Yousef Nasrawi
Jordan University of Science and Technology
Title: Efficacy of lower arch leveling, lower incisors’ root resorption, and pain associated with the correction of curve of Spee using different orthodontic archwires: a randomized clinical trial.
Biography
Biography: Yousef Nasrawi
Abstract
Abstract
Objectives To compare between 3 archwires (AWs) for leveling curve of Spee (COS) in terms of efficacy of reduction, external apical root resorption (EARR), pain experienced, and the lower arch dimensional changes during COS leveling.
Trial design: Randomized clinical trial.
Setting: Jordan University of Science and Technology Postgraduate dental clinics.
Material and methods: Fifty-three subjects with COS > 5 mm were included in this study. The subjects were randomly divided into three groups based on the AW used: group 1, 0.017X0.025-inch stainless-steel (SS) AW; group 2, 0.019X0.025-inch SSAW; and group 3, 0.021X0.025-inch β-titanium (TMA) AW. The intervention was randomly allocated using the permuted random block size of 3 with a 1:1:1 allocation ratio. In the three groups, a 5-mm depth reverse COS was placed in the AWs. The following time points were defined for COS assessment: T1, before interventional leveling AW placement; and T2–T7, 1–6 months after interventional leveling AW placement. Records consisted of dental study models and periapical (PA) radiographs.
Pain scores were recorded using a visual analog scale. Patients were followed up on a monthly basis until COS < 1.5 mm.
Main outcome: measures COS depth reduction, lower incisors’ EARR, pain scores, and arch dimensional changes.
Results An overall reduction of 3.82 mm, 4.47 mm, and 3.85 mm of the depth of COS was achieved in groups 1, 2, and 3, respectively. The mean differences of 0.65 mm between groups 1 and 2 and 0.62 mm between groups 2 and 3 were significant at P < 0.05. Lower incisors’ EARR during leveling COS ranged from 0.68 to 0.72 mm, from 0.63 to 0.82 mm, and from 0.53 to 0.88 mm in groups 1, 2, and 3, respectively (P > 0.05). Higher pain scores were reported by group 2 subjects during the first 24 h. Arch length and width increased significantly in groups 2 and 3 (P < 0.05). In all groups, COS leveling was achieved by lower incisor intrusion and proclination and lower molar extrusion.
Conclusions: All investigated AWs were effective in leveling COS with minimal lower incisors’ EARR (< 1 mm). COS was leveled by lower incisors’ intrusion and proclination and lower molar extrusion. Pain scores were the highest in group 2 during the first 24 h.
Clinical relevance: The 3 investigated leveling AWs were effective for the leveling COS and at the same time safe on the roots of the lower anterior teeth.
References
1. Carcara S, Preston CB, Jureyda O (2001) The relationship between the curve of Spee, relapse, and the Alexander discipline. In Semin Orthod 7(2):90–99
2. Ahmed I, Nazir R, Erum G, Ahsan T (2011) Influence of malocclusion on the depth of curve of Spee. J Pak Med Assoc
61(11):1056–1059
3. Paes-Souza SA, Mara..n-V.squez GA, Galisteu-Luiz K, Ferreira DMTP, Maia LC, Nojima MDCG (2022) Is there variation in the depth of the curve of Spee in individuals with different dentoskeletal patterns? A systematic review with meta-analysis.
Eur J Orthod. https:// doi. org/ 10. 1093/ ejo/ cjab0 78
4. Proffit WR, Fields H, Sarver D (2007) Contemporary orthodontics. Mosby Elsevier St Louis 160:207–217
5. Burstone CR (1977) Deep overbite correction by intrusion. Am J Orthod 72(1):1–22
6. Parker CD, Nanda RS, Currier GF (1995) Skeletal and dental changes associated with the treatment of deep bite malocclusion. Am J Orthod Dentofacial Orthop 107(4):382–393
7. Bernstein RL, Preston CB, Lampasso J (2007) Leveling the curve of Spee with a continuous archwire technique: a longterm cephalometric study. Am J Orthod Dentofacial Orthop 131(3):363–371
8. Parker CD, Nanda RS, Currier GF (1995) Skeletal and dental changes associated with the treatment of deep bite malocclusion. Am J OrthodDentofacial Orthop 107(4):382-393
9. Marshall SD, Caspersen M, Hardinger RR, Franciscus RG, Aquilino SA, Southard TE (2008) Development of the curve of Spee. Am J Orthod Dentofacial Orthop 134(3):344–352
10. Cheon SH, Park YH, Paik KS, Ahn SJ, Hayashi K, Yi WJ, Lee SP (2008) Relationship between the curve of Spee and dentofacial morphology evaluated with a 3-dimensional reconstruction method in Korean adults. Am J Orthod Dentofacial Orthop 133(5):640-e7
11. Levander E, Malmgren O (1988) Evaluation of the risk of root resorption during orthodontic treatment: a study of upper incisors. Euro J Orthod 10(1):30–38
12. Mau.s CP, Nascimento RR, Vilella OD (2015) Severe root resorption resulting from orthodontic treatment: prevalence and risk factors. Dental Press J Orthod 20:52–58
13. Chiqueto K, Martins DR, Janson G (2008) Effects of accentuated and reversed curve of Spee on apical root resorption. Am J Orthod Dentofacial Orthop 133(2):261–268
14. Costopoulos G, Nanda R (1996) An evaluation of root resorption incident to orthodontic intrusion. Am J Orthod Dentofacial Orthop 109(5):543–548
15. Xiaoting LI, Yin T, Yangxi C (2010) Interventions for pain during fixed orthodontic appliance therapy: a systematic review. Angle Orthod 80(5):925–932