MINI-IMPLANT SUPPLEMENT Journal of Orthodontics, Vol.

41, 2014, S15–S23

Biomechanics of incisor retraction with mini-

implant anchorage
Madhur Upadhyay, Sumit Yadav and Ravindra Nanda
University of Connecticut, Health Center, Farmington, CT, USA

Mini-implants have been successfully incorporated into orthodontic practice all over the world. One of the most
popular applications of mini-implant anchorage is to facilitate retraction of the anterior teeth. This article reviews
the mechanics involved in anterior tooth retraction with mini-implant supported anchorage. An attempt has been
made to synthesize information available in the literature and present it in a manner that is easily understandable
from a clinical perspective. We discuss the fundamental differences mini-implant based incisor retraction has when
compared to conventional techniques, mechanical factors affecting this process and provide a step-by-step analysis
of incisor retraction. In addition, various models of space closure are discussed that have evolved through careful
evaluation of in vitro and in vivo experiments.

Key words: Mechanics, mini-implants, incisor retraction

Received 8 April 2014; accepted 8 June 2014

Introduction
The extraction of premolar teeth and labial segment
retraction is generally indicated when there is obvious
protrusion. In the presence of a full unit class II
malocclusion or class I bimaxillary protrusion, ancho-
rage control is important because maintenance of
posterior buccal segment position is critical. A loss in
molar anchorage not only compromises correction of
the anterior–posterior discrepancy, but also affects the
overall vertical dimension of the face (Upadhyay et al.,
2008a,b; 2010). The application of mini-implant (MI)
supported anchorage can circumvent these anchorage
reinforcement issues and help maintain molar position
whilst establishing a class I canine relationship.
The science behind the use of MIs and their effect on
the dentition has undergone a paradigm shift since the
introduction of these appliances into clinical orthodon-
tics almost two decades ago. Through this paper we
intend to highlight the evolution of the biomechanics
involved in incisor retraction with MI anchorage and
how the scientific evidence is constantly evolving this
process.
Mechanical differences in incisor retraction between
MIs and conventional techniques
The use of MIs for the retraction of anterior teeth presents
a paradigm shift from conventional methods of space
closure. The shift is seen not only in the anchorage demand
between the two techniques but also in the biomechanics
involved. When using conventional mechanics, force appli-
cation is usually parallel to the occlusal plane and hence,
the orthodontist is only required to analyze force in one
plane. However, because MIs are usually placed apical
to the occlusal plane into the bone between the roots of
teeth, the force applied is always at an angle (notably, the
preferred location for MI placement is between the roots
of the second premolars and first molars close to the
mucogingival junction; care should be taken that the MIs
are not inserted too far apically in the movable mucosa,
since this can lead to failure due to persistent inflammation
around the insertion site). This angulated force lends itself
to be broken into two components by the law of vector
resolution (Upadhyay et al., in press): a horizontal
retraction force (r) and a vertical intrusive force (i). The
force applied with MIs in such a setup is also closer to the
Centre of Resistance (CRES) of the anterior unit.
Therefore, the MF (Moment due to the Force) is
significantly less, compared to that generated in
conventional mechanics (Upadhyay et al., 2008a,b;
2009; 2010; 2012). Clinically it translates into a
decreased tendency for the teeth to tip (Figure 1).
With conventional mechanics, the posterior segment
usually serves as the passive anchor unit, while the anterior
teeth act as the active unit. The force system is there-
fore differentially expressed in the active unit and the

