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Liu C, Wei Z, Jian F, McIntyre G, Millett DT, Lai W, Wang Y. Initial arch wires used in orthodontic treatment with fixed appliances. Cochrane Database Syst Rev 2024; 2:CD007859. [PMID: 38319008 PMCID: PMC10845215 DOI: 10.1002/14651858.cd007859.pub5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
BACKGROUND Initial arch wires are the first arch wires inserted into fixed appliance at the beginning of orthodontic treatment. With a number of different types of orthodontic arch wires available for initial tooth alignment, it is important to understand which are most efficient and which cause the least amount of root resorption and pain during the initial aligning stage of treatment. This is the third update of a Cochrane review 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 We searched Cochrane Oral Health's Trials Register, CENTRAL, MEDLINE, Embase, and two ongoing trials registries on 4 July 2022. SELECTION CRITERIA We included randomised controlled trials (RCTs) of different initial arch wires used to align teeth with fixed orthodontic braces. We included people with full-arch fixed orthodontic appliances on the upper arch, lower arch, or both arches. DATA COLLECTION AND ANALYSIS Two independent review authors were responsible for study selection, data extraction, and assessment of risk of bias in included studies. We contacted corresponding authors of included studies to obtain missing information. We resolved disagreements by discussion between the review authors. Our main outcomes were alignment rate (movement of teeth in mm), root resorption, time to alignment, and intensity of pain measured on a 100-mm visual analogue scale (VAS). We pooled data from studies with similar interventions and outcomes using random-effects models. We reported mean differences (MDs) with 95% confidence intervals (CIs) for continuous data, risk ratios (RRs) with 95% CIs for dichotomous data, and alignment rate ratios with 95% CIs for time-to-event data. Two independent review authors assessed the certainty of evidence. We resolved disagreements by discussion between the review authors. MAIN RESULTS We included 29 RCTs with 1915 participants (2581 arches) in this review. Studies were generally small (sample sizes ranged from 14 to 200 participants). Duration of follow-up varied between three days and six months. Eleven studies received funding, six received no funding, and 12 provided no information about funding sources. We judged eight studies at high risk of bias, nine at low risk, and 12 at unclear risk. We grouped the studies into six main comparisons. Multistrand stainless steel wires versus wires composed of other materials Six studies with 409 participants (545 arches) evaluated multistrand stainless steel (StSt) wires versus wires composed of other materials. We are very uncertain about the effect of multistrand StSt wires versus other wires on alignment rate (4 studies, 281 participants, 417 arches; very low-certainty evidence). There may be little to no difference between multistrand StSt wires and other wires in terms of intensity of pain (MD -2.68 mm, 95% CI -6.75 to 1.38; 2 studies, 127 participants, 127 arches; low-certainty evidence). Conventional nickel-titanium wires versus superelastic nickel-titanium wires Four studies with 266 participants (274 arches) evaluated conventional nickel-titanium (NiTi) wires versus superelastic NiTi wires. There may be little to no difference between the different wire types in terms of alignment rate (124 participants, 124 arches, 2 studies; low-certainty evidence) and intensity of pain (MD -0.29 mm, 95% CI -1.10 to 0.52; 2 studies, 142 participants, 150 arches; low-certainty evidence). Conventional nickel-titanium wires versus thermoelastic copper-nickel-titanium wires Three studies with 210 participants (210 arches) evaluated conventional Ni-Ti versus thermoelastic copper-nickel-titanium (CuNiTi) wires. We are very uncertain about the effects of the different arch wires on alignment rate (1 study, 66 participants, 66 arches; very low-certainty evidence). There may be little to no difference between conventional NiTi wires and thermoelastic CuNiTi wires in terms of time to alignment (alignment rate ratio 1.30, 95% CI 0.68 to 2.50; 1 study, 60 participants, 60 arches; low-certainty evidence). Superelastic nickel-titanium wires versus thermoelastic nickel-titanium wires Twelve studies with 703 participants (936 arches) evaluated superelastic NiTi versus thermoelastic NiTi wires. There may be little to no difference between superelastic NiTi wires and thermoelastic NiTi wires in alignment rate at four weeks (MD -0.28 mm, 95% CI 0.62 to 0.06; 5 studies, 183 participants, 183 arches; low-certainty evidence). We are very uncertain about the effects of the different wires on root resorption (2 studies, 52 participants, 312 teeth; very low-certainty evidence). Superelastic NiTi wires compared with thermoelastic NiTi wires may result in a slight increase in time to alignment (MD 0.5 months, 95% CI 0.21 to 0.79; 1 study, 32 participants, 32 arches; low-certainty evidence) but are probably associated with a slight increase in intensity of pain (MD 6.96 mm, 95% CI 1.82 to 12.10; 3 studies, 94 participants, 138 arches, moderate-certainty evidence). Single-strand superelastic nickel-titanium wires versus coaxial superelastic nickel-titanium wires Three studies with 104 participants (104 arches) evaluated single-strand superelastic NiTi versus coaxial superelastic NiTi wires. Use of single-strand superelastic NiTi wires compared with coaxial superelastic NiTi wires probably results in a slight reduction in alignment rate at four weeks (MD -2.64 mm, 95% CI -4.61 to -0.67; 2 studies, 64 participants, 64 arches, moderate-certainty evidence). Different sizes of nickel-titanium wires Two studies with 149 participants (232 arches) compared different types of NiTi wires. There may be little to no difference between different sizes of NiTi wires in terms of pain (low-certainty evidence). AUTHORS' CONCLUSIONS Superelastic NiTi wires probably produce slightly more pain after one day than thermoelastic NiTi wires, and single-strand superelastic NiTi wires probably have a lower alignment rate over four weeks compared with coaxial superelastic NiTi wires. All other evidence on alignment rate, root resorption, time to alignment, and pain is of low or very low certainty in all comparisons. Therefore, there is insufficient evidence to determine whether any particular arch wire material or size is superior to any other. The findings of this review are imprecise and unreliable; well-designed larger studies are needed to give better estimates of the benefits and harms of different arch wires. Orthodontists should exercise caution when interpreting the findings of this review and be prepared to adapt their treatment plans based on individual patient needs.
