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Cureus May 2022The objective of the current review was to evaluate the effectiveness of traditional and accelerated methods of palatally impacted canine's (PIC) traction in terms of... (Review)
Review
The Effectiveness of Conventional and Accelerated Methods of Orthodontic Traction and Alignment of Palatally Impacted Canines in Terms of Treatment Time, Velocity of Tooth Movement, Periodontal, and Patient-Reported Outcomes: A Systematic Review.
The objective of the current review was to evaluate the effectiveness of traditional and accelerated methods of palatally impacted canine's (PIC) traction in terms of treatment duration, velocity, periodontal, and patient-reported variables. An electronic search for randomized controlled trials (RCTs) and controlled clinical trials (CCTs) published between January 1990 and October 2021 was conducted in nine databases. Five major orthodontic journals were hand searched for additional studies. The participants were patients with unilateral or bilateral PICs who received conventional or accelerated orthodontic treatment with fixed appliances. Cochrane's risk of bias tool (RoB 2 tool) for RCTs and ROBINS-I tool for CCTs were used to assess the risk of bias. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines were used to assess the overall quality of the evidence. Nine articles (eight RCTs and one CCT) were included in this review (371 patients). There was no clarity in most studies about the possible effect of the mechanical traction method on treatment outcomes. The treatment duration decreased (about three to six months) when the open surgical method was used with traditional techniques and the traction velocity increased significantly (about 1-1.5 mm/month) when acceleration methods were used. No significant differences were found between the conventional intervention groups, as well as between the traditional and accelerated groups, in terms of most periodontal variables (p > 0.005). No significant differences were found in the pain levels associated with traditional PICs' traction when comparing different exposure methods in the short-term follow-up (1-10 days), while contradictory results were found in the pain incidence between these methods. The relationship between the pain/discomfort levels and the type of mechanical traction method was not evaluated. According to the GRADE, the quality of evidence supporting these findings ranged from low to very low. The combination of the open surgical technique with various designs of either superelastic wires or elastic traction means can lead to a reduction in the orthodontic treatment duration of PICs. The use of direct anchorage by miniscrews to move the PICs away from the adjacent teeth roots can lead to a reduction in root resorption and shorten the treatment duration. The evidence supporting these findings ranged from low to very low. The use of different types of mechanical means for conventional PICs' traction, with the use of open or closed traction techniques, does not lead to significant differences in periodontal outcomes between intervention groups. Contradictory results exist regarding the severity of the perceived pain in relation to the surgical exposure type, and the relationship between this variable and the mechanical traction method is still unclear. The use of accelerated methods for PICs' traction can lead to an increase in the velocity of traction movement with no significant differences in periodontal outcomes between accelerated and conventional methods. The evidence supporting these findings ranged from low to very low. More high-quality randomized CCTs are needed to establish good evidence in this field. The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021274476) during the first stages of this review.
PubMed: 35572459
DOI: 10.7759/cureus.24888 -
Microbial colonisation associated with conventional and self-ligating brackets: a systematic review.Journal of Orthodontics Jun 2022Decalcification and gingivitis caused by plaque accumulation around brackets are common iatrogenic effects of fixed appliances. The influence of conventional versus...
BACKGROUND
Decalcification and gingivitis caused by plaque accumulation around brackets are common iatrogenic effects of fixed appliances. The influence of conventional versus self-ligating bracket design on microbial colonisation is unknown.
OBJECTIVE
To assess the levels of microbial colonisation associated with conventional and self-ligating brackets.
SEARCH SOURCES
Three databases were searched for publications from 2009 to 2021.
DATA SELECTION
Randomised controlled trials comparing levels of microbial colonisation before and during treatment with conventional and self-ligating brackets were assessed independently and in duplicate.
DATA EXTRACTION
Data were extracted independently by two authors from the studies that fulfilled the inclusion criteria. Risk of bias assessments were made using the revised Cochrane risk of bias tool for randomized trials. The quality of the included studies was assessed using the Critical Appraisal Skills Programme Checklist.
RESULTS
A total of 11 randomised controlled trials were included in this systematic review. Six of the studies were found to be at low risk of bias and five presented with some concerns. The studies were considered moderate to high quality. Five trials reported no statistically significant difference in microbial colonisation between bracket types. The remaining studies showed mixed results, with some reporting increased colonisation of conventional brackets and others increased colonisation of self-ligating brackets. The heterogeneity of study methods and outcomes precluded meta-analysis.
