An 18-month clinical study of bond failures with resin-modified glass ionomer cement in orthodontic practice

Abstract

The purpose of this study was to evaluate, over an 18-month period, the clinical performances of a resin-modified glass ionomer cement for bonding orthodontic brackets and to analyze various factors that influenced their survival and failure rates. Two orthodontists using the edgewise technique participated in this study; 6113 brackets, including 20 molar tubes, were bonded with Fuji Ortho LC (GC, Europe, N.V. Leuven, Belgium) in 135 patients. Ceramic, metal, and resin brackets were tested, and both operators used the same bonding method for the brackets. The survival rate and the failure rate of the brackets were evaluated. The rates were determined by operator, bracket type, tooth position in the dental arch, and age and sex of the patients. Bracket survival rates were estimated using the Kaplan-Meier test. The Cox-Mantel statistical test with a level of significance set at 0.05 was used to compare survival curves. The chi-square test was used at a level of P <.05 to compare failure rates. The overall failure rate for the sample was 7%, and the overall survival rate was equal to 0.918. Age had no significant influence on the failure rate (P =.07); however, it had a significant influence on the survival rate (P <.01). The best survival rates were obtained in the groups aged 16 to 20 years (S[t] = 0.943) and older than 20 years (S[t] = 0.929). The difference between males and females was not statistically significant in terms of failure rate (P =.17). However, the Cox-Mantel test showed a higher bracket survival rate for the males (S[t] = 0.924) than for the females (S[t] = 0.839) (P <.00001). The influence of the operator was not statistically significant on the failure rate (P =.08); however, it was significant on the survival rate (P <.0002). Location in the arch had a significant influence on the failure and survival rates. The worst results were obtained in the upper incisors and the canines, and the best results in the lower premolars. Fifteen percent of the molar tubes failed; their survival rate was equal to 0.833. The failure rate was significantly greater for resin brackets than for metal or ceramic brackets (P =.007). The highest survival rate was obtained with ceramic brackets (P =.0001). This in vivo study showed that bonding brackets and molar tubes with Fuji Ortho LC is compatible with clinical orthodontic practice. (Am J Orthod Dentofacial Orthop 2001;120:406-15)