Friction in Orthodontics: A

Comprehensive Analysis of Influencing

Factors and Advanced Clinical
Strategies
Introduction
Importance of Friction in Orthodontic Biomechanics
Friction is a fundamental physical concept that arises when attempting to move one object over
the surface of another. In the field of orthodontics, this concept gains significant importance,
particularly when applying sliding mechanics, a common technique used to move teeth along
the archwire to achieve desired alignment and correct malocclusion. The resistive force
generated at the contact interface between the archwire and the bracket slot is known as friction
in this context.
Friction poses a fundamental clinical challenge for orthodontists, as it acts as a counterforce
opposing the desired direction of tooth movement. This resistance can significantly reduce the
efficiency of applied orthodontic forces, potentially slowing the rate of tooth movement and thus
increasing the overall treatment duration. Furthermore, the need to apply greater forces to
overcome friction can complicate anchorage control, a concept referring to the resistance to
unwanted movement of teeth (usually posterior teeth) while moving other teeth.
Studies indicate that a significant portion of the applied orthodontic force may be lost due to
friction, with estimates ranging from 12% to over 60% under certain conditions. This means that
for a sufficient effective force to reach the tooth's supporting tissues and stimulate the necessary
biological response for movement, the clinician must apply a higher initial force. This is not
without risks, as applying excessive forces may increase the likelihood of root resorption and
negatively affect the bone remodeling process and surrounding periodontal tissues.

Report Objectives and Content

This report aims to provide an in-depth scientific review and comprehensive analysis of the
phenomenon of friction in the context of orthodontics. It will review the basic definitions of
friction and its various components, focusing on distinguishing between static and kinetic friction
and the more encompassing concept of resistance to sliding. Subsequently, the multiple factors
influencing friction levels will be analyzed, whether biological (such as the effect of saliva and
plaque) or mechanical (such as the properties of bracket and wire materials and design, ligation
methods, and contact angle).
The report will also discuss the clinical impacts of friction on the efficiency of tooth movement
and anchorage control, exploring how friction can be an obstacle or, in some cases, beneficial.
A significant portion will be dedicated to reviewing innovative strategies and materials
developed to manage and reduce friction, including advanced bracket designs like self-ligating
brackets, enhanced wire properties such as surface coatings, and various ligation techniques.
Finally, the report will highlight the latest research developments and future trends in
understanding and managing friction in orthodontics, offering clinical and research
recommendations based on available evidence. This report relies primarily on a review of
scientific literature and published research in orthodontics, biomechanics, and dental materials,
aiming to provide a comprehensive and accurate information source for specialists and
researchers in this field.

Understanding Friction and Resistance to Sliding in

Orthodontics
Definition of Friction (FR)
In physics, friction is defined as the force that arises between two contacting surfaces when one
attempts to move relative to the other, acting to resist or impede this relative motion. The
direction of the frictional force is always tangential to the contacting surfaces and opposite to the
direction of potential or actual movement. In orthodontics, friction primarily occurs at the contact
interface between the archwire and the inner surface of the bracket slot, and sometimes with the
ligation mechanism.
The force of friction adheres to basic physical laws, being directly proportional to the normal
force (F_N) pressing the contacting surfaces together. The normal force represents how strongly
the wire presses against the walls of the bracket slot. Frictional force also depends on the
nature of the contacting surfaces, mathematically expressed through the "coefficient of friction"
(μ). The coefficient of friction is a property of the contacting materials and reflects how easily or
difficultly they slide over each other. The relationship can be expressed by the basic friction
equation: F_F = \mu \times F_N. The greater the normal force or the coefficient of friction, the
greater the frictional force resisting movement.

Types of Friction: Static vs. Kinetic

Two main types of friction are distinguished based on the state of relative motion between the
contacting bodies:
●​ Static Friction (SF): This is the resistive force that must be overcome to initiate the
movement of a stationary object relative to another surface. The value of static friction
increases with the applied force attempting to move the object, up to a maximum value. If
the applied force exceeds this maximum value, the object begins to move. In
orthodontics, the applied force on the tooth must be sufficient to overcome the static
friction between the wire and bracket to initiate tooth sliding along the wire.
●​ Kinetic (Dynamic) Friction (KF): Once the object starts moving, the force resisting the
motion is called kinetic friction. The value of kinetic friction is typically less than the
maximum value of static friction for the same two surfaces. This force must be overcome
to maintain the continuous movement of the tooth at a relatively constant speed along the
wire.
Relative Importance in Orthodontics: Understanding the difference between static and kinetic
friction is of significant clinical importance. Tooth movement during sliding mechanics is not a
smooth, continuous sliding motion but rather a series of intermittent events involving initial
tipping of the tooth, contact of the wire with bracket corners (binding), a small movement, a
temporary stop, correction of the tooth's position (uprighting), and so on. Each time the tooth
temporarily stops during this cycle, the applied orthodontic force must again overcome static
friction (which is higher than kinetic friction) to restart the movement. For this reason, static
friction is considered the more critical and resistive factor in tooth movement during sliding
mechanics, as it must be overcome repeatedly. If the applied force drops below the level of
static friction, tooth movement may cease entirely. This requires the application of a continuous
and sufficient force to ensure the ongoing overcoming of static friction and achieve effective
tooth movement.

Concept of Resistance to Sliding (RS)

Research and clinical studies have shown that the total force resisting the movement of a
bracket along an archwire in the oral environment is a more complex phenomenon than just
classical friction (FR), which is typically measured under ideal laboratory conditions (e.g., no
angle between wire and bracket). Therefore, a more comprehensive and accurate term,
"Resistance to Sliding" (RS), has been proposed to describe this resistance.
Components of RS: Resistance to sliding (RS) consists of three main components that interact
to determine the total resistance to movement:
1.​ Classical Friction (FR): This is the friction resulting from direct contact between the wire
surface and the inner surface of the bracket slot when there is "clearance" between them,
i.e., when the wire does not fully fill the slot and is in a relatively "passive configuration"
without a significant contact angle. This component primarily depends on the coefficient of
friction (μ) between the materials and the normal force (N) resulting from ligation or the
pressure of the wire within the slot.
2.​ Binding (BI): Binding occurs when the tooth tips or rotates in response to the applied
force, or when the wire flexes under load. This tipping or flexion causes the wire to
contact forcefully with the edges or sharp corners of the bracket slot. The greater the
contact angle between the wire and the bracket corner, the greater the binding force and
thus the resistance to sliding increases significantly. The angle at which this sharp contact
begins is called the "critical contact angle" (\theta_c). The magnitude of this angle
depends on the dimensions of the wire and slot (the clearance between them).
3.​ Notching (NO): In cases of severe binding, and when the applied forces exceed the
material's resistance, permanent deformation can occur on the wire surface at the point of
contact with the sharp bracket corner. This deformation or "notching" causes the sliding
movement to stop completely as the wire "gets stuck" in the bracket. Movement does not
resume until the forces or tooth position change sufficiently to release this notch, or it may
require intervention from the clinician.
The total resistance to sliding can be expressed by the equation: RS = FR + BI + NO.
Understanding the dynamic nature of the RS components is crucial. At the beginning of
movement or when the wire is passive in the slot, classical friction (FR) may be the dominant
component. However, the tooth quickly begins to tip under the influence of the force, leading to
an increase in the contact angle and exceeding the critical angle. At this point, binding (BI)
becomes the dominant and most influential component of resistance to sliding. In extreme
cases, notching (NO) can occur. This means that strategies focusing solely on reducing the
coefficient of friction (μ) to decrease FR (such as using lubricants or smooth surface coatings)
may not be sufficient to effectively reduce RS in clinical practice, as BI and NO often play the
larger role. Effective strategies must also consider factors that reduce binding and notching,
such as using more flexible wires or brackets with designs that reduce corner sharpness or
provide better tipping control.