CONCLUSION
Of the 11 studies included in this systematic review, five found no differences in colonisation between conventional and self-ligating brackets. The remaining studies showed mixed results. The evidence is inconclusive regarding the association between bracket design and levels of microbial colonisation.
Topics: Dental Plaque; Humans; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires
PubMed: 34839734
DOI: 10.1177/14653125211056023 -
International Orthodontics Dec 2021To test the null hypothesis that there was no difference in treatment efficiency between therapies undertaken with conventional (CBs), passive self-ligating (PSLBs) or... (Meta-Analysis)
Meta-Analysis
AIM
To test the null hypothesis that there was no difference in treatment efficiency between therapies undertaken with conventional (CBs), passive self-ligating (PSLBs) or active self-ligating (ASLBs) brackets.
MATERIALS AND METHODS
An electronic search was performed in 3 data bases (Pubmed, Web of Science, Cochrane Library) from their origin up to January 2019. Additional references were hand searched. Search was strictly restricted to randomized controlled trials (RCTs) and split-mouth design studies (SMDs). RCTs and SMDs were initially processed separately and subsequently combined in a network meta-analysis. The following variables were evaluated: treatment duration, number of visits, occlusal outcomes, alignment rate, transverse arch dimensional changes, incisor position modification, rate of space closure, anchorage loss, bond failure, root resorption, perception of discomfort during the initial phase of alignment, time to ligate in or to untie an archwire, periodontal variables, quality of life.
RESULTS
On 229 papers, 30 RCTs and 9 SMDs were finally included in this study. Out of 85 comparisons, 16 only revealed statistically significant differences. It was quicker to untie and ligate an 0.014 NiTi arch from/in 6 ASLBs anterior ceramic brackets compared to 6 ceramic CBs. It was also more painful to insert and remove an 0.019×0.025 SS wire in/from PSLB's brackets compared to CB's attachments. Compared to conventional brackets, there was less maxillary incisor proclination with PSLBs in non-extraction cases. Moreover, there was less bleeding on probing 4-5 weeks after bonding with PSLBs compared to CBs brackets. The only significant difference between ASLBs and PSLBs was that alignment was 10 days faster with active self-ligating braces compared with passive self-ligating braces even if treatment duration between ASLBs and PSLBs was not significantly different. The network meta-analysis revealed that IMPA was greater in extractions cases with CBs compared with both ASLBs (+2,5°) and PSLBs (+1,6°).
CONCLUSIONS
The vast majority of the studied variables did not show any significant differences between the three types of brackets. The most significant findings were that it was quicker to insert and remove archwires from ASLBs compared to CBs, and it was more painful to insert and remove an 0.019×0.025" stainless steel wire in/from PSLBs compared to CBs. The major difference between ASLBs and PSLBs was that alignment was 10 days faster with active self-ligating braces compared with passive self-ligating braces even if treatment duration between ASLBs and PSLBs was not significantly different. Most of the claims put forward by the suppliers were not substantiated by our network meta-analysis.
Topics: Humans; Mouth; Network Meta-Analysis; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Stainless Steel
PubMed: 34629309
DOI: 10.1016/j.ortho.2021.09.005 -
European Journal of Orthodontics Mar 2022The aim of this systematic review was to compare the different force delivery systems for orthodontic space closure by sliding mechanics. (Meta-Analysis)
Meta-Analysis
BACKGROUND/OBJECTIVES
The aim of this systematic review was to compare the different force delivery systems for orthodontic space closure by sliding mechanics.
SEARCH METHODS
Multiple sources including Cochrane Central, Ovid Medline, Embase etc. were used to identify all relevant studies.
SELECTION CRITERIA
Randomized controlled trials (RCT) of parallel-group and split-mouth designs were included.
PARTICIPANTS
Orthodontic patients of any age treated with fixed orthodontic appliances and requiring space closure.
DATA COLLECTION AND ANALYSIS
Search result screening, data extraction and quality assessment were performed independently and in duplicate by 2 reviewers. The included studies were grouped into parallel-arm and split-mouth studies and subgroup analysis was then performed for the type of retraction subsets; en-masse and individual canine retraction. A traditional meta-analysis, and network meta-analysis (NMA) for direct and indirect comparisons for the rate of space closure were performed.
