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The Cochrane Database of Systematic... Jul 2018Initial arch wires are the first arch wires to be inserted into the fixed appliance at the beginning of orthodontic treatment and are used mainly for the alignment of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Initial arch wires are the first arch wires to be inserted into the fixed appliance at the beginning of orthodontic treatment and are used mainly for the alignment of teeth by correcting crowding and rotations. With a number of different types of orthodontic arch wires available for initial tooth alignment, it is important to understand which wire is most efficient, as well as which wires cause least amount of root resorption and pain during the initial aligning stage of treatment. This is an update of the review entitledInitial arch wires for alignment of crooked teeth with fixed orthodontic braces, which was first published in 2010.
OBJECTIVES
To assess the effects of initial arch wires for the alignment of teeth with fixed orthodontic braces, in terms of the rate of tooth alignment, amount of root resorption accompanying tooth movement, and intensity of pain experienced by patients during the initial alignment stage of treatment.
SEARCH METHODS
Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 5 October 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2017, Issue 9), MEDLINE Ovid (1946 to 5 October 2017), and Embase Ovid (1980 to 5 October 2017. The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) of initial arch wires to align teeth with fixed orthodontic braces. We included only studies involving participants with upper or lower, or both, full arch fixed orthodontic appliances.
DATA COLLECTION AND ANALYSIS
Two review authors were responsible for study selection, 'Risk of bias' assessment and data extraction. We resolved disagreements by discussion between the review authors. We contacted corresponding authors of included studies to obtain missing information. We assessed the quality of the evidence for each comparison and outcome as high, moderate, low or very low, according to GRADE criteria.
MAIN RESULTS
For this update, we found three new RCTs (228 participants), bringing the total to 12 RCTs with 799 participants. We judged three studies to be at high risk of bias, and three to be at low risk of bias; six were unclear. None of the studies reported the adverse outcome of root resorption. The review assessed six comparisons.1. Multistrand stainless steel versus superelastic nickel-titanium (NiTi) arch wires. There were five studies in this group and it was appropriate to undertake a meta-analysis of two of them. There is insufficient evidence from these studies to determine whether there is a difference in rate of alignment between multistrand stainless steel and superelastic NiTi arch wires (mean difference (MD) -7.5 mm per month, 95% confidence interval (CI) -26.27 to 11.27; 1 study, 48 participants; low-quality evidence). The findings for pain at day 1 as measured on a 100 mm visual analogue scale suggested that there was no meaningful difference between the interventions (MD -2.68 mm, 95% CI -6.75 to 1.38; 2 studies, 127 participants; moderate-quality evidence).2. Multistrand stainless steel versus thermoelastic NiTi arch wires. There were two studies in this group, but it was not appropriate to undertake a meta-analysis of the data. There is insufficient evidence from the studies to determine whether there is a difference in rate of alignment between multistrand stainless steel and thermoelastic NiTi arch wires (low-quality evidence). Pain was not measured.3. Conventional NiTi versus superelastic NiTi arch wires. There were three studies in this group, but it was not appropriate to undertake a meta-analysis of the data. There is insufficient evidence from these studies to determine whether there is any difference between conventional and superelastic NiTi arch wires with regard to either alignment or pain (low- to very low-quality evidence).4. Conventional NiTi versus thermoelastic NiTi arch wires. There were two studies in this group, but it was not appropriate to undertake a meta-analysis of the data. There is insufficient evidence from these studies to determine whether there is a difference in alignment between conventional and thermoelastic NiTi arch wires (low-quality evidence). Pain was not measured.5. Single-strand superelastic NiTi versus coaxial superelastic NiTi arch wires. There was only one study (24 participants) in this group. There is moderate-quality evidence that coaxial superelastic NiTi can produce greater tooth movement over 12 weeks (MD -6.76 mm, 95% CI -7.98 to -5.55). Pain was not measured.6. Superelastic NiTi versus thermoelastic NiTi arch wires. There were three studies in this group, but it was not appropriate to undertake a meta-analysis of the data. There is insufficient evidence from these studies to determine whether there is a difference in alignment or pain between superelastic and thermoelastic NiTi arch wires (low-quality evidence).
AUTHORS' CONCLUSIONS
Moderate-quality evidence shows that arch wires of coaxial superelastic nickel-titanium (NiTi) can produce greater tooth movement over 12 weeks than arch wires made of single-strand superelastic NiTi. Moderate-quality evidence also suggests there may be no difference in pain at day 1 between multistrand stainless steel arch wires and superelastic NiTi arch wires. Other than these findings, there is insufficient evidence to determine whether any particular arch wire material is superior to any other in terms of alignment rate, time to alignment, pain and root resorption.