Address for correspondence: Madhur Upadhyay, University of

Connecticut, Health Center, Farmington, CT, USA.
Email: madhurup@yahoo.com
# 2014 British Orthodontic Society DOI 10.1179/1465313314Y.0000000114
 S16 Upadhyay et al. Mini-implant Supplement
Figure 1 Biomechanical design of the force system
involved during en masse retraction of anterior teeth.
The vector of force varies between conventional
mechanics (FO) and implant-based mechanics (FI) for
space closure. Here, FI..r.i, (F5total force, i5intrusive
component and r5retractive component). Also the
moment created by the implant will be significantly less
than that created by conventional mechanics (Force
application with implants is closer to the CRES and
M5F6distance to the CRES). Note: with the conventional
approach there is no intrusive force generated
Figure 2 Anterior teeth that have to be distalized a greater distance (a) and will be automatically predisposed to
greater degrees of tipping than those requiring less distalization (b) (Note: the molar represents the posterior
segment while the incisor represents the anterior teeth)
JO September 2014
anchorage or passive unit within the same arch. In
contrast, when MIs are incorporated as the third part,
precise movement of the anterior and posterior segments is
possible. Accurate planning for the amount of desired
tooth movement is thus a prerequisite before active
treatment can be initiated. The clinical observation of the
amount of tipping will depend on the amount of space
closure. A greater amount of space closure will yield
greater side effects or in this case, tipping. With conven-
tional techniques, part of the space is taken up by molar
mesialization. Previous research has shown that in contrast
to MI supported anchorage; conventional methods show
2–3 mm of anchorage loss in a typical extraction case
(Upadhyay et al., 2008a,b; 2009; 2010). This implies that
the anterior teeth during space closure with MIs are
automatically predisposed to more tipping and ‘dumping’
as they have to be distalized a greater distance in order to
close the extraction space (Figure 2). Therefore, greater
degrees of torque control might be warranted for space
closure utilizing skeletal anchorage.
These and other differences have lead to a gradual
evolution of MI-based mechanics in orthodontics. How-
ever, before exploring this further, the mechanics of space
closure is discussed in more detail.
 JO September 2014 Mini-implant Supplement
Figure 3 Basic mechanics of tooth movement. Here, F5
retraction force, MF5moment due to the force, MC5
counterbalancing moment
Basic models for space closure
During the process of incisor retraction, the objective is to
apply a force between the incisor and the posterior
segment in order to close the space that exists between
them. This force is usually applied on the brackets
attached to the crowns of the teeth (Figure 3) and is
occlusal and buccal to the CRES of the units experiencing
the force. This generates MF, which causes tipping and
rotation of the teeth in the direction of the applied force
(Smith and Burstone, 1984; Upadhyay et al., 2012). Here
it is easy to see that by simply controlling the MF, different
types of tooth movement can be achieved (tipping,
translation, etc.). However, how can we manipulate the
MF? In orthodontics there are only two broad mechanical
pathways to achieve this: (1) changing the line of force
application (or reducing the magnitude of MF) or (2)
counterbalancing the MF (adding another moment in the
opposite direction).
Changing the line of force application
A simple way of accomplishing this is to apply the force
closer to the CRES of the anterior teeth. A rigid attachment,
often called a power arm, can be attached to the bracket on
the crown of the tooth or on the wire itself. Force can then
be applied to this power arm. In this way, the line of force is
moved to a different location, thereby altering its distance
from the CRES. This also causes a change in the moment of
the force. For example, if the power arm can be made long
and rigid to extend to the CRES of the tooth, MF can be
entirely eliminated, as the applied force will pass through
the CRES (Moment5Applied force6distance from the
CRES). Based on theoretical calculations, in vitro and in
vivo experiments, and with certain assumptions, we have
proposed a model (Figure 4), which describes various
types of tooth movement, depending upon the line of force
application and by the location of the tooth centre of
Fundamentals of the mechanics involved S17
Figure 4 Altering the line of force application can
change Centre of rotation and/or the type of tooth
movement. Orange: Uncontrolled tipping, Blue: Con-
trolled tipping, Pink: Translation, Purple: Root move-
ment, Green: Root movement with crown moving
forward. (Red dot: centre of resistance, other dots: centre
of rotations corresponding with the line of force)
rotation as a rotation axis (Kojima et al., 2012; Kojima
and Fukui, 2014; Sia et al., 2009; Tanne et al., 1988;
Tominaga et al., 2009). Figure 4 shows the centre of
rotation for every level of force. Notably, this model only
applies for maxillary incisors and measures only initial
tooth movement.
This approach is easier to execute with skeletal anchor-
age because MIs are usually placed between the roots of
the molar and premolar. Here, the height of both the
power arm and MI can be varied, depending upon the
line of force required. It works well for both multiple
and individual teeth (Figure 5). However, for movements
requiring greater degrees of control, such as translation or
root movement, this method possesses certain problems.
The ‘long’ arms can be a source of irritation to the patient,
by extending high into the vestibule and/or impinging
on the gingiva and cheeks. Additionally, the arms are
sometimes not rigid enough and can undergo some degree
of flexion under the applied force. Therefore, retraction of
incisors is often performed without the use of a power
arm. However, without the power arm the ability to
reduce the MF is also lost. In this situation, how do we
control the tooth movement? How do we bring about the
desired tooth movement, which can be so easily achieved
with power arms?
Counterbalancing the MF (sliding mechanics with MIs)
The en masse retraction described at the beginning of the
article outlined the forces and moments during the initial
stages of space closure (representing only the beginning
phase of retraction). What happens later? It is well known
 S18 Upadhyay et al. Mini-implant Supplement JO September 2014