Factors Influencing Friction and RS

The phenomenon of friction and resistance to sliding in orthodontics is influenced by a complex
and interrelated set of factors that can be broadly classified into biological factors related to the
oral environment and mechanical factors related to the properties of the orthodontic appliances
themselves.

Biological Factors
The oral environment is dynamic and variable, and its components directly affect the interface
between the wire and the bracket:
●​ Saliva:
○​ Saliva acts as a natural lubricant in the mouth, containing glycoproteins like mucin
that reduce friction between moving surfaces. Therefore, friction values measured
in laboratory studies conducted under dry conditions (without saliva) tend to be
higher than those actually occurring in the mouth.
○​ A comparative study showed that natural human saliva and mucin-based artificial
saliva (MUC) significantly reduce friction compared to dry conditions, with no
statistical difference between them, suggesting MUC can be a good model for
simulating salivary lubrication effects in lab studies. In contrast, the effect of distilled
water and carboxymethylcellulose-based artificial saliva (CMC) was less effective in
reducing friction.
○​ These findings underscore the importance of considering the effect of salivary
lubrication when interpreting laboratory study results and applying them to clinical
practice. Differences in friction between various materials might be less pronounced
in the moist oral environment compared to dry conditions.
●​ Plaque/Biofilm and Other Accumulations:
○​ Orthodontic appliances, with their complex surfaces and angles, provide an ideal
environment for the accumulation of plaque, food debris, calculus, and acquired
pellicle.
○​ The buildup of these materials on wire surfaces and within bracket slots increases
surface roughness and alters the nature of the contact interface, inevitably leading
to increased friction and resistance to sliding.
○​ The difficulty in maintaining perfect oral hygiene with orthodontic appliances makes
the accumulation of these substances a common problem. Thus, meticulous and
continuous oral care is important not only for preventing caries and gum disease
but also for contributing to the reduction of unwanted friction levels, which may
improve the efficiency of tooth movement.
●​ Biodegradation/Corrosion:
○​ Orthodontic materials, especially metal alloys, are exposed to the chemically and
biologically aggressive oral environment, characterized by saliva, pH fluctuations,
enzymes, and microorganisms.
○​ These conditions can lead to biodegradation or chemical corrosion of wire and
bracket surfaces over time. Corrosion alters surface roughness and chemical
composition, which can increase the coefficient of friction and resistance to sliding
 during the long treatment period.
○​ This factor poses an additional challenge for laboratory studies, as it is difficult to
simulate the long-term effect of corrosion occurring in the oral environment on the
frictional properties of orthodontic materials.

Mechanical Factors
These factors relate to the physical and mechanical properties of the orthodontic appliance
components themselves:
●​ Bracket Properties:
○​ Material: The bracket material is one of the most important mechanical factors.
Generally, stainless steel (SS) brackets exhibit the lowest friction levels compared
to other materials when used with SS wires. Ceramic brackets, whether
polycrystalline or monocrystalline, show significantly higher friction levels,
potentially double that of SS brackets, mainly due to the higher coefficient of friction
and surface roughness of ceramics. Some studies show conflicting results on
whether monocrystalline or polycrystalline is lower. Brackets made of polymeric
materials (like polycarbonate or composites) may show varying friction levels,
sometimes similar to SS and sometimes lower, depending on the material type,
ligation method, and testing conditions. Titanium brackets show friction similar to
SS.
○​ Metal-Slot Ceramic Brackets: To overcome the high friction issue of ceramic
brackets while maintaining aesthetics, ceramic brackets with an internal slot made
of stainless steel have been developed. These brackets have proven effective in
significantly reducing friction compared to all-ceramic brackets, with friction levels
approaching those of metal brackets.
○​ Design:
■​ Width: There is no complete consensus on the effect of bracket width.
Classical theory suggests wider brackets provide better control over tipping
and rotation, reducing the contact angle and thus binding (BI) and friction.
However, other analyses suggest narrower brackets might be preferable in
some cases, and that there is an optimal relationship between bracket width
and inter-bracket distance for minimum friction.
■​ Slot Dimensions: The slot size (typically 0.018 or 0.022 inches) affects the
amount of clearance between the wire and bracket. Larger slots (0.022)
provide greater clearance with small and medium wires, reducing the
likelihood of binding and friction in the early stages of treatment (leveling and
alignment). Smaller slots (0.018) offer greater control in the final stages
requiring precise expression of torque and tip using rectangular wires that fill
the slot, but may increase binding and friction in the early stages or with large
wires.
■​ Self-Ligating Brackets (SLBs): These represent a significant design
innovation aimed at reducing friction by incorporating a mechanism (clip or
door) to close the slot and secure the wire, eliminating the need for traditional
elastic or metal ligatures. The basic idea is to reduce the normal force (N)
applied to the wire within the slot, which is the main component causing
classical friction (FR) in traditional brackets ligated with elastics.
■​ Passive vs. Active: SLBs are divided into two main types. Passive
 brackets (e.g., Damon, SmartClip) have a closing mechanism (like a
sliding door or a flexible clip that doesn't press on the wire) that
transforms the open slot into something resembling a tube, allowing the
wire to slide more freely, especially when there is significant clearance
(with small wires) and in the absence of a large contact angle. They are
thought to generate the least friction under these conditions. Active
brackets (e.g., Speed, In-Ovation, Quick) contain a flexible spring clip
that actively presses the wire into the slot. This pressure is believed to
provide better control over tooth rotation and torque but may increase
friction, especially when the clip contacts large wires or when an angle
forms between the wire and bracket.
■​ In Vitro vs. Clinical Results: Laboratory (in vitro) studies consistently
show that SLBs, especially the passive type, generate significantly
lower frictional forces than conventional brackets tied with elastic
ligatures, when using small round wires and under ideal conditions
(zero angulation). However, the picture becomes less clear when
simulating clinical conditions more closely, i.e., when there is
angulation or when using large rectangular wires that fill the slot. In
these situations, binding (BI) increases significantly and becomes the
dominant factor in resistance to sliding (RS), and the differences in RS
between SLBs and conventional brackets may diminish or disappear.
More importantly, the majority of high-quality randomized clinical trials
(RCTs) have not found conclusive evidence that using SLBs leads to a
tangible reduction in overall treatment duration or the number of
follow-up visits required compared to conventional brackets. This gap
between promising laboratory results and less decisive clinical
outcomes strongly suggests that resistance to sliding in the clinical
environment is not solely determined by classical frictional forces (FR)
reduced by SLBs, but is significantly influenced by other factors like
binding (BI) and notching (NO), as well as biological factors and
individual patient response.
●​ Archwire Properties:
○​ Material: Similar to brackets, the wire material significantly influences friction.
Stainless steel (SS) wires provide the lowest friction when used with SS brackets.
Nickel-titanium (NiTi) alloys, whether superelastic or heat-activated, and
cobalt-chromium alloys (like Elgiloy) show higher friction than SS. Titanium
molybdenum alloys (TMA or Beta-Titanium) are known to generate the highest
friction levels due to their inherent surface roughness and high coefficient of friction.
○​ Size and Cross-Section:
■​ Generally, as the wire size increases (diameter of round wires or dimensions
of rectangular wires), the available clearance within the bracket slot
decreases. This reduction in clearance increases the likelihood of binding (BI)
at the slightest tooth tipping and also increases the probability of notching
(NO) with stiff wires, leading to a significant increase in resistance to sliding
(RS).
■​ For rectangular wires, the occluso-gingival dimension is the most critical
factor affecting friction when angulation is present.
■​ Rectangular wires tend to exhibit higher friction than round wires with a
 diameter similar to one of their dimensions, due to increased contact surface
area and higher probability of binding at the edges.
○​ Surface Roughness: Inherently rougher surfaces, like TMA wires or some poorly
polished NiTi wires, lead to a higher coefficient of friction and thus increased
frictional force. Surface coatings can significantly modify surface roughness, either
increasing or decreasing it.
○​ Stiffness (Modulus of Elasticity): Wire stiffness affects how it interacts with the
bracket when angulated. Stiffer wires (like SS) transmit force more effectively but
also generate higher binding forces (BI) at angles and are more prone to notching
(NO). Less stiff, more flexible wires (like NiTi) may flex more within the slot at
angles, potentially reducing sharp binding forces and allowing smoother movement
in some cases, especially in the initial stages of leveling and aligning severely
crowded teeth.
○​ Coatings: Will be discussed in detail later, but generally, various coatings (e.g.,
polymers, noble metals, metal oxides, nanomaterials) applied to the wire surface
aim to modify its surface properties, primarily reducing the coefficient of friction (μ)
or increasing surface smoothness to decrease classical friction (FR).
●​ Ligation Methods:
○​ The method of securing the wire within the bracket slot plays a pivotal role in
determining the normal force (N) applied to the wire, thus directly influencing the
classical friction component (FR).
○​ Elastomeric Ligatures: The most common method, but they generate the highest
friction levels compared to other methods. This is because the elastomer presses
the wire firmly into the slot, significantly increasing the normal force (N).
Additionally, the elastomer itself has a relatively high coefficient of friction, and its
force and properties degrade over time in the oral environment.
○​ Steel Ligatures: Can provide lower friction levels than elastomeric ligatures, but
this depends heavily on how tightly they are tied. If tied loosely, they allow greater
wire freedom and reduce normal force and friction. If tied tightly, they can generate
high friction. Disadvantages include longer chair time for placement and removal,
and potential irritation to soft tissues.
○​ Low-Friction Ligatures: Special types of ligatures, often made of improved
polymeric materials or innovative designs (e.g., Slide ligatures), have been
developed to reduce ligation force and friction compared to traditional elastomeric
ligatures. Some studies suggest their performance may approach that of
self-ligating brackets in reducing friction.
○​ Self-Ligation: As discussed under brackets, this design aims to reduce or eliminate
the normal force from external ligation, significantly decreasing classical friction.
○​ The choice of ligation method represents an important strategy the clinician can use
to control friction levels, especially in stages where classical friction (FR) is the
major influencing factor (e.g., initial leveling and alignment stages using small,
round wires). Changing from elastomeric to loosely tied steel ligatures or using
SLBs can significantly reduce the normal force and thus friction.
●​ Wire-Bracket Angulation:
○​ The contact angle between the wire and bracket is one of the most critical factors
determining the amount of binding (BI), and consequently, resistance to sliding (RS)
under clinical conditions.
○​ This angle arises from the mismatch between the wire axis and the bracket slot
 axis, which inevitably occurs during the correction of tipped or rotated teeth, or
when applying torque.
○​ As this angle increases, the force with which the wire presses against the bracket
corners increases, leading to a sharp rise in binding (BI) and resistance to sliding
(RS).
○​ The extent of RS increase with angulation is influenced by two main factors: the
amount of clearance between the wire and slot (less clearance leads to binding at
smaller angles), and the stiffness of the wire (greater stiffness leads to higher
binding force at the same angle).
○​ This again emphasizes that binding (BI), not necessarily classical friction (FR), is
the decisive factor determining resistance to sliding in most phases of actual
orthodontic treatment, especially when dealing with severe malocclusions or using
large rectangular wires in the final stages for torque control. This partly explains
why some strategies that effectively reduce FR in the lab (like SLBs) may not
always translate into significant acceleration of tooth movement clinically, as BI
might become the limiting factor for resistance.

