

◦ It is most important to impress upon the patient and the parents, that if
there is any difficulty in wearing elastics it should be informed to your
office immediately.
 Conclusion

• To put it in a nutshell, elastics are a prime consideration in orthodontics.

• Elastics are one of the most versatile materials available to the

orthodontist.

• It is an invaluable tool of the orthodontist armamentarium.

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