Topics: Alloys; Dental Alloys; Humans; Orthodontic Brackets; Orthodontic Wires; Randomized Controlled Trials as Topic; Root Resorption; Tooth Movement Techniques; Toothache
PubMed: 30064155
DOI: 10.1002/14651858.CD007859.pub4 -
The Cochrane Database of Systematic... Apr 2010The initial arch wire is the first arch wire to be inserted into the fixed appliance at the beginning of orthodontic treatment and is used mainly for correcting crowding... (Review)
Review
BACKGROUND
The initial arch wire is the first arch wire to be inserted into the fixed appliance at the beginning of orthodontic treatment and is used mainly for correcting crowding and rotations of teeth. With a number of orthodontic arch wires available for initial tooth alignment, it is important to understand which wire is most efficient, as well as which wires cause the least amount of root resorption and pain during the initial aligning stage of treatment.
OBJECTIVES
To identify and assess the evidence for the effects of initial arch wires for alignment of teeth with fixed orthodontic braces in relation to alignment speed, root resorption and pain intensity.
SEARCH STRATEGY
We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (30th November 2009), CENTRAL (The Cochrane Library 2009, Issue 4), MEDLINE (1950 to 30th November 2009) and EMBASE (1980 to 30th November 2009). Reference lists of articles were also searched. There was no restriction with regard to publication status or language of publication. We contacted all authors of included studies to identify additional studies.
SELECTION CRITERIA
Randomised controlled trials (RCTs) of initial arch wires to align crooked teeth with fixed orthodontic braces were selected. Only studies involving patients with upper and/or lower full arch fixed orthodontic appliances were included.
DATA COLLECTION AND ANALYSIS
Two review authors were responsible for study selection, validity assessment and data extraction. All disagreements were resolved by discussion amongst the review team. Corresponding authors of included studies were contacted to obtain missing information.
MAIN RESULTS
Seven RCTs, with 517 participants, provided data for this review. Among them, five trials investigated the speed of initial tooth alignment comparing: 0.016 inch ion-implanted A-NiTi wire versus 0.016 inch A-NiTi versus 0.0175 multistrand stainless steel wire; 0.016x0.022 inch medium force active M-NiTi wire versus 0.016x0.022 inch graded force active M-NiTi wire versus 0.0155 inch multistrand stainless steel wire; 0.016 inch superelastic NiTi wire versus 0.016 inch NiTi wire; 0.014 inch superelastic NiTi wire versus 0.0155 inch multistrand stainless steel wire; 0.016 inch CuNiTi wire versus 0.016 inch NiTi wire. The other two studies investigated pain intensity experienced by patients during the initial stage of treatment comparing: 0.014 inch superelastic NiTi wire versus 0.014 inch NiTi wire; 0.014 inch superelastic NiTi wire versus 0.015 inch multistrand stainless steel wire. Data analyses were often inappropriate within the included studies.
AUTHORS' CONCLUSIONS
There is some evidence to suggest that there is no difference between the speed of tooth alignment or pain experienced by patients when using one initial aligning arch wire over another. However, in view of the general poor quality of the including trials, these results should be viewed with caution. Further RCTs are required.
Topics: Dental Alloys; Humans; Orthodontic Brackets; Orthodontic Wires; Randomized Controlled Trials as Topic; Root Resorption; Tooth Movement Techniques; Toothache
PubMed: 20393961
DOI: 10.1002/14651858.CD007859.pub2 -
American Journal of Orthodontics and... Aug 1989This review article describes the mechanical properties and clinical applications of stainless steel, cobalt-chromium, nickel-titanium, beta-titanium, and multistranded... (Review)
Review
This review article describes the mechanical properties and clinical applications of stainless steel, cobalt-chromium, nickel-titanium, beta-titanium, and multistranded wires. The consolidation of this literature will provide the clinician with the basic working knowledge on orthodontic wire characteristics and usage. Mechanical properties of these wires are generally assessed by tensile, bending, and torsional tests. Although wire characteristics determined by these tests do not necessarily reflect the behavior of the wires under clinical conditions, they provide a basis for comparison of these wires. The characteristics desirable in an orthodontic wire are a large springback, low stiffness, good formability, high stored energy, biocompatibility and environmental stability, low surface friction, and the capability to be welded or soldered to auxiliaries. Stainless steel wires have remained popular since their introduction to orthodontics because of their formability, biocompatibility and environmental stability, stiffness, resilience, and low cost. Cobalt-chromium (Co-Cr) wires can be manipulated in a softened state and then subjected to heat treatment. Heat treatment of Co-Cr wires results in a wire with properties similar to those of stainless steel. Nitinol wires have a good springback and low stiffness. This alloy, however, has poor formability and joinability. Beta-titanium wires provide a combination of adequate springback, average stiffness, good formability, and can be welded to auxiliaries. Multistranded wires have a high springback and low stiffness when compared with solid stainless steel wires. Optimal use of these orthodontic wires can be made by carefully selecting the appropriate wire type and size to meet the demands of a particular clinical situation.