Impact of Friction on Tooth Movement and Anchorage

The presence of friction and resistance to sliding (RS) at the wire-bracket interface has
significant clinical implications affecting the efficiency of tooth movement, anchorage
requirements, and the overall biomechanics of orthodontic treatment.

Force Loss and Movement Efficiency

The fundamental principle in orthodontic biomechanics is that the applied force must reach the
supporting tissues of the tooth (periodontal ligament and alveolar bone) to stimulate the cellular
response leading to tooth movement. However, a significant portion of the force applied by the
clinician to the orthodontic appliance does not actually reach these tissues; instead, it is
consumed in overcoming the resistive forces at the wire-bracket interface, i.e., resistance to
sliding (RS).
This loss of effective force directly reduces the efficiency of sliding mechanics. Instead of the
entire applied force being used to move the tooth, a part is "wasted" in overcoming friction and
binding. As a result, tooth movement may be slower than expected, leading to an extension of
the overall orthodontic treatment duration.
To ensure that sufficient force reaches the tooth to stimulate biological movement (usually within
the optimal force range to avoid tissue damage), the clinician must apply a higher initial force
when activating the orthodontic appliance. This compensation for the force lost due to RS must
be done cautiously, as applying excessive forces can have undesirable side effects, as
mentioned earlier (e.g., root resorption, increased anchorage loss, tissue stress).

Friction and Anchorage

Anchorage is a critical concept in orthodontics referring to the resistance to unwanted tooth
movement while moving other teeth. Friction plays a dual and sometimes contradictory role
concerning anchorage:
●​ Anchorage Loss: In many treatment scenarios, such as closing extraction spaces by
 retracting anterior teeth, the posterior teeth (molars and premolars) serve as the
anchorage unit that should remain as stationary as possible. In this case, resistance to
sliding (RS) acts as an impeding force to the movement of the anterior teeth, requiring the
application of a higher retraction force to overcome it. This higher force affects not only
the anterior teeth but also acts as a reaction (according to Newton's third law) on the
posterior anchorage unit, increasing its tendency to move forward (Mesial Movement),
which is known as anchorage loss. The higher the RS, the greater the force required, and
the higher the risk of unwanted anchorage loss.
●​ Anchorage Enhancement: On the other hand, friction can be strategically utilized to
enhance anchorage in cases requiring maximum stability of the anchorage unit (Maximum
Anchorage Cases). In these situations, the clinician might intentionally choose orthodontic
components that generate higher friction in the anchorage area (such as using rough
TMA wires in the posterior segments, using higher friction brackets, or ligating posterior
brackets tightly) to help resist their unwanted forward movement. In this context, friction
becomes "beneficial" as it helps achieve a specific treatment goal of maintaining the
position of posterior teeth.
This dual nature of friction requires the clinician to have a precise understanding of the
anchorage requirements for each individual case and to select appliances and mechanics that
provide the appropriate level of friction to achieve the desired goals. What is considered "high
friction" and undesirable in the context of moving a specific tooth might be "useful resistance" in
the context of stabilizing another tooth.

Tipping and Uprighting Cycles

As previously mentioned, tooth movement in sliding mechanics is rarely an ideal bodily
movement where the root and crown move by the same amount and direction. Since the
orthodontic force is typically applied to the tooth crown (via the bracket) away from its center of
resistance (located within the root), the tooth tends to tip in the direction of the applied force.
This tipping increases the contact angle between the wire and the bracket, causing binding.
When binding occurs, effective sliding movement stops, and uprighting forces begin to act (due
to the wire's elasticity and attempt to return to its original shape), correcting the tooth's
inclination and releasing the binding, initiating a new cycle of tipping, binding, and uprighting.
Resistance to sliding (RS), especially the binding component (BI), directly affects these cycles.
The higher the RS, the greater the amount of tipping required for binding to occur, and the
greater the force needed to correct this tipping and release the binding. This makes the sliding
process intermittent and less efficient, as part of the force and energy is "wasted" in these
repeated cycles of tipping and uprighting instead of achieving net sliding movement.
Therefore, strategies to reduce RS, particularly those that minimize binding (BI), can contribute
to making the sliding movement closer to bodily movement, reducing the number and severity of
tipping and uprighting cycles, leading to more efficient and smoother tooth movement.