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Affiliation(s)
- Chang Liu
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, Department of Information Management (Department of Dental Informatics), Department of Evidence-Based Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhi Wei
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fan Jian
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | | | - Declan T Millett
- Oral Health and Development, Cork University Dental School and Hospital, Cork, Ireland
| | - Wenli Lai
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yan Wang
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Bhatia NK, Chugh VK, Shankar SP, Vinay A P R, Singh S, Moungkhom P, Sardana R. Alignment efficiency and three-dimensional assessment of root resorption after alignment with conventional and copper-nickel-titanium archwires: A randomized controlled trial. Dental Press J Orthod 2024; 28:e2323177. [PMID: 38198391 PMCID: PMC10773444 DOI: 10.1590/2177-6709.28.6.e2323177.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/23/2023] [Indexed: 01/12/2024] Open
Abstract
OBJECTIVE To compare alignment efficiency and root resorption between nickel-titanium (NiTi) and copper-nickel-titanium (CuNiTi) archwires after complete alignment in mandibular anterior region. METHODS In this two-arm parallel single-blind randomized controlled trial, forty-four patients with Class I malocclusion with mandibular anterior crowding were recruited form orthodontic clinic of All India Institute of Medical Sciences (Jodhpur, India). Patients were randomly allocated into NiTi and CuNiTi groups, with a 1:1 allocation. Alignment was performed using 0.014-in, 0.016-in, 0.018-in, 0.019x0.025-in archwire sequence in the respective groups, which terminated in 0.019 x 0.025-in stainless-steel working archwire. The primary outcome was alignment efficiency, measured on study models from baseline (T0) to the first, second, third, fourth and fifth-month (T5). Secondary outcome was root resorption, measured from CBCT scans taken at T0 and T5. Mixed-factorial ANOVA was used to compare Little's Irregularity Index (LII). For assessing the proportion of patients with complete alignment at the end of each month, Kaplan-Meier survival curve was built and time to treatment completion was compared between groups using log rank test. Paired t-test was used to assess external apical root resorption (EARR) within groups, whereas independent t-test was used to evaluate LII and EARR between the groups. RESULTS Twenty-two patients were recruited in each group. One patient was lost to follow-up in the CuNiTi group. No statistically significant differences were observed in alignment efficiency between the groups (p>0.05). Intergroup comparison revealed that the changes in root measurement in three-dimensions were not statistically significant (p>0.05), except for mandibular right central incisor, which showed increased resorption at root apex in NiTi group (p<0.01). CONCLUSION The two alignment archwires showed similar rate of alignment at all time points. Root resorption measurement did not differ between the NiTi and CuNiTi groups, except for the mandibular right central incisor, which showed more resorption in NiTi group.
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Affiliation(s)
- Navleen Kaur Bhatia
- All India Institute of Medical Sciences, Department of Dentistry, Section of Orthodontics (Jodhpur, Rajasthan, India)
| | - Vinay Kumar Chugh
- All India Institute of Medical Sciences, Department of Dentistry, Section of Orthodontics (Jodhpur, Rajasthan, India)
| | - Sam Prasanth Shankar
- All India Institute of Medical Sciences, Department of Dentistry, Section of Orthodontics (Jodhpur, Rajasthan, India)
| | - Ritvik Vinay A P
- All India Institute of Medical Sciences, Department of Dentistry, Section of Orthodontics (Jodhpur, Rajasthan, India)
| | - Surjit Singh
- All India Institute of Medical Sciences, Department of Pharmacology (Jodhpur, Rajasthan, India)
| | - Priyawati Moungkhom
- All India Institute of Medical Sciences, Department of Dentistry, Section of Orthodontics (Jodhpur, Rajasthan, India)
| | - Rinkle Sardana
- All India Institute of Medical Sciences, Department of Dentistry, Section of Orthodontics (Jodhpur, Rajasthan, India)
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Song Z, Zhou Z, Xu Y, Wang J, Ji W, Zhou Y. A digital orthodontic arch wire design system with interactive adjustment and intelligent optimization. Comput Biol Med 2023; 167:107671. [PMID: 37948967 DOI: 10.1016/j.compbiomed.2023.107671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/16/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023]
Abstract
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.
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Affiliation(s)
- Zefeng Song
- State Key Laboratory of Mechanics and Control for Aerospace Structures, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, China
| | - Zhengdong Zhou
- State Key Laboratory of Mechanics and Control for Aerospace Structures, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, China.
| | - Yunfei Xu
- State Key Laboratory of Mechanics and Control for Aerospace Structures, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, China
| | - Jiawen Wang
- State Key Laboratory of Mechanics and Control for Aerospace Structures, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, China
| | - Wentao Ji
- State Key Laboratory of Mechanics and Control for Aerospace Structures, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, China
| | - Yifan Zhou
- State Key Laboratory of Mechanics and Control for Aerospace Structures, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, China
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Jain S, Sharma P, Shetty D. Comparison of two different initial archwires for tooth alignment during fixed orthodontic treatment-A randomized clinical trial. J Orthod Sci 2021; 10:13. [PMID: 34568209 PMCID: PMC8423150 DOI: 10.4103/jos.jos_17_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 08/17/2020] [Accepted: 02/26/2021] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES: The aim of the study was to clinically evaluate and compare 0.016-inch superelastic nickel–titanium (NiTi) and 0.016-inch heat-activated nickel–titanium (NiTi) archwires in terms of alignment efficiency, root resorption, and pain intensity. METHOD: A total of 20 patients requiring fixed orthodontic treatment, having Little's irregularity index of 5–8, and requiring first premolar extractions were recruited. They were randomly allocated to receive two different archwires (0.016-inch superelastic NiTi or 0.016-inch thermoelastic NiTi). Good-quality impressions were taken of the lower arch before archwire placement (T0) and at every month after that till the alignment was complete. The rate of tooth alignment was measured on casts by determining Little's irregularity index. The pain experienced by the patient was assessed 24 hours and 1 week after the placement of the archwire on a visual analogue scale. Cone beam computed tomographic radiographs of lower anterior teeth were taken before and after alignment to assess root resorption. Data obtained were subjected to statistical analysis using the SPSS software (version 20.0). The level of significance was kept at 5%. RESULTS: The repeated measures ANOVA indicated that there was no significant difference in the aligning efficiency of superelastic and heat-activated NiTi wires. (p = 0.45). The Mann Whitney U test showed that superelastic NiTi wires had statistically significant higher VAS scores than heat-activated NiTi at 24 hours and 1-week interval (p < 0.05). Student's t-test indicated greater root resorption with superelastic NiTi but the difference was not statistically significant. CONCLUSION: Both the wires showed similar aligning efficiency and resulting root resorption. Superelastic NiTi was observed to produce more pain compared to heat-activated NiTi in the aligning phase.
