The unique arch wire slot design of the TRIAMOND™ bracket together with the self-ligating clip mechanism act to maintain the full-fit of the arch wire in all dimensions within the slot. This characteristic eliminates any “play” between the arch wire and bracket slot, which is inherent to Edgewise. 

Therefore, moments of couples (rather than forces) are produced without binding at the bracket corners which occurs with rectangular slots and undersized wires, i.e. Edgewise.

The differences in arch wire and slot dimensions in rectangular slot appliances in contrast create binding of the wire at the slot corners and a couple of the applied force. 

This may generate notching of the wire beyond binding, both serve to increase frictional forces.

The implications of these differences are that less friction is created by TRIAMOND™ brackets under conditions of malalignment as well as with larger sized finishing wires.

The graphic shows a omparison of frictional forces generated by displacing a 0.195”x0.025” wire through a straight 5-bracket segment of 3 different rectangular slot brackets, and a Wedgewise wire through an analogous TRIAMOND™ configuration. Note the 2.5-3.5x greater friction caused by rectangular slot variants.

Major differentiating characteristics of Wedgewise are found in the biomechanical responses as expressed by the TRIAMOND™ appliance. For example, comparing biomechanical behaviors in resolving crowded mandibular incisors, specifically, the most lingually/occlusally displaced such tooth. When an Edgewise appliance, regardless of method of ligation, is used to correct this malocclusion, the aforementioned tooth has expressed on it labially and apically directed forces. 

This results in labial movement of the crown due to a horizontal force in this direction and the vertical force directed apically and forward of the center of resistance which creates a moment to rotate the tooth labially. These forces also cause lingual movement of the root apex. Taken together, this distribution of forces improves the alignment of the dental crown, but causes uncontrolled tipping.

The force diagram shows as expressed on an elastomeric/steel ligature ligated (a), and self-ligating (b), alignment wire in an Edgewise bracket.

In contrast, the same conditions treated with the Wedgewise / Triamond™ appliance generates different more beneficial force vectors . 

Firstly, the two angulated walls with the arch wire held against them produce divergent forces with their corresponding opposing moments. 

Secondly, the unique design and interplay of the self-ligating non-locking and non-rigid clip which counters the forces caused by the arch wire, comprises a third-class lever. 

This produces a moment in the opposite direction of that generated by the labial/intrusive forces caused by the arch wire, therefore, tipping now is controlled and can be eliminated. 

Taking into account the lack of binding at the slot edges and the differential forces created by the clip and unique slot geometry, as well as a reduction of uncontrolled tipping, a reduction of overall treatment duration can be expected. This is not just another self-ligating bracket!

Firstly, the preferred course of diagnosis and treatment planning is carried out. Wedgewise does not dictate one type of treatment preference.

Secondly, bracket placement is performed without any compensations for side effects experienced in Edgewise (i.e. for bite opening/closing, prevention of collapse into an extraction site, etc.). Leveling and alignment are accomplished using a 0.016” nickel titanium arch wire. Should the calibrated self-ligating clip mechanism not be able to be nearly or fully be closed, it can be done so at only one corner with full engagement planned for the ensuing appointment. Alternatively, a 0.014” nickel titanium wire can be used.

This clinical picture shows after initial TRIAMOND™ bracket bonding how the a 0.016” nickel titanium arch wire was ligated. The severity of the rotation of the maxillary right second premolar precluded full arch wire insertion, therefore, the clip was utilized to engage it only on its distal corner. Full engagement was possible at the next appointment.

In yet another deviation from common rectangular slots, a consequence of the Wedgewise mechanism is that intra/inter elastic forces can be applied from the initial alignment wire. Meaning, that elastic chains, Class II/III elastics can be applied together already with the alignment wire. Since higher force levels required in rectangular .022"/.018" slot designs, preclude this option, these supplemental forces are not delivered prior to the working stage, whereas in Wedgewise lighter forces can be applied earlier in treatment. 

Meaning, that when 0.014” and 0.016” nickel titanium arch wires are used, 2- or 4-ounce elastics, respectively, are appropriate. Depending on the thickness of the elastic products to be used, simultaneous use of elastic chain(s) with intermaxillary elastics often requires engagement of the chain only around the incisal wings of the given bracket where said intermaxillary elastics will also be engaged. 

The following clinical picture shows a patient in the working/finishing stage of treatment where space closure is being performed in the maxillary arch using an elastomeric chain which bi-passes the clip of the canine to permit easier engagement of a Class II elastic to this tooth.

Under these conditions, it should be anticipated that a half-cusp Class II canine relationship be resolved to a Class I within 1-2 appointments, given patient cooperation.

The clip is best opened and closed using the accompanying tool. It has a tip that exactly fits the purchase point in the center of the clip and is engaged by orienting the handle of the tool horizontal to the occlusal plane either from the mesial or distal. All that is required to either close or open the clip is to roll the handle of the tool between the thumb and forefinger a fraction of a turn with little effort. The clip has been designed and tested to maintain its integrity and undergo this function well beyond its dependable clinical use. It has not been shown to fail or become difficult to manipulate under any conditions of oral hygiene (i.e. calculous build up etc.).   

Due to the full expression of the prescription delivered by the TRIAMOND™ appliance, it is recommended that once the alignment stage arch wire has become passive, that tooth positions be evaluated and any needed bracket re-positioning be done. The alignment arch wire(s) should then be re-engaged to complete this stage of treatment. In Wedgewise this will eliminate or significantly reduce any wire bending that would otherwise be necessary during both the working and finishing stages of Edgewise.

It is recommended that patients be seen every 6 weeks for adjustments. These appointments should be comprised of either replacement or provision of elastic products, bracket repositioning, or progressing to the second and final stage of treatment, working/finishing, by changing to the 0.016” square stainless-steel Wedgewise arch wires. 

This arch wire can be adjusted/bent/detailed using the Wedgewise plier whose beak/tip mimics the slot of the TRIAMOND™ bracket. This provides a positive non-crushing hold of the arch wire so that it cannot twist or slip as when adjusting Edgewise wires. Furthermore, as opposed to Edgewise, where there is always play between the arch wire and bracket slot requiring overestimation of any detail bends needed, in Wedgewise these conditions have been eliminated and only the required detailing should be performed.