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Alignment Efficiency and Coating Durability of Aesthetic Archwires

Date:

Node: 422801

Studies

Study First Submitted Date 2019-03-10
Study First Posted Date 2019-03-15
Last Update Posted Date 2021-05-11
Start Month Year October 2, 2017
Primary Completion Month Year January 31, 2020
Verification Month Year May 2021
Verification Date 2021-05-31
Last Update Posted Date 2021-05-11

Detailed Descriptions

Sequence: 20709243
Description The development of superelastics nickel titanium (SE NiTi) has overcome problems with previous aligning archwires. This archwire is deemed to be the gold standard aligning archwire for Straight Wire® system due to its shape memory effect, high elasticity and low permanent deformation which delivers continuous force for orthodontic tooth alignment. The only drawbacks of this wire type are it is expensive, have high frictional resistance (Kapila et al., 1990) and is associated with hypersensitivity reaction in nickel allergic patients (Bass et al., 1993).

Development of teflon or polytetrafluoroethylene (PTFE) which is anti-adherent and possesses aesthetic property had been used as orthodontic bracket, archwire and ligature coating. This polymer consists of synthetic fluorine-containing resin or epoxy resin composed mainly of polytetrafluoroethylyene to simulate tooth colour. The polymeric chain with good mechanical stability had been shown to reduce the frictional resistance between bracket-archwire interface and when used as archwire ligature (Farronato et al., 2012, De Franco et al., 1995). PTFE-coated brackets were reported to minimise the formation of biofilm during treatment which can reduce the risk of enamel decalcification (Demling et al., 2010). Furthermore, the coated aesthetic archwires have potential to obviate any allergic reaction during orthodontic treatment in patients with known hypersensitivity to nickel alloy.

Manufacturers have claimed that the aesthetic archwires available in the market have good color stability (remains unchanged for 6 to 8-week duration), good coating durability and low friction, allowing faster tooth movement. However, to our experience, these claims are the opposite.

As these aesthetic archwires are much more expensive than the conventional superelastic nickel titanium, it is therefore important to establish a clinical data to allow clinicians and patients to make a justifiable choice on treatment and develop further research in this area.

Facilities

Sequence: 199956380 Sequence: 199956381 Sequence: 199956382
Name School of Dental Sciences Name Advanced Medical & Dental Institute Name Desa Murni Dental Clinic
City Kubang Kerian City Kepala Batas City Permatang Pauh
State Kelantan State Penang State Penang
Zip 16150 Zip 13200 Zip 13500
Country Malaysia Country Malaysia Country Malaysia

Conditions

Sequence: 52137101
Name Tooth Movement
Downcase Name tooth movement

Id Information

Sequence: 40133619
Id Source org_study_id
Id Value USM/JEPeM/17010022

Countries

Sequence: 42541178
Name Malaysia
Removed False

Design Groups

Sequence: 55557222 Sequence: 55557223 Sequence: 55557224 Sequence: 55557225
Group Type Experimental Group Type Experimental Group Type Experimental Group Type Active Comparator
Title RMO FLi® Tooth-coloured superelastic Nickel Titanium Title G&H G4 Tooth-coloured superelastic Nickel Titanium Title Orthocare Euroform® Cosmetic Tooth-coloured superelastic Nickel Titanium Title Conventional superelastic Nickel Titanium
Description This group has been allocated with upper and lower round 0.014" RMO FLi® Tooth-coloured superelastic Nickel Titanium aesthetic archwires for a duration of 8 weeks. Description This group has been allocated with upper and lower round 0.014" G&H G4 Tooth-coloured superelastic Nickel Titanium aesthetic archwires for a duration of 8 weeks. Description This group has been allocated with upper and lower round 0.014" Orthocare Euroform® Cosmetic Tooth-coloured superelastic Nickel Titanium aesthetic archwires for a duration of 8 weeks. Description This group has been allocated with conventional upper and lower round 0.014" superelastic Nickel Titanium archwires for a duration of 8 weeks.

Interventions

Sequence: 52453021 Sequence: 52453022
Intervention Type Other Intervention Type Other
Name Aesthetic archwires Name Control group
Description During bond-up, randomly allocated envelope will be opened and archwires will be ligated with elastomeric ligatures.After 4 weeks,the same archwires will be retied.Any fractured archwire will be recorded and discarded.The fractured wire will be replaced with conventional archwire and treatment continues.On the 2nd follow-up (at 8th week), the tested wires are collected, disinfected, dried and placed back in the allocated envelope.Upper and lower impressions will be taken.Questionnaires will be answered by participants.The trial ends and treatment continues as planned.Fractured archwire will be recorded and discarded. Description During bond-up, randomly allocated envelope will be opened and archwires will be ligated with elastomeric ligatures.After 4 weeks,the same archwires will be retied.Any fractured archwire will be recorded and discarded.The fractured wire will be replaced with conventional archwire and treatment continues.On the 2nd follow-up (at 8th week), the tested wires are collected, disinfected, dried and placed back in the allocated envelope.Upper and lower impressions will be taken.This group will not answer the questionnaire.The trial ends and treatment continues as planned.Fractured archwire will be recorded and discarded.