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Affiliation(s)
- Shubhangi Jain
- Department of Orthodontics and Dentofacial Orthopedics, I.T.S-CDSR, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Payal Sharma
- Department of Orthodontics and Dentofacial Orthopedics, I.T.S-CDSR, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Divya Shetty
- Department of Orthodontics and Dentofacial Orthopedics, I.T.S-CDSR, Muradnagar, Ghaziabad, Uttar Pradesh, India
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Kyprianou C, Chatzigianni A, Daratsianos N, Bourauel C. Vertical and Orovestibular Forces Generated by Beta-Titanium and Stainless-Steel Rectangular Wires in Labial and Fully Customized Lingual Bracket Systems. MATERIALS (BASEL, SWITZERLAND) 2021; 14:5632. [PMID: 34640028 PMCID: PMC8510413 DOI: 10.3390/ma14195632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 12/02/2022]
Abstract
This study aimed to investigate the force values exerted from rectangular wires when combined with conventional labial and fully customized lingual appliances under predefined, idealized activation. Fully customized lingual brackets of two brands Incognito™ (3M Unitek, Monrovia, CA, USA) and WIN (DW Lingual Systems, Bad Essen, Germany) and labial brackets of another brand, discovery® MIM and discovery® smart systems (Dentaurum, Ispringen, Germany), were chosen. Stainless-steel and beta-titanium wires of 0.018" × 0.025" were examined. For IncognitoTM, 0.0182" × 0.025" beta-titanium wires were tested. Intrusion/extrusion and orovestibular movements were performed in a range of 0.2 mm, and the forces were recorded for each 0.1 mm of the movement. Mean values and standard deviations were calculated for all measurements, and ANOVA was performed for statistical analysis. Slight differences were observed between the forces generated from beta-titanium and stainless-steel wires. The same wire generated in some cases 5-53% higher forces with the lingual appliance due to the vertical orientation of the long walls during intrusion/extrusion and increased wire stiffness at the anterior region. Beta-titanium and stainless-steel 0.018" × 0.025" wires can generate similar force values during the final stages of the orthodontic therapy; thus, possibly only one of the two alloys could be used in each orthodontic wire sequence.
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Affiliation(s)
- Chrystalla Kyprianou
- Department of Oral Medical Technology, School of Dentistry, Faculty of Medicine, University of Bonn, 53111 Bonn, Germany;
| | - Athina Chatzigianni
- Department of Orthodontics, School of Health Sciences, Faculty of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Nikolaos Daratsianos
- Department of Orthodontics, School of Dentistry, Faculty of Medicine, University of Bonn, 53111 Bonn, Germany;
| | - Christoph Bourauel
- Department of Oral Medical Technology, School of Dentistry, Faculty of Medicine, University of Bonn, 53111 Bonn, Germany;
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Perception of Iraqi Orthodontists and Patients toward Accelerated Orthodontics. Int J Dent 2021; 2021:5512455. [PMID: 34007278 PMCID: PMC8102096 DOI: 10.1155/2021/5512455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/15/2021] [Accepted: 04/22/2021] [Indexed: 11/18/2022] Open
Abstract
Background/Purpose. In the literature, no consensus about the duration of orthodontic treatment has been reached out. This study aimed to identify orthodontist's and patient's perception about the time of orthodontic treatment and their willingness to undergo and pay for various acceleration techniques and procedures. Materials and Methods. An electronic survey was conducted from August to October 2020. The questionnaire consisted of 20 multiple choice questions which was designed and emailed to members of the Iraqi Orthodontic Society and self-administered to patients in several orthodontic centers in Baghdad. The questionnaire included questions about the perception toward the duration of orthodontic treatment, approval of different procedures used to reduce treatment time, and how much fee increment they are able to pay for various techniques and appliances. Descriptive and chi-square test statistics were used, and the level of significance was set at p ≤ 0.05. Results. The response rate was 78.7%. The willingness for additional techniques and procedures was rated in the following order: customized appliances: 50.8% orthodontists and 38.4% patients, followed by intraoral vibrating devices: 49.2% orthodontists and 38.1% patients, piezocision: 10.2% orthodontists and 8.2% patients, and corticotomies: 8.1% orthodontists and 5.9% patients. Most orthodontists were willing to pay up to 40% of treatment income for the acceleration procedure, while the payment of patients was up to 20%. Conclusion. Both orthodontists and patients were interested in techniques that can decrease the treatment duration. Noninvasive accelerating procedures were more preferable by orthodontists and patients than invasive surgical procedures.
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Abid MF, Alhuwaizi AF, Al-Attar AM. Do orthodontists aim to decrease the duration of fixed appliance treatment? J Orthod Sci 2021; 10:6. [PMID: 34084762 PMCID: PMC8102932 DOI: 10.4103/jos.jos_36_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/17/2020] [Accepted: 01/23/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES: The aim of the present study was to investigate the trends in the use of fixed appliance and accelerated orthodontics to decrease the treatment duration. Further, this study aimed to assess the effect of demographic factors on the participant's choice of treatment modality. METHODS: This was a cross-sectional study in the form of questionnaire-based online survey especially designed and distributed to 265 orthodontists via email. The questions aimed to collect basic information about the participants and respondents’ choices for decreasing the treatment duration. The data were analyzed according to gender, level of academic education and years of clinical experience using Chi-square test. RESULTS: A response rate of 85.2% was reported. Most of the orthodontists aimed to reduce the treatment duration by the biomechanical (66.8%) and surgical approaches (27.4%). The use of sliding mechanics (69.4%) and one-step retraction was more common (66.3%). MBT bracket prescription was more prevalent (51.7%), followed by Roth (41.1%). Conventional brackets were used more than self-ligating brackets, and aesthetic brackets were avoided by one third of the respondents. NiTi wires were the most commonly used wires during the alignment stage (44.2%). However, the effect of gender, years of clinical experience and specialty level of education showed some effects on the use of certain techniques and clinical practice of the respondents. CONCLUSIONS: Most of the orthodontists aimed to decrease orthodontic treatment duration by using biomechanical and surgical approaches. Gender and clinical experience to a certain extent affected the participants’ choice during orthodontic treatment.
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Affiliation(s)
- Mushriq F Abid
- Department of Orthodontic, College of Dentistry, Baghdad University, Baghdad, Iraq
| | - Akram F Alhuwaizi
- Department of Orthodontic, College of Dentistry, Baghdad University, Baghdad, Iraq
| | - Ali M Al-Attar
- Department of Orthodontic, College of Dentistry, Baghdad University, Baghdad, Iraq
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Nabbat SA, Yassir YA. A clinical comparison of the effectiveness of two types of orthodontic aligning archwire materials: a multicentre randomized clinical trial. Eur J Orthod 2020; 42:626-634. [PMID: 32011678 DOI: 10.1093/ejo/cjz102] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To compare the heat-activated nickel titanium (HANT) with superelastic nickel-titanium (SENT) archwires in terms of their effectiveness of aligning teeth, possibility of inducing root resorption, and perception of pain. SUBJECTS AND METHODS Orthodontic patients aged 12 years or over with mandibular anterior crowding of 3-6 mm, who required treatment without extractions were randomly allocated (a simple non-stratified randomization) to the HANT and SENT archwires groups with a 1:1 allocation ratio. The archwire sequence in both groups was 0.014-inch and 0.016-inch, respectively. Each archwire was placed for 4 weeks. The outcome measures included the amount of crowding assessed blindly using Little's irregularity index (LII), apical root resorption, and pain perception. The effectiveness of alignment was tested using 2 × 2 mixed factorial analysis of variance (ANOVA) model, while root resorption and pain perception were tested by the Mann-Whitney U-test and Wilcoxon signed-rank test (P < 0.05). RESULTS Thirty-four patients were randomized and recruited from four centres, of those 31 were analysed (15 participants for the HANT and 16 for the SENT groups) with an overall mean age of 19.13 ± 5.73 years. The total reduction in the LII was 2.69 mm and 2.74 mm for the HANT and SENT groups, respectively. This did not reach the level of statistical (P = 0.809) or clinical significance. Similarly, root resorption and pain perception showed non-significant difference between groups. However, there was a slight increase in root resorption with the SENT group. LIMITATIONS A long-term evaluation of root resorption is required. CONCLUSIONS Both HANT and SENT archwires were equally effective in the aligning stage of orthodontic treatment. Root resorption with SENT wires should be monitored throughout treatment. REGISTRATION The trial was registered with ClinicalTrials.gov on 18 September 2019, registration number: NCT04090931.
