Clinical application of wide and extra-wide archwires in the treatment of dentoalveolar malocclusions

Abstract

Introduction. Aesthetic and functional considerations have always been the main concerns in the orthodontic treatment of dentoalveolar malocclusions. The objective of this study was to assess the effectiveness of the use of wide and extra-wide archwires in reducing treatment time, compared with conventional archwire therapy. Materials and methods. A retrospective cohort study was performed. A total of 180 patients aged between 14 and 36 years old were enrolled and divided into two groups: a classical treatment group, including standard NiTi/SS archwires (n=100), and an alternative treatment group with wide and extra-wide CuNiTi/TA/TMA/SS archwires (n=80). The treatment period, estimated in months, was considered the primary outcome. As secondary outcomes, inter-canine, inter-premolar, and inter-molar widths were estimated. Results. The duration of treatment in the Alternative group was 20.2 ± 4.4 months, with a median of 19.0 months (range: 12–38 months), while the Classic group showed a mean treatment duration of 28.9 ± 5.2 months, a median of 30.0 months (range: 14–39 months), with a mean difference of 8.7 months. Statistical analysis revealed a significant difference in treatment duration between the two protocols (Mann–Whitney U = 863, p < 0.001), with a large effect size (rrb = −0.78; 95% CI: −0.84 to −0.71), indicating practical relevance. Regarding secondary outcomes, transverse maxillary measurements, including inter-canine, inter-premolar, and inter-molar widths, showed similar changes before and after treatment in both groups. The available data did not provide sufficient evidence to reject the null hypothesis about the differences between the groups for these parameters, with no clinically meaningful differences. Conclusions. The application of wide and extra-wide archwires represents an effective orthodontic approach associated with reduced treatment duration, while preserving satisfactory occlusal stability and ensuring a favorable level of patient comfort.