Variation in form of mandibular, light, round, preformed NiTi archwires

Impact of the prefabricated forms of NiTi archwires on orthodontic forces delivered to the mandibular dental arch

BACKGROUND

Although preformed archwires with a variety of arch forms are currently commercially available, the effects of variation in the shape of these archwires on the orthodontic force at each tooth are not well understood. Therefore, we evaluated the forces delivered by various types of commercially available preformed nickel-titanium alloy (NiTi) archwires in a simulated mandibular dental arch.

METHODS

Sixty-three types of 0.019 × 0.025-inch preformed NiTi archwires from 15 manufactures were selected for analysis. The intercanine width (ICW) and intermolar width (IMW) of each archwire were measured at the mean canine and first molar depths of 30 untreated subjects with normal occlusions. Each archwire was placed in a multi-sensor measurement system simulating the mandibular dental arch of subjects with normal occlusions, and orthodontic forces in the facial-lingual direction at the central incisors, canines, and first molars were measured. Correlations between the ICW, IMW, and ICW/IMW ratio of archwires and the delivered forces were analyzed. The archwires were classified into the following four groups according to the ICW and IMW: Control group, ICW and IMW are within the means ± standard deviations of the normal ranges; Ovoid group, narrow ICW and IMW; Tapered group, narrow ICW; and Square group, narrow IMW. The forces were compared among these groups for each tooth.

RESULTS

Significant correlations between the measured archwire width and force to each tooth were found, except between IMW and forces at the central incisors and canines. Significant differences in the forces were found among all groups, except between the Ovoid and Tapered groups at all teeth and between the Ovoid/Tapered and Control groups at the first molar. Significantly greater orthodontic forces in the facial direction were delivered at the central incisors by the archwires in the Ovoid and Tapered groups when compared with the archwires in the other groups.

CONCLUSION

These findings suggest that there is a possible risk of a clinically significant level of unfavorable orthodontic force being delivered to the mandibular incisors in labial inclination when using a preformed archwire with an ICW that is narrower than the dental arch.

Impact of passive self-ligation and conventional elastic ligation on orthodontic force in the simulation of a mandibular lateral incisor linguoversion

INTRODUCTION

This study compared three-dimensional forces delivered to the displaced tooth and its adjacent teeth between passive self-ligation (PSL) and conventional elastic ligation (CL) in simulation of mandibular lateral incisor linguoversions.

METHODS

A multisensor system was used to measure three-dimensional forces delivered to brackets attached to the mandibular left central incisor, lateral incisor, and canine (FDI tooth numbers 31, 32, and 33, respectively). Two ligation methods (PSL and CL), 3 nickel-titanium (0.014-inch) archwires similar to the arch form of normal occlusion, and 2 displacements (1 and 4 mm) were tested.

RESULTS

In 1-mm displacement, forces were significantly smaller in CL than in PSL at 32 in the labial direction and larger at 31 in the mesial direction for all 3 types of archwires (P <0.01 for both). For 2 of 3 archwires, forces were larger in CL than in PSL at 33 in the lingual direction (P <0.01). In 4-mm displacement, forces were significantly larger in CL than in PSL at 31 in the mesial direction and significantly smaller in CL than in PSL at 33 in the distal direction for all 3 archwires (P <0.05 and P <0.01, respectively). Mean forces in the vertical direction were small, ranging from -0.05 to 0.05 N.

CONCLUSIONS

Under a small amount of displacement, force magnitude in PSL was smaller than that in CL at the displaced tooth in labial-lingual directions. Under a large amount of displacement, a more "open coil spring effect" was significantly obtained in CL than PSL at both adjacent teeth of the displaced tooth.

Can 3D imaging and digital software increase the ability to predict dental arch form after orthodontic treatment?

INTRODUCTION

This study aimed to evaluate the ability of dental clinicians to predict posttreatment dental arch forms in patients with malocclusion with the aid of 3D imaging and digital software in comparison with a conventional method.

METHODS

Pretreatment and posttreatment dental plaster casts of 100 patients (200 maxillary models and 200 mandibular models) were selected. Three orthodontists selected the best-fitted archwires among 5 commercially available preformed nickel-titanium archwires using 2 methods. In the conventional method, they fit the archwires to pretreatment casts, and in the digital method, they fit the scanned wire to a 3D digital model, using Ortho-Aid, a locally developed 3D software, using clinical bracket points as reference for wire fitness. The predicted posttreatment archwire in each method was compared with the best-fit archwire on the actual posttreatment model of each patient in both methods, and the level of agreement was calculated. The interobserver agreement between the 3 orthodontists in each method was evaluated using intraclass correlation coefficient and the Dahlberg formula.

RESULTS

Orthodontists predicted the final treatment outcome in 50% of cases using the conventional method and 58% using the digital method. However, the range of method error was significantly higher in the conventional method (0.425-3.853 mm for the conventional vs 0.451-0.584 mm for the digital).

CONCLUSIONS

Although the clinicians' ability to predict the final dental arch form after orthodontic treatment and the agreement between clinicians increased by the use of digital equipment, orthodontists can predict the final arch form in about 60% of patients.

Agreement of the clinician's choice of archwire selection on conventional and virtual models

OBJECTIVES

To compare archwire selection on dental casts with archwire selection using a three-dimensional (3D) software program (OrthoAid) and assess agreement between clinicians.

MATERIALS AND METHODS

The best-fitting archwires were selected for dental casts of 100 patients with malocclusion using two approaches by three orthodontists. The first method was to visually determine the fitness of five preformed nickel titanium archwires to the arch form on a dental cast (subjective method). The second method was archwire selection on a virtual image of the same cast by means of 3D software (objective method). Agreement between selections performed by the orthodontists was calculated using Kappa statistics. The accuracy of fit of the archwires to the curves fitted to the arch form was also calculated or reversely assessed by means of the root mean square (RMS) for both methods using the Dahlberg formula.

RESULTS

The mean RMS of the distances between the patient arch forms and the archwires for the subjective method was 1.163-1.366 mm. The agreement of selections between orthodontists was 42%-58% (Kappa ranged from .074 to .382). Using the 3D software (objective method), the mean RMS decreased to 0.966-1.171 mm, and agreement increased to 47% to 84% (Kappa ranged from .444 to .747).

CONCLUSIONS

The use of 3D computer software for archwire selection in patients with malocclusion provided better adaptation and interexaminer reliability.