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Affiliation(s)
- Sarah A Nabbat
- Department of Orthodontic, College of Dentistry, University of Baghdad, Iraq
| | - Yassir A Yassir
- Department of Orthodontic, College of Dentistry, University of Baghdad, Iraq
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Amaya S, Pérez A, Guzmán H, Espinosa A, Motta G, Mojica J, Plaza-Ruiz SP. Changes in the mechanical properties of two nickel-titanium archwires after 3 months of clinical usage. J World Fed Orthod 2020; 9:175-180. [PMID: 33168487 DOI: 10.1016/j.ejwf.2020.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/08/2020] [Accepted: 10/12/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Nickel-titanium archwires have unique mechanical properties that make them the archwire of choice during the first phase of orthodontic treatment. However, during its clinical use when subjected to oral conditions, these properties can undergo great changes. MATERIALS AND METHODS A sample of 24 randomly chosen superelastic NiTi orthodontic archwires (12 TE and 12 PSE) with a 0.014-inch round section from the same manufacturer were distributed into four groups of six archwires each. The first two groups were new wires (as-received), which were used as controls (T0), and the other two were collected after 3 months of clinical usage (as-retrieved) in orthodontic patients (T1). Mechanical properties were measured by mechanical tensile testing and three-point bending tests under the same experimental and temperature conditions (36°C) in a universal testing machine. Comparisons between the groups at T0 and T1 were performed with t-tests and Mann-Whitney U tests. A paired t-test and Wilcoxon signed rank sum test were used for intragroup comparisons (T1-T0). RESULTS At baseline, PSE wires presented significantly (P < 0.05) higher load at fracture, range, ultimate tensile strength (UTS), yield strength, springback, maximum tension and flexural ultimate strength (FUS) than those of TE wires. At T1, a significant decrease in load at fracture and UTS in PSE wires and in FUS in TE wires was found. After 3 months of clinical usage, the changes (T1-T0) in the mechanical properties of both alloys were similar. CONCLUSIONS After 3 months of clinical usage, wires lost some of their mechanical properties and had less resistance to breakage. However, the as-received differences between both wires were maintained after clinical usage.
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Affiliation(s)
- Suly Amaya
- Assistant Professor, Orthodontic Department, Fundación Universitaria CIEO UniCIEO, Bogotá, Colombia.
| | - Alexandra Pérez
- Assistant Professor, Orthodontic Department, Fundación Universitaria CIEO UniCIEO, Bogotá, Colombia
| | - Humberto Guzmán
- Associate Professor, Orthodontic Department, Fundación Universitaria CIEO UniCIEO, Bogotá, Colombia
| | - Andrés Espinosa
- Orthodontic Program Resident, Orthodontic Department, Fundación Universitaria CIEO UniCIEO, Bogotá, Colombia
| | - Grecia Motta
- Orthodontic Program Resident, Orthodontic Department, Fundación Universitaria CIEO UniCIEO, Bogotá, Colombia
| | - Juan Mojica
- Orthodontic Program Resident, Orthodontic Department, Fundación Universitaria CIEO UniCIEO, Bogotá, Colombia
| | - Sonia P Plaza-Ruiz
- Associate Professor, Orthodontic Department, Fundación Universitaria CIEO UniCIEO, Bogotá, Colombia
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Effectiveness of two thermal activated orthodontic archwire sequences based on transition temperature range during alignment: A randomized non-controlled comparative study. Int Orthod 2020; 18:706-713. [PMID: 33071153 DOI: 10.1016/j.ortho.2020.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/16/2020] [Accepted: 09/20/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION It has been suggested that heat-activated NiTi archwires (HANT) speed up crowding alleviation. HANT wires are available with different austenite finish temperatures. OBJECTIVE The aim of the present study was to compare the effectiveness of two alignment sequences using thermally activated archwires with different austenite activation temperatures for the correction of mandibular anterior crowding. MATERIAL AND METHODS The following NiTi archwire sequence was used for both groups: 0.012 in (conventional NiTi), 0.018 in (heat-activated NiTi archwires), 0.016×0.022 in (heat-activated NiTi archwires) and 0.019×0.025 in (conventional NiTi). The conventional NiTi used for both groups belongs to the same commercial brand. Two different austenite activation temperatures (35°C and 37°C) were used for the heat-activated archwires. The primary outcome was the degree of crowding correction measured on study models. The secondary outcome was crowding survival time over a six-month period. This RTC included fifty-four patients that were randomly allocated to the two different archwire sequences. A Mann-Whitney test was used to compare the groups regarding crowding alleviation. A survival curve was created using the Kaplan-Meier method to illustrate the reduction of crowding over time. A Mantel-Cox log-rank test was used to compare survival times (until correction of crowding). RESULTS No differences in crowding alleviation were identified between both groups (log-rank test; P=0.77). CONCLUSIONS The two alignment sequences with different thermal activated archwires at 35°C and 37°C achieved similar clinical results during the correction of mandibular anterior crowding.
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Coated nickel titanium archwires and their uncoated counterparts: In-vitro contemporary comparison of unloading forces. Int Orthod 2020; 18:374-379. [PMID: 32037208 DOI: 10.1016/j.ortho.2020.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/02/2020] [Accepted: 01/10/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare the unloading forces between aesthetic nickel titanium (NiTi) wires coated with rhodium and epoxy resin, as well as their uncoated equivalents. Additionally, intragroup comparisons between the different deactivation forces were evaluated, and the inner alloy cores were determined. MATERIAL AND METHODS Forty-four 0.018" NiTi wire segments were equally divided into 4 groups: E- NiTi coated with epoxy resin, C- NiTi uncoated, R- heat-activated NiTi coated with rhodium, and T- heat-activated NiTi uncoated. The unloading values were recorded at 0.5, 1, 2, and 3mm using a 3-point bending test, according to the method in ISO Standard 15.841. Cross-sectional scanning electron microscopy was used to assess the inner alloy core thickness of the wires. RESULTS The intergroup comparison was successively: at 0.5mm: E (1.21)>C (0.60)=R (0.63)=T (0.58); at 1mm: E (1.30)=C (1.23)>R (0.91)=T (0.80); at 2mm:C (1.93)>E (1.36)=R (1.20) and R (1.20)=T (1.00) and E (1.36)>T (1.00); at 3mm:C (2.44)>R (2.02)>E (1.62)=T (1.68). The intragroup comparisons showed for all groups that the forces were statistically higher at 3mm than the other deactivations (p<0.01). Group E presented a reduced inner alloy core (.0155). CONCLUSION The unloading forces demonstrated variability between the wires tested and between the different deactivations. Therefore, depending on the type of movement required and the periodontal conditions, orthodontists should pay attention during archwire selection.
