Cochrane · intervention · CD007859
Initial arch wires used in orthodontic treatment with fixed appliances
Liu, C, Wei, Z, Jian, F, et al. · Cochrane Database of Systematic Reviews · 2024 · Cochrane Library
Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.
Questions
34
current version
GRADE rated
12
No studies
16
Included studies
29
as reported
No studies 16 · 47.1%Ungraded 6 · 17.6%Very low 3 · 8.8%Low 7 · 20.6%Moderate 2 · 5.9%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Participants of any age with full-arch fixed orthodontic appliances on the upper arch, lower arch, or both. Excluded: concurrent palatal expansion or extraoral appliances, previous active orthodontic treatment, or relevant medical history. | 1915 participants (2581 arches) from 29 RCTs; sample sizes 14 to 200 participants; 13 studies included children/adolescents and adults, 13 only children/adolescents, 2 only adults. |
| Intervention | Initial arch wire (one material, cross-sectional shape or size) | Materials evaluated: conventional and multistrand stainless steel; conventional, single-strand superelastic, coaxial/multistrand superelastic, ion-implanted superelastic, coated superelastic, thermoelastic (with and without copper) NiTi; and TiNbTaZr; in sizes 0.012 to 0.018 inch |
| Comparison | Initial arch wires (first arch wire inserted into the fixed appliance at the beginning of treatment; excludes later arch wires), compared in terms of: (1) material; (2) cross-sectional shape; (3) cross-sectional size | Comparators drawn from the same set of stainless steel and NiTi wire types and sizes |
| Outcomes | Primary outcomes: alignment rate (tooth movement over a period of time); incidence/prevalence and amount of root resorption. Secondary outcomes: time to next/working arch wire; time to alignment; pain (intensity on VAS or categorical scale, and duration; analgesic consumption) | Alignment rate (n=20); Root resorption (n=3); Time to next/working arch wire (n=2); Time to alignment (n=3); Pain intensity (n=13) |
| Study designs | Randomised controlled trials | Randomised controlled trials (n=29) |
| Timing | Not reported | 3 days to 6 months |
Search date: 2022-07-04. Databases: Cochrane Oral Health's Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE Ovid; Embase Ovid; US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov; World Health Organization International Clinical Trials Registry Platform
Questions and results
Show all 5 versionsSuperelastic NiTi arch wire vs Multistrand stainless steel arch wire
Population: People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Time to next/working arch wire | No studies reported time to next/working arch wire | 0 studies | No studies |
Root resorption | Root resorption: not reported | 0 studies | No studies |
Time to alignment | Cobb 1998 measured time to alignment but reported results only as graphs, with no numerical data | 1 study | Ungraded |
Pain day 1 7 to 14 days | MD 2.68 [-1.38, 6.75] 2.68 [-1.38, 6.75] mm (VAS; superelastic higher) | 2 studies · 127 participants | Low Downgraded: risk of bias, imprecision |
Superelastic NiTi arch wire vs Conventional (stabilised) NiTi arch wire
Population: People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Time to alignment | Time to alignment: not reported | 0 studies | No studies |
Pain day 1 3 to 7 days | MD 0.29 [-0.52, 1.10] 0.29 [-0.52, 1.10] mm (VAS; superelastic higher) | 2 studies · 142 participants | Low Downgraded: risk of bias, imprecision |
Time to next/working arch wire | MD 0.40 [-0.10, 0.90] | 1 study · 88 participants | Ungraded |
Root resorption | Root resorption: not reported | 0 studies | No studies |
Alignment rate 5 to 10 weeks | Conventional NiTi vs superelastic NiTi (O'Brien 1990; Ong 2011); not pooled due to clinical heterogeneity; little or no difference in alignment rate | 2 studies · 124 participants | Low Downgraded: risk of bias, imprecision |
Thermoelastic copper NiTi (CuNiTi) arch wire vs Conventional NiTi arch wire
Population: People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain | Pain: not reported | 0 studies | No studies |
Alignment rate 4 weeks | MD 0.10 [-0.95, 1.15] 0.10 [-0.95, 1.15] mm/4 weeks (CuNiTi faster) | 1 study · 66 participants | Very low Downgraded: risk of bias, imprecision |