Figure 5 Power arm based space closure. (a) En masse retraction of anterior teeth shows controlled tipping. (b)
Translation of the canine using a power arm

that space closure is a dynamic process and things change
as teeth move. Considerable research in this area has
provided us with a more detailed representation of the
incisor movement and its effect on the entire dentition
(Barlow and Kula, 2008; Josell et al., 1997; Kojima and
Fukui, 2010; Kojima et al., 2012; Kojima and Fukui, 2014;
Moore and Waters, 1993; Sia et al., 2009; Tominaga et al.,
2009) Based on the evidence gathered from this pool of
research, we have further refined the mechanical model of
incisor retraction with MIs. Essentially, incisor retraction
can be divided into four phases (Figure 6):
Phase I: This initiation of incisor retraction. A single
force (F) is applied in an upward and backward/distal
direction (Figure 6a). This force produces a moment
(MF) acting at the CRES of the incisor segment, causing it
to tip as it is being distalized. Since there is some degree of
play between the archwire and the bracket slot at this
stage, the tooth is free to tip in the mesio-distal direction
in an uncontrolled manner, creating a centre of rotation
(CROT) slightly apical to the CRES (Kojima et al., 2012;
Kojima and Fukui, 2014; Sia et al., 2009; Tominaga et al.,
2009) (Figure 4). This can also be referred to as the
 JO September 2014 Mini-implant Supplement Fundamentals of the mechanics involved S19

Figure 6 Mechanics of incisor retraction with MIs (Red dot: centre of rotation). (a) Phase I (The unsteady state/
uncontrolled tipping). The archwire-bracket play allows for uncontrolled tipping of the incisor. Note: Due to the
play there is no MC (moment due to a couple) generated. (b) Phase II (The controlled state/controlled tipping).
The archwire-bracket play does not exist anymore. There are signs of initial contact between the archwire and the
bracket edges giving rise to MC. However still MF..MC. (c) Phase III (Restorative phase/root uprighting due to
decreasing force). There is a decrease in the force levels causing a decrease in MF. Here MF,,MC. Note the
deflected wire now springs back as the retraction force is reduced causing a reduction in the moment. (d) Phase
IV (Continuous/heavy force). Permanent deflection of the archwire due to the continuous/heavy F making the MC
ineffective in creating any root correction. Here again MF..MC

‘unsteady state’ of incisor retraction, characterized by
uncontrolled tipping. Here it is easy to see that the greater
the play the more tipping occurs or in other words the
smaller the size of the archwire the greater the tipping.
Phase II: The incisor is now tipped to the extent that
the clearance (or play) between the bracket slot and the
wire has been eliminated. Figure 6b depicts the incisors
somewhat later in time relative to Figure 6a. Archwire–
bracket slot contact now exists. This two-point con-
tact by the archwire creates a moment in the opposite
direction of MF resulting in less tipping of the incisors
when compared to phase I. This is the ‘counterbalancing
moment’ or ‘moment due to a couple’ (MC). As the
wire further deflects, MC continues to increase (Force a
deflection, as we will see later) and the CROT moves
apically, creating controlled tipping of the incisors. This
can also be called the ‘steady state’ of incisor retraction.
From this point onwards, the movement of the teeth will
depend upon the nature of the retraction force, i.e. a
steady continuous force or a force decreasing with time.
This at the clinical level is a very relevant supposition.
Phase III (decreasing force): For space closure to enter
this phase, it must be assumed that the distal driving force
is undergoing a constant decay through the retraction
process. This is often seen with an elastomeric chain
or active tiebacks. (Barlow and Kula, 2008; Josell et al.,
1997) As the force decreases, so does the MF; however,
because of the angulated bracket and the local bending
 S20 Upadhyay et al. Mini-implant Supplement JO September 2014