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Cardoso PC, Espinosa DG, Mecenas P, Flores-Mir C, Normando D. Pain level between clear aligners and fixed appliances: a systematic review. Prog Orthod 2020; 21:3. [PMID: 31956934 PMCID: PMC6970090 DOI: 10.1186/s40510-019-0303-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 12/13/2019] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To assess if there is any difference in pain levels between orthodontic treatment with clear aligners or fixed appliances. MATERIALS AND METHODS An electronic search was completed in PubMed, The Cochrane Database, Web of Science, Scopus, Lilacs, Google Scholar, Clinical Trials, and OpenGrey databases without any restrictions until February 2019. All comparative study types contrasting pain levels between clear aligners and fixed appliances were included. The risk of bias (RoB) was assessed using the Newcastle-Ottawa Scale, ROBINS-I-Tool, or ROB 2.0 according to the study design. The level of evidence was assessed through the GRADE tool. RESULTS After removal of duplicates, exclusion by title and abstract, and reading the full text, only seven articles were included. Five were prospective non-randomized clinical trials (CCT), one was a cross-sectional study, and one was a randomized clinical trial (RCT). Two studies presented a high RoB, three a moderate RoB, and two a low RoB (including the RCT). A meta-analysis was not performed because of clinical, statistical, and methodological heterogeneity. Most of the studies found that pain levels in patients treated with Invisalign were lower than those treated with conventional fixed appliances during the first days of treatment. Differences disappeared thereafter. No evidence was identified for other brands of clear aligners. CONCLUSIONS Based on a moderate level of certainty, orthodontic patients treated with Invisalign appear to feel lower levels of pain than those treated with fixed appliances during the first few days of treatment. Thereafter (up to 3 months), differences were not noted. Malocclusion complexity level among included studies was mild. Pain is one of many considerations and predictability and technical outcome are more important, mainly considering that the difference does not seem to occur after the first months of the orthodontic treatment.
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Affiliation(s)
| | | | - Paulo Mecenas
- Federal University of Pará (UFPA), Belém, Pará, Brazil
| | - Carlos Flores-Mir
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - David Normando
- Faculty of Dentistry, Federal University of Pará (UFPA), Rua Augusto Correa 01, Belém, Pará, 66075-110, Brazil.
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A comparative assessment of clinical efficiency between premium heat-activated copper nickel-titanium and superelastic nickel-titanium archwires during initial orthodontic alignment in adolescents: a randomized clinical trial. Prog Orthod 2019; 20:46. [PMID: 31840204 PMCID: PMC6911816 DOI: 10.1186/s40510-019-0299-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 11/12/2019] [Indexed: 11/29/2022] Open
Abstract
Background To compare the clinical efficiency of premium heat-activated copper nickel-titanium (Tanzo Cu-NiTi) and NT3 superelastic NiTi during initial orthodontic alignment. Subject and methods A total of 50 patients were randomly allocated to 1 of 2 different archwire types (group 1, Tanzo Cu-NiTi; group 2, NT3 superelastic NiTi). Eligibility criteria included Class I or Class II malocclusion, moderate maxillary anterior crowding, and healthy periodontal condition. Impressions of the upper arches were taken before archwire placement (T0) and at every 4 weeks (T1, T2, T3, and T4). For T1 and T2 stages, 0.014-in., and for T3 and T4 stages, 0.018-in. archwires were used. The primary outcome was the alignment efficiency assessed using Little’s irregularity index. The secondary outcomes were arch width and incisor inclination changes. Data were analyzed using independent samples t test, repeated measures ANOVA, and Mann-Whitney U test. Marginal models were established for the estimation of coefficients. Results The anterior irregularity index reduction was mostly observed between T0 and T2 periods, which were respectively − 7.40 ± 0.50 mm (p < 0.001; 95% CI, − 8.94, − 5.85) and − 6.80 ± 0.55 mm (p < 0.001; 95% CI, − 8.49, − 5.12) for groups 1 and 2 (p < 0.001). With both wires, Little’s irregularity index decreased over time, and the difference between the groups was not significant (p = 0.581; estimated effect size, 0.011). No statistically significant difference was found between the groups in terms of intercanine and intermolar width and incisor inclination changes. Conclusion There were no significant between-group differences in alignment efficiency, arch width, and incisor inclination change. There was an increased alignment with 0.014-in. compared with 0.018-in. diameter archwire.
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Vásquez-Cárdenas J, Zapata-Noreña Ó, Carvajal-Flórez Á, Barbosa-Liz DM, Giannakopoulos NN, Faggion CM. Systematic reviews in orthodontics: Impact of the PRISMA for Abstracts checklist on completeness of reporting. Am J Orthod Dentofacial Orthop 2019; 156:442-452.e12. [PMID: 31582116 DOI: 10.1016/j.ajodo.2019.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 05/01/2019] [Accepted: 05/01/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION This study evaluated and compared the completeness of reporting of abstracts of orthodontics systematic reviews before and after the publication of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Abstracts Checklist (PRISMA-A). METHODS Abstracts of systematic reviews and meta-analyses in orthodontics published in PubMed, Latin American and Caribbean Health Sciences Literature, and the Cochrane Database of Systematic Reviews databases before March 23, 2018, that met the predefined inclusion and exclusion criteria, were evaluated using the 12 items of PRISMA-A, scoring each item from 0 to 2. Abstracts were classified into 2 groups: before and after publication of the PRISMA-A checklist. Three calibrated evaluators (intraclass correlation coefficient and kappa > 0.8) assessed the scores for compliance with the checklist. The number of authors, country of affiliation of the first author, performance of meta-analysis, and topic of the article were recorded. A regression analysis was performed to assess the associations between abstract characteristics and the PRISMA-A scores. RESULTS Of 1034 abstracts evaluated, 389 were included in the analysis. The mean PRISMA-A score was 53.39 (95% CI, 51.83-54.96). The overall score for studies published after the publication of the checklist was significantly higher than for studies published before (P ≤ 0.0001). The components returning significantly higher scores after publication of PRISMA-A were title (P = 0.024), information from databases (P = 0.026), risk of bias (P ≤ 0.0001), included studies (P ≤ 0.0001), synthesis of results (P ≤ 0.0001), interpretation of results (P = 0.035), financing and conflict of interest (P ≤ 0.0001), and registration (P ≤ 0.0001). These results showed the positive effect of PRISMA-A had on the quality of reporting of orthodontics systematic reviews. Nevertheless, the poor adherence revealed that there is still need for improvement in the quality of abstract reporting. CONCLUSIONS The quality of reporting of abstracts of orthodontic systematic reviews and meta-analyses increased after the introduction of PRISMA-A.
