Curve of Spee: Speed of Leveling Using Different Orthodontic Archwires

Study Overview
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Brief Summary
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The objectives if this study was to evaluate the efficacy of 3 different rectangular archwires in the correction of the curve of Spee (COS), to record the time needed to level excessive COS in the mandibular arch using the 3 archwire sizes, to investigate the changes in intercanine and intermolar widths and arch length during leveling, to measure the arterio-posterior and vertical movement for the lower incisors and lower molars, to record pulpal blood flow and to detect the root resorption in the lower anterior teeth associated with leveling excessive COS using the 3 different archwires.

Detailed Description
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Fifty one subjects with an excessive COS were included in this study. The subjects will be randomly divided into three groups; Group one (17 patients): leveling of COS using 0.017X0.025-inch stainless steel archwire. Group two (17 patients): leveling of COS using 0.019X0.025-inch stainless steel archwire. Group three (17 patients): leveling of COS using 0.021X0.025-inch Titanium molybdenum archwire. In the three groups, a 5mm depth reverse COS will be inserted. Records consisted of lateral cephalograms (pre-treatment, at T0 and post-treatment), peri-apical radiographs (at T0 and at T5), study casts (pre-treatment and at each time point during the tudy). Patients will be followed up on monthly visits without removing leveling archwires where alginate impressions were taken for the lower arch. Pain scores during the first week of leveling will be recorded using visual analogue scale (VAS).The amount of COS correction in mm, changes in intercanine in mm, intermolar and arch length in mm, pain scores and lower incisors root resorptions in mm will be measured.

Official Title
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Curve of Spee: Speed of Leveling Using Different Orthodontic Archwire Size and Material - A Randomized Clinical Trial

Conditions
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Orthodontic Treatment

Intervention / Treatment
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* Procedure: 0.017X0.025 Stainless steel
* Procedure: 0.019X0.025 Stainless steel
* Procedure: 0.021X0.025 B-Titanium archwire


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 16 years and ≤ 30 years Overbite covering more than half of the lower incisor height Curve of Spee ≥ 4 millimeters Mild crowding in lower arch where non-extraction treatment is indicated. Normally inclined or retroclined lower incisors Averaged or reduced lower vertical height Good oral hygiene and healthy periodontium All permanent teeth are present except for the third molars Exclusion Criteria: Severe crowding in lower arch where extraction treatment is indicated. Missing permanent molars or Premolars Poor oral hygiene and Periodontal disease Systemic health problems and medications were taken History of previous orthodontic treatment Smoking

Ages Eligible for Study
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Minimum Age: 16 Years
Maximum Age: 30 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Leveling of the curve of Spee
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 0.017X0.025 Stainless Steel Archwire<br>Leveling of COS using 0.017X0.025 Stainless Steel (SS) Archwire A reverse COS using 0.017X0.025 SS was used to correct the excessive COS in the lower arch. | Procedure: 0.017X0.025 Stainless steel<br>* Leveling curve of Sppe using 0.017X0.025 SS archwire<br>|
| Experimental: 0.019X0.025 Stainless Steel Archwire<br>A reverse COS using 0.019X0.025 SS was used to correct the excessive COS in the lower arch. | Procedure: 0.019X0.025 Stainless steel<br>* Leveling curve of Sppe using 0.019X0.025 Stainless steel archwire<br>|
| Experimental: 0.021X0.025 TMA archwire<br>A reverse COS using 0.021X0.025 TMA archwire was used to correct the excessive COS in the lower arch. | Procedure: 0.021X0.025 B-Titanium archwire<br>* Leveling curve of Sppe using 0.019X0.025 B-Titanium archwire<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Curve of Spee depth changes during leveling | The change in Curve of Spee in millimetres | 4 to 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain perception | A10-point visual analogue scale of 10 cm length where 0 indicate no pain and 10 indicate intolerable pain | one week | 
| Root Resorption | change in root length in millimeters | 6 months | 
| Pulpal blood flow | Change in blood flow using laser flowmetry | one month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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root resorption, pain, pulpal blood flow