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BioMed Research International 2021To compare the orthodontic bracket debonding force and assess the bracket failure pattern clinically between different teeth by a validated prototype debonding device. ....
OBJECTIVE
To compare the orthodontic bracket debonding force and assess the bracket failure pattern clinically between different teeth by a validated prototype debonding device. . Thirteen (13) patients at the end of comprehensive fixed orthodontic treatment, awaiting for bracket removal, were selected from the list. A total of 260 brackets from the central incisor to the second premolar in both jaws were debonded by a single clinician using a validated prototype debonding device equipped with a force sensitive resistor (FSR). Mean bracket debonding forces were specified to ten (10) groups of teeth. Following debonding, Intraoral microphotographs of the teeth were taken by the same clinician to assess the bracket failure pattern using a 4-point scale of adhesive remnant index (ARI). Statistical analysis included one-way ANOVA with post hoc Tukey HSD and independent sample -test to compare in vivo bracket debonding force, Cohen's kappa (), and a nonparametric Kruskal-Wallis test for the reliability and the assessment of ARI scoring.
RESULTS
A significant difference ( < 0.001) of mean debonding force was found between different types of teeth in vivo. Clinically, ARI scores were not significantly different ( = 0.921) between different groups, but overall higher scores were predominant.
CONCLUSION
Bracket debonding force should be measured on the same tooth from the same arch as the significant difference of mean debonding force exists between similar teeth of the upper and lower arches. The insignificant bracket failure pattern with higher ARI scores confirms less enamel damage irrespective of tooth types.
Topics: Adult; Dental Cements; Device Removal; Equipment Failure; Humans; Mechanical Phenomena; Orthodontic Brackets; Tooth; Young Adult
PubMed: 33959664
DOI: 10.1155/2021/6663683 -
The Cochrane Database of Systematic... Apr 2018Bonding of orthodontic brackets to teeth is important to enable effective and efficient treatment with fixed appliances. The problem is bracket failure during treatment... (Review)
Review
BACKGROUND
Bonding of orthodontic brackets to teeth is important to enable effective and efficient treatment with fixed appliances. The problem is bracket failure during treatment which increases operator chairside time and lengthens treatment time. A prolonged treatment is likely to increase the oral health risks of orthodontic treatment with fixed appliances one of which is irreversible enamel decalcification. This is an update of the Cochrane Review first published in 2003. A new full search was conducted on 26 September 2017 but no new studies were identified. We have only updated the search methods section in this new version. The conclusions of this Cochrane Review remain the same.
OBJECTIVES
To evaluate the effects of different orthodontic adhesives for bonding.
SEARCH METHODS
Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 26 September 2017), the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 8) in the Cochrane Library (searched 26 September 2017), MEDLINE Ovid (1946 to 26 September 2017), and Embase Ovid (1980 to 26 September 2017). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
Trials were selected if they met the following criteria: randomised controlled trials (RCTs) and controlled clinical trials (CCTs) comparing two different adhesive groups. Participants were patients with fixed orthodontic appliances. The interventions were adhesives that bonded stainless steel brackets to all teeth except the molars. The primary outcome was debond or bracket failure.
DATA COLLECTION AND ANALYSIS
Data were recorded on decalcification as a secondary outcome, if present. Information regarding methods, participants, interventions, outcome measures and results were extracted in duplicate by pairs of review authors. Since the data were not presented in a form that was amenable to meta-analysis, the results of the review are presented in narrative form only.
MAIN RESULTS
Three trials satisfied the inclusion criteria. A chemical cured composite was compared with a light cured composite (one trial), a conventional glass ionomer cement (one trial) and a polyacid-modified resin composite (compomer) (one trial). The quality of the trial reports was generally poor.
AUTHORS' CONCLUSIONS
There is no clear evidence on which to make a clinical decision of the type of orthodontic adhesive to use.
Topics: Compomers; Decalcification, Pathologic; Dental Bonding; Dental Cements; Glass Ionomer Cements; Humans; Orthodontic Brackets; Randomized Controlled Trials as Topic
PubMed: 29630138
DOI: 10.1002/14651858.CD002282.pub2 -
Journal of the World Federation of... Aug 2023The 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... (Review)
Review
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?