Strategies for Managing and Reducing Friction

Given the significant impact of friction and resistance to sliding (RS) on the efficiency of
orthodontic treatment, numerous strategies and materials have been developed to control
friction levels and reduce them when necessary. These strategies primarily focus on modifying
the properties of brackets, wires, and the ligation methods between them.

Innovations in Bracket Design

●​ Self-Ligating Brackets (SLBs):
○​ Principle: As mentioned earlier, these brackets work via a built-in mechanism (clip
or door) to secure the wire in the slot, eliminating the need for external ligatures and
significantly reducing the normal force (N) applied to the wire, thereby decreasing
classical friction (FR).
○​ Types (Passive and Active): Passive SLBs allow greater freedom of wire
movement within the slot and exhibit the lowest classical friction, especially with
small wires and in the absence of angulation, making them an attractive option for
the initial stages of treatment (leveling and alignment) where friction reduction is
desired to facilitate tooth movement. Active SLBs, with their clip pressing on the
wire, may offer better control over torque and rotation in the final stages of
treatment, but this pressure can increase friction when using large wires or when
angulation is present.
○​ Clinical Considerations: Despite the clear theoretical and laboratory benefits of
SLBs in reducing classical friction, clinical evidence regarding their effectiveness in
reducing overall treatment time remains limited and contradictory. Clinicians must
weigh the potential benefits (especially in early stages) against the higher cost of
these brackets, keeping in mind that binding (BI) may become the dominant factor
controlling RS in later stages regardless of bracket type.
●​ Metal-Slot Ceramic Brackets:
○​ Represent a compromise combining the aesthetic appearance of ceramic brackets
with the superior mechanical performance of metal brackets regarding friction. By
incorporating a stainless steel slot within the ceramic bracket body, the coefficient of
friction is significantly reduced compared to an all-ceramic slot, resulting in friction
levels approaching those of full metal brackets. This option is attractive for patients
seeking an aesthetic solution without a major sacrifice in sliding efficiency.
●​ Other Designs:
○​ Research and development include designs aimed at reducing the sharpness of
slot edges to decrease the likelihood of binding (BI) and notching (NO).
○​ Use of new materials with inherently low coefficients of friction.
○​ Modification of slot dimensions to optimize the balance between clearance and
control.

Development of Archwire Properties

●​ Material Selection:
○​ Using stainless steel (SS) wires with SS brackets is considered the gold standard
for achieving the lowest classical friction (FR) during sliding phases.
○​ Titanium molybdenum (TMA) wires should be avoided in stages requiring significant
free sliding due to their inherent high friction. They can be useful in final stages
requiring precise bends or in anchorage units to increase resistance.
○​ Nickel-titanium (NiTi) wires, with their high flexibility, can be beneficial in the initial
stages for leveling and alignment, or when dealing with large tipping angles, as their
flexibility can reduce sharp binding forces compared to stiffer SS wires.
 ●​ Appropriate Dimensions:
○​ The clinician should select the smallest wire cross-section capable of achieving the
required movement and providing necessary control for the current treatment stage,
especially when sliding is the primary goal.
○​ Using large, full-slot wires significantly increases binding and friction and should be
limited to the final stages requiring maximum control of torque, tip, and rotation,
where sliding is less critical.
●​ Surface Coatings:
○​ Coating the surface of orthodontic wires is a very active research area aimed at
improving their surface properties, primarily reducing the coefficient of friction (μ)
and increasing smoothness to decrease RS.
○​ Types: The materials used for coatings vary widely and include:
■​ Polymers: Such as polytetrafluoroethylene (PTFE or Teflon), known for its
low-friction properties.
■​ Noble Metals: Such as rhodium (Rh) and gold (Au).
■​ Nitride and Carbon Compounds: Such as titanium nitride (TiN), chromium
nitride (CrN), diamond-like carbon (DLC), and carbon nitride (CNx).
■​ Metal Oxides: Such as aluminum oxide (Al2O3), titanium dioxide (TiO2), and
zirconium oxide (ZrO2).
■​ Nanomaterials: Including silver nanoparticles (Ag NPs), zinc oxide
nanoparticles (ZnO NPs), fullerene-like tungsten disulfide nanoparticles
(IF-WS2), and molybdenum disulfide (MoS2).
○​ Effectiveness: Numerous laboratory studies have shown that various types of
these coatings can significantly reduce frictional forces compared to uncoated
wires. For example, nano-metal oxide coatings, especially ZrO2, have shown
remarkable effectiveness in reducing friction across different wire types. Coatings
like Ni-PTFE , CNx , and IF-WS2 have also shown promising results in friction
reduction, along with potential for other beneficial properties like antibacterial
resistance (with CNx and Ag NPs). Metal coatings like rhodium can provide a
smooth, corrosion-resistant surface.
○​ Challenges: Despite promising laboratory results, challenges remain for the
widespread clinical application of these coatings. These include ensuring the
durability of the coating and its resistance to wear and delamination in the harsh
oral environment over the long treatment period. The effect of the coating on the
wire's fundamental mechanical properties (like flexibility and formability) must also
be evaluated, along with ensuring the biocompatibility of the coating and its
non-release of harmful ions, and the additional cost of these coated wires. It has
also been noted that some coatings might increase friction if they peel off or if used
with uncoated brackets, potentially leading to an undesirable interaction between
the coating surface and the bracket surface.

Improving Ligation Methods

●​ "Loosely Tied" Steel Ligatures: A simple and effective method to reduce normal force
(N) and friction compared to traditional elastomeric ligatures or tightly tied steel ligatures.
Requires skill from the clinician to ensure the tie is not overly tight while still adequately
securing the wire.
●​ Low-Friction Elastomeric Ligatures: An alternative to traditional elastomeric ligatures,
 using special materials or designs (like Slide ligatures) to reduce friction. May be easier to
use than steel ligatures and offer better friction results than traditional elastomers.
●​ Using SLBs: As discussed earlier, using self-ligating brackets is a fundamental design
strategy to reduce ligation force and classical friction.