Topics: Chromium Alloys; Dental Stress Analysis; Elasticity; Nickel; Orthodontic Appliances; Orthodontic Wires; Stainless Steel; Tensile Strength; Titanium
PubMed: 2667330
DOI: 10.1016/0889-5406(89)90251-5 -
The Cochrane Database of Systematic... Apr 2013Initial arch wires are the first arch wires to be inserted into the fixed appliance at the beginning of orthodontic treatment and are used mainly for the alignment of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Initial arch wires are the first arch wires to be inserted into the fixed appliance at the beginning of orthodontic treatment and are used mainly for the alignment of teeth by correcting crowding and rotations. With a number of different types of orthodontic arch wires available for initial tooth alignment, it is important to understand which wire is most efficient, as well as which wires cause the least amount of root resorption and pain during the initial aligning stage of treatment. This is an update of the review 'Initial arch wires for alignment of crooked teeth with fixed orthodontic braces' first published in the Cochrane Database of Systematic Reviews 2010, Issue 4.
OBJECTIVES
To assess the effects of initial arch wires for alignment of teeth with fixed orthodontic braces in relation to alignment speed, root resorption and pain intensity.
SEARCH METHODS
We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 2 August 2012), CENTRAL (The Cochrane Library 2012, Issue 7), MEDLINE via OVID (1950 to 2 August 2012) and EMBASE via OVID (1980 to 2 August 2012). We also searched the reference lists of relevant articles. There was no restriction with regard to publication status or language of publication. We contacted all authors of included studies to identify additional studies.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) of initial arch wires to align teeth with fixed orthodontic braces. Only studies involving participants with upper and/or lower full arch fixed orthodontic appliances were included.
DATA COLLECTION AND ANALYSIS
Two review authors were responsible for study selection, validity assessment and data extraction. All disagreements were resolved by discussion amongst the review team. Corresponding authors of included studies were contacted to obtain missing information.
MAIN RESULTS
Nine RCTs with 571 participants were included in this review. All trials were at high risk of bias and a number of methodological limitations were identified. All trials had at least one potentially confounding factor (such as bracket type, slot size, ligation method, extraction of teeth) which is likely to have influenced the outcome and was not controlled in the trial. None of the trials reported the important adverse outcome of root resorption.Three groups of comparisons were made.(1) Multistrand stainless steel initial arch wires compared to superelastic nickel titanium (NiTi) initial arch wires. There were four trials in this group, with different comparisons and outcomes reported at different times. No meta-analysis was possible. There is insufficient evidence from these trials to determine whether or not there is a difference in either rate of alignment or pain between stainless steel and NiTi initial arch wires.(2) Conventional (stabilised) NiTi initial arch wires compared to superelastic NiTi initial arch wires. There were two trials in this group, one reporting the outcome of alignment over 6 months and the other reporting pain over 1 week. There is insufficient evidence from these trials to determine whether or not there is any difference between conventional (stabilised) and superelastic NiTi initial arch wires with regard to either alignment or pain.(3) Single-strand superelastic NiTi initial arch wires compared to other NiTi (coaxial, copper NiTi (CuNiTi) or thermoelastic) initial arch wires. The three trials in this comparison each compared a different product against single-strand superelastic NiTi. There is very weak unreliable evidence, based on one very small study (n = 24) at high risk of bias, that coaxial superelastic NiTi may produce greater tooth movement over 12 weeks, but no information on associated pain or root resorption. This result should be interpreted with caution until further research evidence is available. There is insufficient evidence to determine whether or not there is a difference between either thermoelastic or CuNiTi and superelastic NiTi initial arch wires.
