Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2013 Apr 30;2013(4):CD007859.
doi: 10.1002/14651858.CD007859.pub3.

Initial arch wires for tooth alignment during orthodontic treatment with fixed appliances

Fan Jian  1 , Wenli Lai, Susan Furness, Grant T McIntyre, Declan T Millett, Joy Hickman, Yan Wang
Affiliations
Meta-Analysis

Initial arch wires for tooth alignment during orthodontic treatment with fixed appliances

Fan Jian et al. Cochrane Database Syst Rev. .

Update in

Abstract

Background: Initial arch wires are the first arch wires to be inserted into the fixed appliance at the beginning of orthodontic treatment and are used mainly for the alignment of teeth by correcting crowding and rotations. With a number of different types of orthodontic arch wires available for initial tooth alignment, it is important to understand which wire is most efficient, as well as which wires cause the least amount of root resorption and pain during the initial aligning stage of treatment. This is an update of the review 'Initial arch wires for alignment of crooked teeth with fixed orthodontic braces' first published in the Cochrane Database of Systematic Reviews 2010, Issue 4.

Objectives: To assess the effects of initial arch wires for alignment of teeth with fixed orthodontic braces in relation to alignment speed, root resorption and pain intensity.

Search methods: We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 2 August 2012), CENTRAL (The Cochrane Library 2012, Issue 7), MEDLINE via OVID (1950 to 2 August 2012) and EMBASE via OVID (1980 to 2 August 2012). We also searched the reference lists of relevant articles. There was no restriction with regard to publication status or language of publication. We contacted all authors of included studies to identify additional studies.

Selection criteria: We included randomised controlled trials (RCTs) of initial arch wires to align teeth with fixed orthodontic braces. Only studies involving participants with upper and/or lower full arch fixed orthodontic appliances were included.

Data collection and analysis: Two review authors were responsible for study selection, validity assessment and data extraction. All disagreements were resolved by discussion amongst the review team. Corresponding authors of included studies were contacted to obtain missing information.

Main results: Nine RCTs with 571 participants were included in this review. All trials were at high risk of bias and a number of methodological limitations were identified. All trials had at least one potentially confounding factor (such as bracket type, slot size, ligation method, extraction of teeth) which is likely to have influenced the outcome and was not controlled in the trial. None of the trials reported the important adverse outcome of root resorption.Three groups of comparisons were made.(1) Multistrand stainless steel initial arch wires compared to superelastic nickel titanium (NiTi) initial arch wires. There were four trials in this group, with different comparisons and outcomes reported at different times. No meta-analysis was possible. There is insufficient evidence from these trials to determine whether or not there is a difference in either rate of alignment or pain between stainless steel and NiTi initial arch wires.(2) Conventional (stabilised) NiTi initial arch wires compared to superelastic NiTi initial arch wires. There were two trials in this group, one reporting the outcome of alignment over 6 months and the other reporting pain over 1 week. There is insufficient evidence from these trials to determine whether or not there is any difference between conventional (stabilised) and superelastic NiTi initial arch wires with regard to either alignment or pain.(3) Single-strand superelastic NiTi initial arch wires compared to other NiTi (coaxial, copper NiTi (CuNiTi) or thermoelastic) initial arch wires. The three trials in this comparison each compared a different product against single-strand superelastic NiTi. There is very weak unreliable evidence, based on one very small study (n = 24) at high risk of bias, that coaxial superelastic NiTi may produce greater tooth movement over 12 weeks, but no information on associated pain or root resorption. This result should be interpreted with caution until further research evidence is available. There is insufficient evidence to determine whether or not there is a difference between either thermoelastic or CuNiTi and superelastic NiTi initial arch wires.

Authors' conclusions: There is no reliable evidence from the trials included in this review that any specific initial arch wire material is better or worse than another with regard to speed of alignment or pain. There is no evidence at all about the effect of initial arch wire materials on the important adverse effect of root resorption. Further well-designed and conducted, adequately-powered, RCTs are required to determine whether the performance of initial arch wire materials as demonstrated in the laboratory, makes a clinically important difference to the alignment of teeth in the initial stage of orthodontic treatment in patients.

PubMed Disclaimer

Conflict of interest statement

The participating review authors declare that they have no financial conflict of interest and that they do not have any associations with industry regarding the subject of this review.

Figures

Figure 1
Figure 1
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Analysis 1.1
Analysis 1.1
Comparison 1 Multistrand stainless steel versus NiTi arch wires, Outcome 1 Pain (VAS) day 1.
Analysis 1.2
Analysis 1.2
Comparison 1 Multistrand stainless steel versus NiTi arch wires, Outcome 2 Pain (VAS) day 7.
Analysis 2.1
Analysis 2.1
Comparison 2 Conventional (stabilised) NiTi versus superelastic NiTi arch wires, Outcome 1 Tooth movement.
Analysis 2.2
Analysis 2.2
Comparison 2 Conventional (stabilised) NiTi versus superelastic NiTi arch wires, Outcome 2 Pain (VAS) day 1.
Analysis 2.3
Analysis 2.3
Comparison 2 Conventional (stabilised) NiTi versus superelastic NiTi arch wires, Outcome 3 Pain (VAS) day 7.
Analysis 2.4
Analysis 2.4
Comparison 2 Conventional (stabilised) NiTi versus superelastic NiTi arch wires, Outcome 4 Analgesic consumption.
Analysis 3.1
Analysis 3.1
Comparison 3 Single‐strand superelastic NiTi versus other NiTi, Outcome 1 Alignment (mm/12 weeks) ‐ Single‐strand vs coaxial.
Analysis 3.2
Analysis 3.2
Comparison 3 Single‐strand superelastic NiTi versus other NiTi, Outcome 2 Alignment rate ratio.
Analysis 3.3
Analysis 3.3
Comparison 3 Single‐strand superelastic NiTi versus other NiTi, Outcome 3 Pain (VAS) day 1 ‐ Superelastic vs thermoelastic.
Analysis 3.4
Analysis 3.4
Comparison 3 Single‐strand superelastic NiTi versus other NiTi, Outcome 4 Pain (VAS) day 2 ‐ Superelastic vs thermoelastic.
See this image and copyright information in PMC

