original article

Evaluation of conformity of preformed orthodontic

archwires and dental arch form
Maheen Ahmed1, Attiya Shaikh2, Mubassar Fida3

DOI: https://doi.org/10.1590/2177-6709.24.1.044-052.oar

Introduction: The alterations in the arch form during treatment are dictated by the dimensions of the archwires. Objective:
This study aimed to determine the mean arch dimensions of a sample of Pakistani subjects and to evaluate the conformity
of preformed archwires with mandibular arch form. Methods: The dental records of 1,500 adult subjects were evaluated.
The mandibular casts of 42 subjects (males = females = 21) with balanced facial profile, Class I occlusion, ideal overjet and
overbite were included. Brackets were bonded on all teeth. Arch dimensions were evaluated at canines, first premolars, second
premolars, first and second molars, with digital vernier calipers. The arch widths at the level of aforementioned teeth were eval-
uated on the digitized archwires, using the mean arch depths of the subjects. Results: In males, the archwires were found to be
wider at canines and premolars, and significantly narrower at first (p < 0.001, 95% CI = 2.03 - 5.74) and second molars (p < 0.001,
95% CI = 2.29 - 7.73) as compared to the arch dimensions of the mandibular casts. In females, the archwires were significantly
narrower at canines (p < 0.001, 95% CI = 1.4 - 3.97), and first (p = 0.02, 95% CI = 0.402 - 4.41) and second molars (p < 0.001,
95% CI = 1.76 - 6.13).Conclusion: No single commercially available archwires evaluated in the present study conformed to
the arch dimensions of our subjects. Utilization of the currently available archwires may result in unwarranted modification of
arch form, which may lead to unstable post-treatment teeth position.

Keywords: Orthodontic wire. Relapse. Stability.

Introdução: as alterações no formato da arcada dentária durante o tratamento são ditadas pelas dimensões do arco ortodôntico.
Objetivo: o presente estudo teve como objetivos determinar a dimensão média das arcadas dentárias de pacientes paquistaneses
e avaliar a conformidade entre diferentes arcos ortodônticos pré-fabricados e o formato da arcada inferior. Métodos: os registros
odontológicos de 1.500 pacientes adultos foram analisados e, desses, foram selecionados modelos de gesso de 42 pacientes (21
de cada sexo, masculino e feminino) com perfil facial equilibrado, Classe I de Angle, sobressaliência e sobremordida adequadas.
Foram, então, colados braquetes ortodônticos em todos os dentes. Utilizando um paquímetro digital, as dimensões das arcadas
foram avaliadas nos seguintes dentes: caninos, primeiros pré-molares, segundos pré-molares, primeiros e segundos molares.
Utilizando-se a profundidade média das arcadas dos pacientes, as larguras das arcadas, no nível dos dentes acima mencionados,
foram comparadas aos arcos ortodônticos digitalizados. Resultados: nos homens, a largura do arco ortodôntico, em compa-
ração às dimensões dos modelos de gesso inferiores, foi maior nos caninos e pré-molares e significativamente menor nos pri-
meiros molares (p < 0,001, IC 95% = 2,03 - 5,74) e segundos molares (p < 0,001, IC 95% = 2,29 - 7,73). Nas mulheres, os arcos
ortodônticos foram significativamente mais estreitos nos caninos (p < 0,001, IC 95% = 1,4 - 3,97), primeiros molares (p = 0,02,
IC 95% = 0,402 - 4,41) e segundos molares (p < 0,001, IC 95% = 1,76 - 6,13). Conclusão: nenhum dos arcos ortodônticos co-
mercialmente disponíveis avaliados no presente estudo esteve em conformidade com as dimensões das arcadas dos pacientes da
amostra. O uso dos arcos ortodônticos atualmente disponíveis pode resultar em modificações indesejáveis no formato da arcada,
e pode levar à instabilidade na posição dos dentes após o tratamento.

Palavras-chave: Arco ortodôntico. Recidiva. Estabilidade.