of the archwire, the MC remains constant. Therefore,

MC.MF (Figure 6c). This results in restoration of the
axial inclination of the incisors (uprighting or root cor-
rection). This can be called the ‘restorative phase’ of
incisor retraction and can be clinically referred to as
the third-order torquing of the incisors. With the reactiva-
tion of the elastomeric chain the process resumes from
phase I.
Phase IV (Continuous force or heavy force): Incisor
retraction enters this phase if the retraction force is either
constant or heavy to begin with. Examples can be: nickel
titanium closed coil springs or heavy elastomeric chain.
Here, due to the heavy retraction force MF always being
.MC, there is anterior bending or deflection of the arch-
wire and tipping of the incisors continues (Figure 6d).
Clinically, the incisors might appear as ‘dumped’ or
retroclined (loss of torque) with a deep bite, sometimes
accompanied with a lateral open bite, with the molars Figure 7 Biomechanical design for the force system
tipped forward due to a similar wire deformation. This involved after space closure. Retraction of the upper
deformation is accompanied by an increase in friction anterior teeth still in progress. Note the increase in the
and/or binding at the wire-bracket interface, making angulation of the total force relative to the occlusal
tooth movement slow. It is important to mention here plane (Here, F..r<i). Such a mechanical configuration
has important implications for vertical control and
that at any point if MC5MF, the incisors would theore- Class II correction
tically undergo translation. However, this almost never
happens, as it is very difficult to maintain such a delicate
balance between the moments for any measurable period plane angle and in some situations, even resulting in
of time. intrusion of the posterior teeth and consequent upward
and forward rotation of the mandibular plane. (Upadhyay
Sequela of phase IV: distalization effect of MI- et al., 2008a,b; 2010; Hee Oh et al., 2011)
assisted retraction
It has been reported that MI-assisted retraction of the Mechanical factors affecting incisor retraction
incisors has the potential to distalize the whole arch It is evident from the previous discussion that the archwire-
en masse (Upadhyay et al., 2008a,b; 2009; 2010; 2012). bracket clearance is a very important factor in determining
This can occur primarily in two situations, which are not the type of anterior tooth movement in sliding mechanics.
necessarily mutually exclusive. At the end of phase IV, The greater the degree of play between the archwire and
there is increased binding and inter-locking of the archwire the bracket, the greater will be the tipping as the incisor
to the bracket. This causes the upward and backward brackets can rotate into that space, causing the roots to
retraction force to be transmitted to the posterior segment move labially (Tominaga et al., 2012). In other words, the
through the archwire. The stiffer and thicker the archwire, incisors will undergo a prolonged phase I space closure.
the more pronounced this effect will be. A similar effect is Table 1 shows the approximate values of play between
seen when the space between the anterior and posterior archwires and a 0.02260.028 inch bracket slot (Dellinger,
teeth is completely closed, but the retraction force is 1978; Joch et al., 2010; Schwaninger, 1978). Needless to
continued for closing residual anterior spaces. This results
in transmission of the total force to the posterior segments Table 1 Archwire-bracket clearance angle (play) for various
through the interdental contacts, producing a distal and archwires when placed in a 0.02260.028 inch bracket slot
intrusive force on the posterior teeth and a moment on the
entire arch (Figure 7). These mechanics have often been Wire size (inches) Amount of play (u)
employed to correct class II molar relationships without
0.01660.022 16–18
extractions. (Hee Oh et al., 2011; Park et al., 2005)
0.01760.025 12–14
Distalization with MIs also helps with efficient control of
0.01960.025 6–8
the vertical dimension by preventing extrusion of the
0.02160.025 2–3
molars (Figure 7), thereby maintaining the mandibular
 JO September 2014 Mini-implant Supplement
Figure 8 The amount of play between the bracket and
archwire depends on the size of the archwire
say, a 0.01660.022 inch wire will show more tipping than
a 0.01960.025 inch wire (Figure 8).
However, in the previous section it has been assumed
that the orthodontic wire in question acts as a ‘rigid
beam’. In reality this is not the case. An important
mechanical aspect to consider is the flexural rigidity of the
archwire, which is critical in regulating wire deformation.
Flexural rigidity (D) is denoted by EI, where E is Young’s
modulus of the archwire material, and I is the moment of
inertia of the cross-sectional area. It is defined as the
wire’s ability to resist deformation under load. Once the
tipping of incisors has occurred and there is no wire
bracket clearance, the flexural rigidity of the archwire or
the archwire deformation under the applied load (retrac-
tion force) will largely determine the type of tooth
movement (Kojima and Fukui, 2010; Adams et al.,
1987). If the wire undergoes elastic deformation, the
incisors will keep on tipping in spite of the ‘zero’
clearance between the archwire and bracket (phase IV
of incisor retraction). The amount of archwire defor-
mation can be estimated depending on both the flexural
rigidity of the archwire and net force acting on the
incisors. As a rule, smaller sized and less stiff archwires
show increased flexion when subjected to retraction
forces (Ouchi et al., 1998). Therefore, it is advisable to
carry out ‘en masse’ space closure with rigid stainless
steel archwires, as opposed to the more flexible nickel-
titanium based archwires.
The mechanical factors described in the preceding
section can be put together to form an equation to
illustrate the mechanics of a wire under a load (Adams
et al., 1987; Brantley et al., 2001):
FL3
D~
KD
Here, D is the amount of deflection of the archwire
under the applied load F from its original position (as
shown in Figure 6c and d), L is the length of the archwire
Fundamentals of the mechanics involved S21
between the two attachments (here it can be assumed
between the molar and the incisors), D is the flexural
rigidity described above, K is a constant that reflects the
stiffness of the beam and is dependent upon the brackets
supporting it. Please note, this equation is more suitable
to describing tooth movement that mimics a ‘three point
bending test’ or a cantilever beam with the load con-
centrated at the free end.
The ‘hybrid model’ of space closure with MI
anchorage.
The hybrid approach combines the two methods of
controlling anterior teeth retraction, applying a counter-
balancing moment and changing the line of force
application (Figure 9). In this approach, a power arm
is soldered on to the archwire mesial to the canine,
bilaterally. In this way the clinician can choose the line
of force application from the CRES through the power
arm to the MI. This will help in controlling the MF from
the beginning of space closure. Remember, the closer
the line of force to the CRES the lesser is the moment due
to force (Figure 4). Additionally, the retraction force
from the power arm causes the upward deformation
and the torsion of the anterior segment of the archwire.
This torsion of the archwire produces a couple, which
works as an anti-tipping moment to the anterior teeth
(Figure 10) as the available play is reduced by the wire
twisting within the bracket slot and creating a moment
due to a couple in the opposite direction of MF. In other
words, this couple has a lingual root tipping effect on
the incisors. Longer power arms are more effective in
minimizing archwire deflection than shorter ones as the
MF is reduced. Also, thicker wires will provide better
torsional control than lighter wires as we saw in the
preceding section. Additionally, it is important to begin
with an optimal force level (light not heavy) for retraction,
which preferably decays with time (as is seen with an
elastic chain) so that any deformation or deflection of
the archwire can be restored. In other words, every effort
should be made to confine incisor retraction to Phase III
as discussed previously.
Summary and conclusions
MIs are currently one of the best modalities to maintain
‘absolute’ anchorage. However, by themselves they do not
guarantee a well-defined and controlled retraction within
the anterior teeth. Side effects are bound to happen. An
understanding of the basic tenants of space closure via
sliding mechanics can help prevent these unwanted side
effects. Line of force application, amount of force, force
decay and constancy, archwire-bracket play and archwire
deflection (regulated primarily by the archwire properties)
 S22 Upadhyay et al. Mini-implant Supplement JO September 2014

