The straight-wire appliance: Individualization versus customization

The straight-wire appliance is an individualized, fully-programmed appliance system that has been in clinical use since the early 1970s. A study of tooth positions in individuals with naturally occurring harmonious occlusions led to the discovery of the Six Keys to Normal (Optimal) Occlusion which provided data for bracket features and prescription values incorporated into the straight-wire appliance. It was based on the notion that tooth anatomy, morphology, and optimal positions were alike enough among individuals, regardless of age, sex, or race to justify using prefabricated brackets with average prescription values. New technologies have led to advancements in appliance customization. Customized brackets can be made-to-order with one-of-a-kind prescription values and bracket base contours that fit precisely to the morphologic characteristics of the teeth. If costs and material qualities were comparable, would treatment efficiency or treatment outcomes be superior when using a customized appliance compared with a prefabricated straight-wire appliance? If not, why not? & COPY; 2023 World Federation of Orthodontists. Published by Elsevier Inc. All rights reserved.