Comparison of GUMMETAL® and stainless steel alloy during canine retraction: A pilot split-mouth randomized controlled trial

Abstract

A TiNb alloy wire (GUMMETAL® [GM], Toyota Central R&D Labs, Inc., Nagakute, Japan) was recently developed with unique properties for orthodontic applications. This pilot split-mouth randomized controlled trial compared maxillary canine retraction during space closure using sliding mechanics on GM vs. stainless steel (SS) archwires. Subjects who met the inclusion criteria were treated with fixed appliances and maxillary first-premolar extractions between September 2020 and March 2022. After leveling and aligning, maxillary archwires, fabricated by crimping together segments of 0.016×0.022" GM and SS archwires, were placed and canine retraction initiated using nickel-titanium coil springs. Digital models of the maxillary arch were superimposed at 0, 4, 8 and 12 weeks and the amount of canine movement (mm), rate of movement (mm/month), and 3-dimensional changes (rotational, vertical extrusion, tip) were measured and compared statistically. Of the 12 subjects recruited, only six completed the study with a median age of 15.8 years (12.0-17.4 years). At 12 weeks, the median canine retraction was 3.41mm (IQR: 2.10, 4.76) with GM versus 3.71mm (IQR: 1.62, 6.45) with SS. The retraction rate was 1.14mm/month (IQR: 0.69, 1.59) with GM, versus 1.24mm/month (IQR: 0.54, 2.15) with SS. The median rotational, vertical and tip changes of the canine were 7.90̊, 0.59mm and 6.15̊ with GM, and 7.25̊, 0.29mm and 2.05̊ with SS. Intergroup differences with all measurements were not statistically significant. No significant differences were found between GM and SS during maxillary canine retraction. GM demonstrated clinical potential for space closure mechanics, however, future larger studies are needed.