Effectiveness of nickel‐titanium springs vs elastomeric chains in orthodontic space closure: A systematic review and meta‐analysis

Abstract

The aim of this study is to explore the effectiveness of nickel titanium closing springs (NiTi-CS) and elastomeric power chains (EPC) in orthodontic space closure and to assess the adverse periodontal effects, cost efficiency and patient-centred outcomes between both of these methods. Methods: An electronic search of online databases (Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Scopus, LILACS and Web of Science), reference lists and grey literature as well as hand search were conducted without language restriction up to November/2017. Two authors blindly and in duplicate were involved in study selection, quality assessment and the extraction of data. Only randomized clinical trials (RCTs) were included. The quality of the studies was assessed using the Cochrane Collaboration's risk of bias tool.95% confidence intervals and mean difference for continuous data were calculated. A meta-analysis that generated a random-effect model for the comparable outcomes was conducted, and heterogeneity was measured using I 2 statistic. Results: Of 187 records, 4 RCTs met the criteria and were included in the quantitative synthesis featuring 290 test quadrants. Faster space closure with NiTi-CS was observed with a mean difference of (0.20 mm/month, 95% CI: 0.12 to 0.28). Loss of anchorage appears to be similar within both groups when synthesized qualitatively. With exception to anchorage loss, secondary outcomes could not be investigated in the included trials.Conclusions: There is a moderate quality of evidence suggesting a faster orthodontic space closure with the NiTi-CS when compared to EPC. A comparable amount of anchorage loss was observed regardless of the utilized method of space closure. Further high-quality RCTs with parallel-groups, reporting on the adverse effects and patientcentred values, are recommended. K E Y W O R D Smeta-analysis, nickel-titanium, power chain elastic, space closure, systematic review

Evaluation of the Effect of Combined Low Energy Laser Application and Micro-Osteoperforations versus the Effect of Application of Each Technique Separately On the Rate of Orthodontic Tooth Movement

“…Many techniques [ 20 ] [ 21 ] [ 22 ] are available to perform retraction of the canine in the extraction space regarding anchorage preparation and the force used of retraction (amount, direction, and force decay). Standardization of the technique of canine retraction was a must so, the use of mini-screws was decided as a direct anchor for retraction of the canine as well as closing coil spring was used providing continuous 150 g of force for canine retraction.…”

Examination of postextraction space closure speed using elastic chains and NiTi closed coil springs

“…In several in vivo studies, NiTi springs have been shown to provide faster and more reliable space closure, and that is consistent with our research. It is believed that retaining a constant force over a certain period of time contributes most to their efficiency [16,32].…”

“…U nekoliko in vivo studija NiTi opruge su pokazale da obezbeđuju brže i pouzdanije zatvaranje prostora, što je u skladu sa ovim istraživanjem. Smatra se da zadržavanje konstantne sile kroz određeni period najviše doprinosi njihovoj efikasnosti [16,32].…”

Authors' response

“…Today, we face new literature, and perhaps the systematic review by Mohammed et al 7 is a game changer. Besides the fact that it compares NiTi coils springs with elastomeric chains instead of active tiebacks, this systematic review is worth looking into in detail.…”