1
Bakhtawer Amin Medical and Dental College (Multan, Pakistan). How to cite: Ahmed M, Shaikh A, Fida M. Evaluation of conformity of pre-
2
Liaquat College of Dentistry (Karachi, Pakistan). formed orthodontic archwires and dental arch form. Dental Press J Orthod. 2019
3
The AgaKhan University Hospital, Department of Surgery, Section of Jan-Feb;24(1):44-52.
Dentistry (Karachi, Pakistan). DOI: https://doi.org/10.1590/2177-6709.24.1.044-052.oar

Submitted: May 04, 2017 - Revised and accepted: October 25, 2017
» The authors report no commercial, proprietary or financial interest in the products
or companies described in this article. Contact address: Maheen Ahmed (BDS, FCPS-Orthodontics), Registrar-
Orthodontics, Bakhtawer Amin Medical and Dental College, Multan, Pakistan
Email: [email protected]

© 2019 Dental Press Journal of Orthodontics 44 Dental Press J Orthod. 2019 Jan-Feb;24(1):44-52
Ahmed M, Shaikh A, Fida M original article

INTRODUCTION in males and females of a sample of Pakistani subjects.

Relapse of the corrected malocclusion, being one These mean arch dimensions were further used to
of the biggest dilemmas of orthodontic treatment, has identify the commercially preformed archwires cur-
consistently been a topic of discussion in the orth- rently available in Pakistan that best conform to the
odontic literature. A review of the literature showed arch dimensions of these subjects.
that only 30% of the treated cases retained their
alignment ten years post retention, which is further MATERIAL AND METHODS
reduced to only 20% at the time of the twenty years The study was conducted on the mandibular casts
follow up.1 Freitas et al2 reported a mean mandibular of 42 adult subjects (males = 21; females = 21) aged
crowding of 1.96 mm (26.54%) over long term dur- 18-30 years meeting the following inclusion criteria:
ing the post-retention phase. Factors that may affect well-balanced facial profile, Class I molar, canine and
relapse include the continued growth of jaws, severity incisor relationship, and an ideal overjet and overbite.
of original malocclusion, incisor position, arch form Subjects with any dental prosthesis, arch length dis-
and mode of retention.3 Amongst these, the modifi- crepancy greater than 2 mm or history of facial/dental
cation of original arch form during orthodontic treat- trauma were excluded.
ment is considered to be one of the most common The sample size was calculated using the findings
causes of relapse.4,5 of Jonathan et al,14 who reported a mean canine width
The dental arch form is initially shaped by the of 35.22 ± 1.54 mm in males and 33.49 ± 1.49 mm in
configuration of the supporting bone. After the erup- females. Keeping α = 0.05 and power of the study as
tion of teeth, it is further modified by the surround- 90 %, a sample size of 17 subjects in each group was
ing musculature and functional forces.6 If this arch required. This number was inflated to 21 subjects
form is altered during orthodontic treatment, there is in each group. This resulted in a total sample of 42
a tendency for it to return to its pretreatment shape. subjects. The dental records of 1,500 adult patients
Various studies have reported the return of the ca- with complete dentition (excluding third molars)
nine and molar widths to pretreatment position dur- presenting to the dental clinics at a tertiary care hos-
ing the post-retention phase if the original arch form pital and university were evaluated to finally obtain
is modified.7-10 Hence, the maintenance of original the sample of 42 subjects meeting the aforemen-
arch form rather than arch modification is generally tioned inclusion criteria.
recommended to reduce the relapse tendency.
The modern straight-wire appliance consists of Determination of arch form dimensions of
brackets with built-in prescriptions and archwires. subjects without bracket-archwire assembly
The archwires come in various sizes and shapes, ac- A sharply trimmed lead pencil (Staedtler HB,
cording to different manufacturers’ specifications. Nürnberg, Germany) was used to mark the facial
These wires are designed according to the mean arch axis (FA) points on all the teeth, with the aid of a
dimensions derived from a specific population. When bracket positioning gauge (3M Unitek, Monrovia,
a particular form of archwire is used, the existing arch Calif). The marked points were remeasured to avoid
form of an individual is altered to match the shape of any discrepancy. A plastic transparent ruled grid was
that particular wire. Moreover, the arch form tends then placed on each mandibular cast. The purpose
to differ among various ethnic and age groups.11,12 As was to provide a stable base to place the measuring
the dental arch form may vary due to aforementioned instrument, and grids served as guidelines to avoid
reasons, there is no consensus on the ideal shape and measurement errors, especially when measuring the
size of the archwire. Further, the majority of the arch depths. A digital vernier caliper (Mitutoyo, Ka-
commercially available archwires are manufactured in wasaki, Japan) was used to perform the following lin-
USA, China and other countries according to their ear measurements:
population standards.13 Therefore, it is critical to se- 1. Arch width: Canine (IC), first premolar (IP1),
lect the appropriate archwire form for each case. The second premolar (IP2), first molar (IM1) and second
present study aimed to determine the arch dimensions molar (IM2) widths, measured as the distance between