RESULTS
Thirteen studies, six parallel-arm and seven split-mouth were included. The traditional meta-analysis comparing Nickel-titanium (NiTi) closed coil springs and elastomeric power chain for the rate of tooth movement showed statistically significant difference favouring NiTi springs (MD: 0.24; 95% CI, 0.03-0.45; I2 0%, P = 0.02) and the comparison between NiTi springs and active ligatures also showed statistically significant result favouring NiTi springs (MD: 0.53; 95% CI, 0.44-0.63; I2 0%, P ˂ 0.00001) for the rate of tooth movement. NMA for the rate of space closure showed fairly confident evidence for NiTi coil springs when compared with elastomeric chain and active ligatures. The NiTi coil spring ranked best between all methods of space closure.
CONCLUSIONS
There is moderate quality evidence in favour of NiTi coil springs for the rate of space closure when compared with active ligature and low quality of evidence favouring NiTi springs when compared with elastomeric chain. The ranking from NMA showed NiTi coil springs to be the best method for space closure with 99% chance. An urgent need for standardization of study designs and the need for development of an agreed core outcome sets and core outcome instrument measurement sets is evident.
REGISTRATION
PROSPERO CRD42020157811.
Topics: Dental Alloys; Elasticity; Humans; Orthodontic Space Closure; Orthodontic Wires; Titanium; Tooth Movement Techniques
PubMed: 34609513
DOI: 10.1093/ejo/cjab047 -
Head & Face Medicine Jul 2021Orthodontic retention aims to maintain optimal teeth positions after active treatment. The stability is affected by numerous factors, including patients' individual... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Orthodontic retention aims to maintain optimal teeth positions after active treatment. The stability is affected by numerous factors, including patients' individual features, thus retention should be adjusted in the most optimal way. Bonding a retainer makes retention less dependent on patient's compliance.
QUESTIONS ARISE
What wire or fiber splint type provides the best treatment stability? What materials should be used to bond the wire or fiber splint? Should be the bonding procedure be direct or indirect? The aim of the study is to assess and synthesize available controlled trials investigating failures of fixed retainers.
METHODS
Literature searches of free text and MeSH terms were performed in Scopus, Web of Science, Embase and PubMed Central in order to find studies, referring to failures of fixed retention (12th February 2021). The keywords were: ("orthodontic retainers AND failure AND wire"). The framework of this systematic review according to PICO was: Population: orthodontic patients; Intervention: fixed orthodontic retainer bonding; Comparison: Different protocols of fixed orthodontic retention applied; Outcomes: failure rate, survival rate. Three different specific scales from the Cochrane Collaboration Handbook were used, according to each study type. Additionally, a meta-analysis was conducted to compare the effectiveness of retention using fiber reinforced composite and multistranded steel wire.
RESULTS
The search identified 177 potential articles: 114 from PubMed, 41 from Scopus, 20 from Web of Science and 2 from Embase. After excluding studies inconsistent with selection criteria, 21 studies were included and subjected to qualitative analysis. The main outcome investigated was failure rate. This systematic review has some potential limitations due to the heterogeneity of design between included studies.
CONCLUSIONS
No retainer is proved to guarantee a perfect stability of dental alignment. The retainer should be bonded to all adherent teeth, preferably with additional use of bonding resin. No wire or fiber splint present superior characteristics concerning failure rate. Fiber reinforced composite retention is more sensitive to operator skills, and with imperfect bonding technique, failure rate is much higher. During the first 6 months after bonding retainer the patient should be under frequent control. The study protocol was registered in PROSPERO database with the number CRD42021233406.
