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The swift integration of ‘Gummetal’ into the orthodontic armamentarium can be attributed to its distinct advantages as an entirely new Ti-Nb-based beta titanium alloy. Developed by Toyota Central R&D Labs and publicly revealed in April 2003, this innovative material is rapidly reshaping orthodontic practices. Its sui generis properties allow its use as a potential substitute for the Multi-Loop Edgewise Archwire (MEAW) method. Three-dimensional orthodontic movement using this new alloy could eliminate the disadvantages of the MEAW method, such as its technical complexity and patient discomfort. In our comprehensive review of the current literature, we examined relevant publications sourced from the PUBMED database and explored one seminal work on Gummetal from the journal literature. Characteristic properties of Gummetal, such as its exceptional flexibility, superelasticity, and malleability (approximately 10 times greater than conventional metals), enable seamless formation of bends without posing challenges, thereby allowing precise control over orthodontic force application. Also worthy of mention are Gummetal’s biocompatibility and non-toxic properties, along with its low coefficient of friction. The wire seems to be a relatively easy way to achieve good occlusion. Its usage does not require extensive experience in terms of manual skill, and it is not time consuming. Diligent usage of any prescribed plastics by the patient is crucial to prevent complications and ensure successful orthodontic outcomes.

Background: Incisor retraction is often a crucial phase in ongoing orthodontic treatment, with significant implications for alveolar remodeling mechanisms. There are two prevailing theories which seek to explain this. According to the first, teeth move with the bone, while according to the second, teeth move within the bone. This systematic review seeks to assess morphometric changes in the maxillary alveolar process resulting from incisor retraction following premolar extraction and to evaluate the potential for bone remodeling associated with orthodontic movement. Methods: The study was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The following electronic databases were searched: PubMed, Google Scholar, Web of Science EMBASE and the Cochrane Central Register of Controlled Trials. The databases were searched using the following keywords: “Bone remodeling and retraction of incisors”, “Alveolar bone and incisor retraction”, “Bone thickness and incisor retraction”, and “Bone changes and orthodontic treatment”. Search filters were utilized to identify relevant papers and articles written in English and published during the last 10 years. Based on the information provided in their abstracts, papers and articles were selected according to the following criteria: randomized clinical trials (RCTs), controlled clinical prospective trials (CCTs), and retrospective studies. Articles unrelated to the study’s scope or failing to meet inclusion criteria were excluded. These generally comprised individual case reports, case series reports, literature reviews, experimental studies, studies with limited data (including conference abstracts and journal writings), studies involving an unrepresentative group of patients (less than 10 patients), studies concerning patients with syndromes, and animal experiments. The remaining articles which were deemed relevant underwent comprehensive reference review and such journals as the American Journal of Orthodontics, Dentofacial Orthopedics, International Orthodontics, Journal of Clinical Orthodontics, and Angle Orthodontist were manually searched. Results: Seven articles meeting the inclusion criteria articles were selected for final evaluation, with a total of 284 participants, including 233 women and 51 men. During the analysis of the results included in the publications, a lack of homogeneity was observed, rendering a reliable statistical analysis and heterogeneity assessment unobtainable. Noteworthy disparities in methodologies and measurements posed a risk of drawing inappropriate conclusions. Consequently, emphasis was placed on qualitative analysis, emphasizing the need for standardization in future studies of a similar nature, to enable valid and comparable analyses. Conclusions: The research findings incorporated in this review demonstrate that significant bone loss occurs because of incisor retraction, which diminishes distance between the bone surface and the root surface on the palatal aspect. The magnitude of this change may vary, contingent upon both the extent of incisor displacement and alterations in their inclination, thereby affecting the positioning of the root tips. This change is significantly higher in adults than in growing adolescents. The rationale behind this assertion lies in the widely recognized phenomenon of declining cellular activity with advancing age. The decrease in the speed and intensity of cellular changes may explain the diminished capacity for remodeling as patient age increases. There is ongoing discourse regarding alterations in the volume of bone on the labial aspect of the alveolar process. Further research is necessary to measure whether bone remodeling during orthodontic movement is contingent upon other factors, such as the speed and biomechanics of retraction, the level of applied orthodontic force, and the patient age.

