Abstract
ABSTRACTObjective: The purposes of this study were to present a prototype of a bracket-positioning gauge, which makes vertical inclination of the instrument difficult, allowing a reduction of vertical bracket positioning error, and to test its accuracy in bracket positioning by groups of individuals with different clinical experience and in specific groups of teeth. Methods: For the testing of the prototype, four groups of six participants each were used: Group 1 was composed of undergraduate students in the dental school, who had no previous experience in bonding orthodontic attachments; Group 2 was composed of orthodontic graduate students in the dental school; Group 3 consisted of orthodontists with a maximum of 5 years of clinical experience; Group 4 comprised orthodontists with more than 5 years of clinical experience. A typodont was simulated with a Class I crowded malocclusion, which reproduced the same occlusal characteristics for all groups to be bonded. All participants were instructed to bond 0.022×0.028-in Edgewise brackets on the labial surfaces of the upper and lower incisors, canines, and premolars at a height of 4 mm from the incisal edge or the labial cusp tip. Results: Only the mean value of Group 1 showed statistically significant difference in the comparison with the standard measurement. In the groups of teeth, the difference was significant for the premolar and incisor groups. Conclusion: Clinical experience interfered with the accuracy of vertical positioning of orthodontic attachments. As for the groups of teeth, premolars, followed by canines and incisors had the closest mean values to the standard measurement.
Highlights
The correct positioning of orthodontic brackets is of paramount importance for the orthodontic mechanics and treatment results.[3,4,5,6,7,8,9]
The purposes of this study were to present a prototype of a bracket-positioning gauge, which makes undesirable vertical inclination of the instrument more difficult than with other gauges, allowing a reduction of vertical bracket positioning error; and to test its accuracy in bracket positioning by groups of individuals with different clinical experience and in specific groups of teeth
The gauge was machined and assembled at Robtec industry in the city of Diadema, São Paulo, Brazil. It consists of a star-like metal base with four points, which allow the placement of orthodontic attachments at the heights of 3.5mm, 4.0mm, 4.5mm, and 5.0mm (Fig 1)
Summary
Orthodontic treatment should provide the patient with functional and aesthetic balance between dental, skeletal and facial structures.[1,2] In this process, the correct positioning of orthodontic brackets is of paramount importance for the orthodontic mechanics and treatment results.[3,4,5,6,7,8,9] Poorly positioned brackets may result in poor teeth alignment, torque alterations,[10,11,12,13,14,15,16,17] changes in arch length,[18] distortions in bracket prescription,[19] as well as occlusal interferences that can compromise masticatory function.[7,10,18]For some authors, brackets should be centered on the crown of the tooth,[3,20] whereas others recommend placing the brackets at specific heights for each tooth or group of teeth.[7,10,13,16,21,22,23,24,25] Bracket positioning, is influenced by the operator and tooth morphology.[2,26,27,28,29]Studies show that gauges used for bracket placement, when used with the wrong inclination, may interfere with the correct bracket height.[9,19,28,29] The Boone gauge, one of the most used bracket positioning devices, allows inadequate inclination of the instrument when positioning orthodontic attachments, regardless of the operator’s clinical experience.[30]. Orthodontic treatment should provide the patient with functional and aesthetic balance between dental, skeletal and facial structures.[1,2] In this process, the correct positioning of orthodontic brackets is of paramount importance for the orthodontic mechanics and treatment results.[3,4,5,6,7,8,9] Poorly positioned brackets may result in poor teeth alignment, torque alterations,[10,11,12,13,14,15,16,17] changes in arch length,[18] distortions in bracket prescription,[19] as well as occlusal interferences that can compromise masticatory function.[7,10,18]. Studies show that gauges used for bracket placement, when used with the wrong inclination, may interfere with the correct bracket height.[9,19,28,29] The Boone gauge, one of the most used bracket positioning devices, allows inadequate inclination of the instrument when positioning orthodontic attachments, regardless of the operator’s clinical experience.[30]
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