Predictors of Curve of Spee Leveling in Class II Division 1 Malocclusion Treated With Reverse Curve of Spee Archwires: An Observational Study.

Introduction Aligning and leveling is the initial stage of comprehensive fixed orthodontic treatment aimed at minimizing the depth of the curve of Spee (COS). Various techniques exist to decrease the magnitude of the curve. This study investigates the skeletal and dental factors that reduce COS in individuals with minor class II malocclusions receiving nitinol (NiTi) wires with a reverse curve of Spee (RCS). Materials and methods The data for this observational study was collected from a sample of 84 patients who had class II molar relations and were sequentially treated with RCS NiTi wires throughout the initial leveling and aligning phase. All patients with class II molar relationships underwent non-extraction procedures during the leveling phase. The COS was determined using digitalized dental models. Skeletal and dental characteristics that could impact COS were identified and quantified using digital lateral cephalograms and orthopantomograms recorded during the pre-treatment (T1) and post-leveling (T2) stages. After calibrating the radiographs and models, we acquired angular and linear data. The data was categorized based on gender, growth pattern, and initial alignment of the teeth. We analyzed the differences between the groups using an independent t-test and an ANOVA. A paired t-test was used to compare the difference in the dimensional values between (T1) and (T2) points. Following the correlation coefficient tests, the study used stepwise multiple linear regression analysis to assess the predictive value of independent factors on the COS. The results were considered statistically significant at p < 0.05. Results The COS decreased by -1.43 ± 0.68 mm, which is statistically significant (<0.001*). There is no significant difference in COS reduction between the categorical variables. Despite statistically significant differences in the parameters between pre- and post-treatment, the linear correlation between most of the variables and COS reduction ranged from very weak (<0.20) to weak (0.20-0.39). Conclusions The vertical extrusion of lower premolars and molars combined with the intrusion of lower incisors contributed to the reduction of the COS by RCS wires. There is a change in the orientation of the occlusal plane with the flattening of the COS.

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Human subjects: Consent was obtained or waived by all participants in this study. The Institutional Ethical Committee of Narayana Dental College & Hospital issued approval ICE/NDCH/2022/MAR/P-24. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.