© 2019 Dental Press Journal of Orthodontics 45 Dental Press J Orthod. 2019 Jan-Feb;24(1):44-52
original article Evaluation of conformity of preformed orthodontic archwires and dental arch form

the FA points on canines, first premolars, second pre- Canon flatbed scanner (CanoScan LiDE 210). In or-
molars, first molars and second molars, respectively. der to minimize the magnification error, a millime-
2. Arch depth: Canine, first premolars, second ter ruler was placed along with the archwires during
premolars, first molars and second molars widths, scanning. The Adobe Photoshop software (version
measured as the perpendicular distance from the 7.0, Photoshop, Adobe, San Jose, Calif) was further
midway point between the line connecting the FA used to deduce any magnification error. The mean
points on the central incisors and the line connecting canine, first premolar, second premolar, first molar
the FA points on the respective teeth. and second molar depths as measured from the man-
dibular casts of 42 subjects were used as reference to
Determination of arch form dimensions of sub- measure the canine (CW), first premolar (PW1), sec-
jects with bracket-archwire assembly ond premolar (PW2), first molar (MW1) and second
The metal brackets (Roth 0.022 x 0.028-in slot; molar  (MW2) widths on the archwires. The Adobe
3M Unitek, Monrovia, Calif) were then bonded on Photoshop software was used for the measurements
teeth of all the mandibular casts by the main inves- on the digitized archwires (Fig 2). The readings were
tigator on the FA points. These brackets were tied rounded off to two decimal points. All the measure-
with elastomeric ligatures to a 0.017 x 0.025-in stain- ments on the casts and archwires were repeated twice
less steel (SS) wire (3M Unitek, Monrovia, Calif). to rule out any measurement error.
The aforementioned wire size was used as all the com-
mercially available archwires evaluated in the cur- Statistical analysis
rent study were of the same dimension. The  brack- Ten dental casts and archwires were randomly se-
et axis  (BA) point was determined as the middle of lected and remeasured by the main investigator to de-
the archwire slot, in line with the FA point on each termine the intraexaminer reliability (Table 2). The re-
tooth. The following linear measurements were then sult showed a high correlation between the two sets of
made (Fig 1): readings. The archwires were scanned and arch dimen-
1. Arch width: Canine (CW), first premolar sions were evaluated using Adobe Photoshop software.
(PW1), second premolar (PW2), first molar (MW1), Ten archwires were randomly selected and were manu-
second molar (MW2) widths, measured as the dis-
tances between BA points on canines, first premo-
lars, second premolars, first molars and second mo-
lars, respectively.
2. Arch depth: Canine (CD), first premolar (PD1),
second premolar (PD2), first molar (MD1) and sec-
ond molar (MD2) depths, measured as the perpen-
dicular distance from the point midway on the arch-
1 2 3 4 5
wire between the line connecting the BA points on
the central incisors and the line connecting the BA
points on the respective teeth. Canine Depth

First Premolar Depth

Determination of arch width of commercially
available preformed archwires Second Premolar depth

A total of 15 different archwires from 6 different

manufacturers of 5 shapes were analyzed (Table 1). First Molar Depth
The archwires included in the study were the ones
that are commonly being used at various orthodon- Second Molar Depth
tic centers in Pakistan. To reduce the risk of bias,
all the archwires were given a specific code prior to
Figure 1 - Variables measured on mandibular cast with bracket-archwire as-
the analysis. These archwires were scanned using a sembly.