Topics: Dental Bonding; Humans; Orthodontic Appliance Design; Orthodontic Retainers; Orthodontic Wires
PubMed: 34301280
DOI: 10.1186/s13005-021-00281-3 -
L' Orthodontie Francaise Dec 2020The aim of this systematic review and meta-analysis was to compare self-ligating brackets (SLBs) considered as a whole to conventional brackets (CBs). An electronic... (Meta-Analysis)
Meta-Analysis
The aim of this systematic review and meta-analysis was to compare self-ligating brackets (SLBs) considered as a whole to conventional brackets (CBs). An electronic search was performed in three databases (PubMed, MEDLINE via Web of Science, Cochrane Library) from their origin up to June 2017. Additional articles were hand searched from January 2006 to June 2017. This meta-analysis was restricted to randomized controlled trials (RCTs) and split mouth design studies (SMDs). No distinction was made between active and passive SLBs. The following variables were investigated : treatment duration, number of visits, alignment rate, rate of space closure, perception of discomfort during the initial phase of treatment, pain experience during wire insertion or removal, bond failure rate, time to ligate in or to untie an archwire, periodontal indices, occlusal outcomes, transverse arch dimensional changes and root resorption. 25 RCTs and 9 SMDs were finally selected. It was more painful to insert or remove a 0.019× 0.025 SS archwire in/from SLBs. It was significantly quicker to insert or remove an archwire from SLBs. There was less bleeding on probing with SLBs 4 or 5 weeks after bonding. All other variables did not exhibit any significant difference between SLBs and CBs. Out of the 31 comparisons between self-ligating and conventional brackets, 9 only revealed statistically significant differences. This meta-analysis contradicts most of the promotional statements put forward by the distributors.
Topics: Face; Humans; Mouth; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Root Resorption
PubMed: 33355535
DOI: 10.1684/orthodfr.2020.29 -
Head & Face Medicine Nov 2020The Multiloop Edgewise Archwire (MEAW) appliance is an orthodontic treatment method suitable for the therapy of severe types of malocclusions such as open bites or... (Review)
Review
BACKGROUND
The Multiloop Edgewise Archwire (MEAW) appliance is an orthodontic treatment method suitable for the therapy of severe types of malocclusions such as open bites or anterior crossbites. The cephalometric Denture Frame Analysis (DFA) provides a supportive diagnostic tool for patient-specific treatment planning concerning the rearrangement of occlusion within the "denture frame". The objective of this study is to give a comprehensive overview of the national and international scientific literature about MEAW and DFA regarding the general therapeutic effects, advantages and limitations.
METHODS AND MATERIALS
A computerized literature search was performed using four principal medical databases (PubMed/Medline, Google Scholar, Web of Science and Cochrane Central Register of Controlled Trials) and supplemented by manual searching of the references listed in the retrieved articles. The results were screened and assessed following the PRISMA guidelines.
RESULTS
Six hundred seventy-seven full articles were assessed for eligibility. A number of 134 articles went through qualitative analysis and 3 studies were finally involved in comparative synopsis. The findings reveal advantageous characteristics of the MEAW technique such as a high degree of three-dimensional individual tooth control and a comparatively low load deflection rate, causing mostly dentoalveolar changes without significantly influencing the skeletal structures.
CONCLUSION
Based on current literature, the MEAW technique appears to have several therapeutic benefits and serves as a sufficient alternative treatment method for dentoalveolar compensation, when measures of orthognathic surgery are rejected. Concerning the deficient data basis of available literature and the low level of scientific evidence, further studies are required in order to expand on the knowledge in this subject area. Several aspects like the effectiveness or the long-term stability have to be evaluated more extensively. Moreover, the transferability of the DFA to ethnic groups other than the Asian ethnicity should be examined further.
Topics: Cephalometry; Dentures; Humans; Malocclusion; Orthodontic Wires; Tooth Movement Techniques
PubMed: 33243257
DOI: 10.1186/s13005-020-00247-x -
International Orthodontics Sep 2019Patients in active fixed orthodontic treatment or fixed retention phase may require magnetic resonance (MR) scans of the head and neck region. Orthodontists are... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Patients in active fixed orthodontic treatment or fixed retention phase may require magnetic resonance (MR) scans of the head and neck region. Orthodontists are challenged to decide whether to keep or remove orthodontic appliances prior to the scans. The aim of this study was to determine the effect of orthodontic appliances on the diagnostic capability of MR images.
METHODS
Four electronic databases were searched, with no language restrictions, from database inception to October 2016: PubMed, EMBASE, CINAHL, EBMR. A search in Google Scholar and ProQuest, as well as a manual search, were also conducted. Two independent reviewers assessed articles for inclusion. Original studies including any orthodontic appliance on human subjects were considered. Outcomes measured were development of artefacts, diagnostic quality, accuracy, and treatment outcomes. Risk of bias was assessed with the Cochrane Risk of Bias Assessment and QUADAS-2 tools.