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Affiliation(s)
- Jenny Vásquez-Cárdenas
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Óscar Zapata-Noreña
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Álvaro Carvajal-Flórez
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Diana María Barbosa-Liz
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia.
| | | | - Clovis Mariano Faggion
- Department of Periodontology and Operative Dentistry, Faculty of Dentistry, University of Münster, Münster, Germany
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Aydın B, Şenışık NE, Koşkan Ö. Evaluation of the alignment efficiency of nickel-titanium and copper-nickel-titanium archwires in patients undergoing orthodontic treatment over a 12-week period: A single-center, randomized controlled clinical trial. Korean J Orthod 2018; 48:153-162. [PMID: 29732301 PMCID: PMC5932317 DOI: 10.4041/kjod.2018.48.3.153] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 08/29/2017] [Accepted: 10/07/2017] [Indexed: 11/24/2022] Open
Abstract
Objective The aim of this trial was to compare the alignment efficiency and intermaxillary arch dimension changes of nickel-titanium (NiTi) or copper-nickel-titanium (CuNiTi) round archwires with increasing diameters applied sequentially to the mandibular arch. Methods The initial alignment phase of fixed orthodontic treatment with NiTi or CuNiTi round archwires was studied in a randomly allocated sample of 66 patients. The NiTi group comprised 26 women, 10 men, and the CuNiTi (27℃) group comprised 20 women, 10 men. The eligibility criteria were as follows: anterior mandibular crowding of minimum 6 mm according to Little's Irregularity Index (LII), treatment requiring no extraction of premolars, 12 to 18 years of age, permanent dentition, skeletal and dental Class I malocclusion. The main outcome measure was the alignment of the mandibular anterior dentition; the secondary outcome measure was the change in mandibular dental arch dimensions during 12 weeks. Simple randomization (allocation ratio 1:1) was used in this single-blind study. LII and mandibular arch dimensions were measured on three-dimensional digital dental models at 2-week intervals. Results No statistically significant difference was observed between NiTi and CuNiTi according to LII (p > 0.05). Intercanine and intermolar arch perimeters increased in the CuNiTi group (p < 0.001). Inter-first premolar width showed a statistically significant interaction in week × diameter × application (p < 0.05). Conclusions The effects of NiTi and CuNiTi round archwires were similar in terms of their alignment efficiency. However, the intercanine and intermolar arch perimeters, and the inter-first premolar width changes differed between groups.
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Affiliation(s)
- Burcu Aydın
- Department of Orthodontics, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
| | - Neslihan Ebru Şenışık
- Department of Orthodontics, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
| | - Özgür Koşkan
- Departments of Animal Science, Genetics, and Biometrics, Faculty of Agriculture, Suleyman Demirel University, Isparta, Turkey
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DiBiase AT, Woodhouse NR, Papageorgiou SN, Johnson N, Slipper C, Grant J, Alsaleh M, Khaja Y, Cobourne MT. Effects of supplemental vibrational force on space closure, treatment duration, and occlusal outcome: A multicenter randomized clinical trial. Am J Orthod Dentofacial Orthop 2018; 153:469-480.e4. [DOI: 10.1016/j.ajodo.2017.10.021] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 10/01/2017] [Accepted: 10/01/2017] [Indexed: 12/17/2022]
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17
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Comparison of arch width and depth changes and pain/discomfort with conventional and copper Ni-Ti archwires for mandibular arch alignment. J World Fed Orthod 2018. [DOI: 10.1016/j.ejwf.2018.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Mahmoudzadeh M, Farhadian M, Alijani S, Azizi F. Comparaison de deux arcs initiaux (A-NiTi et NiTi thermiques) pour évaluer la quantité d’alignement dentaire et la perception de la douleur : étude clinique randomisée. Int Orthod 2018; 16:60-72. [PMID: 29478924 DOI: 10.1016/j.ortho.2018.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Majid Mahmoudzadeh
- Département d'orthodontie, faculté dentaire, université de sciences médicales, Hamadan, Iran
| | - Maryam Farhadian
- Unité de recherche de modélisation, biostatistique et santé publique des maladies non transmissibles, université d'Hamadan de sciences médicales, Hamadan, Iran
| | - Sara Alijani
- Département d'orthodontie, faculté dentaire, université de sciences médicales, Hamadan, Iran
| | - Fatemeh Azizi
- Département d'orthodontie, faculté dentaire, université de sciences médicales, Kermanshah, Iran.
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Clinical comparison of two initial arch wires (A-NiTi and Heat Activated NiTi) for amount of tooth alignment and perception of pain: A randomized clinical trial. Int Orthod 2018; 16:60-72. [PMID: 29478933 DOI: 10.1016/j.ortho.2018.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The aim of this study was to compare two initial arch wires, 0.014″ A-NiTi and 0.016″ Heat Activated NiTi (HANT), for amount of tooth alignment and perception of pain. MATERIALS AND METHODS In total, 59 orthodontic patients (21 males and 38 females) from three orthodontic clinics participated in this 2-arm, parallel-group clinical trial and were randomized to 0.014″ A-NiTi (n=30) or 0.016″ HANT groups (n=29). Patient recruitment commenced in April 2016 and ended in December 2016. Age of the patients was between 12 to 25 years with an average of 17.92±3.74 years. Eligibility criteria included permanent dentition, non-extraction treatment plan in lower arch, Irregularity Index>2 in lower arch, no systemic disease influencing pain, no chronic Non Steroid Anti Inflammatory Drug (NSAID) therapy, and no history of dental pain, mucosal ulcers or temporomandibular disorders (TMD). Blinding was applicable to the patients and outcome assessment. The primary outcome was to compare the reduction of the Irregularity Index mean from bonding sessions to 4 weeks later in these groups and the secondary outcome was evaluation of the pain according to the modified McGill Pain Questionnaire (MPQ) with Visual Analogue Scale questionnaire (VAS). RESULTS The mean differences of irregularity indices between the two groups are not statistically significant (95% CI: 0.39-1.03; P=0.36) and according to the questionnaire, there was no significant difference between the two groups in trigger, site, description, duration, beginning, medication, and pain reduction over time. However, the VAS scale of HANT group was significantly higher than that of A-NiTi (P=0.04). CONCLUSION Results from this investigation suggested that there was no clinical difference in amount of tooth alignment and perception of pain between 0.014″ A-NiTi and 0.016″ HANT wires.