© 2019 Dental Press Journal of Orthodontics 46 Dental Press J Orthod. 2019 Jan-Feb;24(1):44-52
Ahmed M, Shaikh A, Fida M original article

Table 1 - Shapes of arch wires and manufacturer.

Bonewill-Hawley Ovoid Tapered Square Brader

Shape

All Star Ortho Organizer Ortho Organizer Ortho Organizer Orthoclassic

Orthocare Orthoclassic 3M Orthoclassic All Star
Brand
3M 3M Dentsply
All Star Orthocare

The arch dimensions as measured from BA point

Canine Depth
with the bracket-archwire assembly were com-
1 pared between the two genders (Table 4). The CD
First Premolar Depth
(p = 0.035, 95% CI = 0.181 - 1.77) and MW1 (p < 0.033,
2
Second Premolar depth 95% CI = 0.685 - 3.25) showed significant differences.
3
First Molar Depth In males, the mean CW (p = 0.030, 95% CI  =
4 0.027  - 
0.034) and PW1 (p  = 0.039, 95% CI =
Second Molar Depth 0.033 - 0.040) as measured on the preformed arch-
5
wires were found to be wider as compared to the
mean arch widths of the subjects included in the
study. In  contrast, the mean MW1 (p < 0.001,
95% CI  =  2.03 - 5.74) and MW2 (p < 0.001, 95%
CI  =  2.29 - 7.73) were found to be narrower (Ta-
ble 5). The comparison of each individual preformed
Figure 2 - Variables measured on preformed archwires using mean arch
depths as measured on mandibular cast.
archwire with the mean arch width of the mandibular
cast in male subjects is shown in Figure 3.
In females, the mean CW (p < 0.001,
95% CI  =  1.4  - 3.97), MW1 (p = 0.02, 95%
ally measured by hand using a digital vernier calliper. CI  =  0.402  - 
4.41) and MW2 (p < 0.001, 95%
The same archwires were then remeasured on Adobe CI  =  1.76 - 6.13) of the preformed archwires was
Photoshop software, to determine the absolute error found to be narrower as compared to the mean arch
(Table 2). The Shapiro-Wilk test was used to check widths of the subjects (Table 5). Different archwires
the normality of the data, and showed a non-normal were then compared individually with the mean arch
distribution. The Mann-Whitney U test was used to dimensions of the mandibular arch in both males
compare the mean arch dimensions between genders. and females separately (Figs 3 and 4). In the cur-
The  same statistical analysis was used to compare the rent study, the Brader archwire shape in both males
mean arch widths of the mandibular arch and archwires. and females most closely conformed to the mean
canine width of our subjects. The narrow shape of
RESULTS archwires, i.e. Bonewill-Hawley, ovoid and tapered
The mean arch dimensions as measured from the forms, more closely conformed to the first premo-
FA point without the bracket wire assembly on the lar width in males and females, respectively. In the
mandibular casts are shown in Table 3. All the arch second premolar, first molar and second molar re-
dimensions were found to be larger in males as com- gion, arch forms like square, ovoid and Brader more
pared to the females. closely matched our subjects.

© 2019 Dental Press Journal of Orthodontics 47 Dental Press J Orthod. 2019 Jan-Feb;24(1):44-52
original article Evaluation of conformity of preformed orthodontic archwires and dental arch form

Table 2 - Intra-examiner reliability.

