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The Angle Orthodontist Jan 2021The purpose of this cohort study was to evaluate the effect of self-ligating brackets (SB) and other related factors that influence orthodontic treatment time. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
The purpose of this cohort study was to evaluate the effect of self-ligating brackets (SB) and other related factors that influence orthodontic treatment time.
MATERIALS AND METHODS
This was a two-armed prospective study. Consecutively treated patients who were recruited from a private practice were enrolled and asked to choose between SB and conventional brackets (CB). If the patient did not have a preference, that patient was randomly allocated. An identical archwire sequence was used, and all patients were treated by a single orthodontist. Treatment duration, number of bracket failures, poor oral hygiene, poor elastic wear, whether or not to orthodontic mini-implants (OMI) were used, OMI failure, extraction, American Board of Orthodontics Discrepancy Index, and arch length discrepancy were measured and statistically analyzed using t-tests, correlation analysis, and analysis of covariance (ANCOVA). Stepwise regression analysis was conducted to generate an equation to predict treatment duration.
RESULTS
A total of 134 patients with an average age of 22.73 years were included. The average treatment duration was 28.63 months. ANCOVA showed no significant difference in treatment duration between CB and SB. Stepwise regression analysis could explain 64.6% of the variance in treatment duration using five variables.
CONCLUSIONS
SB did not exhibit a significant reduction in treatment time as compared with CB. Patient cooperation, extractions, and malocclusion severity had a significant impact on treatment duration.
Topics: Adult; Cohort Studies; Dental Implants; Humans; Orthodontic Anchorage Procedures; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Prospective Studies; Young Adult
PubMed: 33289803
DOI: 10.2319/050220-379.1 -
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 -
BMC Oral Health Jul 2022Before the magnetic resonance imaging (MRI) examination fixed orthodontic devices, such as brackets and wires, cause challenges not only for the orthodontist but also...
BACKGROUND
Before the magnetic resonance imaging (MRI) examination fixed orthodontic devices, such as brackets and wires, cause challenges not only for the orthodontist but also for the radiologist. Essentially, the MRI-safe scan of the fixed orthodontic tools requires a proper guideline in clinical practice. Therefore, this systematic review aimed to examine all aspects of MRI-safe scan, including artifact, thermal, and debonding effects, to identify any existing gaps in knowledge in this regard and develop an evidence-based protocol.
METHODS
The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement was used in this study. The clinical question in "PIO" format was: "Does MRI examination influence the temperature of the orthodontic devices, the size of artifacts, and the debonding force in patients who have fixed orthodontic bracket and/or wire?" The search process was carried out in PubMed, PubMed Central, Scopus, and Google Scholar databases. The search resulted in 1310 articles. After selection according to the eligibility criteria, 18 studies were analyzed by two reviewers. The risk of bias was determined using the Quality In Prognosis Studies tool.
RESULTS
Out of the eligible 18 studies, 10 articles examined the heating effect, 6 were about the debonding effect, and 11 measured the size of artifact regarding brackets and wires. Considering the quality assessment, the overall levels of evidence were high and medium. The published studies showed that heating and debonding effects during MRI exposure were not hazardous for patients. As some wires revealed higher temperature changes, it is suggested to remove the wire or insert a spacer between the appliances and the oral mucosa. Based on the material, ceramic and plastic brackets caused no relevant artifact and were MRI-safe. Stainless steel brackets and wires resulted in susceptibility artifacts in the orofacial region and could cause distortion in the frontal lobe, orbits, and pituitary gland. The retainer wires showed no relevant artifact.
CONCLUSIONS
In conclusion, the thermal and debonding effects of the fixed orthodontic brackets and wires were irrelevant or resoluble; however, the size of the artifacts was clinically relevant and determined most significantly the feasibility of fixed brackets and wires in MRI examination.
Topics: Artifacts; Humans; Magnetic Resonance Imaging; Orthodontic Brackets; Orthodontic Wires; Stainless Steel
PubMed: 35854295
DOI: 10.1186/s12903-022-02317-9 -
Dental Press Journal of Orthodontics 2022Many patients wearing orthodontic appliances request alterations in the shade of their teeth during orthodontic treatment.
INTRODUCTION
Many patients wearing orthodontic appliances request alterations in the shade of their teeth during orthodontic treatment.
OBJECTIVE
This study aimed to evaluate the efficacy of different products for bleaching and whitening under orthodontic brackets.
METHODS
Seventy bovine incisors were randomly divided into five groups (n = 14): C) non-whitening toothpaste (control); WTsi) hydrated silica whitening toothpaste; WThp) 2% hydrogen peroxide whitening toothpaste; OB) in-office bleaching; and HB) at-home bleaching. Two buccal surface areas were evaluated using the Easyshade spectrophotometer: under the metal bracket (experimental) and around the bracket (control). The paired t-test, ANOVA, and Tukey tests were applied for statistical analysis.