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Papageorgiou SN, Höchli D, Eliades T. Outcomes of comprehensive fixed appliance orthodontic treatment: A systematic review with meta-analysis and methodological overview. Korean J Orthod 2017; 47:401-413. [PMID: 29090128 PMCID: PMC5653689 DOI: 10.4041/kjod.2017.47.6.401] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 02/21/2017] [Accepted: 03/29/2017] [Indexed: 12/13/2022] Open
Abstract
Objective The aim of this systematic review was to assess the occlusal outcome and duration of fixed orthodontic therapy from clinical trials in humans with the Objective Grading System (OGS) proposed by the American Board of Orthodontics. Methods Nine databases were searched up to October 2016 for prospective/retrospective clinical trials assessing the outcomes of orthodontic therapy with fixed appliances. After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of the mean OGS score and treatment duration were performed and 95% confidence intervals (CIs) were calculated. Results A total of 34 relevant clinical trials including 6,207 patients (40% male, 60% female; average age, 18.4 years) were identified. The average OGS score after treatment was 27.9 points (95% CI, 25.3–30.6 points), while the average treatment duration was 24.9 months (95% CI, 24.6–25.1 months). There was no significant association between occlusal outcome and treatment duration, while considerable heterogeneity was identified. In addition, orthodontic treatment involving extraction of four premolars appeared to have an important effect on both outcomes and duration of treatment. Finally, only 10 (39%) of the identified studies matched compared groups by initial malocclusion severity, although meta-epidemiological evidence suggested that matching may have significantly influenced their results. Conclusions The findings from this systematic review suggest that the occlusal outcomes of fixed appliance treatment vary considerably, with no significant association between treatment outcomes and duration. Prospective matched clinical studies that use the OGS tool are needed to compare the effectiveness of orthodontic appliances.
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Affiliation(s)
- Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Damian Höchli
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Kaklamanos EG, Mavreas D, Tsalikis L, Karagiannis V, Athanasiou AE. Treatment duration and gingival inflammation in Angle’s Class I malocclusion patients treated with the conventional straight-wire method and the Damon technique: a single-centre, randomised clinical trial. J Orthod 2017; 44:75-81. [DOI: 10.1080/14653125.2017.1316902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Eleftherios G. Kaklamanos
- Department of Orthodontics, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Dimitrios Mavreas
- Practice Limited to Orthodontics, Athens, Greece
- Department of Orthodontics, Faculty of Medicine and Pharmacy, CHIR – Unit Dentistry – ORHE, Vrije University, Brussels, Belgium
| | - Lazaros Tsalikis
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vassilis Karagiannis
- School of Mathematics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasios E. Athanasiou
- Department of Orthodontics, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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Mousoulea S, Papageorgiou SN, Eliades T. Treatment effects of various prescriptions and techniques for fixed orthodontic appliances. J Orofac Orthop 2017; 78:403-414. [PMID: 28397082 DOI: 10.1007/s00056-017-0094-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 03/02/2017] [Indexed: 01/22/2023]
Affiliation(s)
- Sophia Mousoulea
- Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force General Hospital, Athens, Greece
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Faculty of Medicine, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Faculty of Medicine, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
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Papageorgiou SN, Gölz L, Jäger A, Eliades T, Bourauel C. Lingual vs. labial fixed orthodontic appliances: systematic review and meta-analysis of treatment effects. Eur J Oral Sci 2016; 124:105-18. [PMID: 26916846 DOI: 10.1111/eos.12250] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2015] [Indexed: 10/22/2022]
Abstract
The aim of this systematic review was to compare the therapeutic and adverse effects of lingual and labial orthodontic fixed appliances from clinical trials on human patients in an evidence-based manner. Randomized and prospective non-randomized clinical trials comparing lingual and labial appliances were included. Risk of bias within and across studies was assessed using the Cochrane tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Random-effects meta-analyses were conducted, followed by subgroup and sensitivity analyses. Six electronic databases were searched from inception to July 2015, without limitations. A total of 13 papers pertaining to 11 clinical trials were included with a total of 407 (34% male/66% female) patients. Compared with labial appliances, lingual appliances were associated with increased overall oral discomfort, increased speech impediment (measured using auditory analysis), worse speech performance assessed by laypersons, increased eating difficulty, and decreased intermolar width. On the other hand, lingual appliances were associated with increased intercanine width and significantly decreased anchorage loss of the maxillary first molar during space closure. Based on existing trials, there is insufficient evidence to make robust recommendations for lingual fixed orthodontic appliances regarding their therapeutic or adverse effects, as the quality of evidence was low.
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Affiliation(s)
- Spyridon N Papageorgiou
- Department of Orthodontics, School of Dentistry, University of Bonn, Bonn, Germany.,Department of Oral Technology, School of Dentistry, University of Bonn, Bonn, Germany
| | - Lina Gölz
- Department of Orthodontics, School of Dentistry, University of Bonn, Bonn, Germany
| | - Andreas Jäger
- Department of Orthodontics, School of Dentistry, University of Bonn, Bonn, Germany
| | - Theodore Eliades
- Clinic of Orthodontics and Paediatric Dentistry, Center of Dental Medicine, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph Bourauel
- Department of Oral Technology, School of Dentistry, University of Bonn, Bonn, Germany
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Woodhouse NR, DiBiase AT, Papageorgiou SN, Johnson N, Slipper C, Grant J, Alsaleh M, Cobourne MT. Supplemental vibrational force does not reduce pain experience during initial alignment with fixed orthodontic appliances: a multicenter randomized clinical trial. Sci Rep 2015; 5:17224. [PMID: 26610843 PMCID: PMC4661602 DOI: 10.1038/srep17224] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 10/27/2015] [Indexed: 01/06/2023] Open
Abstract
This prospective randomized trial investigated the effect of supplemental vibrational force on orthodontic pain during alignment with fixed-appliances. Eighty-one subjects < 20 years-old undergoing extraction-based fixed-appliance treatment were randomly allocated to supplementary (20-minutes/day) use of an intra-oral vibrational device (AcceleDent®) (n = 29); an identical non-functional (sham) device (n = 25) or fixed-appliances only (n = 27). Each subject recorded pain intensity (using a 100-mm visual-analogue scale) and intake of oral analgesia in a questionnaire, following appliance-placement (T1) and first-adjustment (T2) for 1-week (immediately-after, 4, 24, 72-hours and at 1-week). Mean maximum-pain for the total sample was 72.96 mm [SD 21.59; 95%CI 68.19–77.74 mm] with no significant differences among groups (P = 0.282). Subjects taking analgesics reported slightly higher maximum-pain although this was not significant (P = 0.170). The effect of intervention was independent of analgesia (P = 0.883). At T1 and T2, a statistically and clinically significant increase in mean pain was seen at 4 and 24-hours, declining at 72-hours and becoming insignificant at 1-week. For mean alignment-rate, pain-intensity and use of analgesics, no significant differences existed between groups (P > 0.003). The only significant predictor for mean pain was time. Use of an AcceleDent vibrational device had no significant effect on orthodontic pain or analgesia consumption during initial alignment with fixed appliances.