First reading Second reading

Parameter (n=10) (n=10) Mean difference ± SD P-value** ICC
Mean ± SD (mm) Mean ± SD (mm)
Arch width measurements made on dental casts
Canine Width 29.88 ± 2.20 29.95 ± 2.21 0.01 ± 0.33 0.926 0.987
First Premolar Width 41.19 ± 2.70 40.90 ± 2.70 0.09 ± 0.46 0.556 0.964
Second Premolar Width 42.94 ± 2.60 42.60 ± 2.50 0.02 ± 0.63 0.922 0.987
First Molar Width 49.67 ± 2.83 50.00 ± 2.94 0.17 ± 0.73 0.484 0.940
Second Molar Width 53.00 ± 2.69 53.50 ± 2.71 0.09 ± 0.78 0.737 0.989
Archwire measurements made on Adobe Photoshop
Canine Width 27.87 ± 2.11 27.88 ± 2.01 0.70 ± 0.36 0.553 0.987
First Premolar Width 39.85 ± 1.52 39.95 ± 1.85 0.29 ± 0.97 0.371 0.937
Second Premolar Width 45.56 ± 3.99 45.58 ± 3.70 0.34 ± 0.84 0.232 0.946
First Molar Width 53.43 ± 2.10 53.60 ± 2.11 0.33 ± 0.60 0.115 0.979
Second Molar Width 59.38 ± 5.32 59.47 ± 5.27 0.50 ± 0.35 0.06 0.991
Archwire measurements made by hand and then repeated on Adobe Photoshop
Canine Width 29.20 ± 1.94 27.87 ± 2.11 0.12 ± 0.51* 0.474 0.977
First Premolar Width 40.20 ± 2.44 39.85 ± 1.52 0.04 ± 0.74* 0.868 0.965
Second Premolar Width 42.33 ± 2.72 45.56 ± 3.99 0.61 ± 0.97* 0.077 0.935
First Molar Width 48.83 ± 2.98 53.43 ± 2.10 0.03 ± 0.87* 0.915 0.958
Second Molar Width 52.36 ± 2.61 59.38 ± 5.32 0.01 ± 0.64* 0.962 0.972

n = 10; SD = Standard Deviation; ICC = Intraclass Correlation Coefficient. *Mean absolute error. **Paired sample t-test.

Table 3 - Mean arch dimensions in males and females without bracket-archwire assembly.

Males (n = 21) Females (n = 21)

Parameter
Mean ± SD (mm) Mean ± SD (mm)
Intercanine Width (IC) 28.09 ± 2.16 28.23 ± 1.48
First Premolar Width (IP1) 37.64 ± 1.35 37.29 ± 1.73
Second Premolar Width (IP2) 43.8 ± 2.16 42.73 ± 2.25
First Molar Width (MW1) 50.73 ± 1.83 47.58 ± 5.75
Second Molar Width (MW2) 56.38 ± 4.13 54.93 ± 2.72
Canine Depth 6.46 ± 0.94 5.81 ± 0.75
First Premolar Depth 12.6 ± 2.04 11.96 ± 2.19
Second Premolar Depth 19.11 ± 2.22 18.98 ± 1.74
First Molar Depth 27.09 ± 2.12 26.01 ± 1.83
Second Molar Depth 38.47 ± 2.73 36.97 ± 2.88

n = 42; SD = Standard Deviation.

Table 4 - Comparison of arch dimension parameters between males and females with bracket-archwire assembly.