Comparative Table of Friction Reduction Strategies

To summarize and compare the different strategies available for managing friction, the following
table provides an overview of their mechanisms of action, effectiveness, potential advantages,
and disadvantages:
Strategy Primary Lab Clinical Other Potential Key Sources
Friction Effectiveness Effectiveness Advantages Disadvantag
Reduction (FR, ideal (Reduced Tx es
Mechanism conditions) Time)
SLBs Reduce High Contradictory Reduced Higher cost,
(Passive) ligation force / Unproven ligation time, bulkier?, less
(N) better torque
hygiene? control?
(esp. w/
small wires)
SLBs Reduce Medium to Contradictory Better Higher cost,
(Active) ligation force High / Unproven rotation/torqu increased
(N) e control? friction w/
(vs. passive) large
wires/angulat
ion,
mechanical
complexity
Ceramic Reduce Medium Not Good Higher cost
Brackets coefficient of (better than sufficiently aesthetics than metal,
(Metal Slot) friction (μ) full ceramic) studied potentially
weaker than
metal
SS Low inherent High (lowest Reference Low cost, Non-aestheti
Brackets/Wi μ classical FR) standard strength, c
res formability
NiTi Wires Higher Potentially Essential for Shape Higher
(vs. SS) flexibility lower at high early stages memory, high friction than
(reduces BI?) angles flexibility SS (ideal
cond.), not
formable
TMA Wires - (Increases Low (highest Used for Good Very high
(vs. SS) friction) FR) other formability, friction
purposes moderate
(bending, strength
anchorage)
Coated Reduce μ, High Promising Reduced Coating
Strategy Primary Lab Clinical Other Potential Key Sources
Friction Effectiveness Effectiveness Advantages Disadvantag
Reduction (FR, ideal (Reduced Tx es
Mechanism conditions) Time)
Wires (e.g., increase but needs friction, durability?,
ZrO2) smoothness clinical maybe cost?, effect
studies aesthetic/anti on other
bacterial properties?
Coated Reduce μ High Needs Very low Coating
Wires (e.g., (slippery long-term friction durability?,
PTFE) surface) clinical peeling?
studies
Steel Reduce Medium to Effective but Good control Longer chair
Ligatures ligation force High technique-de (if needed), time,
(Loose) (N) pendent low cost potential
irritation
Low-Friction Reduce Medium Needs Easier than
Elastics ligation force (better than clinical steel?, less
(N) traditional) studies effective than
SLBs?,
elastomer
degradation?
Note: The effectiveness of strategies can vary significantly depending on the treatment stage,
type of movement required, wire size used, and the presence of tipping or rotation.

Clinical Considerations and Treatment Planning

Understanding the principles of friction and resistance to sliding (RS) and the factors influencing
them is not just an academic exercise; it has direct and significant applications in the daily
clinical practice of orthodontics. Clinicians must integrate this knowledge into the
decision-making process when planning treatment, selecting appliances, and determining
appropriate force levels.

Impact of Friction on Appliance Selection and Force Level

The expected level of friction should be a factor considered when choosing the bracket system,
wires, and ligation method for a specific case.
●​ Bracket Selection: If the primary goal is to facilitate sliding (as in closing large spaces),
the clinician might lean towards using brackets with inherently low friction (like stainless
steel brackets) or designs aimed at reducing friction (such as passive self-ligating
brackets or metal-slot ceramic brackets). If precise control of torque and tip is the priority
(as in the final stages), other brackets (like conventional or active self-ligating) might be
more suitable, even if their friction is slightly higher.
●​ Wire Selection: Wire material and size should be chosen based on the stage
requirements. For sliding phases, stainless steel (SS) wires are generally preferred due to
their low friction and sufficient stiffness to maintain arch form. TMA wires should be
avoided in these stages. Flexible NiTi wires can be used in the initial stages for easier
 initial alignment while reducing binding forces. The smallest effective wire capable of
achieving the required movement should be used.
●​ Ligation Method: The ligation method can be used as a tool to adjust friction. Switching
from elastomeric ligatures (high friction) to loosely tied steel ligatures or using SLBs
(lower friction) can be done when free sliding is desired.
●​ Force Level: Since part of the applied force will be lost due to RS, the clinician must
estimate this loss and apply a sufficient initial force to ensure a biologically effective force
reaches the tooth. However, extreme caution must be exercised to avoid applying
excessive forces, which can increase the risk of root resorption, harm supporting tissues,
and increase anchorage loss. The goal should always be to use the lightest possible force
capable of achieving the desired movement after overcoming RS.

Anchorage Management Strategies in the Presence of Friction

The relationship between friction and anchorage is complex and requires careful planning.
●​ Assessing Anchorage Requirements: The clinician must first determine the anchorage
requirements for the case: is it maximum, moderate, or minimum anchorage?
●​ Controlling Friction Based on Anchorage:
○​ Maximum Anchorage: When maintaining the position of posterior teeth is critical,
friction can be used as an adjunct. Friction in the anchorage unit can be increased
by using TMA wires, higher friction brackets, tightly ligating posterior brackets, or
using additional anchorage devices (like Temporary Anchorage Devices - TADs) to
counteract the higher forces needed to overcome friction in the movement area.
○​ Minimum Anchorage: When posterior tooth movement is desired or acceptable
(e.g., to help correct a Class II relationship), friction should be minimized as much
as possible in both the anchorage unit and the movement area to facilitate the
movement of both groups of teeth.
●​ Differential Mechanics: Principles of differential friction can be used, employing systems
with different friction levels in various parts of the dental arch to achieve selective
movement.

Relationship Between Friction, Treatment Duration, and Outcomes

It is logical to assume that high friction, being a resistive force, will slow down tooth movement
and thus prolong the overall treatment duration. This is the rationale behind the development of
many low-friction techniques and materials.
However, as repeatedly emphasized, the relationship between friction values measured in the
laboratory (especially classical friction FR) and the actual treatment duration in clinical practice
is not a simple linear relationship. This is due to several reasons:
1.​ Dominance of Binding (BI): In clinical conditions, binding (BI) resulting from tooth tipping
and wire angulation is often the largest and most determining component of resistance to
sliding (RS), not classical friction (FR). Appliances with low FR may not necessarily
reduce BI significantly.
2.​ Biological Factors: The effects of saliva, plaque, and corrosion can alter the actual
friction levels in the mouth compared to laboratory conditions.
3.​ Individual Patient Response: The biological tissue response to orthodontic forces varies
from patient to patient.
4.​ Other Factors: Clinician skill, patient cooperation (especially with elastics), and case
 complexity all play a role in determining treatment duration.
Therefore, clinicians should be cautious about marketing claims that focus solely on "low
friction" as the sole factor for improving treatment efficiency. Any orthodontic system should be
evaluated comprehensively, considering its ability to control tooth movement in three
dimensions, anchorage requirements, ease of use, cost, and available clinical evidence, not just
laboratory-measured friction values. An excessive focus on reducing friction might sometimes
come at the expense of precise control over tooth position, which is essential for achieving
excellent and stable treatment outcomes.

Recent Developments and Future Research

The field of orthodontics is witnessing continuous advancements in materials and technologies,
and understanding and managing friction and resistance to sliding remains an important focus
for research and development. Recent innovations aim to improve treatment efficiency, reduce
side effects, and enhance patient comfort.

Promising Materials and Coatings

●​ New Materials for Brackets and Wires: Research continues into new materials that
combine desirable mechanical properties (like strength and flexibility), excellent
biocompatibility, improved surface characteristics (such as low friction and corrosion
resistance), and aesthetic appearance.
●​ Nanocoatings: This area represents the most active research front currently regarding
the modification of orthodontic wire surface properties. Nanotechnology allows the
application of extremely thin layers of various materials onto the wire surface, potentially
offering multiple benefits:
○​ Friction Reduction: Laboratory studies have shown promising results for
nanocoatings of metal oxides like ZrO2 (zirconium oxide), TiO2 (titanium dioxide),
and Al2O3 (aluminum oxide) in significantly reducing friction, with ZrO2 showing the
best results in some studies.
○​ Antibacterial Properties: Some nanocoatings, such as those containing silver
nanoparticles (Ag NPs), zinc oxide nanoparticles (ZnO NPs), or carbon nitride
(CNx), have demonstrated antibacterial properties, which could help reduce plaque
accumulation and prevent gum disease and caries around orthodontic appliances.
○​ Improved Biocompatibility and Corrosion Resistance: Certain coatings (like TiN
or CNx) can enhance the corrosion resistance of the base alloys and improve their
biocompatibility.
○​ Challenges: The long-term durability of these coatings in the oral environment,
their effect on the wire's mechanical properties, and their cost still require further
research and clinical evaluation.
●​ Wires with Improved Mechanical Properties: Development of new alloys or innovative
heat treatments for NiTi wires aimed at improving their properties, such as Low Hysteresis
(L&H) NiTi wires. These wires are thought to provide more continuous forces and might
reduce binding and friction compared to traditional NiTi wires, with some studies showing
they generate less friction.
Computational Modeling
●​ Finite Element Method (FEM): This technique has become a powerful tool for studying
the complex biomechanics of the wire-bracket-tooth-bone system. FEM allows
researchers to create detailed 3D models and simulate the effects of different forces,
stress distribution, and levels of friction and binding under various conditions that are
difficult to replicate accurately in the lab or measure directly in the mouth.
●​ Applications: FEM can be used to compare the performance of different bracket and
wire designs, evaluate the effect of various tip and torque angles on RS, understand how
forces are distributed to supporting tissues, and optimize appliance design for more
efficient and safer tooth movement.