Topics: Humans; Orthodontic Wires; Orthodontic Brackets; Dental Occlusion; Treatment Outcome
PubMed: 37419789
DOI: 10.1016/j.ejwf.2023.06.004 -
Journal of Dental Research Dec 2022White spot lesions and enamel cracks are the 2 most prominent diseases that occur after orthodontic treatment and are caused by enamel demineralization from accumulated...
White spot lesions and enamel cracks are the 2 most prominent diseases that occur after orthodontic treatment and are caused by enamel demineralization from accumulated bacterial biofilms and/or enamel damage caused by the removal of residual adhesive after bracket debonding. Inspired by the self-assembled amelogenin nanoribbons in enamel, we developed an enamel coating with a self-assembling antimicrobial peptide, D-GL13K, to simultaneously reduce demineralization and residual adhesive. The self-assembled amphiphilic nanoribbons significantly increased the hydrophobicity of the etched enamel, which reduced the permeability of the coated enamel surfaces as desired. The antimicrobial activity of this coating was evaluated against by colony-forming unit counting and live/dead assays. The anti-demineralization effect was demonstrated by the reduced demineralization depth analyzed by optical coherence tomography and the increased Vickers hardness. The coatings did not reduce the shear bond strength but significantly reduced the adhesive remnant index score. This bioinspired enamel coating may provide a new strategy for preventing white spot lesions and enamel cracks after orthodontic treatment.
Topics: Humans; Orthodontic Brackets; Nanotubes, Carbon; Dental Enamel; Streptococcus mutans; Dental Caries; Dental Bonding; Tooth Demineralization
PubMed: 36271659
DOI: 10.1177/00220345221129806 -
BioMed Research International 2022Failure of brackets is a common problem in orthodontics. This affects the treatment time, cost, and compliance of the patient. This study was conducted to estimate the...
Failure of brackets is a common problem in orthodontics. This affects the treatment time, cost, and compliance of the patient. This study was conducted to estimate the bracket failure rate and the related factors for the long term. This ambidirectional cohort study included 150 nonsyndromic orthodontic patients undergoing fixed appliance therapy for the last two years. The same patients were followed for 7 months. Different variables related to bracket failure were evaluated. The available data were analyzed descriptively, and the Kaplan-Meier estimate was used to measure the bracket survival rate from the date of bonding to failure. . A total of 180 bracket bond failures in the 150 included patients (52.2% males and 47.8% females) with a median age of 17 years (range 10-25 years). 69% of brackets failures were reported within the first 6 months after bonding. About 58.3% of bracket failure was noticed in adolescent patients before the age of 18 years. The majority of the cohort (81.1%) has good oral hygiene. The failure rate in patients with normal overbite was 41.1%, in decreased overbite cases was 15%, while in deep bite cases the failure rate was 43.9% with a statistically significant difference. Adults show less bracket failure (41.7%) than adolescent patients (58.3%). More bracket failure was noted in the lower arch (55%) than the upper arch (45%), and there were more bond failures posteriorly (61%) than on the anterior teeth (39%). Majority (41.1%) of the bracket failed on round NiTi wires. . The bracket failure rate was 6.4%, with most bracket failure occurring in the first 6 months after bonding with individual difference. There was more incidence of bond failure in an increased overbite, adolescents, lower arch, posterior teeth, and lighter alignment wires.
Topics: Adolescent; Adult; Child; Equipment Failure Analysis; Female; Humans; Incidence; Male; Orthodontic Brackets
PubMed: 35059463
DOI: 10.1155/2022/5128870 -
International Orthodontics Mar 2017Root resorption is one of the leading problems in orthodontic treatment. Most earlier studies have assessed the incidence and severity of root resorption following... (Review)
Review
INTRODUCTION
Root resorption is one of the leading problems in orthodontic treatment. Most earlier studies have assessed the incidence and severity of root resorption following orthodontic treatment using fixed appliances as well as associated factors. However, few studies have assessed these parameters in the context of orthodontic treatment using thermoplastic splints or aligners. The aim of this systematic review was to assess the incidence and severity of root resorption following orthodontic treatment using aligners and associated factors. A comparative analysis was also made with fixed multi-bracket treatments.
