When you begin the leveling and aligning stage in fixed orthodontic treatment, one challenge always lurks around the corner—upper anterior teeth love to tip forward. This is especially true with preadjusted edgewise appliances because of the built-in tip in the brackets.
To solve this, McLaughlin and Bennett introduced something brilliantly simple: the laceback ligature. The idea was elegant—use a figure-eight stainless-steel ligature from the molar to the canine to prevent incisor flaring and apply light distalizing forces on the canine.
But the clinical question is:
👉 Are laceback ligatures actually effective?
👉 And how do they compare to something stronger, like NiTi closed coil springs?
A controlled clinical study by Melih Sueri and Tamer Turk (Angle Orthodontist, 2006) provides the answers—and some surprises.
1. PURPOSE OF LACEBACK LIGATURES
- Prevent forward tipping of upper anterior teeth during leveling.
- Apply a light, interrupted distalizing force on canines.
- Provide controlled movement with minimal anchorage loss.
2. FORCE APPLICATION
Laceback Ligature
- Material: 0.010″ stainless steel ligature wire
- From first molar → canine
- Re-tighten at every visit
- Force type: interrupted / light
NiTi Closed Coil Spring
- Material: Superelastic NiTi
- Force: 150 g
- From first molar → canine
- Reactivate monthly
- Force type: continuous
3. CLINICAL EFFECTS
Canine Movement
| Parameter | Laceback | NiTi Coil Spring |
|---|---|---|
| Distal movement | ~1.67 mm | ~4.07 mm |
| Distal tipping | 4.5° | 11.6° |
| Rotation | 2.7° distobuccal | 7.8° distopalatal |
| Movement rate | 0.66 mm/month | 1.61 mm/month |
🔎 Interpretation:
- Lacebacks = Slower but more controlled movement
- NiTi coil springs = Faster, less controlled, more tipping & rotation
4. MOLAR MOVEMENT (Anchorage Loss)
| Parameter | Laceback | NiTi Coil Spring |
|---|---|---|
| Mesial movement | 0.70 mm | 1.93 mm |
| Mesial tipping | 3.9° | 3.1° |
🔎 Interpretation:
- Lacebacks cause significantly less anchorage loss.
5. INCISOR EFFECTS
- Upper incisors show retroclination and posterior movement with both methods due to overall anterior segment retraction forces.
WHEN TO USE WHAT?
✔ Use Laceback Ligatures When:
- You want maximum anchorage control
- You’re in the leveling & aligning stage
- Controlling canine tipping/rotation is critical
- Light, intermittent forces are preferred
✔ Use NiTi Closed Coil Springs When:
- You need faster canine retraction
- Anchorage can be reinforced or is less critical
- Canine tipping is acceptable or planned
Final Thoughts
This study beautifully highlights a truth every orthodontist must embrace:
Success isn’t just about moving teeth—it’s about controlling how they move.
Lacebacks may look old-school, but they offer unmatched finesse during the initial phase of treatment. NiTi coils, on the other hand, are powerful tools when used at the right time.
Mastering when to use each one is a hallmark of an excellent clinician.
Dentowesome 