Males (n = 21) Females (n = 21) 95 % Confidence Interval

Parameter P-value
Mean ± SD (mm) Mean ± SD (mm) Lower limit Upper limit
Canine Width (CW) 28.54 ± 1.99 30.97 ± 1.85 0.206 -3.6 1.2
First Premolar Width (PW1) 40.24 ± 1.35 39.89 ± 1.73 0.614 -0.655 1.35
Second Premolar Width (PW2) 45.92 ± 3.73 45.78 ± 2.28 0.515 -1.81 2.11
First Molar Width (MW1) 54.04 ± 1.83 52.07 ± 2.18 0.033* 0.685 3.25
Second Molar Width (MW2) 58.67 ± 4.13 57.20 ± 2.72 0.394 -0.823 3.74
Canine Depth (CD) 5.97 ± 0.94 5.33 ± 0.74 0.035* 0.181 1.77
First Premolar Depth (PD1) 14.42 ± 2.04 13.77 ± 2.19 0.273 -0.726 2.02
Second Premolar Depth (PD2) 20.92 ± 2.33 20.79 ± 1.75 0.676 -1.13 1.4
First Molar Depth (MD1) 28.90 ± 2.12 27.82 ± 1.83 0.127 -0.172 2.34
Second Molar Depth (MD2) 40.28 ± 2.74 38.78 ± 2.89 0.053 -0.289 3.3

n = 42; SD = Standard Deviation. *p < 0.05, ** p < 0.01; Mann-Whitney U test.

© 2019 Dental Press Journal of Orthodontics 48 Dental Press J Orthod. 2019 Jan-Feb;24(1):44-52
Ahmed M, Shaikh A, Fida M original article

Table 5 - Comparison of arch width dimensions between preformed archwires and mandibular arch including bracket-archwire assembly.

Preformed archwire 95 % Confidence Interval

Mandibular arch
Gender Parameter (n = 15) P-value
(Mean ± SD) (mm) Lower limit Upper limit
(Mean ± SD) (mm)
Canine Width (CW) 28.54 ± 1.99 29.84 ± 2.07 0.030* 0.027 0.034
First Premolar Width (PW1) 40.24 ± 1.35 41.42 ± 2.84 0.039* 0.033 0.040
Male
Second Premolar Width (PW2) 45.92 ± 3.73 46.13 ± 3.31 0.874 -2.66 2.23
(n=21)
First Molar Width (MW1) 54.04 ± 1.83 50.15 ± 3.58 0.001* 2.03 5.74
Second Molar Width (MW2) 58.67 ± 4.13 53.66 ± 3.60 0.001* 2.29 7.73
Canine Width (CW) 30.97 ± 1.85 28.28 ± 1.86 < 0.001* 1.4 3.99
First Premolar Width (PW1) 39.89 ± 1.73 40.98 ± 2.84 0.077 -2.7 0.51
Female
Second Premolar Width (PW2) 45.78 ± 2.28 46.05 ± 3.31 0.571 -2.2 1.65
(n=21)
First Molar Width (MW1) 52.07 ± 2.18 49.66 ± 3.53 0.019* 0.402 4.41
Second Molar Width (MW2) 57.20 ± 2.72 53.26 ± 3.55 0.001* 1.76 6.13

n = 42; SD = Standard Deviation. *p < 0.05; ** p < 0.01; Man-Whitney U test.

A.
A.Canine
CanineWidth
Width B.
B.First
FirstPremolar
PremolarWidth
Width C.
C. Second
SecondPremolar
PremolarWidth
Width
a. Canine Depth b. First Premolar Depth c. Second Premolar depth

Ortho Organizer - ovoid

D. d. First
D.First
First Molar
Molar
Molar Depth
Width
Width e.
E.Second
E. Second MolarWidth
SecondMolar
Molar Depth
Width Ortho Organizer - tapered
Ortho Organizer - square
Ortho Classic - square
Ortho Classic - ovoid
Ortho Classic - Brader
3M - ovoid
3M - tapered
3M - square
All Star - Bonewill-Hawley
All Star - catenary
All Star - Brader
Dentsply - Brader Figure 3 - Males: comparison of individual pre-
Orthocare - Bonewill-Hawley formed archwires with mean arch widths, includ-
Orthocare - Brader ing bracket-archwire assembly.

a. Canine Depth
A. Canine Width B. b. First
First Premolar
Premolar WidthDepth C.c.Second
Second Premolar
Premolar Width depth

