There are too many orthodontic arch wires; which ones are right for my practice?
By Dr. Adrian J. Palencar, MUDr, MAGD, IBO, FADI, FPFA, FICD
An arch wire in orthodontics is a wire conforming to the alveolar or dental arch that can be used with brackets as a source of force in correcting irregularities in position of the teeth. An arch wire can also be used to develop arches to some degree and maintain the existing dental and alveolar position.
There are many genres of arch wires on the market; pertaining to SHAPE: Standard, Oval Pro-form and DLX arch wires, FUNCTION: Torqued, Reverse curve of Spee (RCS), Adjustable Utility arch wire, Posted, Keyhole, T loop and Mushroom arch wires, COMPOSITION: Stainless Steel, Nickel Titanium (CuNiTi, NiTi – Thermal), CNA – Beta Titanium, Nickel-Free, Braded arch wires, Tooth colour)
For simplicity, the author will be discussing only the shape and composition of arch wires in this Monthly Tip. A young orthodontic practitioner, by taking orthodontic courses from plethora of instructors, may be confused with the sequence of the arch wires in treatment of patients. Every instructor has his/her favorite arch wires and the sequence, which may be challenging for the young dentist. The author is an instructor for Rondeau Seminars for the past 17 years and he would like to present you a simple approach we have integrated with our students.
Shape of the arch wire
We subscribe to the functional philosophy at Rondeau Seminars; therefore, we suggest only two arch shapes: Pro-Form for most orthodontic patients and DLX for patients who require additional width. If an additional torque is required in the incisor region, a Nitanium 20° anterior torque rectangular arch wires are available.
Simplified sequence of the arch wires (composition)
Leveling arch wires (level, align and rotate)
- A .014 NiTi (or Bio-Kinetix PlusÔ Thermal, or CuÔ Nitanium 27°C, or CuÔ Nitanium 35°C)
- A .018 NiTi (or Bio-Kinetix PlusÔ Thermal, or CuÔ Nitanium 27°C, or CuÔ Nitanium 35°C)
Working arch wires: These are the only ones, where a force may be applied (i.e. open coil springs, closing coil springs, elastomeric chains, power thread and elastics)
- A .019 x .025 Variable Force 3Ô Thermal Nitanium (this wire may be also considered as a final leveling arch wire). Leave this arch wire in for 3 months
- A .019 x .025 CNAÔ – Beta Titanium
- A .018 CNA Ô- Beta Titanium (for cases where the expression of torque is not desired)
Finishing (detailing) arch wire
- A .019 x .025 Multi-braidÔ, stainless steel 8 strands braded arch wire.
The majority of orthodontic treatment in SWA can be successfully accomplished with the arch wires listed above. Rondeau Seminars does not introduce stainless steel in Level I and II, except the Sectional mechanics and the Utility arches.
Disclaimer: The above listed arch wires are Trademark of Ortho Organizers (Henry Schein and Cerum). The author has no financial interests or benefits in this company.
- Rondeau Seminars, Level I, Session 2; 69 – 83
- Rondeau Seminars, Case finishing; 62
- Ortho Organizers Catalogue