Keywords

Sequence: 79819858 Sequence: 79819859 Sequence: 79819860 Sequence: 79819861 Sequence: 79819862
Name tooth alignment Name coating loss Name color change Name patient perception Name aesthetic archwire
Downcase Name tooth alignment Downcase Name coating loss Downcase Name color change Downcase Name patient perception Downcase Name aesthetic archwire

Design Outcomes

Sequence: 177257785 Sequence: 177257786 Sequence: 177257787 Sequence: 177257788
Outcome Type primary Outcome Type secondary Outcome Type secondary Outcome Type secondary
Measure Alignment efficiency Measure Coating loss Measure Color change Measure Participant perception towards aesthetic archwires
Time Frame 8 weeks Time Frame 8 weeks Time Frame 8 weeks Time Frame 8 weeks
Description The tooth irregularity between pre- and post-experiment dental casts are measured in millimetres. The difference between the two measurement will be calculated in percentage. Description The amount of coating loss between the used and unused archwires will be measured in percentage. Description The difference in colour (colour change) between used and unused archwires will be measured in CIE L* a* b* colour space units. Description Patient perception will be assessed using oral aesthetic subjective impact scale (OASIS) questionnaires after the use of aesthetic archwires (at week 8). The cumulative score will be used to determine the perception (14 and below = positive perception; 15 and above = negative perception).

Sponsors

Sequence: 48288918
Agency Class OTHER
Lead Or Collaborator lead
Name Universiti Sains Malaysia

Overall Officials

Sequence: 29267217
Role Principal Investigator
Name Anis F Kamaruddin, MOrth
Affiliation Advanced Medical & Dental Institute

Design Group Interventions

Sequence: 68105028 Sequence: 68105029 Sequence: 68105030 Sequence: 68105031
Design Group Id 55557223 Design Group Id 55557224 Design Group Id 55557222 Design Group Id 55557225
Intervention Id 52453021 Intervention Id 52453021 Intervention Id 52453021 Intervention Id 52453022

Eligibilities

Sequence: 30746590
Gender All
Minimum Age 11 Years
Maximum Age N/A
Healthy Volunteers Accepts Healthy Volunteers
Criteria Inclusion Criteria:

Patient aged 11 years old and above in permanent dentition with all teeth from upper and lower 6 – 6 are present, tooth apices are closed
Patients who require complete bond-up with upper and lower pre-adjusted edgewise bracket system, MBT prescription with bracket slot size 0.022"
Able to give consent* *Assent form is required for children below 18 years of age

Exclusion Criteria:

Patients with cleft lip and palate and other craniofacial deformities and syndromes
Patients with medical problems / medications that can influence rate of tooth movement
Teeth blocked out of the arch / ectopic teeth not allowing bracket placement and ligation at bond-up
Hypodontia with more than one tooth missing in any quadrant
Have had orthodontic treatment before

Adult True
Child True
Older Adult True

Calculated Values

Sequence: 254113533
Number Of Facilities 3
Registered In Calendar Year 2019
Actual Duration 28
Were Results Reported False
Has Us Facility False
Has Single Facility False
Minimum Age Num 11
Minimum Age Unit Years
Number Of Primary Outcomes To Measure 1
Number Of Secondary Outcomes To Measure 3

Designs

Sequence: 30492875
Allocation Randomized
Intervention Model Parallel Assignment
Observational Model
Primary Purpose Treatment
Time Perspective
Masking Quadruple
Masking Description The participants will select only one sealed envelope containing the archwires which has been labelled and coded without looking at other archwires. Both operators and participants are not informed of the brands of the coated archwires. The statistician will analyse the data based on the assigned codes. The codes will be broken by the principal investigator after the results have been produced.
Subject Masked True
Caregiver Masked True
Investigator Masked True
Outcomes Assessor Masked True

Responsible Parties

Sequence: 28859164
Responsible Party Type Principal Investigator
Name Anis Kamaruddin
Title Principal investigator
Affiliation Universiti Sains Malaysia

Study References

Sequence: 52030656 Sequence: 52030657 Sequence: 52030658 Sequence: 52030659 Sequence: 52030660
Pmid 8456786 Pmid 2378317 Pmid 21478301 Pmid 20139131 Pmid 7726464
Reference Type background Reference Type background Reference Type background Reference Type background Reference Type background
Citation Bass JK, Fine H, Cisneros GJ. Nickel hypersensitivity in the orthodontic patient. Am J Orthod Dentofacial Orthop. 1993 Mar;103(3):280-5. doi: 10.1016/0889-5406(93)70009-D. Citation Kapila S, Angolkar PV, Duncanson MG Jr, Nanda RS. Evaluation of friction between edgewise stainless steel brackets and orthodontic wires of four alloys. Am J Orthod Dentofacial Orthop. 1990 Aug;98(2):117-26. doi: 10.1016/0889-5406(90)70005-W. Citation Farronato G, Maijer R, Caria MP, Esposito L, Alberzoni D, Cacciatore G. The effect of Teflon coating on the resistance to sliding of orthodontic archwires. Eur J Orthod. 2012 Aug;34(4):410-7. doi: 10.1093/ejo/cjr011. Epub 2011 Apr 8. Citation Demling A, Elter C, Heidenblut T, Bach FW, Hahn A, Schwestka-Polly R, Stiesch M, Heuer W. Reduction of biofilm on orthodontic brackets with the use of a polytetrafluoroethylene coating. Eur J Orthod. 2010 Aug;32(4):414-8. doi: 10.1093/ejo/cjp142. Epub 2010 Feb 5. Citation De Franco DJ, Spiller RE Jr, von Fraunhofer JA. Frictional resistances using Teflon-coated ligatures with various bracket-archwire combinations. Angle Orthod. 1995;65(1):63-72; discussion 73-4. doi: 10.1043/0003-3219(1995)0652.0.CO;2.

Ipd Information Types

Sequence: 3331316 Sequence: 3331317
Name Statistical Analysis Plan (SAP) Name Informed Consent Form (ICF)