An evaluation of clinicians' choices when selecting archwires

The aim of this research was to determine the choices made by clinicians with respect to archwires and arch form during the initial and latter stages of orthodontic treatment with fixed appliances. A questionnaire-based study was carried out at Bristol Dental Hospital between November 2005 and March 2006. Questionnaires were distributed within the dental hospital and at local meetings in order to obtain a mixed sample of hospital and practice-based orthodontists. The clinicians asked to complete the questionnaire were consultant orthodontists (n = 37), specialist practitioners (n = 36), senior specialist registrars in orthodontics (n = 10), and dentists with a special interest in orthodontics (n = 17). The questionnaire consisted of two parts: the first was concerned with the initial alignment phase of treatment and the second with the space-closing phase of treatment in premolar extraction cases. The choice of archwires, significance of arch form, and intra-arch dimensions considered important at both stages were assessed. The clinicians were also asked about their usual practice with regard to adaptation of working archwires and the use of study models and symmetry charts. One hundred questionnaires were returned, giving a response rate of 92.6 per cent. The majority of clinicians felt that preservation of the pre-treatment arch form was essential in the latter but not in the early stages of treatment. In particular, conservation of the original intercanine width was considered important. However, there was no uniformity in how arch form should be preserved. Some respondents used study models and symmetry charts as an aid, but even then they were used in different ways. There was no uniformity in the landmarks used when adapting stainless steel archwires to arch form. Therefore, even when clinicians do adapt their archwires carefully with the intention of preserving arch form, are they choosing the correct arch form?