MATERIALS AND METHODS
The data bases consulted were: Medline, Embase, EBSCO Host, Cochrane Library and Science Direct. Our search included meta-analyses, randomized and non-randomized controled trials, cohort studies and descriptive studies published before December 2015 and evidencing a connection with the incidence and severity of root resorption following orthodontic treatment using aligners alone or compared with fixed multi-bracket treatments.
RESULTS
Among the 93 selected references, only 3 studies met our selection criteria. The incidence of root resorption ranged between 0 and 46%, of which 6% were severe cases. Relative to fixed multi-bracket non-extraction treatments to correct the same malocclusions, the incidence of resorption ranged between 2% and 50%, of which 22% were severe cases. In both techniques, the incidence of resorption was higher for the maxillary incisors and was not influenced by either age or sex.
CONCLUSION
In malocclusion cases not requiring extractions, orthodontic aligner treatment is possibly associated with a lower incidence of resorption than fixed multi-bracket treatment. Further research encompassing extraction cases is needed to better assess the incidence and severity of root resorption following the use of these removable appliances.
Topics: Humans; Malocclusion; Orthodontic Appliances; Orthodontic Brackets; Root Resorption
PubMed: 28131611
DOI: 10.1016/j.ortho.2016.12.019 -
Photobiomodulation, Photomedicine, and... Dec 2021This study sought to compare enamel surface morphology and orthodontic bracket re-bonding strength after phosphoric acid- or erbium-doped yttrium aluminum garnet...
This study sought to compare enamel surface morphology and orthodontic bracket re-bonding strength after phosphoric acid- or erbium-doped yttrium aluminum garnet (Er:YAG) laser-mediated re-etching. A total of 81 extracted premolars were obtained from patients undergoing orthodontic procedures. Conventional etching with 35% phosphoric acid was first used to bond brackets to the enamel surface. Then brackets were de-bonded 1 week later. These samples were then separated randomly into three groups ( = 27 teeth each group) and re-bonded with new brackets after one of the following re-etching manners: Group A-35% phosphoric acid, Group B-Er:YAG laser (200 mJ, 30 Hz), and Group C-Er:YAG laser (250 mJ, 30 Hz). The enamel surface and the interface of enamel and adhesive were then analyzed through scanning electron microscopy. Shear bond strength (SBS) and adhesive remnant index (ARI) were also measured. Samples in Group A exhibited significant residual adhesive at the enamel surface, whereas samples in Groups B and C showed a cleaner surface with more distinct and evenly distributed honeycomb-like structures. Further, samples in Group C displayed a larger average SBS value between the two laser-etching groups, although there were no significant differences in SBS values or ARI scores between the acid and laser re-etching groups ( > 0.05). Er:YAG laser-based enamel re-etching (250 mJ, 30 Hz) produces an uniform honeycomb-like structure and a trend of similar SBS compared with 35% phosphoric acid-mediated re-etching. Er:YAG laser-mediated re-etching seems to be a promising alternative approach for bracket re-bonding.
Topics: Acid Etching, Dental; Dental Enamel; Humans; Lasers, Solid-State; Orthodontic Brackets; Phosphoric Acids; Surface Properties
PubMed: 34797698
DOI: 10.1089/photob.2021.0049 -
Brazilian Dental Journal 2020The aim of this study was to analyze the influence of orthodontic bracket type (metallic or ceramic) and mouthguard on biomechanical response during impact....
The aim of this study was to analyze the influence of orthodontic bracket type (metallic or ceramic) and mouthguard on biomechanical response during impact. Two-dimensional plane-strain models of a patient with increased positive overjet of the maxillary central incisor was created based on a CT scan, simulating the periodontal ligament, bone support, gingival tissue, orthodontic brackets (metallic or ceramic) and mouthguard. A nonlinear dynamic impact finite element analysis was performed in which a steel object hit the model at 1 m/s. Stress distributions (Von Mises and Modified Von Mises) and strain were evaluated. Stress distributions were affected by the bracket presence and type. Models with metallic and ceramic bracket had higher stresses over a larger buccal enamel impact area. Models with ceramic brackets generated higher stresses than the metallic brackets. Mouthguards reduced the stress and strain values regardless of bracket type. Mouthguard shock absorption were 88.37% and 89.27% for the metallic and ceramic bracket, respectively. Orthodontic bracket presence and type influenced the stress and strain generated during an impact. Ceramic brackets generated higher stresses than metallic brackets. Mouthguards substantially reduced impact stress and strain peaks, regardless of bracket type.
