En-masse retraction with a preformed nickel-titanium and stainless steel archwire assembly and temporary skeletal anchorage devices without posterior bonding

Jeong-Hyun Jee, Hyo-Won Ahn, Kyung-Won Seo, Seong-Hun Kim, Yoon-Ah Kook, Kyu-Rhim Chung, Gerald Nelson, Jeong-Hyun Jee, Hyo-Won Ahn, Kyung-Won Seo, Seong-Hun Kim, Yoon-Ah Kook, Kyu-Rhim Chung, Gerald Nelson

Abstract

Objective: To evaluate the therapeutic effects of a preformed assembly of nickel-titanium (NiTi) and stainless steel (SS) archwires (preformed C-wire) combined with temporary skeletal anchorage devices (TSADs) as the sole source of anchorage and to compare these effects with those of a SS version of C-wire (conventional C-wire) for en-masse retraction.

Methods: Thirty-one adult female patients with skeletal Class I or II dentoalveolar protrusion, mild-to-moderate anterior crowding (3.0-6.0 mm), and stable Class I posterior occlusion were divided into conventional (n = 15) and preformed (n = 16) C-wire groups. All subjects underwent first premolar extractions and en-masse retraction with pre-adjusted edgewise anterior brackets, the assigned C-wire, and maxillary C-tubes or C-implants; bonded mesh-tube appliances were used in the mandibular dentition. Differences in pretreatment and post-retraction measurements of skeletal, dental, and soft-tissue cephalometric variables were statistically analyzed.

Results: Both groups showed full retraction of the maxillary anterior teeth by controlled tipping and space closure without altered posterior occlusion. However, the preformed C-wire group had a shorter retraction period (by 3.2 months). Furthermore, the maxillary molars in this group showed no significant mesialization, mesial tipping, or extrusion; some mesialization and mesial tipping occurred in the conventional C-wire group.

Conclusions: Preformed C-wires combined with maxillary TSADs enable simultaneous leveling and space closure from the beginning of the treatment without maxillary posterior bonding. This allows for faster treatment of dentoalveolar protrusion without unwanted side effects, when compared with conventional C-wire, evidencing its clinical expediency.

Keywords: Anchorage; Orthodontic mini-implant; Orthodontic treatment; Tooth movement.

Conflict of interest statement

The authors report no commercial, proprietary, or financial interest in the products or companies described in this article.

Figures

Figure 1
Figure 1
Temporary skeletal anchorage device-dependent en-masse retraction mechanics. A and B, Biocreative therapy with conventional C-wires; note the bends and steps in the archwire. C and D, Biocreative therapy with preformed C-wires.
Figure 2
Figure 2
Temporary skeletal anchorage devices used in this study. A and B, Two-component C-implants. C and D, C-tubes.
Figure 3
Figure 3
Preformed C-wire fabrication. A, Bending of stainless steel (SS) archwire for the retraction hooks and soldering of the crimpable stop tubes. B, Insertion of nickel-titanium archwire into the tubes and contouring of the hooks for passive sliding according to the height of the C-tubes. C, Contouring of the remaining SS section. D, Final configuration of preformed C-wire.
Figure 4
Figure 4
(A) Bonded mesh-tube appliance (BMTA) on the mandibular arch. The BMTA is comprised of a 0.022-inch single tube on the mandibular second premolar connected to metal mesh on the mandibular first molar (B).
Figure 5
Figure 5
Soft tissue and skeletal cephalometric measurements. 1, Upper lip to E-line (UL to E-line); 2, lower lip to E-line (LL to E-line); 3, sella-nasion to palatal plane angle (SN-PP); 4, SN to anatomic occlusal plane angle (SN-Occ); 5, SN to mandibular plane angle (SN-MP); 6, pterygoid vertical plane to A point distance (PTV-A); 7, pterygoid vertical plane to B point distance (PTV-B); 8, lower anterior facial height (anterior nasal spine to menton; ANS-Me).
Figure 6
Figure 6
Dental cephalometric measurements. 1, Sellanasion to maxillary incisor angle (SN-U1); 2, SN to maxillary first molar angle (SN-U6); 3, mandibular plane to mandibular incisor angle (MP-L1); 4, mandibular plane to mandibular first molar angle (MP-L6); 5, pterygoid vertical plane to maxillary incisor tip distance (PTV-U1); 6, pterygoid vertical plane to maxillary first molar centroid distance (PTV-U6); 7, palatal plane to maxillary incisor tip distance (PP-U1); 8, palatal plane to maxillary first molar centroid distance (PP-U6); 9, mandibular lingual cortex to mandibular first molar centroid distance (LC-L6); 10, mandibular plane to mandibular incisor tip distance (MP-L1v); 11, mandibular plane to mandibular first molar centroid distance (MP-L6v).
Figure 7
Figure 7
Therapeutic progress with one preformed C-wire. A to C, Pretreatment. D to F, Immediately after bonding. G to I, Three months after treatment. J to L, Nine months after treatment. M to O, Fifteen months after treatment. P to R, Posttreatment (nineteen month after treatment).
Figure 8
Figure 8
Occlusal views showing relief of crowding and retraction of the maxillary anterior teeth. A, Immediately after bonding. B, Three months after bonding. C, Nine months after bonding. D, Fifteen months after bonding.
Figure 9
Figure 9
Lateral cephalograms and superimposed tracings. A, Pretreatment lateral cephalogram. B, Post-retraction lateral cephalogram. C, Superimposition of the pretreatment (solid line) and post-retraction (dotted line) tracings.

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