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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 -
The Angle Orthodontist Oct 1987Etiologies and various treatment modalities regarding anterior openbite are discussed to elucidate the pros and cons of different approaches, with emphasis on...
Etiologies and various treatment modalities regarding anterior openbite are discussed to elucidate the pros and cons of different approaches, with emphasis on understanding of the true nature of anterior openbite. Subjective interpretation in a diagnosis invariably leads into an erroneous description of a malocclusion, which can lead to a disastrous result. Cognizance of the anatomy, histology, physiology, and dynamics of orthodontic mechanotherapy can bring most openbite malocclusions into the realm of treatability, with a high degree of success and stability without surgical intervention. A Multiloop Edgewise Archwire (MEAW) technic developed over the past nineteen years is introduced, and three illustrative cases are presented.
Topics: Adolescent; Adult; Cephalometry; Child; Equipment Design; Female; Humans; Male; Malocclusion; Orthodontic Appliances; Orthodontic Wires; Tooth Movement Techniques
PubMed: 3479033
DOI: 10.1043/0003-3219(1987)057<0290:AOAITW>2.0.CO;2 -
BMC Oral Health Jul 2022Before the magnetic resonance imaging (MRI) examination fixed orthodontic devices, such as brackets and wires, cause challenges not only for the orthodontist but also...
BACKGROUND
Before the magnetic resonance imaging (MRI) examination fixed orthodontic devices, such as brackets and wires, cause challenges not only for the orthodontist but also for the radiologist. Essentially, the MRI-safe scan of the fixed orthodontic tools requires a proper guideline in clinical practice. Therefore, this systematic review aimed to examine all aspects of MRI-safe scan, including artifact, thermal, and debonding effects, to identify any existing gaps in knowledge in this regard and develop an evidence-based protocol.
METHODS
The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement was used in this study. The clinical question in "PIO" format was: "Does MRI examination influence the temperature of the orthodontic devices, the size of artifacts, and the debonding force in patients who have fixed orthodontic bracket and/or wire?" The search process was carried out in PubMed, PubMed Central, Scopus, and Google Scholar databases. The search resulted in 1310 articles. After selection according to the eligibility criteria, 18 studies were analyzed by two reviewers. The risk of bias was determined using the Quality In Prognosis Studies tool.
RESULTS
Out of the eligible 18 studies, 10 articles examined the heating effect, 6 were about the debonding effect, and 11 measured the size of artifact regarding brackets and wires. Considering the quality assessment, the overall levels of evidence were high and medium. The published studies showed that heating and debonding effects during MRI exposure were not hazardous for patients. As some wires revealed higher temperature changes, it is suggested to remove the wire or insert a spacer between the appliances and the oral mucosa. Based on the material, ceramic and plastic brackets caused no relevant artifact and were MRI-safe. Stainless steel brackets and wires resulted in susceptibility artifacts in the orofacial region and could cause distortion in the frontal lobe, orbits, and pituitary gland. The retainer wires showed no relevant artifact.
CONCLUSIONS
In conclusion, the thermal and debonding effects of the fixed orthodontic brackets and wires were irrelevant or resoluble; however, the size of the artifacts was clinically relevant and determined most significantly the feasibility of fixed brackets and wires in MRI examination.
Topics: Artifacts; Humans; Magnetic Resonance Imaging; Orthodontic Brackets; Orthodontic Wires; Stainless Steel
PubMed: 35854295
DOI: 10.1186/s12903-022-02317-9 -
The Angle Orthodontist Jan 2021The purpose of this cohort study was to evaluate the effect of self-ligating brackets (SB) and other related factors that influence orthodontic treatment time. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
The purpose of this cohort study was to evaluate the effect of self-ligating brackets (SB) and other related factors that influence orthodontic treatment time.
MATERIALS AND METHODS
This was a two-armed prospective study. Consecutively treated patients who were recruited from a private practice were enrolled and asked to choose between SB and conventional brackets (CB). If the patient did not have a preference, that patient was randomly allocated. An identical archwire sequence was used, and all patients were treated by a single orthodontist. Treatment duration, number of bracket failures, poor oral hygiene, poor elastic wear, whether or not to orthodontic mini-implants (OMI) were used, OMI failure, extraction, American Board of Orthodontics Discrepancy Index, and arch length discrepancy were measured and statistically analyzed using t-tests, correlation analysis, and analysis of covariance (ANCOVA). Stepwise regression analysis was conducted to generate an equation to predict treatment duration.