Background: Understanding the anatomy of the incisive canal is crucial for effective diagnosis and treatment planning in clinical orthodontics. This is because, during orthodontic tooth movement, there is a risk of contact between the roots of the upper central incisors and the incisive canal. Objective: The aim of this study was to assess the anatomical variability of the incisive canal using cone beam computed tomography (CBCT), as well as to evaluate its correlation with age, sex, and the position of the maxillary central incisors. There are only a few studies on this topic. Materials and methods: We analysed CBCT data from 67 patients aged from 13 to 49 years. This study was conducted at the Wroclaw Medical University. Measurements were performed twice by two independent researchers, and intra-observer error and correlation were calculated. The mean difference between the first and second observations and between observers was also assessed. We examined the dimensions of the incisive canal and its relationship to the roots of the upper central incisors in relation to age and gender. Results: Our study results revealed a significant correlation between the width and length of the incisive canal. Males exhibited a significantly greater canal length at the lowest point of the incisive canal on the palatal wall. Additionally, males had wider canals compared to females. The analysis of canal width and distance between the most mesial point of the root and the line passing through the most anterior point of the incisive canal showed a negative correlation in all age groups of men. The analysis of incisal inclination and incisal canal inclination showed a very strong relationship, especially in the age group of 13 to 20 years. Several potential risk groups of contact between the roots of central incisors and the incisive canal have been identified based on their structure and the planned incisors’ orthodontic movement. Conclusions and implications: Knowledge of the anatomy of the incisive canal and the use of 3D imaging in high-risk patients can prevent resorption of the incisor root by considering the individual anatomical conditions of the patient when planning orthodontic tooth movement. We recommend performing a CBCT scan before starting orthodontic treatment in the case of moderate and significant retraction of the incisors, or a significant change in their inclination due to the wide anatomical diversity of the incisive canal, especially in adult patients.

Background: Root resorption is one of the complications of orthodontic treatment, and has a varied and unclear aetiology. Objective: To evaluate the relationship between upper incisor resorption and contact with the incisive canal and the risk of resorption during orthodontic treatment associated with upper incisor retraction and torque control. Search methods: According to PRISMA guidelines, the main research question was defined in PICO. Scientific databases MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were searched for linking keywords: Resorption of roots incisive canal, Resorption of roots nasopalatine canal, Incisive canal retraction and Nasopalatine canal retraction. Selection criteria: No time filters were applied due to the significantly limited number of studies. Publications in the English language were selected. Based on the information provided in the abstracts, articles were selected according to the following criteria: controlled clinical prospective trials and case reports. No randomised clinical trials (RCTs) or controlled clinical prospective trials (CCTs) were found. Articles unrelated to the topic of the planned study were excluded. The literature was reviewed, and the following journals were searched: American Journal of Orthodontics and Dentofacial Orthopedics, International Orthodontics, Journal of Clinical Orthodontics, Angle Orthodontist, Progress in Orthodontics, Orthodontics and Craniofacial Research, Journal of Orofacial Orthopedics, European Journal of Orthodontics and Korean Journal of Orthodontics. Data collection and analysis: The articles were subjected to risk of bias and quality assessment using the ROBINS-I tool. Results: Four articles with a total of 164 participants were selected. In all studies, differences in root length were observed after contact with the incisive canal, which was statistically significant. Conclusions and implications: The contact of incisor roots with the incisive canal increases the risk of resorption of these roots. IC anatomy should be considered in orthodontic diagnosis using 3D imaging. The risk of resorption complications can be reduced by appropriate planning of the movement and extent of the incisor roots (torque control) and the possible use of incisor brackets with built-in greater angulation. Registration CRD42022354125.