AUTHORS' CONCLUSIONS
There is no reliable evidence from the trials included in this review that any specific initial arch wire material is better or worse than another with regard to speed of alignment or pain. There is no evidence at all about the effect of initial arch wire materials on the important adverse effect of root resorption. Further well-designed and conducted, adequately-powered, RCTs are required to determine whether the performance of initial arch wire materials as demonstrated in the laboratory, makes a clinically important difference to the alignment of teeth in the initial stage of orthodontic treatment in patients.
Topics: Dental Alloys; Humans; Orthodontic Brackets; Orthodontic Wires; Randomized Controlled Trials as Topic; Root Resorption; Tooth Movement Techniques; Toothache
PubMed: 23633347
DOI: 10.1002/14651858.CD007859.pub3 -
American Journal of Orthodontics and... Jan 2019
Topics: Dental Bonding; Orthodontic Appliances, Fixed; Orthodontic Retainers; Orthodontic Wires; Survival Rate; Treatment Outcome
PubMed: 30591163
DOI: 10.1016/j.ajodo.2018.09.009 -
Microscopy Research and Technique May 2022Several mechanical and biological factors may change the orthodontic wire frictional resistance (FR). Titanium dioxide (TiO ) and silica dioxide (SiO ) nanoparticle (NP)...
Several mechanical and biological factors may change the orthodontic wire frictional resistance (FR). Titanium dioxide (TiO ) and silica dioxide (SiO ) nanoparticle (NP) coatings may be used to improve the characteristics of materials, reducing FR between archwire and bracket. This in vitro study aimed to evaluate the FR of orthodontic wires with and without coating in both dry and wet environments and measure the surface roughness (SR). One hundred and eighty segments of rectangular Cr-Ni orthodontic wires (Morelli Co, Brazil) were divided into three groups according to the NP coating applied: TiO group; SiO group; and control group. The SR parameters were measured in an optical profilometer, the surface morphology was analyzed with scanning electron microscopy (SEM), and FR was performed in a universal testing machine in dry and wet environments (n = 30). The statistical analysis was performed using the Generalized Estimated Equations model with a Bonferroni post-test (α = 0.05). It was observed that SiO NP coating decreased FR significantly when compared to the TiO and control groups, in both environments (p < .001). The SiO and TiO groups presented statistically lower SR than the control group and were similar to each other (p < .001). The SiO group presented the lower depth of Valley parameter than the TiO group (p < .001). The SEM showed that the TiO coating had the most heterogeneous surface morphology than the SiO and control groups. The orthodontic wires with NP coating modified the FR and morphology. The SiO coating reduced FR in both dry and wet environments and decreased SR. Titanium dioxide (TiO ) and silica dioxide (SiO ) nanoparticles coatings may be used to reduce frictional resistance (FR) between archwire and bracket as well as to improve surface morphology. The SiO coating reduced FR in both dry and wet environments and decreased the SR of Cr-Ni orthodontic wire. The TiO coating promoted the most heterogeneous surface morphology of Cr-Ni orthodontic wire.
Topics: Dental Alloys; Friction; Materials Testing; Nanoparticles; Orthodontic Brackets; Orthodontic Wires; Silicon Dioxide; Surface Properties; Titanium
PubMed: 34997799
DOI: 10.1002/jemt.24049 -
Computers in Biology and Medicine Dec 2023The design of orthodontic arch wires is a prerequisite for orthodontic treatment that determines the subsequent orthodontic effects. Current methods for designing...
The design of orthodontic arch wires is a prerequisite for orthodontic treatment that determines the subsequent orthodontic effects. Current methods for designing orthodontic arch wires are often based on traditional manual techniques, which suffer from problems such as low accuracy and efficiency. To address these issues, a digital orthodontic arch wire design system has been developed using Unity 3D and C#. This system allows for the interactive adjustment and intelligent optimization of the shape of digital orthodontic arch wires. The developed system includes modules for curve design, contour construction, and collision detection of orthodontic arch wires, which can be customized interactively to meet the personalized needs of patients. In addition, an energy-constrained method is employed to optimize the shape of certain regions of the arch wire, which helps overcome distortion and interference issues caused by unreasonable interaction. The effectiveness of the developed system has been evaluated through experiments on digital design and optimization of orthodontic arch wires. Results demonstrate that the system can achieve accurate and efficient digital design of orthodontic arch wires, effectively reduce distortion, and is expected to improve the orthodontic effect.
