Evaluation of the efficiency of SmartArch, copper-NiTi, and NiTi archwires in resolving mandibular anterior crowding: A double-blinded randomized controlled trial

Abstract

BACKGROUND/OBJECTIVE: Resolution of crowding remains a chief concern for patients seeking orthodontic treatment. The choice of the initial aligning archwire is crucial for achieving treatment success. Nickel-titanium (NiTi) archwires have been the first choice since their introduction. Multi-force archwires are a recent development that claims to deliver optimal orthodontic force tailored to specific teeth. The aim of this study was to compare the clinical efficiency of SmartArch® archwires with conventional and thermoelastic NiTi. METHODOLOGY: Thirty-nine patients were randomly allocated into three groups (group 1: NiTi, group 2: Cu-NiTi, and group 3: SmartArch®). Only patients with Little’s irregularity index of >4 mm were included. Study models were fabricated at each time interval of four weeks (T0, T1, T2, and until decrowding). The reduction in the irregularity score was calculated and analyzed using the Shapiro-Wilk and Kolmogorov-Smirnov tests, the Kruskal-Wallis test, the Kaplan-Meier method to create a survival curve, and Mantel-Cox log-rank test to compare survival times. RESULTS: The Little’s irregularity index reduced with treatment in all patients, irrespective of the groups, with no significant difference (P = 0.467) in the reduction among the groups evaluated. On average, it took 10.77 ± 2.52 weeks for group 1, 11 ± 4.22 weeks for group 2, and 9.54 ± 2.6 weeks for group 3. Patients with rotated canines took a longer duration to achieve decrowding, irrespective of the archwires used. CONCLUSION: This study found no clinically significant difference in the efficiency of decrowding among the archwires. The study was approved by the Institutional Review Board and Institutional Ethical Committee (IGIDSIEC2021NRP13PGTHODO) and registered under the Clinical Trial Registry (CTRI/2021/09/036859) of India.

Keywords

• alignment
• cu-niti
• decrowding
• initial archwire
• lower anterior crowding
• mandibular anterior teeth
• multi-force archwire
• smartarch®