Time to next/working arch wire | MD 0.00 [-0.51, 0.51] | 1 study · 86 participants | Ungraded |
Time to alignment (alignment rate ratio) 6 months | HR 1.30 [0.68, 2.50] | 1 study · 60 participants | Low Downgraded: imprecision |
Root resorption | Root resorption: not reported | 0 studies | No studies |
Single-strand superelastic NiTi arch wire vs Coaxial superelastic NiTi arch wire
Population: People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Time to alignment | Time to alignment: not reported | 0 studies | No studies |
Time to next/working arch wire | No studies reported time to next/working arch wire | 0 studies | No studies |
Alignment rate 4 weeks | MD -2.64 [-4.61, -0.67] -2.64 [-4.61, -0.67] mm/4 weeks | 2 studies · 64 participants | Moderate Downgraded: imprecision |
Pain | Pain: not reported | 0 studies | No studies |
Root resorption | Root resorption: not reported | 0 studies | No studies |
Superelastic NiTi arch wire vs Thermoelastic NiTi arch wire
Population: People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Time to next/working arch wire | MD 0.40 [-0.11, 0.91] | 1 study · 86 participants | Ungraded |
Time to alignment 16 weeks | MD 0.5 [0.21, 0.79] 0.5 [0.21, 0.79] months | 1 study · 32 participants | Low Downgraded: risk of bias, imprecision |
Root resorption (reduction in root length) 16 weeks | MD -0.05 [-0.14, 0.04] -0.05 [-0.14, 0.04] mm (root length reduction) | 2 studies · 52 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Alignment rate 4 to 16 weeks | MD -0.28 [-0.62, 0.06] -0.28 [-0.62, 0.06] mm/4 weeks | 5 studies · 183 participants | Low Downgraded: risk of bias, imprecision |
Pain day 1 7 days | MD 6.96 [1.82, 12.10] 6.96 [1.82, 12.10] mm (VAS) | 3 studies · 94 participants | Moderate Downgraded: imprecision |
NiTi arch wire of one cross-sectional size vs NiTi arch wire of a different cross-sectional size
Population: People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Root resorption | Root resorption: not reported | 0 studies | No studies |
Pain 7 days | Different sizes of NiTi wires (Alhaija 2021; Erdinc 2004); not pooled due to clinical heterogeneity; little or no difference at day 1. Erdinc 0.014 vs 0.016 inch higher pain at day 4 MD 5.00 (0.19 to 9.81) and day 6 MD… | 2 studies · 149 participants | Low Downgraded: risk of bias, imprecision |
Time to next/working arch wire | No studies reported time to next/working arch wire | 0 studies | No studies |
Time to alignment | Time to alignment: not reported | 0 studies | No studies |
Alignment rate | Alignment rate: not reported | 0 studies | No studies |
Coated superelastic NiTi wire (BioCosmetic, Titanol, TP Aesthetic or Tooth Tone) vs A different coated superelastic NiTi wire
Population: People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Alignment rate 8 weeks | Four-arm study of different coated superelastic NiTi wires (Ulhaq 2017); reduction in LII over 8 weeks; no difference between the four groups (ANOVA P=0.627) | 1 study | Ungraded |
Superelastic NiTi arch wire vs Titanium-niobium-tantalum-zirconium (TiNbTaZr) arch wire
Population: People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Alignment rate 8 to 12 weeks | Superelastic NiTi (Sentalloy) vs TiNbTaZr (Gummetal) (Nordstrom 2018); LII change over 8 to 12 weeks; no clear difference (ANOVA P=0.6938) | 1 study · 28 participants | Ungraded |
Multistrand stainless steel wire vs Wires of other materials (conventional stainless steel, superelastic NiTi, thermoelastic NiTi)
Population: People receiving orthodontic treatment with fixed appliances (upper and/or lower full arch)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Alignment rate 6 weeks to 6 months | Multistrand StSt versus other materials (conventional StSt, superelastic NiTi, thermoelastic NiTi); alignment rate not pooled due to clinical heterogeneity (Cobb 1998; Evans 1998; Quintao 2005; West 1995); results… | 4 studies · 281 participants | Very low Downgraded: risk of bias, imprecision |
Time to alignment | Time to alignment: not reported | 0 studies | No studies |
Root resorption | Root resorption: not reported | 0 studies | No studies |