Unwanted tooth movement produced by the bonded retention wire : the “wire syndrome,” observations, theories, clinical consequences : second part

Abstract

Sometimes teeth can move even if they seem to have been perfectly stabilised by a retention wire. We call this phenomenon the “wire syndrome”. It has been well described both in the mandibular and maxillary arches in part one of this article. For the moment, there has been no mechanical explanation for this phenomenon in the scientific literature. After an analysis of photographic documents from fellow specialists and an examination of cases from our own office, we have developed a theory to explain the mechanical element involved. We will divide our analysis into two hypotheses. They could be inter-connected. The first so-called “intrinsic” hypothesis groups together procedural erreurs which all lead to the use of an active bonded wire. In such cases, the wire is directly responsible for the movements. Its action is the same as that of an orthodontic device directly bonded on the teeth. The second “extrinsic” hypothesis shows that a tooth with a well bonded wire can rotate if the link between the wire and the composite is broken and if force is present. The clinical evidence we have gathered could allow us to combat this phenomenon efficiently.