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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 -
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 -
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 -
Hua Xi Kou Qiang Yi Xue Za Zhi = Huaxi... Jun 2018This review aims to assess the relationship between initial archwire materials and pain at the initial stage of orthodontic treatment. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This review aims to assess the relationship between initial archwire materials and pain at the initial stage of orthodontic treatment.
METHODS
On October 1, 2017, seven databases were searched electronically for studies oninitial archwire materials and pain at the initial stage of orthodontic treatment. Quality assessment was performed with bias risk assessment tools suggested by Cochrane's handbook. Data extraction of included studies was also carried out. Network Meta- analysis was conducted using R 3.4.2 (with JAGS 4.3.0), GeMTC 0.14.3, and STATA 11.0.
RESULTS
Five studies with 330 participants were included, comparing four different materials: multi-stranded stainless steel, conventional nickel-titanium, super-elastic nickel-titanium, and thermal heat-activated nickel-titanium. Two studies were at low risk of bias, one was at high risk of bias, and the remaining two were at unclear risk of bias. Network Meta-analysis results showed no statistical differences of pain among the four initial archwire materials at day 1 and day 7. However, the most painless material was most likely to be thermal heat-activated nickel-titanium on rank probability.
CONCLUSIONS
On statistical probability, thermal heat-activated nickel-titanium initial arch wires is most likely to cause the least pain at the initial stage of orthodontic treatment, compared with other materials.
Topics: Dental Alloys; Humans; Materials Testing; Network Meta-Analysis; Nickel; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Pain; Stainless Steel; Surface Properties; Titanium
PubMed: 29984932
DOI: 10.7518/hxkq.2018.03.013 -
The Cochrane Database of Systematic... Feb 2017Orthodontic treatment involves using fixed or removable appliances (dental braces) to correct the positions of teeth. The success of a fixed appliance depends partly on... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Orthodontic treatment involves using fixed or removable appliances (dental braces) to correct the positions of teeth. The success of a fixed appliance depends partly on the metal attachments (brackets and bands) being glued to the teeth so that they do not become detached during treatment. Brackets (metal squares) are usually attached to teeth other than molars, where bands (metal rings that go round each tooth) are more commonly used. Orthodontic tubes (stainless steel tubes that allow wires to pass through them), are typically welded to bands but they may also be glued directly (bonded) to molars. Failure of brackets, bands and bonded molar tubes slows down the progress of treatment with a fixed appliance. It can also be costly in terms of clinical time, materials and time lost from education/work for the patient. This is an update of the Cochrane review first published in 2011. A new full search was conducted on 15 February 2017 but no new studies were identified. We have only updated the search methods section in this new version. The conclusions of this Cochrane review remain the same.
OBJECTIVES
To evaluate the effectiveness of the adhesives used to attach bonded molar tubes, and the relative effectiveness of the adhesives used to attach bonded molar tubes versus adhesives used to attach bands, during fixed appliance treatment, in terms of: (1) how often the tubes (or bands) come off during treatment; and (2) whether they protect the bonded (or banded) teeth against decay.
SEARCH METHODS
The following electronic databases were searched: Cochrane Oral Health's Trials Register (to 15 February 2017), the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 1) in the Cochrane Library (searched 15 February 2017), MEDLINE Ovid (1946 to 15 February 2017), and Embase Ovid (1980 to 15 February 2017). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
Randomised controlled trials of participants with full arch fixed orthodontic appliance(s) with molar tubes, bonded to first or second permanent molars. Trials which compared any type of adhesive used to bond molar tubes (stainless steel or titanium) with any other adhesive, were included.Trials were also included where:(1) a tube was bonded to a molar tooth on one side of an arch and a band cemented to the same tooth type on the opposite side of the same arch;(2) molar tubes had been allocated to one tooth type in one patient group and molar bands to the same tooth type in another patient group.
DATA COLLECTION AND ANALYSIS
The selection of papers, decision about eligibility and data extraction were carried out independently and in duplicate without blinding to the authors, adhesives used or results obtained. All disagreements were resolved by discussion.
MAIN RESULTS
Two trials (n = 190), at low risk of bias, were included in the review and both presented data on first time failure at the tooth level. Pooling of the data showed a statistically significant difference in favour of molar bands, with a hazard ratio of 2.92 (95% confidence intervals (CI) 1.80 to 4.72). No statistically significant heterogeneity was shown between the two studies. Data on first time failure at the patient level were also available and showed statistically different difference in favour of molar bands (risk ratio 2.30; 95% CI 1.56 to 3.41) (risk of event for molar tubes = 57%; risk of event for molar bands 25%).One trial presented data on decalcification again showing a statistically significant difference in favour of molar bands. No other adverse events identified.
AUTHORS' CONCLUSIONS
From the two well-designed and low risk of bias trials included in this review it was shown that the failure of molar tubes bonded with either a chemically-cured or light-cured adhesive was considerably higher than that of molar bands cemented with glass ionomer cement. One trial indicated that there was less decalcification with molar bands cemented with glass ionomer cement than with bonded molar tubes cemented with a light-cured adhesive. However, given there are limited data for this outcome, further evidence is required to draw more robust conclusions.
Topics: Dental Cements; Dental Restoration Failure; Humans; Light-Curing of Dental Adhesives; Molar; Orthodontic Brackets; Randomized Controlled Trials as Topic; Self-Curing of Dental Resins
PubMed: 28230910
DOI: 10.1002/14651858.CD008236.pub3 -
BMC Oral Health Nov 2016The aim of this study was to compare the external apical root resorption (EARR) in patients receiving fixed orthodontic treatment with self-ligating or conventional... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The aim of this study was to compare the external apical root resorption (EARR) in patients receiving fixed orthodontic treatment with self-ligating or conventional brackets.
METHODS
Studies comparing the EARR between orthodontic patients using self-ligating or conventional brackets were identified through electronic search in databases including CENTRAL, PubMed, EMBASE, China National Knowledge Infrastructure (CNKI) and SIGLE, and manual search in relevant journals and reference lists of the included studies until Apr 2016. The extraction of data and risk of bias evaluation were conducted by two investigators independently. The original outcome underwent statistical pooling by using Review Manager 5.
RESULTS
Seven studies were included in the systematic review, out of which, five studies were statistically pooled in meta-analysis. The value of EARR of maxillary central incisors in the self-ligating bracket group was significantly lower than that in the conventional bracket group (SMD -0.31; 95% CI: -0.60--0.01). No significant differences in other incisors were observed between self-ligating and conventional brackets.
CONCLUSIONS
Current evidences suggest self-ligating brackets do not outperform conventional brackets in reducing the EARR in maxillary lateral incisors, mandible central incisors and mandible lateral incisors. However, self-ligating brackets appear to have an advantage in protecting maxillary central incisor from EARR, which still needs to be confirmed by more high-quality studies.
Topics: Humans; Incisor; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Root Resorption
PubMed: 27871255
DOI: 10.1186/s12903-016-0320-y -
BMC Oral Health Nov 2015The purpose of this systematic review is to identify and review the orthodontic literature with regards to assessing possible differences in canine retraction rate and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The purpose of this systematic review is to identify and review the orthodontic literature with regards to assessing possible differences in canine retraction rate and the amount of antero-posterior anchorage (AP) loss during maxillary canine retraction, using conventional brackets (CBs) and self-ligating brackets (SLBs).
METHODS
An electronic search without time or language restrictions was undertake in September 2014 in the following electronic databases: The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE via OVID, EMBASE via OVID, Web of science. We also searched the reference lists of relevant articles. Quality assessment of the included articles was performed. Two of the authors were responsible for study selection, validity assessment and data extraction.
RESULTS
Six studies met the inclusion criteria, including 2 randomized controlled trials and 4 control clinical studies. One was assessed as being at low risk of bias. Five trials were assessed as being at moderate risk of bias. The meta-analysis from 6 eligible studies showed that no statistically significant difference was observed between the 2 groups in the rate of canine retraction and loss of antero-posterior anchorage of the molars.
CONCLUSION
There is some evidence from this review that both brackets showed the same rate of canine retraction and loss of antero-posterior anchorage of the molars. The results of the present systematic review should be viewed with caution due to the presence of uncontrolled interpreted factors in the included studies. Further well-designed and conducted randomized controlled trials are required, to facilitate comparisons of the results.
Topics: Cuspid; Humans; Orthodontic Brackets; Orthodontic Wires; Tooth Movement Techniques
PubMed: 26531223
DOI: 10.1186/s12903-015-0127-2 -
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 -
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 -
The Angle Orthodontist May 2010To evaluate the clinical differences in relation to the use of self-ligating brackets in orthodontics. (Review)
Review
OBJECTIVE
To evaluate the clinical differences in relation to the use of self-ligating brackets in orthodontics.
MATERIALS AND METHODS
Electronic databases were searched; no restrictions relating to publication status or language of publication were applied. Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) investigating the influence of bracket type on alignment efficiency, subjective pain experience, bond failure rate, arch dimensional changes, rate of orthodontic space closure, periodontal outcomes, and root resorption were selected. Both authors were involved in study selection, validity assessment, and data extraction. Disagreements were resolved by discussion.
RESULTS
Six RCTs and 11 CCTs were identified. Meta-analysis of the influence of bracket type on subjective pain experience failed to demonstrate a significant advantage for either type of appliance. Statistical analysis of other outcomes was unfeasible because of inadequate methodological design and heterogenous designs.
CONCLUSIONS
At this stage there is insufficient high-quality evidence to support the use of self-ligating fixed orthodontic appliances over conventional appliance systems or vice versa.
Topics: Controlled Clinical Trials as Topic; Humans; Meta-Analysis as Topic; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Randomized Controlled Trials as Topic; Research Design; Treatment Outcome
PubMed: 20050755
DOI: 10.2319/081009-454.1