Topics: Humans; Orthodontic Wires; Equipment Design
PubMed: 37948967
DOI: 10.1016/j.compbiomed.2023.107671 -
American Journal of Orthodontics and... Jul 2012
Topics: Algorithms; Dental Research; Factor Analysis, Statistical; Humans; Orthodontic Brackets; Orthodontic Wires; Orthodontics; Research Design
PubMed: 22749001
DOI: 10.1016/j.ajodo.2012.03.020 -
European Journal of Orthodontics Jun 1992A logical basis for the sequence of wires chosen during orthodontic treatment with fixed appliances is presented. This utilizes a new more realistic model for the radial...
A logical basis for the sequence of wires chosen during orthodontic treatment with fixed appliances is presented. This utilizes a new more realistic model for the radial deflection of a segment of the archwire in which the wire is restrained by the ligatures on the misaligned tooth, contacts the inner edges of the brackets either side, and is restrained by the outer ligatures on these brackets. The model, analysed using simple beam theory, allows the determination of the upper and lower bounds for the range of deflection over which orthodontic forces within the optimum range are produced without distortion for any given wire providing its flexural rigidity (EI) and yield stress in bending (sigma o) are known. The same model can be applied to vertical deflections. Some wire sequences recommended on clinical experience appear to conform to this more pragmatic approach, although to cater for even moderate misalignment the forces predicted by the model are higher than normally considered desirable.
Topics: Dental Alloys; Elasticity; Materials Testing; Orthodontic Brackets; Orthodontic Wires; Stress, Mechanical; Surface Properties
PubMed: 1628690
DOI: 10.1093/ejo/14.3.240 -
Journal of Orofacial Orthopedics =... Sep 2010A major requirement for orthodontic wires is superior elasticity. The question arises whether today's nickel titanium wires display a distinctively superelastic plateau... (Comparative Study)
Comparative Study
BACKGROUND AND OBJECTIVE
A major requirement for orthodontic wires is superior elasticity. The question arises whether today's nickel titanium wires display a distinctively superelastic plateau also under torsional loading, and whether typical torsion angles are sufficient to produce adequate torquing moments with superelastic wires. The objective of this study was to compare various nickel titanium and steel wires in a pure torsion experiment.
MATERIAL AND METHODS
To experimentally examine the torque characteristic of orthodontic wires, we used nickel titanium wires manufactured by Dentaurum (Tensic®) and ODS (Euro Arch NiTi) measuring 0.40 × 0.40 mm2, 0.40 × 0.56 mm2, 0.43 × 0.64 mm2, 0.46 × 0.64 mm2, 0.48 × 0.64 mm2, 0.51 × 0.51 mm2, and steel wires made by Dentaurum (remanium®), 3M Unitek (HI-T™ II Stainless Steel) measuring 0.40 × 0.40 mm2, 0.40 × 0.56 mm2, 0.43 × 0.56 mm2, 0.43 × 0.64 mm2, 0.46 × 0.64 mm2, 0.48 × 0.64 mm2, 0.51 × 0.51 mm2. Torque was measured at an ambient temperature of 37 ° C for the nickel titanium wires. The distance between the bearing points was 10 mm for all measurements. The steel wires' torquing moments were determined at a torsion angle of 20 °, the torquing moments of the nickel titanium wires were investigated on the plateau, and we compared the results of the means and the standard deviations of all wires. Starting and end points of the loading and unloading plateau were determined for all nickel titanium wires.
RESULTS
The torquing moment/torsion angle diagrams of the nickel titanium wires by different manufacturers displayed the curves typical of superelastic wires. The torquing moments of the wires with a smaller cross-section yielded values below 5 Nmm and thus appear obviously too small (e.g. Dentaurum Tensic®, 0.40 × 0.40 mm2: 1.3 Nmm). The mean values of the loading plateau's starting point yielded values of about 20 °.
CONCLUSIONS
As the torsional play in the bracket slot of the wires with a smaller cross-section is typically about 10 °, we doubt whether these wires reach the superelastic plateau. Moreover, we observed production-associated variations in the material properties of various nickel titanium wires. It is thus difficult for the practitioner to draw a correlation between a wire's crosssection and the actual torquing moment delivered.
Topics: Dental Stress Analysis; Humans; Nickel; Orthodontic Wires; Steel; Titanium; Torque
PubMed: 20963545
DOI: 10.1007/s00056-010-1028-2