Int J Stomatol

Int J Stomatol ›› 2025, Vol. 52 ›› Issue (3): 366-379.doi: 10.7518/gjkq.2025036

• Original Articles • Previous Articles    

Effects of initial archwires of different sizes and materials on initial pain during orthodontic treatment: a systema-tic review and Bayesian network meta-analysis

Zhi Wei(),Chang Liu,Yan Wang,Wenli Lai()   

  1. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2024-01-05 Revised:2024-06-24 Online:2025-05-01 Published:2025-04-30
  • Contact: Wenli Lai E-mail:1575587389@qq.com;wenlilai@scu.edu.cn

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Abstract:

Objective The effects of variations in the size and materials of initial archwires on initial pain during ortho-dontic treatment were explored. Methods Seven commonly used databases were searched from inception to October 1, 2023 for publications related to orthodontic archwires and pain. Relevant literature was selected on the basis of inclusion criteria. Moreover, the methodological quality of the included studies was assessed using the risk of bias assessment tool for the nonrandomized studies of interventions recommended by Cochrane, and data were extracted accordingly. Network meta-analysis was performed using R software 4.3.2 (calling JAGS 4.3.1) and GeMTC 0.14.3 software. Results A total of 11 studies involving 632 patients and 10 intervention measures were included. Among the 11 studies, three had low risk of bias, one had high risk of bias, and seven had unclear bias risk. One, two, and seven days after the initial placement of fixed orthodontic appliances, no statistically significant difference in the visual analog scale (VAS) scores of pain was found between any two of the 10 archwires. However, forest plots results show that the pain level of heat-activated nickel-titanium archwires (HANT) is lower than that of superelastic nickel-titanium archwires (P<0.05), and rank probability plot analysis indicated that the material with the smallest VAS score was most likely the 0.012-inch (0.305 mm) HANT. Conclusion No difference in orthodontic pain intensity was found among the 10 initial archwires of different sizes and materials, and using the 0.012-inch HANT archwire as the initial archwire during fixed ortho-dontic treatment may cause the least amount of initial pain.

Key words: orthodontic archwires, pain, systematic review, visual analog scale

CLC Number: 

  • R783.5

TrendMD: 

Fig 1

Flow chart of literature screening"

Tab 1

Characteristics of included studies"

研究地区研究类型患者数量（男/女）年龄/岁干预措施结局指标
Alhaija等[12]约旦双臂双盲RCT40（13/27）19.50±1.39*0.014、0.016英寸SENTVAS
Azizi等[7]伊朗双臂三盲RCT88（44/44）18.6±4.4*0.014英寸SENT、0.014英寸HANTVAS
初可嘉等[8]中国三臂RCT45（21/24）24.20±3.44*0.014英寸SENT，0.012、0.014英寸HANTVAS
Cioffi等[13]意大利双臂双盲RCT30（11/19）14.7±3.7*0.016英寸SENT、0.016英寸HANTVAS
Erdin?等[14]土耳其双臂单盲109（52/57）14.20±1.52*0.014英寸CNT、0.016英寸CNTVAS
Fernandes等[15]挪威双臂RCT128（72/56）12.6#0.014英寸SENT、0.014英寸CNTVAS
Jain等[16]印度双臂双盲RCT20（6/14）18.9±3.6*0.016英寸HANT、0.016英寸SENTVAS
Jones等[17]英国双臂RCT43（23/20）9.4~16.8&0.014英寸SENT、0.015英寸MSSVAS
Kishore等[18]印度双臂RCT14—0.016英寸SENT、0.016英寸CNTVAS
任庆源[19]中国双臂双盲RCT44（11/33）14.4±2.6*0.014英寸SENT、0.014英寸HANTVAS
Sandhu等[20]印度双臂双盲RCT85（42/43）14.1±2.0*0.016英寸SENT、0.017 5英寸MSSVAS

Fig 2

Risk of bias graph"