A. Canine Width B. First Premolar Width C. Second Premolar Width

Ortho Organizer - ovoid

D. First Molar Width E. Second Molar Width Ortho Organizer - tapered
Ortho Organizer - square
d. Molar
D. First First Molar
Width Depth E.e.Second
Second Molar
Molar WidthDepth Ortho Classic - square
Ortho Classic - ovoid
Ortho Classic - Brader
3M - ovoid
3M - tapered
3M - square
All Star - Bonewill-Hawley
All Star - catenary
All Star - Brader
Dentsply - Brader Figure 4 - Females: comparison of individual pre-
Orthocare - Bonewill-Hawley
formed archwires with mean arch widths, includ-
Orthocare - Brader
ing bracket-archwire assembly

© 2019 Dental Press Journal of Orthodontics 49 Dental Press J Orthod. 2019 Jan-Feb;24(1):44-52
original article Evaluation of conformity of preformed orthodontic archwires and dental arch form

DISCUSSION nificant difference between the two groups. As varia-

The dimensions of an arch tend to vary between tions in arch depth may affect arch width of archwires,
genders and among various ethnicities.15-17 In the therefore all the preformed archwires were compared
present study, the arch width at canines, first premo- separately for males and females.
lars and first molars was found to be similar to that of The canine and molar widths with the brack-
Turkish subjects.15 In contrast, the Colombians and et-archwire assembly when compared to studies
Koreans were found to have wider arch dimensions as conducted on other populations were found to be
compared to our subjects.16,17 Hence, it is impossible variable. 21,22 The differences in results among vari-
to define an ideal generalized arch form that may be ous studies may be due to variations in thickness
used as a universal template for all populations. of bracket-wire assembly. Hence, the canine width
To minimize the changes in arch form during reported in all the studies is not an accurate repre-
orthodontic treatment, the form of a particular arch- sentation of that population’s arch width and differ-
wire may be modified according to an individual’s ences may occur if a bracket of different thickness
arch form. This is only possible if wires with good is used. To avoid this variation, the actual canine
formability such as beta titanium (TMA) or stain- and molar widths were also reported in the current
less steel (SS) are used. The nickel-titanium (NiTi) study excluding the bracket-archwire assembly.
wires possess only 10-28% of the stiffness of the SS These findings may be used and modified in cases
wires. These wires are difficult to modify due to su- where a bracket system with different bracket base
perelasticity and poor formability. Hence, if these thickness is used.
preformed wires do not conform to an individual’s All the preformed archwires were found to be
arch shape, they may result in undue modification of wider in the canine and premolars region as compared
the original arch form. This has esthetic and stabil- to the mean CW, PW1 and PW2 of the mandibu-
ity implications.18 Secondly, the preformed archwires lar arch in males. On the contrary, when the molar
are manufactured on mean dimensions derived from widths were compared, both the first and second mo-
specific populations. These may not conform to our lars widths of archwires were found to be significantly
population norms due to ethnic variations.13 A survey narrower as compared to the first and second mo-
of the pertinent literature showed that no such study lar widths of the subjects. In females, the archwires
has been conducted on Pakistani population. There- showed significantly narrower CW, MW1 and MW2
fore, the purpose behind this study was to evaluate width dimensions. The stiffness of an archwire is in-
which of the preformed archwires conformed to arch versely proportional to the square root of its length.
forms in our sample of Pakistani subjects. The more distant a tooth is from the midline, the
The mandibular arch has therapeutic limitations lesser is the effect of the lateral expansion forces on
during orthodontic treatment due to surrounding the wire. For example, if the canine is approximately
musculature and occlusal forces.19 Secondly, main- 12 mm and the first molar situated at 35 mm from
taining pretreatment mandibular intercanine width is the midline, the molar would receive only 13% of the
essential to minimize the orthodontic relapse tenden- lateral expansion forces as compared to the canine.
cy.9 For the aforesaid reasons, the mandibular arch Hence, the heavier NiTi archwires are more capable
form was analyzed in the current study. Moreover, of changing the intercanine width during alignment
various studies have reported changes in arch dimen- and should be used with caution.
sions with age.6 Hence, in the present study only adult Other studies have reported both wider and nar-
subjects were included. rower dimensions of the preformed archwires as
In the current study, all the arch dimensions except compared to the arch form in our population.21,22
canine width were found to be narrower in females as The differences in results may be due to ethnic vari-
compared to the males. This may be due to the rea- ations and the choice of different archwire brands
son that males have morphologically larger jaw size and shapes used in the various studies. In the pres-
as compared to females, due to gender dimorphism.20 ent study, only archwires commonly used and eas-
The canine depth and first molar width showed sig- ily available at various orthodontic centers across the