Future Trends
●​ Integration with Digital Technologies and Artificial Intelligence (AI):
○​ Using 3D imaging, intraoral scanning, and CAD/CAM to design and manufacture
customized orthodontic appliances for each patient, potentially improving accuracy
and reducing the need for friction-reducing adjustments.
○​ Applying AI algorithms to analyze patient data, predict tooth movement more
accurately, assist in treatment planning, and possibly design optimized orthodontic
appliances that account for friction factors.
●​ Smart Appliances: Development of orthodontic appliances that might contain embedded
sensors capable of measuring applied forces and friction or binding levels in real-time
within the patient's mouth, providing valuable data for the clinician to adjust and optimize
treatment.
●​ Continued Focus on Biocompatibility: With the development of any new material or
coating, ensuring its long-term safety and biocompatibility remains a top priority.
●​ Critical Need for Clinical Studies: Despite significant progress in laboratory research,
there is still a critical need for more high-quality randomized clinical trials (RCTs) to
evaluate the true clinical effectiveness of new strategies and materials aimed at reducing
friction, and to determine their actual impact on treatment duration, quality of final
outcomes, and long-term stability.
●​ Deeper Understanding of Biological Factors: More research is needed to understand
the dynamic and long-term impact of biological factors like saliva composition, plaque
accumulation, and biodegradation on the frictional properties of different orthodontic
materials in the oral environment.
●​ Exploring Alternatives to Sliding Mechanics: In cases where friction is a major concern
or difficult to control, exploring or refining "frictionless mechanics" techniques as an
alternative might be beneficial, such as using specially designed loops to close spaces or
move teeth without sliding along the main archwire. Loops, like the Opus Loop mentioned
in a recent study, offer alternative mechanisms that may reduce frictional forces and
provide good control over tooth movement.

Conclusion and Recommendations

Summary
Friction and resistance to sliding (RS) are critical and complex factors in the biomechanics of
orthodontics, especially when using sliding techniques. These resistive forces are influenced by
a wide and interconnected range of biological factors (like saliva, plaque, corrosion) and
mechanical factors (such as bracket and wire material and design, ligation method, contact
angle). While classical friction (FR) impedes initial movement, binding (BI) and notching (NO),
arising from tooth tipping and wire contact with bracket corners, are often the dominant
components of RS in clinical practice.
Friction can negatively impact the efficiency of tooth movement by consuming a significant
portion of the applied force, potentially slowing treatment and increasing the burden on
anchorage units, thus raising the risk of anchorage loss. However, friction can also be
strategically exploited in some cases to enhance anchorage when needed.

Control Strategies
Several strategies have been developed to manage and reduce friction, including:
1.​ Appliance Selection: Using brackets and wires with friction properties appropriate for the
treatment stage (e.g., SS for sliding, TMA for final control or anchorage).
2.​ Bracket Design: Utilizing innovative designs like self-ligating brackets (SLBs), especially
passive types in early stages, and metal-slot ceramic brackets as an aesthetic low-friction
alternative.
3.​ Wire Improvement: Selecting appropriate dimensions and using advanced surface
coatings (like nanocoatings with metal oxides or low-friction polymers) that have shown
promising results in reducing friction in laboratory settings.
4.​ Ligation Methods: Employing ligation methods that reduce normal force, such as loosely
tied steel ligatures or low-friction elastomeric ligatures, as alternatives to traditional
elastomeric ties.

Clinical Recommendations
●​ Comprehensive Understanding: Orthodontists should develop a deep understanding of
the principles of friction, binding, and notching, and the multiple factors influencing them
to make informed decisions about appliance and mechanics selection for each case.
●​ Critical Evaluation: Do not rely solely on marketing claims or laboratory results regarding
"low friction." Evaluate the overall clinical performance of any orthodontic system,
including its ability to achieve three-dimensional tooth control, meet anchorage
requirements, ease of use, cost, and available clinical evidence.
●​ Focus on Binding (BI): Given the importance of binding in clinical resistance to sliding,
special attention should be paid to minimizing it by selecting appropriate wire-slot
clearance, using wires with suitable flexibility for the stage, and avoiding excessive forces
that might increase unwanted tooth tipping.
●​ Oral Hygiene: Emphasize the importance of maintaining excellent oral hygiene for
patients, not only for gum and tooth health but also to minimize plaque buildup and other
biological factors that can increase friction.
Research Recommendations
●​ Better Simulation of Clinical Environment: Need to develop laboratory testing models
capable of simulating clinical conditions more realistically, including the effect of saliva,
tipping/uprighting cycles (simulating binding), and long-term changes due to corrosion.
●​ High-Quality Clinical Trials: Conduct more well-designed randomized clinical trials
(RCTs) with long-term follow-up to assess the true clinical effectiveness of new strategies
and materials (like nanocoatings and different SLB types) and their actual impact on
treatment duration, quality of outcomes, and stability.
●​ Continued Research in Materials and Coatings: Continue exploring and developing
new materials and coatings that combine low friction properties, mechanical durability,
corrosion resistance, biocompatibility, and additional beneficial properties like antibacterial
resistance, with careful evaluation of their long-term safety and efficacy.
●​ Deeper Understanding of Biological Factors: Conduct studies focusing on
understanding the dynamic interaction between biological factors (saliva, plaque,
microorganisms) and various orthodontic materials and its effect on friction over time.

