Wilson curve modification in permanent dentition: a retrospective comparison between clear aligners and continuous archwire treatment

Abstract

Objectives To evaluate leveling of the Curve of Wilson (COW) by two different treatment appliances (clear aligners [CA] and continuous archwire fixed appliances [FA]) in a permanent dentition sample of patients. Materials and Methods Digital casts of 40 patients (CA group = 20 patients; FA group = 20 patients) were collected. Angular values for COW, right and left vertical height difference of lower first molars, and linear distance between lower teeth and the WALA ridge were analyzed for pre- (T1), posttreatment (T2) and on final virtual (ClinCheck) models (T2-CC) of the CA group. An unpaired t-test was used to evaluate significant intergroup differences (P < .05), while a paired t-test was used for posttreatment CA intragroup comparison. Results FA group showed better control of second molar crown positions compared to CA group (47-WALA = −0.2 ± 0.1 mm, 37-WALA = −0.6 ± 0.3 mm). No significant difference was detected for linear distance of lower first molars and the WALA ridge or for vertical height difference. CA group showed a greater reduction of distance between lower premolars and the WALA ridge (mean difference: –0.5 mm for both 45-WALA and 35-WALA; mean difference: −0.5 mm for 44-WALA, −0.6 mm for 34-WALA). Predictability for the CA group was high for every measurement (87% Right COW, 89% Left COW, 88% 46 Vertical Diff, 87% 36 Vertical Diff). Conclusions Clear aligner and continuous archwire mechanics were effective in leveling COW. FA was more effective in changing crown position of lower second molars with respect to the WALA ridge, while CA provided a greater distance reduction between lower premolars and WALA ridges compared to FA.