© 2019 Dental Press Journal of Orthodontics 50 Dental Press J Orthod. 2019 Jan-Feb;24(1):44-52
Ahmed M, Shaikh A, Fida M original article

country were evaluated. Moreover, as the arch form CONCLUSIONS

is defined by all the teeth, including canines, premo- » Male subjects showed a trend towards increased arch
lars and molars, in the present study the arch widths depth and width, as compared to the female subjects.
across premolars and second molar widths are also » No single archwire conformed to the mandibular
reported (Table 3). arch dimensions of the subjects included in the study.
Over the years, various forms of archwires have » The mean archwire dimensions were generally
been proposed based on linear parameters and vari- found to be slightly wider at canine, first and second
ous mathematical equations.6,23-26 The shape of the premolars widths.
Bonewill-Hawley arch form is based on equilateral » The mean archwire dimensions were generally found
triangle, whereas the caternary arch form resem- to be slightly narrower at first and second molar widths.
bles a loop of a chain.23 These archwires have wider » Use of archwires that are too wide at canine lev-
arch width dimensions at the second molar region. el should be avoided. Arch width can be more easily
The  Brader arch form, designed according to the controlled with formable archwires such as beta tita-
forces of the surrounding musculature and narrower nium (TMA) or stainless steel (SS).
in the second molar region, was proposed some years
later.24 The use of these archwire shapes may result in
minimal undue modification and decreased crossbite
tendency in the posterior region. As the shape of an
archwire may affect its dimensions, these archwires
were further classified into different categories on the
basis of shape (Table 1). They were then compared
individually with the mean arch dimensions of the
mandibular arch in both males and females separately
(Figs 3 and 4). In the current study, the Brader arch-
wire shape in both males and females most closely
conformed to the mean canine width of our popula-
tion. The narrower shape of archwires, i.e. Bonewill-
Hawley and tapered forms, most closely conformed
to the first and second premolar widths and first mo-
lar widths in both males and females. In the second
molar region, caternary and tapered arch forms in
males and square arch forms in females most closely
conformed to our subjects.
Hence, no single archwire shape from a particular
manufacturing company conformed to the mean arch
dimensions of our subjects. The use of the currently
available preformed archwires may result in altered Author’s contribution (ORCID )
arch forms, increasing the tendency for post-treat-
ment relapse. Ideally, NiTi archwires conforming to Maheen Ahmed (MA): 0000-0003-0806-7739
our population’s dimension should be manufactured Attiya Shaikh (AS): 0000-0002-4469-4185
and made easily available. Until these customized Mubassar Fida (MF): 0000-0003-4842-9896
archwires for our population subjects become avail-
able, the dimensions of the most closely conformed Conception or design of the study: MA. Data acquisi-
archwires should be modified before utilizing them tion, analysis or interpretation: MA, AS, MF. Writing
for our orthodontic practice. This may minimize the the article: MA. Critical revision of the article: MA, AS,
changes in the arch form of an individual, reducing MF. Final approval of the article: MA, AS, MF. Overall
the tendency for post-treatment relapse. responsibility: MA.

© 2019 Dental Press Journal of Orthodontics 51 Dental Press J Orthod. 2019 Jan-Feb;24(1):44-52
original article Evaluation of conformity of preformed orthodontic archwires and dental arch form

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© 2019 Dental Press Journal of Orthodontics 52 Dental Press J Orthod. 2019 Jan-Feb;24(1):44-52