Objective: This review aims to assess the relationship between initial archwire materials and pain at the initial stage of orthodontic treatment.
Methods: On October 1, 2017, seven databases were searched electronically for studies oninitial archwire materials and pain at the initial stage of orthodontic treatment. Quality assessment was performed with bias risk assessment tools suggested by Cochrane's handbook. Data extraction of included studies was also carried out. Network Meta- analysis was conducted using R 3.4.2 (with JAGS 4.3.0), GeMTC 0.14.3, and STATA 11.0.
Results: Five studies with 330 participants were included, comparing four different materials: multi-stranded stainless steel, conventional nickel-titanium, super-elastic nickel-titanium, and thermal heat-activated nickel-titanium. Two studies were at low risk of bias, one was at high risk of bias, and the remaining two were at unclear risk of bias. Network Meta-analysis results showed no statistical differences of pain among the four initial archwire materials at day 1 and day 7. However, the most painless material was most likely to be thermal heat-activated nickel-titanium on rank probability.
Conclusions: On statistical probability, thermal heat-activated nickel-titanium initial arch wires is most likely to cause the least pain at the initial stage of orthodontic treatment, compared with other materials.
目的 评价不同材料的初始弓丝对正畸治疗初始疼痛的影响。方法 通过7个常用数据库对不同材料的初始弓丝与正畸治疗初始疼痛的文献进行电子检索，检索时间截至2017年10月1日。对纳入文献参照Cochrane推荐的偏倚风险评估表进行方法学质量评价并提取数据。应用R软件3.4.2（调用JAGS 4.3.0）、GeMTC 0.14.3及STATA 11.0软件进行网状Meta分析。结果 最终纳入5篇文献，涉及330名患者，涉及4种干预措施（多股不锈钢弓丝、普通镍钛弓丝、超弹镍钛弓丝、热激活镍钛弓丝）。5篇文献中，2篇为低偏倚风险，1篇为高偏倚风险，2篇偏倚风险情况不清。初戴固定矫治器后的第1天及第7天，4种弓丝引起患者疼痛的视觉模拟评分（VAS）两两之间均无统计学差异，但是排秩概率分析表明VAS最小的材料最有可能是热激活镍钛弓丝。结论 固定矫治时选用热激活镍钛弓丝作为初始弓丝可能是正畸治疗初始疼痛最轻的。.
Keywords: dental alloys; network Meta-analysis; orthodontic wires; pain; systematic review.