Abstract
ABSTRACTIntroduction: Several advantages have been established regarding the efficiency of self-ligating brackets (SL). In spite of some controversy surrounding this question in the literature, clinical results confirm that “arch development” requires fewer extractions. Objective: The objective of this study was to compare changes in the transverse and sagittal planes in patients treated with conventional ligating brackets (CL)as well as in patients treated with SL brackets and oversized arches. Methods: A sample was selected from a pool of 300 consecutive cases treated by a single clinician: 51 patients with SL brackets and oversized wires, and 55 with CL brackets. These two groups were compared with a control group of 20 patients. All plaster models were scanned and dental landmarks were measured to identify changes from commencement (T0) to conclusion (T1) of treatment. Lateral cephalograms were analyzed for changes in the lower incisor (IMPA) and the first lower molar distal angulation (MAng). Intraoperator reliability was tested with linear regression analysis. To assure all groups were comparable at T0, an ANOVA test with a 95%confidence interval (CI) was performed for all values. To assess changes from T0 to T1 in all groups, a Student’s t-test with 95% CI was used. Finally, results from the three groups were compared using an ANOVA-test (95% CI) and a post-hoc test. Results: Increases in all the transverse variables were recorded in the two groups treated (SL and CL), except for the lower intercanine distance in the SL group. IMPA difference from T0 to T1 was higher in the CL group, and molar distal angulation (MAng) took place in the SL group. Conclusions: Self-ligating brackets with oversized arches and conventional ligating brackets showed increases in all variables in the transverse plane, except for the SL group at the mandibular intercanine distance. In comparison with the CL group, fewer different IMPA values were observed in the SL group, in which distal molar angulation occurred.
Highlights
Several advantages have been established regarding the efficiency of self-ligating brackets (SL)
Discussion of the study methodology. This retrospective study analyzed three groups of consecutive patients: two groups were treated by a single clinician and compared with a third group, the control group
In two papers citing measurements taken with CBCT, only one compared changes between the two kinds of self-ligating brackets, but not with conventional brackets.[6]
Summary
Several advantages have been established regarding the efficiency of self-ligating brackets (SL). The self-ligating system was first described in 1935, brackets and different shapes of wires made of the latest alloys continue to be developed These systems have grown exponentially from 8.7% in 2002 to 42% in 2008.1 In spite of limited research showing the advantages of SL brackets over conventional ones, a number of papers have claimed that these brackets produce faster dental movements with less or no need for extractions, facilitating easier treatments and stable results.[2] A review of well-designed RCTs (Randomized Control Trial) have only demonstrated that this system shortens chair time and produces less protrusion of the mandibular incisor, without mentioning the many benefits of SL brackets.[3] In addition, recent systematic reviews[4] have not shown any clinical advantages in arch expansion, space closure or orthodontic efficiency. The aim of this study was to compare the transverse and sagittal planes in patients treated with passive self-ligating brackets and oversized arches, as well as in patients treated with conventional brackets
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