Update of

Comment in

References

References to studies included in this review

    1. Cioffi I, Piccolo A, Tagliaferri R, Paduano S, Galeotti A, Martina R. Pain perception following first orthodontic archwire placement‐‐thermoelastic vs superelastic alloys: a randomized controlled trial. Quintessence International2012; Vol. 43, issue 1:61‐9. - PubMed
    1. Cobb NW 3rd, Kula KS, Phillips C, Proffit WR. Efficiency of multi‐strand steel, superelastic Ni‐Ti and ion‐implanted Ni‐Ti archwires for initial alignment. Clinical Orthodontics and Research 1998;1(1):12‐9. - PubMed
    1. Evans TJ. A Clinical Comparison and Performance Perspective of Three Aligning Archwires [MScD dissertation]. Cardiff, UK: University of Wales, 1996.
    2. Evans TJ, Jones ML, Newcombe RG. Clinical comparison and performance perspective of three aligning arch wires. American Journal of Orthodontics and Dentofacial Orthopedics 1998;114(1):32‐9. - PubMed
    1. Fernandes LM, Øgaard B, Skoglund L. Pain and discomfort experienced after placement of a conventional or a superelastic NiTi aligning archwire. A randomized clinical trial [Schmerzen und Beschwerden nach Eingliederung eines herkömmlichen und eines superelastischen NiTi‐Nivellierungsbogens]. Journal of Orofacial Orthopedics 1998;59(6):331‐9. - PubMed
    1. Chan LSC. Pain and Discomfort Experienced During Orthodontic Treatment: a Randomised Controlled Clinical Trial of Two Initial Aligning Archwires [MScD dissertation]. Cardiff, UK: University of Wales, 1990. - PubMed
    2. Jones M, Chan C. The pain and discomfort experienced during orthodontic treatment: a randomized controlled clinical trial of two initial aligning arch wires. American Journal of Orthodontics and Dentofacial Orthopedics 1992;102(4):373‐81. - PubMed
    3. Jones ML, Staniford H, Chan C. Comparison of superelastic NiTi and multistranded stainless steel wires in initial alignment. Journal of Clinical Orthodontics. 1990/10/01 1990; Vol. 24, issue 10:611‐3. - PubMed

References to studies excluded from this review

    1. AlQabandi AK, Sadowsky C, BeGole EA. A comparison of the effects of rectangular and round arch wires in levelling the curve of Spee. American Journal of Orthodontics and Dentofacial Orthopedics 1999;116(5):522‐9. - PubMed
    1. Bernhold M, Bondemark L. Superelastic nickel‐titanium heat‐activated archwires for tooth movement ‐ a prospective randomized study of apical root resorption. Swedish Dental Journal 2001;25:177.
    1. Bloom KL, Bhatia SN. Comparison of copper NiTi and nitinol archwires in initial alignment. European Journal of Orthodontics 1998;20:614.
    1. Chekay BA, Killiany DM, Purcell MV, Frost RA. Apical root resorption: A comparison of wire materials. Journal of Dental Research 1999;78 Special Issue:202 (Abs No 776).
    1. Dalstra M, Melsen B. Does the transition temperature of Cu‐NiTi archwires affect the amount of tooth movement during alignment?. Orthodontics & Craniofacial Research 2004;7(1):21–5. - PubMed

Additional references

    1. Ballard DJ, Jones AS, Petocz P, Darendeliler MA. Physical properties of root cementum: part 11. Continuous vs intermittent controlled orthodontic forces on root resorption. A microcomputed‐tomography study. American Journal of Orthodontics and Dentofacial Orthopedics 2009;136(1):1‐8; discussion 8‐9. - PubMed
    1. Burstone CJ. Variable‐modulus orthodontics. American Journal of Orthodontics 1981;80(1):1‐16. - PubMed
    1. Burstone CJ, Qin B, Morton JY. Chinese NiTi wire‐‐a new orthodontic alloy. American Journal of Orthodontics 1985;87(6):445‐52. - PubMed
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta‐analysis detected by a simple, graphical test. BMJ 1997;315(7109):629‐34. - PMC - PubMed
    1. Erdinç E, Dinçer B. Perception of pain during orthodontic treatment with fixed appliances. European Journal of Orthodontics 2004;26(1):79‐85. - PubMed

References to other published versions of this review

    1. Wang Y, Jian F, Lai W, Zhao Z, Yang Z, Liao Z, et al. Initial arch wires for alignment of crooked teeth with fixed orthodontic braces. Cochrane Database of Systematic Reviews 2010, Issue 4. [DOI: 10.1002/14651858.CD007859.pub2] - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources