Abstract
BackgroundEdgewise fixed orthodontic appliances are available in two different bracket slot sizes (0.018 and 0.022 inch). Both systems are used by clinicians worldwide with some orthodontists claiming the superiority and clinical advantages of one system over the other. However, the scientific evidence supporting this area is scarce and weak. This leaves the clinician’s choice of bracket slot system to clinical preference. We aim to compare the 0.018-inch and 0.022-inch pre-adjusted bracket slot systems in terms of the effectiveness of orthodontic treatment.Methods/DesignThis is a prospective, multicenter, randomized clinical trial, undertaken in the secondary care hospital environment in the NHS Tayside region of Scotland (United Kingdom). A total of 216 orthodontic patients will be recruited in three centers in secondary care hospitals in NHS Tayside. The participants will be randomly allocated to treatment with either the 0.018-inch or 0.022-inch bracket slot systems (n = 108 for each group) using Victory series™ conventional pre-adjusted bracket systems (3 M Unitek, Monrovia, United States). Baseline records and outcome data collected during and at the end of orthodontic treatment will be assessed. The primary outcome measures will be the duration of orthodontic treatment in the maxillary and mandibular arches. The secondary outcome measures will be the number of scheduled appointments for orthodontic treatment in the maxillary and mandibular arches, treatment outcome using Peer Assessment Rating index (PAR), orthodontically induced inflammatory root resorption (as measured using periapical radiographs) and the patient’s perception of wearing orthodontic appliances.DiscussionThe results from the current study will serve as evidence to guide the clinician in deciding whether the difference in bracket slot size has a significant impact on the effectiveness of orthodontic treatment.Trial registrationRegistered with ClinicalTrials.gov on 5 March 2014, registration number: NCT02080338.
Highlights
Edgewise fixed orthodontic appliances are available in two different bracket slot sizes (0.018 and 0.022 inch)
The results from the current study will serve as evidence to guide the clinician in deciding whether the difference in bracket slot size has a significant impact on the effectiveness of orthodontic treatment
Patients who are eligible to receive treatment in the National Health Service (NHS) Scotland should have a significant need of treatment which requires an Index of Orthodontic Treatment Need (IOTN) score of 4 or 5 for the dental health component, or a score of 3 combined with a high aesthetic component score (>5) [11]
Summary
Edgewise fixed orthodontic appliances are available in two different bracket slot sizes (0.018 and 0.022 inch). Both systems are used by clinicians worldwide with some orthodontists claiming the superiority and clinical advantages of one system over the other. The advent of stainless steel alloys facilitated the use of smaller dimension wires with the same rigidity as that of the larger gold alloy archwires. This allowed the bracket slot size to be reduced, and as a result the 0.018-inch bracket slot was introduced into orthodontics. The introduction of the 0.018-inch bracket slot did not eliminate fixed appliance systems using 0.022-inch bracket slots from clinical practice [3]
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