RESULTS
Intragroup comparisons showed that in groups C, WThp and HB, there were statistically significant differences in the enamel color changes (ΔEab) between under and around the bracket areas (C - under bracket = 7.97 ± 2.35, around bracket = 2.86 ± 0.81, p< 0.01; WThp - under bracket = 4.69 ± 2.98, around bracket = 2.05 ± 1.41, p< 0.01; HB - under bracket = 7.41 ± 2.89, around bracket: 9.86 ± 3.32, p= 0.02). Groups WTsi, OB and HB presented similar perception of tooth whiteness (ΔWID) between the tested areas. Intergroup comparisons demonstrated that under the bracket area, the color change (ΔEab) was similar for all groups, except WThp (C = 7.97 ± 2.35; WTsi = 8.54 ± 3.63; WThp = 4.69 ± 2.98; OB = 9.31 ± 4.32; HB = 7.41 ± 2.89; p< 0.01).
CONCLUSIONS
The dental color changes were effective for the products tested in groups WTsi, OB and HB in the presence of metallic orthodontic brackets.
Topics: Animals; Cattle; Color; Dental Enamel; Hydrogen Peroxide; Orthodontic Brackets; Tooth Bleaching; Tooth Bleaching Agents; Toothpastes
PubMed: 36350943
DOI: 10.1590/2177-6709.27.5.e2220325.oar -
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 -
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 -
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 -
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 Angle Orthodontist Mar 2019To compare bracket survival and adhesive removal time between a flash-free and a conventional adhesive for orthodontic bracket bonding. (Randomized Controlled Trial)
Randomized Controlled Trial
A comparative assessment of bracket survival and adhesive removal time using flash-free or conventional adhesive for orthodontic bracket bonding: A split-mouth randomized controlled clinical trial.
OBJECTIVES
To compare bracket survival and adhesive removal time between a flash-free and a conventional adhesive for orthodontic bracket bonding.
MATERIALS AND METHODS
Forty-five consecutive patients had their maxillary incisors, canines, and premolars bonded with ceramic brackets using a flash-free adhesive (APC Flash-Free Adhesive, 3M Unitek, Monrovia, Calif) on one side and a conventional adhesive (APCII Adhesive, 3M Unitek) on the other side. The side allocation was randomized. Bracket failure was recorded at 4-week intervals. The adhesive remnant index (ARI) was scored on debond and adhesive removal timed to the nearest second. The primary outcome was adhesive removal time per quadrant. Secondary outcomes were bracket failure rate, time to first-time failure of a bracket, and ARI score on debond. Paired t-tests were used to compare adhesive removal times and ARI scores between the adhesives with P < .05 considered statistically significant.
RESULTS
Bracket failure rates were 4.3% for the flash-free adhesive and 1.9% for the conventional adhesive, with mean times to first-time failure of 31 weeks for the flash-free adhesive and 42 weeks for the conventional adhesive; neither failure rates nor times to first failure were significantly different. Although the flash-free adhesive left significantly more adhesive on the tooth surface after debonding, the adhesive removal times were 22.2% shorter than with the conventional adhesive.
CONCLUSIONS
Bracket survival with the flash-free adhesive was equivalent to the conventional adhesive when ceramic brackets were bonded. Adhesive removal was significantly faster when using the flash-free adhesive, which may result in time savings of more than 20% compared with the conventional adhesive.
Topics: Bicuspid; Ceramics; Dental Bonding; Dental Cements; Humans; Materials Testing; Orthodontic Brackets; Resin Cements
PubMed: 30230375
DOI: 10.2319/030918-195.1 -
American Journal of Orthodontics and... Jan 2022As a result of the rapid spread of the disease caused by severe acute respiratory syndrome coronavirus 2, the World Health Organization declared a global pandemic on...
INTRODUCTION
As a result of the rapid spread of the disease caused by severe acute respiratory syndrome coronavirus 2, the World Health Organization declared a global pandemic on March 11, 2020. Governments worldwide adopted various measures to stop or slow the spread of coronavirus disease 2019 (COVID-19). One widely used measure was lockdown; workers who could work from home were instructed to do so, and nonessential businesses-including dental clinics-were closed for weeks or months. The purpose of this investigation was to document the incidence of fixed orthodontic appliance failures and the periodontal health status of patients undergoing fixed orthodontic treatment during and after the lockdown period.
METHODS
The sample comprised 350 orthodontic patients (mean age, 16.85 ± 2.59 years; 249 female, 101 male) who underwent orthodontic and periodontal examinations in Adıyaman, Turkey, after a mean lockdown period of 103.7 ± 21.3 days. Frequencies of an orthodontic bracket, elastic ligature, molar band, and miniscrew failures of oral ulcers were recorded, and periodontal parameters were assessed. The effects of sex, age, and the bracket systems used in the patients on the frequencies of these failures were analyzed.
RESULTS
It was revealed that 15.42% (n = 54) of all patients had ≥1 bracket bonding failure, and 8.16% (n = 4) of the patients with miniscrew implantation had ≥1 miniscrew failure. The incidence of bracket bonding failure was significantly higher in men than in women. No significant relationship was found between periodontal parameters and bracket bonding failure. Plaque and gingival scores were higher than those reported for a similar population before a lockdown.
CONCLUSIONS
The results indicated that orthodontic appliances might have higher frequencies of failure during a lockdown than normal times, and lockdown periods may worsen the periodontal health status of the patients.
Topics: Adolescent; Adult; COVID-19; Communicable Disease Control; Female; Humans; Incidence; Male; Orthodontic Appliances; Orthodontic Brackets; Periodontal Index; SARS-CoV-2; Young Adult
PubMed: 34509332
DOI: 10.1016/j.ajodo.2021.01.022