Alignment Efficiency and Discomfort of Three Orthodontic Archwire Sequences: A Randomized Clinical Trial

Abstract

Aim

To compare the efficiency of orthodontic archwire sequences produced by three manufacturers.

Design

Prospective, randomized clinical trial with three parallel groups.

Setting

Private orthodontic practice in Caloundra, QLD, Australia

Subjects and methods

One hundred and thirty‐two consecutive patients were randomized to one of three archwire sequence groups: (i) 3M Unitek, 0·014 inch Nitinol, 0·017 inch×0·017 inch heat activated Ni–Ti; (ii) GAC international, 0·014 inch Sentalloy, 0·016×0·022 inch Bioforce; and (iii) Ormco corporation, 0·014 inch Damon Copper Ni–Ti, 0·014×0·025 inch Damon Copper Ni–Ti. All patients received 0·018×0·025 inch slot Victory Series^TM brackets.

Outcome measures

Mandibular impressions were taken before the insertion of each archwire. Patients completed discomfort surveys according to a seven‐point Likert Scale at 4 h, 24 h, 3 days and 7 days after the insertion of each archwire. Efficiency was measured by time required to reach the working archwire, mandibular anterior alignment and level of discomfort.

Results

No significant differences were found in the reduction of irregularity between the archwire sequences at any time‐point (T1: P = 0·12; T2: P = 0·06; T3: P = 0·21) or in the time to reach the working archwire (P = 0·28). No significant differences were found in the overall discomfort scores between the archwire sequences (4 h: P = 0·30; 24 h: P = 0·18; 3 days: P = 0·53; 7 days: P = 0·47). When the time‐points were analysed individually, the 3M Unitek archwire sequence induced significantly less discomfort than GAC and Ormco archwires 24 h after the insertion of the third archwire (P = 0·02). This could possibly be attributed to the progression in archwire material and archform.

Conclusions

The archwire sequences were similar in alignment efficiency and overall discomfort. Progression in archwire dimension and archform may contribute to discomfort levels. This study provides clinical justification for three common archwire sequences in 0·018×0·025 inch slot brackets.