Orthodontic space closure in sliding mechanics: a systematic review and meta-analysis

Abstract

Summary Background/Objectives The aim of this systematic review was to compare the different force delivery systems for orthodontic space closure by sliding mechanics. Search methods Multiple sources including Cochrane Central, Ovid Medline, Embase etc. were used to identify all relevant studies. Selection criteria Randomized controlled trials (RCT) of parallel-group and split-mouth designs were included. Participants Orthodontic patients of any age treated with fixed orthodontic appliances and requiring space closure. Data collection and analysis Search result screening, data extraction and quality assessment were performed independently and in duplicate by 2 reviewers. The included studies were grouped into parallel-arm and split-mouth studies and subgroup analysis was then performed for the type of retraction subsets; en-masse and individual canine retraction. A traditional meta-analysis, and network meta-analysis (NMA) for direct and indirect comparisons for the rate of space closure were performed. Results Thirteen studies, six parallel-arm and seven split-mouth were included. The traditional meta-analysis comparing Nickel-titanium (NiTi) closed coil springs and elastomeric power chain for the rate of tooth movement showed statistically significant difference favouring NiTi springs (MD: 0.24; 95% CI, 0.03–0.45; I2 0%, P = 0.02) and the comparison between NiTi springs and active ligatures also showed statistically significant result favouring NiTi springs (MD: 0.53; 95% CI, 0.44–0.63; I2 0%, P ˂ 0.00001) for the rate of tooth movement. NMA for the rate of space closure showed fairly confident evidence for NiTi coil springs when compared with elastomeric chain and active ligatures. The NiTi coil spring ranked best between all methods of space closure. Conclusions There is moderate quality evidence in favour of NiTi coil springs for the rate of space closure when compared with active ligature and low quality of evidence favouring NiTi springs when compared with elastomeric chain. The ranking from NMA showed NiTi coil springs to be the best method for space closure with 99% chance. An urgent need for standardization of study designs and the need for development of an agreed core outcome sets and core outcome instrument measurement sets is evident. Registration PROSPERO CRD42020157811

Different Methods of Canine Retraction- Part 1

“…Finally, according to the latest systematic reviews and meta-analyses, the findings of the previous studies have been confirmed regarding the efficiency of power chain and NiTi spring in space closure with low to moderate-quality evidence that NiTi spring produced a faster rate of space closure (46,47) . On the other hand, the quality of evidence is moderate in favor of NiTi coil springs in comparison with the active tie-back (47) .…”

Force behaviour of elastic chains during a simulated gap closure in extraction therapy cases

“…35,36 Orthodontic space closure is commonly performed using sliding mechanics or closing loops, with sliding mechanics representing the predominant method. 31,33,37 Although NiTi coil springs provide relatively constant force levels and have been found to close gaps faster, or at least at a similar rate, orthodontic elastic chains are widely used being the cheaper alternative. 31,33 Orthodontic tooth movement is determined by the moment-to-force (M/F) ratio.…”

Anterior En Masse Retraction in Orthodontics

“…The third study by Sebastian et al compared various force delivery methods for closing orthodontic spaces using sliding mechanics [ 15 ]. According to the NMA rating, NiTi coil springs are the best method for space closure with a 99% likelihood.…”

“…Sebastian's third piece from 2022 by using NiTi springs rather than an active ligature to close spaces, a meta-analysis found that the length of orthodontic treatment might be cut in half. However, it is possible that the difference between NiTi springs and elastomeric chains is not crucial from a therapeutic standpoint [ 15 ]. Antoszewska-Smith's fourth study from 2017 assesses the rate of mesial migration as its main finding [ 14 ].…”

“…Comparing mini-implants to other less minimally invasive osseointegration systems for skeletal anchoring, they are now a safe, reliable, and effective technique [ 13 ]. The creation of mini-implants with high resistance and various shapes demonstrates that research on materials and miniaturization techniques is well-focused and has made significant progress, advancing implantology in the orthodontic sector [ 14 , 15 ].…”