Evaluation of Two Different Methods of Arch Bar Application: A Comparative Prospective Study

Abstract

Purpose To comparatively evaluate the efficacy of a pencil type wire twister and the normal wire twister in terms of various parameters during arch bars application. Method The study involved residents of the department enrolled in MDS course. Two study groups of 60 patients each were made by randomly selecting the patients from the outpatient department of Oral and Maxillofacial surgery who required arch bar application. Group A included the patients who underwent upper and lower arch bar application with the use of a pencil type twister and group B included patients who underwent arch bar application with a normal wire twister. All respondents were given a questionnaire after the completion of procedure involving the use of medical sharps. The paired samples t test was used for statistical analysis. Result Among group A, mean glove perforations, actual wire stick injuries, mean time taken to complete the procedure, mean wire breakage during the procedure was less than in group B. Comfort level of patients and Ease of operator while performing the procedure was more in group A than in group B. Frictional abrasion of the finger was not associated with the use of pencil type twister. Overall rating of the procedure was more in group A than group B.Conclusion The use of pencil type wire twister outweighs normal wire twister in various ways. It increases the overall efficacy of the operator during the procedure.

Implementation of Recent Infection Prevention Procedures Published by Centers for Disease Control and Prevention: Difficulties and Problems in Orthodontic Offices

“…An orthodontist's skill, experience and attention are important because of the extensive use of cutting instruments and metallic ligatures during fixed orthodontics. Specific preventive strategies to reduce the risk of infection due to the puncture of a glove-covered hand include reducing the use of sharp objects by favouring elastomeric ligatures (when clinically possible), selfligating brackets, pencil-type twisters (that reduce glove perforation and wire stick injuries), and surgical alternatives to rapid intermaxillary fixation (inter-maxillary fixation screws etc) (49). Damage to the intra-oral tissues of patients (mucosal trauma) must be prevented by using functioning instruments: any sign of "wear or work fatigue" and any damage to the cutting tips of orthodontic instruments must be promptly identified, and the tip or instrument immediately replaced (10).…”

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“…Similar injuries have been reported in the literature as a common problem. [14] There was no frictional abrasion over the finger recorded in placing the arch bar in the group B.…”

Revisiting the Pencil Wire Twister: An Instrument par excellence

“…Chhabra et al 4 compared the pencil-type wire twister with the traditionally used wire twister and found that the pencil-type twister had lower counts of mean glove perforations, as well as wire injuries to fingers; mean time taken to complete the procedure; and mean wire breakage during the procedure.…”