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Affiliation(s)
- Neil R Woodhouse
- King's College London Dental Institute, Department of Orthodontics, London SE19RT, UK.,Brighton and Sussex University Hospitals NHS Foundation Trust, Royal Alexandra Children's Hospital, Department of Orthodontics, Brighton BN25BE, UK
| | - Andrew T DiBiase
- East Kent Hospitals University NHS Foundation Trust, William Harvey Hospital, Department of Orthodontics, Ashford TN240LZ, UK
| | - Spyridon N Papageorgiou
- University of Bonn, Department of Orthodontics and Department of Oral Technology, Bonn DE-53111, Germany
| | - Nicola Johnson
- Brighton and Sussex University Hospitals NHS Foundation Trust, Royal Alexandra Children's Hospital, Department of Orthodontics, Brighton BN25BE, UK
| | - Carmel Slipper
- Brighton and Sussex University Hospitals NHS Foundation Trust, Royal Alexandra Children's Hospital, Department of Orthodontics, Brighton BN25BE, UK
| | - James Grant
- Brighton and Sussex University Hospitals NHS Foundation Trust, Royal Alexandra Children's Hospital, Department of Orthodontics, Brighton BN25BE, UK
| | - Maryam Alsaleh
- King's College London Dental Institute, Department of Orthodontics, London SE19RT, UK
| | - Martyn T Cobourne
- King's College London Dental Institute, Department of Orthodontics, London SE19RT, UK
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25
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Papageorgiou SN, Keilig L, Hasan I, Jäger A, Bourauel C. Effect of material variation on the biomechanical behaviour of orthodontic fixed appliances: a finite element analysis. Eur J Orthod 2015; 38:300-7. [PMID: 26174769 DOI: 10.1093/ejo/cjv050] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Biomechanical analysis of orthodontic tooth movement is complex, as many different tissues and appliance components are involved. The aim of this finite element study was to assess the relative effect of material alteration of the various components of the orthodontic appliance on the biomechanical behaviour of tooth movement. METHODS A three-dimensional finite element solid model was constructed. The model consisted of a canine, a first, and a second premolar, including the surrounding tooth-supporting structures and fixed appliances. The materials of the orthodontic appliances were alternated between: (1) composite resin or resin-modified glass ionomer cement for the adhesive, (2) steel, titanium, ceramic, or plastic for the bracket, and (3) β-titanium or steel for the wire. After vertical activation of the first premolar by 0.5mm in occlusal direction, stress and strain calculations were performed at the periodontal ligament and the orthodontic appliance. RESULTS The finite element analysis indicated that strains developed at the periodontal ligament were mainly influenced by the orthodontic wire (up to +63 per cent), followed by the bracket (up to +44 per cent) and the adhesive (up to +4 per cent). As far as developed stresses at the orthodontic appliance are concerned, wire material had the greatest influence (up to +155 per cent), followed by bracket material (up to +148 per cent) and adhesive material (up to +8 per cent). LIMITATIONS The results of this in silico study need to be validated by in vivo studies before they can be extrapolated to clinical practice. CONCLUSION According to the results of this finite element study, all components of the orthodontic fixed appliance, including wire, bracket, and adhesive, seem to influence, to some extent, the biomechanics of tooth movement.
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Affiliation(s)
| | - Ludger Keilig
- Oral Technology, and Prosthodontics, Preclinical Education and Dental Materials Science, School of Dentistry, University of Bonn, Germany
| | - Istabrak Hasan
- Oral Technology, and Prosthodontics, Preclinical Education and Dental Materials Science, School of Dentistry, University of Bonn, Germany
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26
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Woodhouse N, DiBiase A, Johnson N, Slipper C, Grant J, Alsaleh M, Donaldson A, Cobourne M. Supplemental Vibrational Force During Orthodontic Alignment. J Dent Res 2015; 94:682-9. [DOI: 10.1177/0022034515576195] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
This prospective 3-arm parallel-group randomized clinical trial investigated the effect of supplemental vibrational force on rate of orthodontic tooth alignment with fixed appliances. Eighty-one subjects (40 males, 41 females; mean age, 14.1 y) undergoing first premolar extraction-based fixed appliance treatment were randomly allocated to treatment supplemented with daily use (20 min) of a removable intraoral vibrational device (AcceleDent; OrthoAccel Technologies Inc.; n = 29), an identical nonfunctional (sham) device ( n = 25), or fixed appliances only ( n = 27). Mandibular study casts were taken at baseline (treatment start: placement of 0.014-in. nickel-titanium arch wire), initial alignment (0.018-in. nickel-titanium arch wire), and final alignment (0.019 x 0.025–in. stainless steel arch wire). Overall mean irregularity index in the mandibular arch at baseline was 8.5 ± 3.8 mm (95% CI, 7.6 to 9.3) with no significant difference between groups ( P = 0.73). For the total sample, mean irregularity index at initial alignment was 2.7 ± 2.8 mm (95% CI, 2.2 to 3.4) with no significant difference between groups ( P = 0.40). Mean time from baseline to initial alignment was 59 ± 25 d (95% CI, 54.5 to 65.6); from initial to final alignment, 150 ± 62.5 d (95% CI, 136 to 165); and baseline to final alignment, 209 ± 65 d (95% CI, 195 to 224). Kaplan-Meier analysis demonstrated that patterns of alignment were not significantly different among the 3 groups ( P = 0.66). Multivariate linear regression for initial and overall alignment rates using initial irregularity index as the covariate showed no significant differences among groups. The most important influence on both initial and overall rates of alignment was initial irregularity ( P = 0.1 × 10−4). This prospective randomized clinical trial found no evidence that supplemental vibrational force can significantly increase the rate of initial tooth movement or reduce the amount of time required to achieve final alignment when used in conjunction with a preadjusted edgewise fixed appliance ( ClinicalTrials.gov NCT02314975).
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Affiliation(s)
- N.R. Woodhouse
- Department of Orthodontics, King’s College London Dental Institute, London, UK
- Department of Orthodontics, Royal Alexandra Children’s Hospital, Brighton and Sussex University Hospitals NHS Foundation Trust, Brighton, UK
| | - A.T. DiBiase
- Department of Orthodontics, William Harvey Hospital, East Kent Hospitals University NHS Foundation Trust, Ashford, UK
| | - N. Johnson
- Department of Orthodontics, Royal Alexandra Children’s Hospital, Brighton and Sussex University Hospitals NHS Foundation Trust, Brighton, UK
| | - C. Slipper
- Department of Orthodontics, Royal Alexandra Children’s Hospital, Brighton and Sussex University Hospitals NHS Foundation Trust, Brighton, UK
| | - J. Grant
- Department of Orthodontics, Royal Alexandra Children’s Hospital, Brighton and Sussex University Hospitals NHS Foundation Trust, Brighton, UK
| | - M. Alsaleh
- Department of Orthodontics, King’s College London Dental Institute, London, UK
| | - A.N.A. Donaldson
- Biostatistics Unit, King’s College London Dental Institute, London, UK
| | - M.T. Cobourne
- Department of Orthodontics, King’s College London Dental Institute, London, UK
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