‫المصادر المقت َبس منها‬

1. SciELO Brazil - The role of friction in orthodontics The role of friction ...,
https://www.scielo.br/j/dpjo/a/KZk48dxHFS8scMJMwFPL5RC/ 2. Friction and Frictionless
Mechanics - Review Article,
http://jamdsr.com/uploadfiles/13orthovol9issue2pp49-55.20210225053107.pdf 3. Friction: An
Overview, https://jmc.gov.jo/sites/default/files/2022-01/rossouw2003.pdf 4. (PDF) The role of
friction in orthodontics - ResearchGate,
https://www.researchgate.net/publication/262554045_The_role_of_friction_in_orthodontics 5.
Friction in orthodontics - PMC, https://pmc.ncbi.nlm.nih.gov/articles/PMC4606615/ 6. Variables
affecting the frictional resistance to sliding in orthodontic brackets - OAText,
https://www.oatext.com/pdf/DOCR-2-160.pdf 7. An in vitro Evaluation of Friction Characteristics
of Conventional Stainless Steel and Self-ligating Stainless Steel Brackets with different,
https://www.thejcdp.com/doi/10.5005/jp-journals-10024-2102 8. Comparison of frictional
resistance between four types of brackets in combination with stainless steel and beta-titanium
archwires - APOS Trends in Orthodontics,
https://apospublications.com/comparison-of-frictional-resistance-between-four-types-of-brackets
-in-combination-with-stainless-steel-and-beta-titanium-archwires/ 9. Friction in orthodontics Ali
Hussein Ali Dina Hamid Obaid,
https://codental.uobaghdad.edu.iq/wp-content/uploads/sites/14/2023/12/Ali-Hussein.pdf 10.
Lubricating conditions: effects on friction between orthodontic ...,
https://pmc.ncbi.nlm.nih.gov/articles/PMC6526759/ 11. Reducing Friction in Orthodontic
Brackets: A Matter of Material or Type of Ligation Selection? In-Vitro Comparative Study -
PubMed Central, https://pmc.ncbi.nlm.nih.gov/articles/PMC9000226/ 12. Reducing Friction in
Orthodontic Brackets: A Matter of Material or Type of Ligation Selection? In-Vitro Comparative
Study - ResearchGate,
https://www.researchgate.net/publication/359706317_Reducing_Friction_in_Orthodontic_Brack
ets_A_Matter_of_Material_or_Type_of_Ligation_Selection_In-Vitro_Comparative_Study 13.
Friction and resistance to sliding in orthodontics: A critical review - ResearchGate,
https://www.researchgate.net/publication/24273135_Friction_and_resistance_to_sliding_in_orth
odontics_A_critical_review 14. Evaluation of Friction in Orthodontics Using Various Brackets
and ..., https://pmc.ncbi.nlm.nih.gov/articles/PMC4080062/ 15. The Question of Friction -
Journal of Clinical Orthodontics,
https://www.jco-online.com/archive/2010/05/281-the-editors-corner-the-question-of-friction/ 16.
Effects of Different Ligature Materials on Friction in Sliding Mechanics - PubMed Central,
https://pmc.ncbi.nlm.nih.gov/articles/PMC4441233/ 17. A Comparative Study of Static and
Kinetic Frictional Resistance during the Sliding of Arch Wires through Orthodontic Brackets -
Semantic Scholar,
https://pdfs.semanticscholar.org/ddab/f0a041b827845c030206cfa40a2c5dd0804a.pdf 18.
Resistance to sliding in orthodontics: misconception or method error? A systematic review and a
proposal of a test protocol - PMC, https://pmc.ncbi.nlm.nih.gov/articles/PMC6041452/ 19.
Governing the Friction in Fixed Orthodontic Appliance,
https://www.ijorth.com/article_245744_5429b0bc984b1943b3c70e81b22ca485.pdf 20.
pmc.ncbi.nlm.nih.gov,
https://pmc.ncbi.nlm.nih.gov/articles/PMC4080062/#:~:text=Static%20friction%E2%80%93it%20
is%20defined,both%20mechanical%20or%20biological%20factors. 21. Frictional and
Frictionless Systems | Pocket Dentistry,
https://pocketdentistry.com/frictional-and-frictionless-systems/ 22. Frictional Properties of
Self-Ligating Brackets and Low-Friction Ligatures - Science Publications,
https://thescipub.com/pdf/crdsp.2012.1.6.pdf 23. Comparative Evaluation of Frictional forces
between different Archwire-bracket Combinations - Semantic Scholar,
https://pdfs.semanticscholar.org/4412/40ac7c4a7f68b3564a94da6ae0091bbb7f37.pdf 24.
Factors affecting friction in the pre-adjusted appliance - PubMed,
https://pubmed.ncbi.nlm.nih.gov/15650066/ 25. (PDF) Friction in orthodontics - ResearchGate,
https://www.researchgate.net/publication/282415385_Friction_in_orthodontics 26. Comparative
assessment of the orthodontic wire's friction coated with zinc oxide nanoparticles by two
methods of chemical precipitation and hydrothermal process - Folia Medica,
https://foliamedica.bg/article/67842/list/18/ 27. A study comparing the resistance to sliding of
three orthodontic brackets under an increasing applied moment,
https://conservancy.umn.edu/bitstreams/73f882df-7867-4d8f-af4f-12bebb98bd33/download 28.
Friction and resistance to sliding in orthodontics: a critical review - PubMed,
https://pubmed.ncbi.nlm.nih.gov/19361729/ 29. A comparison of resistance to sliding of
self-ligating brackets under an increasing applied moment | The Angle Orthodontist - Allen
Press,
https://meridian.allenpress.com/angle-orthodontist/article/81/5/794/59203/A-comparison-of-resis
tance-to-sliding-of-self 30. Active and passive self-ligation—a myth? - PMC,
https://pmc.ncbi.nlm.nih.gov/articles/PMC8925263/ 31. Comparative Evaluation of Frictional
Resistance Between Different Types of Ceramic Brackets and Stainless Steel Brackets With
Teflon-Coated Stainless Steel and Stainless Steel Archwires: An In-Vitro Study,
https://pmc.ncbi.nlm.nih.gov/articles/PMC9107794/ 32. ‫ عيادات الشناوي‬- ‫تعرف على أسباب سقوط قواعد التقويم‬
‫لطب األسنان‬,
https://elshenawy-dentalclinics.com/%D8%A3%D8%B3%D8%A8%D8%A7%D8%A8-%D8%B3
%D9%82%D9%88%D8%B7-%D9%82%D9%88%D8%A7%D8%B9%D8%AF-%D8%A7%D9%8
4%D8%AA%D9%82%D9%88%D9%8A%D9%85/ 33. ‫ مركز أرتي سمايل‬- ‫ هل تقويم االسنان مؤلم ؟‬- Arty
Smile,
https://www.arty-smile.com/%D9%87%D9%84-%D8%AA%D9%82%D9%88%D9%8A%D9%85-
%D8%A7%D9%84%D8%A7%D8%B3%D9%86%D8%A7%D9%86-%D9%85%D8%A4%D9%8
4%D9%85/ 34. ‫ الموقع الرسمي لعيادات‬- ‫ تقويم االسنان المتحرك‬Guarantee dental,
https://guarantee-dental.net/%D8%AA%D9%82%D9%88%D9%8A%D9%85-%D8%A7%D9%84
%D8%A7%D8%B3%D9%86%D8%A7%D9%86-%D8%A7%D9%84%D9%85%D8%AA%D8%A
D%D8%B1%D9%83/ 35. ‫ عيادة الدكتور أحمد ماهر‬- ‫اسباب سقوط قواعد التقويم‬,
https://dr-maher.com/%D8%A7%D8%B3%D8%A8%D8%A7%D8%A8-%D8%B3%D9%82%D9
%88%D8%B7-%D9%82%D9%88%D8%A7%D8%B9%D8%AF-%D8%A7%D9%84%D8%AA%