Figure 9 Clinical application of power arm soldered on 0.01960.025 SS archwires for space closure. The blue arrow
shows the root movement obtained

are critical factors for controlling incisor retraction with
MI-supported anchorage. It is imperative to regulate
these factors in order to minimize archwire deflection for
unwanted side effects, including loss of torque control on
the incisors, resulting deep bite and/or lateral open bite
caused by tipping of the anterior and posterior teeth and
increases in friction/binding forces leading to stagnation
or slowing of tooth movement.
Various models describing incisor retraction have been
proposed in this paper. These suggestions are a culmination
of numerous research papers published in the litera-
ture regarding sliding mechanics and the theoretical

Figure 10 Sliding mechanics with power arm. (a) Moment (blue) due to retraction force. (b) Moment (red)
generated by the torsional effect of the archwire
 JO September 2014 Mini-implant Supplement
interpretations of mechanical laws guiding tooth move-
ment as we understand them at the University of
Connecticut.
Disclaimer statements
Funding None.
Conflicts of interest None.
Ethics approval None.
Acknowledgements
Madhur Upadhyay is thankful to all the past and
present residents of the University of Connecticut for
being very actively involved in his weekly lectures and
discussions on ‘Mechanics of tooth movement.’ A large
part of this paper comes from those discussions.
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