Topics: Ceramics; Dental Stress Analysis; Finite Element Analysis; Humans; Incisor; Materials Testing; Mouth Protectors; Orthodontic Appliance Design; Orthodontic Brackets; Stress, Mechanical
PubMed: 33146339
DOI: 10.1590/0103-6440202002818 -
The Angle Orthodontist May 2022To test a new concept in bracket design-the tip and torque adjustable bracket (TTAB)-to identify its integral ability to change both tip and torque.
OBJECTIVES
To test a new concept in bracket design-the tip and torque adjustable bracket (TTAB)-to identify its integral ability to change both tip and torque.
MATERIALS AND METHODS
The newly designed TTAB underwent independent testing using the orthodontic measurement and simulation system. The TTAB incorporated Roth tip and torque prescription values, with the unique quality of the bracket to enhance or reduce the innate prescribed values of tip (by either +10° or -10°) and torque (by either +7.5° or -7.5°). The TTAB was tested using both the incorporated standard Roth prescription on the rate of canine retraction (sliding mechanics), using 0.018-inch stainless-steel (SS) arch wire, and with alteration of tip values (-10° and +10°). Similarly, frictional measurements and torque evaluations using 0.019 × 0.025-inch SS arch wire were undertaken with the standard prescription and altered torque (+7.5° and -7.5°). In addition, a number of control investigations were performed. Differences were analyzed using analysis of variance.
RESULTS
The rate of observed tooth movement for the TTAB with its prescribed baseline values was comparable to that of the control brackets. Importantly, the alteration of TTAB tip to -10° and +10° significantly (P < .001) increased and reduced, respectively, the rates of canine retraction. In the alteration of torque, at +7.5° and -7.5°, the bracket delivered a moment of +9.3 (2.8) Nmm and -11.9 (3.8) Nmm, respectively, to the lateral incisor (P < .001).
CONCLUSIONS
This in vitro study demonstrates a new concept in preadjusted edgewise bracket design, offering adjustable tip and torque, with the potential for expanded clinical scope.
Topics: Dental Stress Analysis; Materials Testing; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Stainless Steel; Torque
PubMed: 35061018
DOI: 10.2319/061421-474.1 -
Clinical Oral Investigations Jan 2024We aimed to develop a tool for virtual orthodontic bracket removal based on deep learning algorithms for feature extraction from bonded teeth and to demonstrate its...
OBJECTIVE
We aimed to develop a tool for virtual orthodontic bracket removal based on deep learning algorithms for feature extraction from bonded teeth and to demonstrate its application in a bracket position assessment scenario.
MATERIALS AND METHODS
Our segmentation network for virtual bracket removal was trained using dataset A, containing 978 bonded teeth, 20 original teeth, and 20 brackets generated by scanners. The accuracy and segmentation time of the network were tested by dataset B, which included an additional 118 bonded teeth without knowing the original tooth morphology. This tool was then applied for bracket position assessment. The clinical crown center, bracket center, and orientations of separated teeth and brackets were extracted for analyzing the linear distribution and angular deviation of bonded brackets.
RESULTS
This tool performed virtual bracket removal in 2.9 ms per tooth with accuracies of 98.93% and 97.42% (P < 0.01) in datasets A and B, respectively. The tooth surface and bracket characteristics were extracted and used to evaluate the results of manually bonded brackets by 49 orthodontists. Personal preferences for bracket angulation and bracket distribution were displayed graphically and tabularly.
CONCLUSIONS
The tool's efficiency and precision are satisfactory, and it can be operated without original tooth data. It can be used to display the bonding deviation in the bracket position assessment scenario.
CLINICAL SIGNIFICANCE
With the aid of this tool, unnecessary bracket removal can be avoided when evaluating bracket positions and modifying treatment plans. It has the potential to produce retainers and orthodontic devices prior to tooth debonding.
Topics: Orthodontic Brackets; Deep Learning; Dental Bonding; Dental Debonding; Microscopy, Electron, Scanning
PubMed: 38280038
DOI: 10.1007/s00784-023-05440-1