D9%82%D9%88%D9%8A%D9%85/ 36. Functional Coatings for Orthodontic Archwires—A
Review - PMC - PubMed Central, https://pmc.ncbi.nlm.nih.gov/articles/PMC7435379/ 37.
Comparison of TiN and CNx coatings on orthodontic stainless steel_ Tribological and biological
evaluation,
https://ss.bjmu.edu.cn/Sites/Uploaded/File/2020/09/156373576262103759088347637.pdf 38.
Recent advances in antibacterial coatings for orthodontic appliances - Frontiers,
https://www.frontiersin.org/journals/bioengineering-and-biotechnology/articles/10.3389/fbioe.202
3.1093926/full 39. ‫ ما يجب أن تعرفه قبل البدء بالعالج‬:‫اضرار تقويم األسنان‬,
https://www.drammar-clinics.com/%D8%A7%D8%B6%D8%B1%D8%A7%D8%B1-%D8%AA%
D9%82%D9%88%D9%8A%D9%85-%D8%A7%D9%84%D8%A3%D8%B3%D9%86%D8%A7
%D9%86:-%D9%85%D8%A7-%D9%8A%D8%AC%D8%A8-%D8%A3%D9%86-%D8%AA%D8
%B9%D8%B1%D9%81%D9%87-%D9%82%D8%A8%D9%84-%D8%A7%D9%84%D8%A8%D
8%AF%D8%A1-%D8%A8%D8%A7%D9%84%D8%B9%D9%84%D8%A7%D8%AC 40. ‫تقويم‬
‫األسنان‬,
https://www.drammar-clinics.com/%D8%AA%D9%82%D9%88%D9%8A%D9%85-%D8%A7%D
9%84%D8%A7%D8%B3%D9%86%D8%A7%D9%86 41. ‫ دليلك الشامل البتسامة مثالية‬:‫ تقويم األسنان‬-
estethica Global,
https://estethicaglobal.com/ar/%D9%85%D8%AF%D9%88%D9%86%D8%A9/%D8%AA%D9%
82%D9%88%D9%8A%D9%85-%D8%A7%D9%84%D8%A3%D8%B3%D9%86%D8%A7%D9
%86-%D8%AF%D9%84%D9%8A%D9%84%D9%83-%D8%A7%D9%84%D8%B4%D8%A7%D
9%85%D9%84-%D9%84%D8%A7%D8%A8%D8%AA%D8%B3%D8%A7%D9%85%D8%A9-%
D9%85%D8%AB%D8%A7%D9%84%D9%8A%D8%A9 42. ‫ كل ما تود معرفته عن‬:‫ابتسامتك تستحق األفضل‬
‫ تقويم األسنان‬- estethica Global,
https://estethicaglobal.com/ar/%D9%85%D8%AF%D9%88%D9%86%D8%A9/%D8%A7%D8%
A8%D8%AA%D8%B3%D8%A7%D9%85%D8%AA%D9%83-%D8%AA%D8%B3%D8%AA%D8
%AD%D9%82-%D8%A7%D9%84%D8%A3%D9%81%D8%B6%D9%84-%D9%83%D9%84-%
D9%85%D8%A7-%D8%AA%D9%88%D8%AF-%D9%85%D8%B9%D8%B1%D9%81%D8%AA
%D9%87-%D8%B9%D9%86-%D8%AA%D9%82%D9%88%D9%8A%D9%85-%D8%A7%D9%
84%D8%A3%D8%B3%D9%86%D8%A7%D9%86 43. Friction Forces during Sliding of Various
Brackets for Malaligned Teeth: An In Vitro Study,
https://pmc.ncbi.nlm.nih.gov/articles/PMC3603550/ 44. Relative friction minimization in fixed
orthodontic bracket appliances - PubMed, https://pubmed.ncbi.nlm.nih.gov/8964778/ 45.
Frictional Resistance in Self-Ligating Orthodontic Brackets and Conventionally Ligated
Brackets: A Systematic Review - Allen Press,
https://meridian.allenpress.com/angle-orthodontist/article/79/3/592/58120/Frictional-Resistance-i
n-Self-Ligating-Orthodontic 46. Active and passive self-ligation: a myth? Part 1: torque control -
PMC - PubMed Central, https://pmc.ncbi.nlm.nih.gov/articles/PMC8845556/ 47. Orthodontic
treatment efficiency with self-ligating and conventional edgewise twin brackets: A prospective
randomized clinical trial - PMC, https://pmc.ncbi.nlm.nih.gov/articles/PMC8823125/ 48.
Comparison of frictional resistance between passive self-ligating brackets and slide-type
low-friction ligature brackets during the alignment and leveling stage - PubMed Central,
https://pmc.ncbi.nlm.nih.gov/articles/PMC6731002/ 49. Comparison of frictional forces during
the closure of extraction spaces in passive self-ligating brackets and conventionally ligated
brackets using the finite element method - PubMed Central,
https://pmc.ncbi.nlm.nih.gov/articles/PMC6599702/ 50. A multi-center randomized controlled
trial to compare a self-ligating bracket with a conventional bracket in a UK population: Part 1:
Treatment efficiency - PMC - PubMed Central,
https://pmc.ncbi.nlm.nih.gov/articles/PMC8603956/ 51. ‫ مزاياه وطرق تركيبه‬،‫ تقويم الديمون لالسنان‬-
Basmati Clinics,
https://basmaticlinics.com/%D8%AA%D9%82%D9%88%D9%8A%D9%85-%D8%A7%D9%84%
D8%AF%D9%8A%D9%85%D9%88%D9%86-%D9%84%D9%84%D8%A7%D8%B3%D9%86%
D8%A7%D9%86/ 52. ‫ما الفرق بين تقويم الديمون والتقليدي؟ | عالجك الطبية‬,
https://www.ilajak.com/ar/blog/damon-braces 53. ‫ المزايا والعيوب‬،‫ أفضل االنواع‬:‫تقويم األسنان‬,
https://www.ilajak.com/ar/blog/types-of-orthodontics 54. ‫ الدکتور جمیلیان‬- ‫معلومات حول أسالك تقويم األسنان‬,
https://jamilian.net/ar/%D9%85%D8%B9%D9%84%D9%88%D9%85%D8%A7%D8%AA-%D8%
AD%D9%88%D9%84-%D8%A3%D8%B3%D9%84%D8%A7%D9%83-%D8%AA%D9%82%D9
%88%D9%8A%D9%85-%D8%A7%D9%84%D8%A3%D8%B3%D9%86%D8%A7%D9%86/ 55.
Functional Surface Coatings on Orthodontic Appliances: Reviews of Friction Reduction,
Antibacterial Properties, and Corrosion Resistance - MDPI,
https://www.mdpi.com/1422-0067/24/8/6919 56. The Effect of Three Metal Oxide Nanocoatings
on the Frictional Resistance of Superelastic Orthodontic Archwires,
https://www.thejcdp.com/doi/10.5005/jp-journals-10024-3730 57. Properties of the bracket,
archwires, and coating materials used in this study - ResearchGate,
https://www.researchgate.net/figure/Properties-of-the-bracket-archwires-and-coating-materials-u
sed-in-this-study_tbl1_353446393 58. What are the advantages of using metal-coated dental
arch wires in orthodontic treatments?,
https://www.proplate.com/what-are-the-advantages-of-using-metal-coated-dental-arch-wires-in-o
rthodontic-treatments/ 59. How do different metal coatings on dental brackets influence the
overall time of orthodontic treatment? | ProPlate®,
https://www.proplate.com/how-do-different-metal-coatings-on-dental-brackets-influence-the-over
all-time-of-orthodontic-treatment/ 60. ‫تأثير التزوي بين السلك والحاصرة التقويمية في المقاومة االحتكاكية عند استخدام‬
‫ جامعة دمشق‬- ‫حاصرات وأسالك الفوالذ الالصدئ‬,
https://www.damascusuniversity.edu.sy/mag/health/images/stories/621-636.pdf 61. Recent
Advances in Orthodontic Archwires: A Review - PMC,
https://pmc.ncbi.nlm.nih.gov/articles/PMC10667943/ 62. Future of Orthodontics—A Systematic
Review and Meta-Analysis on the Emerging Trends in This Field - PubMed Central,
https://pmc.ncbi.nlm.nih.gov/articles/PMC9861462/ 63. ‫ من المعدن إلى التقويم الحديث‬:‫ تطور تقويم األسنان‬- Dr.
Khaled Al Sayed,
https://khaledalsayed.com/ar/post/%D8%AA%D8%B7%D9%88%D8%B1-%D8%AA%D9%82%
D9%88%D9%8A%D9%85-%D8%A7%D9%84%D8%A3%D8%B3%D9%86%D8%A7%D9%86-
%D9%85%D9%86-%D8%A7%D9%84%D9%85%D8%B9%D8%AF%D9%86-%D8%A5%D9%8
4%D9%89-%D8%A7%D9%84%D8%AD%D8%AF%D9%8A/ 64. Friction and Forces in
Orthodontics: Understanding Space Closure - PubMed,
https://pubmed.ncbi.nlm.nih.gov/39184616/