Fig 3

Risk of bias summary"

Tab 2

Summary table of VAS data extraction for each study"

研究干预措施1 d VAS2 d VAS7 d VAS
平均值标准差n平均值标准差n平均值标准差n
Alhaija等[12]0. 014英寸SENT44.032.41432.029.5148.912.214
0.016英寸SENT28.224.91415.116.81412.325.714
Azizi等[7]0.014英寸SENT58.420.444——————
0.014英寸HANT61.622.343——————
初可嘉等[8]0.012英寸SENT38.78.31548.07.5152.04.115
0.012英寸HANT30.75.91539.39.6150.72.615
0.014英寸HANT37.38.01548.69.9151.33.515
Cioffi等[13]0.016英寸SENT36.028.71550.725.01520.317.415
0.016英寸HANT29.025.91539.721.61518.022.515
Erdin?等[14]0.014英寸CNT4928.3513921.849136.323
0.016英寸CNT4828.1484020.94695.314
Fernandes等[15]0.014英寸SENT36.732.44037.232.5657.112.965
0.014英寸CNT37.831.13936.030.0636.711.059
Jain等[16]0.016英寸HANT35.57.2910———4.11.6610
0.016英寸SENT42.95.8410———5.81.3210
Jones等[17]0.014英寸SENT29.022.42119.621.2211.22.521
0.015英寸MSS23.720.72125.024.4210.51.621
Kishore等[18]0.016英寸SENT27.14.8728.66.97———
0.016英寸CNT24.39.8734.39.87———
任庆源[19]0.014英寸SENT43.927.12431.725.0248.314.024
0.014英寸HANT39.018.92027.617.9202.96.420
Sandhu等[20]0.016英寸SENT28.811.04224.610.4423.51.542
0.0175英寸MSS26.49.04323.05.8433.21.343

Fig 4

Network plot of day 1, 2 and 7 after inserting the archwire"

Tab 3

VAS mean differences and 95%CI"

两两比较1 d2 d7 d
0.014英寸HANT与0.012英寸SENT1.45（-14.89，17.85）-0.67（-20.62，19.41）0.71（-6.15，7.60）
0.014英寸HANT与0.012英寸HANT-6.54（-22.67，9.63）-9.26（-29.52，11.04）-0.60（-7.34，6.21）
0.014英寸SENT与0.014英寸HANT0（-13.39，412.77）-4.09（-26.33，18.16）-5.37（-14.00，3.30）
0.014英寸SENT与0.014英寸CNT-2.26（-19.22，14.70）-3.74（-22.45，14.79）-0.37（-7.91，7.04）
0.014英寸SENT与0.015英寸MSS-5.18（-24.83，14.64）5.28（-17.29，27.98）-0.71（-7.27，5.87）
0.014英寸SENT与0.016英寸HANT-11.04（-28.74，6.17）-11.00（-35.47，13.36）-0.25（-12.03，11.48）
0.014英寸SENT与0.016英寸SENT-4.99（-22.26，10.45）-12.73（-34.06，7.26）1.69（-10.15，13.49）
0.014英寸CNT与0.016英寸CNT-3.51（-19.94，12.49）-1.24（-19.82，16.86）-3.98（-11.21，3.37）
0.016英寸SENT与0.0175英寸MSS-2.39（-18.58，13.59）-1.51（-20.98，18.21）-0.31（-6.82，6.20）

Fig 5

Convergence diagnostics of VAS day1, 2 and 7 after inserting the archwire"

Fig 6

Trace and density of VAS day1, 2 and 7 after inserting the archwire"

Fig 7

Forest plots of VAS day1 after inserting the archwire"

Fig 8

Forest plots of VAS day 2 after inserting the archwire"

Fig 9

Forest plots of VAS day 7 after inserting the archwire"

Fig 10

Rank probability of day 1, 2 and 7 after inserting the archwire"

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