RESULTS
Five of 1052 studies identified were included in the final qualitative synthesis. A total of 90 adult human subjects were included. Orthodontic appliances evaluated were brackets, bands, archwires, and fixed retainers. The outcomes assessed were production of artefacts, diagnostic quality and diagnostic accuracy. Detrimental effects on diagnostic quality, and subsequently diagnostic accuracy, rose with increased stainless steel (SS) and proximity to anatomic area of interest. Orthodontic appliances may render images uninterpretable and non-diagnostic.
CONCLUSIONS
There is fair evidence to suggest orthodontic appliances, mainly those with SS, cause MR artefacts. Removal of metal orthodontic appliances prior to MR scans is recommended, especially if the area of interest is near the orthodontic appliance. Additional evidence is needed to provide guidelines to clinicians.
Topics: Artifacts; Databases, Factual; Head; Humans; Magnetic Resonance Imaging; Neck; Orthodontic Appliances; Orthodontic Brackets; Orthodontic Wires; Orthodontics, Corrective; Stainless Steel
PubMed: 31285157
DOI: 10.1016/j.ortho.2019.06.001 -
Acta Odontologica Scandinavica Mar 2019Anchorage in orthodontics can be provided through several extra- and intra-oral sources including headgear, teeth, cortical bone and soft tissue. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Anchorage in orthodontics can be provided through several extra- and intra-oral sources including headgear, teeth, cortical bone and soft tissue.
OBJECTIVE
The aim of this review was to systematically review the effectiveness of miniscrews in reinforcing anchorage during en-masse retraction of anterior teeth in comparison to conventional anchorage appliances. Search method: Comprehensive searching of the electronic databases was undertaken up to March 2018 in the Cochrane Database of Systematic review, Cochrane Central Register of Controlled Trials, MEDLINE via PubMed and Scopus databases. Additional searching for on-going and unpublished data and hand search of relevant journals were also undertaken, authors were contacted, and reference lists screened. Eligibility criteria: Searches were restricted to randomized clinical trials (RCTs) published in English, which compared anchorage reinforcement using mechanically-retained miniscrews (diameter of 2 mm or less) to conventional anchorage appliances during en-masse retraction of anterior teeth in participants of any age treated with fixed appliances combined with extraction of maxillary premolars.
DATA COLLECTION AND ANALYSIS
Blind and induplicate study selection, data extraction and risk of bias assessment were undertaken. The primary outcome was the amount of mesial movement of the upper first permanent molar (anchorage loss) while secondary outcomes included treatment duration, number of visits, adverse effects and patient-centered outcomes. The risk of bias was assessed using Cochrane risk of bias tool. A random-effects model with its corresponding 95% confidence interval (CI) were generated for comparable outcomes. Statistical heterogeneity across the studies were assessed using the I and Chi test. Additional sensitivity tests were implemented.
RESULTS
Seven RCTs met the inclusion criteria, however, data of 241 participants from 6 RCTs (250 miniscrews and 134 conventional anchorage appliances) were meta-analyzed. Qualities of the included RCTs varied from low to high. The standardized mean difference (SMD) of the anchrage loss between the two intervention groups was 2.07 mm ((95% CI (-3.05) to (-1.08), p < .001, I = 88%, 6 RCTs)) in favour of miniscrews, which was also preserved after excluding the high risk of bias studies (SMD 1.94 mm, 95% CI (-2.46) to (-0.42) p < .001, I = 93%, 3 RCTs)). Information on overall treatment duration, space closure duration, quality of treatment, patient-reported outcomes, adverse effects and number of visit were limited.
CONCLUSION
The result of the meta-analysis suggested that there is moderate quality of evidence that miniscrews are clinically and statistically more effective in preserving orthodontic anchorage than conventional appliances. However, this conclusion is supported by a small number of studies with variable qualities. High-quality RCTs would give a better understanding of miniscrews effectiveness in providing orthodontic anchorage.
Topics: Dental Prosthesis Design; Humans; Orthodontic Anchorage Procedures; Orthodontic Brackets; Orthodontic Wires; Palatal Expansion Technique; Tooth Movement Techniques
PubMed: 30350741
DOI: 10.1080/00016357.2018.1508742 -
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