Comparison of two different initial archwires for tooth alignment during fixed orthodontic treatment-A randomized clinical trial

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.

Keywords: Arch wire; alignment; root resorption.

Figure 1

Patient photograph and dental cast immediately after the placement of the archwire

Figure 2

Patient photograph and dental cast 1 month after the placement of the archwire

Figure 3

Patient photograph and dental cast 2 months after the placement of the archwire

Figure 4

Measuring the irregularity index using Vernier caliper

Figure 5

Measurement the root length on the sagittal section of CBCT before treatment

Figure 6

Measurement the root length on the sagittal section of CBCT after alignment