RESULTS
A total of 134 patients with an average age of 22.73 years were included. The average treatment duration was 28.63 months. ANCOVA showed no significant difference in treatment duration between CB and SB. Stepwise regression analysis could explain 64.6% of the variance in treatment duration using five variables.
CONCLUSIONS
SB did not exhibit a significant reduction in treatment time as compared with CB. Patient cooperation, extractions, and malocclusion severity had a significant impact on treatment duration.
Topics: Adult; Cohort Studies; Dental Implants; Humans; Orthodontic Anchorage Procedures; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Prospective Studies; Young Adult
PubMed: 33289803
DOI: 10.2319/050220-379.1 -
Dental Press Journal of Orthodontics 2020The aim of this study was to evaluate the attractiveness of different types of esthetic orthodontic wires by laypeople and dentists.
OBJECTIVE
The aim of this study was to evaluate the attractiveness of different types of esthetic orthodontic wires by laypeople and dentists.
METHODS
Five different types of orthodontic wires were evaluated: three esthetic wires (Teflon-coated, epoxy resin-coated and rhodium-coated wires), and two metallic wires (stainless steel and NiTi), as control. Monocrystalline ceramic brackets were installed in the maxillary arch of a patient presenting good dental alignment. The five evaluated wires were attached to the orthodontic appliance with an esthetic silicone elastic and photographed. The photographs were evaluated by 163 individuals, 110 dentists and 53 laypeople. The data were statistically evaluated by two-way ANOVA and one-way ANOVA, followed by Tukey tests.
RESULTS
There was a statistically significant difference in the attractiveness among the wires evaluated; the most esthetic was the rhodium-coated wire, followed by the epoxy resin-coated wire and, finally, the Teflon-coated wire, with no significant difference from the stainless steel and NiTi control archwires. There was no significant difference between the groups of evaluators.
CONCLUSION
The most attractive was the rhodium-coated wire, followed by the epoxy resin-coated wire and, finally, the least attractive wire was the Teflon-coated wire, without statistically significant difference to the stainless steel and NiTi wires, used as control.
Topics: Dental Alloys; Esthetics, Dental; Humans; Materials Testing; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Stainless Steel; Surface Properties; Titanium
PubMed: 33503122
DOI: 10.1590/2177-6709.25.6.027-032.oar -
The Kaohsiung Journal of Medical... Apr 2018This literature review investigated a recently developed orthodontic wire composed of a β-titanium alloy known as "Gum Metal" and compared its properties with those of... (Review)
Review
This literature review investigated a recently developed orthodontic wire composed of a β-titanium alloy known as "Gum Metal" and compared its properties with those of conventional wires. The attractive properties of Gum Metal include an ultra-low Young's modulus, non-linear elastic behavior, ultra-high strength, high yield strain, high ductility, and superplastic deformability without work hardening at room temperature. The unique multifunctional characteristics of this new orthodontic wire make it almost ideal for orthodontic applications. The results of this literature review indicate the strong potential use of Gum Metal wire for improving and enhancing the effectiveness of orthodontic treatment.
Topics: Dental Stress Analysis; Elastic Modulus; Humans; Materials Testing; Orthodontic Wires; Orthodontics; Tensile Strength; Titanium
PubMed: 29655408
DOI: 10.1016/j.kjms.2018.01.010 -
Scientific Reports Jun 2022This observational study evaluates three-dimensionally the relation between the root of maxillary canine and overlying labial cortical plate of bone during orthodontic... (Observational Study)
Observational Study
This observational study evaluates three-dimensionally the relation between the root of maxillary canine and overlying labial cortical plate of bone during orthodontic canine retraction. Eighty-four bilateral maxillary canines in 42 patients were retracted in the extraction space of first premolars, using conventional orthodontic NiTi retraction spring delivering 150gm. Three-dimensional evaluation at the cusp tip, root apex, and the overlying cortical bone was done based on Classification of Root/Cortical bone relation (CRCR) before and after canine retraction. 168 observations of the canines pre- and post-retraction showed a mean distal movement of the canine cusp tip of 3.78(± 2.05) mm, while the canine root apex was almost stationary. Scarcely, 5.4% of the canine roots and root apices persisted in the medullary bone during retraction, while 16.1% contacted the overlying cortical bone. Fenestration of the overlying cortical bone by the canine roots or root apices occurred in 78.6% of the sample. The unembellished intimacy between the canine root and apex to the overlying thick dense cortical bone might have the decelerating effect on the maxillary canine retraction. The natural bone plate labial to the maxillary canine root did not yield infront nor enlarge due to canine retraction, but else defeated the current orthodontic biomechanical implementation.
Topics: Cortical Bone; Cuspid; Humans; Maxilla; Orthodontic Wires; Tooth Movement Techniques
PubMed: 35739156
DOI: 10.1038/s41598-022-14663-3 -
Journal of Orofacial Orthopedics =... Jan 2022Gummetal® (Maruemu Works, Osaka, Japan), a new orthodontic wire material successfully used in clinical applications since 2006, is biocompatible and exhibits...
OBJECTIVES
Gummetal® (Maruemu Works, Osaka, Japan), a new orthodontic wire material successfully used in clinical applications since 2006, is biocompatible and exhibits exceptionally high elasticity, nonlinear elastic behavior, plasticity and strength. Systematic comparisons of friction behavior are lacking; thus, the friction of Gummetal® in the binding modus was compared to commonly used low friction wires.
MATERIALS AND METHODS
In vivo tests were run with Gummetal®, CoCr (cobalt-chromium Elgiloy®, Rocky Mountain Orthodontics, Denver, CO, USA), β‑Ti (β-Titanium TMA®, Ormco, Orange, CA, USA), NiTi (nickel-titanium, NiTi-SE, Dentalline, Birkenfeld, Germany), and stainless steel (SS; Ref. 251-925, 3M Unitek, Monrovia, CA, USA) [dimensions: 0.014 inch (0.35 mm), 0.016 inch (0.40 mm), 0.016 × 0.022 inch (0.40 × 0.56 mm), and 0.019 × 0.025 inch (0.48 × 0.64 mm)-β-Ti not available in the dimension 0.014 inch]. These were combined with Discovery® (Dentaurum, Ispringen, Germany), Micro Sprint® (Forestadent, Pforzheim, Germany), Clarity™ (3M Unitek), and Inspire Ice™ (Ormco) and slots in the dimension 0.022 inch (0.56 mm) and, except for the 0.019 × 0.025 inch wires, in the dimension 0.018 inch (0.46 mm). They were ligated with a 0.010 inch (0.25 mm) steel ligature (Smile Dental, Ratingen, Germany). Brackets were angulated by applying a moment of force of 10 Nmm against the wire, which was pulled through the slot at 0.2 mm/s.
RESULTS
In 660 tests using 132 bracket-wire combinations, friction loss for Gummetal® was comparable to and, in a few combinations with Micro Sprint®, significantly lower (p < 0.05) than SS and CoCr. The friction for Gummetal® was significantly lower (p < 0.05) than NiTi, and β‑Ti. In some bracket-wire combinations, lower friction was found with round wires compared to rectangular wires, except for the combination with Inspire Ice™, which was higher but not significant. Slot size did not have a significant effect on friction in most combinations.
CONCLUSION
The low friction associated with Gummetal® wires during arch-guided tooth movement will be a valuable addition to the armamentarium of orthodontists.
Topics: Dental Alloys; Dental Stress Analysis; Friction; Materials Testing; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Titanium
PubMed: 34228140
DOI: 10.1007/s00056-021-00317-y -
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 -
Brazilian Oral Research 2014This study examined the effect of cariogenic and erosive challenges (CCs and ECs, respectively) on the degradation of copper-nickel-titanium (CuNiTi) orthodontic wires....
This study examined the effect of cariogenic and erosive challenges (CCs and ECs, respectively) on the degradation of copper-nickel-titanium (CuNiTi) orthodontic wires. Sixty wire segments were divided into four treatment groups and exposed to CCs, ECs, artificial saliva, or dry storage (no-treatment control). CC and EC were simulated using a demineralizing solution (pH 4.3) and a citric acid solution (pH 2.3), respectively. Following treatment, the average surface roughness (Ra) of the wires was assessed, and friction between the wires and a passive self-ligating bracket was measured. CuNiTi wires subjected to ECs exhibited significantly higher Ra values than did those that were stored in artificial saliva. In contrast, surface roughness was not affected by CCs. Finally, friction between the treated wires and brackets was not affected by ECs or CCs. Our results indicate that CuNiTi orthodontic wires may suffer degradation within the oral cavity, as ECs increased the surface roughness of these wires. However, rougher surfaces did not increase friction between the wire and the passive self-ligating bracket.
Topics: Cariogenic Agents; Copper; Corrosion; Friction; Humans; Materials Testing; Microscopy, Atomic Force; Nickel; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Saliva, Artificial; Statistics, Nonparametric; Surface Properties; Titanium
PubMed: 25098823
DOI: 10.1590/1807-3107bor-2014.vol28.0024