Reverse arch wire technique using undersized wires for enhanced incisor axis control during retraction: A clinical technique and case series

The Reverse Archwire (RAW) technique represents a simplified biomechanical approach that utilizes undersized rectangular archwires to control incisor inclination during en-masse retraction in extraction cases. This case series included three consecutive patients presenting with bialveolar protrusion who were treated with four-premolar extractions using conventional 0.022-inch slot MBT appliances. Initial alignment was achieved with 0.014–0.016-inch nickel–titanium archwires in combination with posterior lacebacks, followed by space closure using 0.016 × 0.022-inch or 0.017 × 0.025-inch stainless-steel archwires incorporating a reverse curve of Spee. No auxiliary anchorage devices, including mini-screws or power arms, were employed. Treatment changes were evaluated using pre- and post-treatment cephalometric analyses and superimposition. All cases demonstrated effective anterior retraction with controlled incisor inclination and preservation of vertical skeletal relationships. The mean reduction in maxillary incisor inclination was 10° relative to the sella-nasion plane, with a corresponding 5 mm decrease in U1-Nasion point A. Mandibular incisors exhibited a mean reduction of 14° relative to the mandibular plane and a 6 mm decrease in L1-Nasion point B. A stable Class I occlusion and improved soft-tissue profile were achieved in all patients. No clinically significant anchorage loss or vertical opening was observed, and treatment outcomes remained stable at 2-year follow-up. Within the limitations of a small case series, the RAW technique appears to provide predictable control of incisor inclination and effective anchorage preservation during space closure without the need for auxiliary anchorage. This approach may offer a clinically efficient and reproducible alternative for anterior control in selected extraction cases.