Abstract
BackgroundAn efficient orthodontic treatment must aim the best occlusal result in the shortest possible time. One of the factors that can interfere in this goal is the bracket debonding during the treatment. This study aimed at assessing the different factors related to brackets failure, highlighting age and patient cooperation with treatment.MethodsThe sample comprised 199 orthodontic patients of both genders (103 women and 96 men); divided into two groups—adolescents (12 to 18 years old, 118 patients) and adults (19 to 59 years old, 81 patients). A questionnaire was applied regarding the motivation of patients to seek treatment and whether they had received information on appliance care; patients also filled out their level of cooperation with treatment in a visual analog scale (VAS). Additionally, other variables were assessed, such as the teeth with bracket debonding, the presence of deep overbite, and the use of bite plate. The Mann-Whitney test was used, and a 5% significance level was applied for analyses.ResultsIt was observed that 20.1% of patients presented at least one tooth with bracket failure, and the lower arch was the most prevalent site (47.5%). Adolescents presented more debonding (25.4%) than adults (12.3%). Individuals with better VAS scores on cooperation sought treatment on their own (p = 0.042), were adults (p ≤ 0.001), and showed lower rate of failure of brackets (p ≤ 0.001). The factors related to malocclusion and treatment performed had no statistical significance.ConclusionGreater cooperation was expected from adult individuals who sought treatment on their own and presented low rate of bracket failure.
Highlights
An efficient orthodontic treatment must aim the best occlusal result in the shortest possible time
Power analysis showed that a sample size of at least 199 patients would give an 100% (α = 1.0) probability of detecting a real difference between groups: mean 11.65 or median 16.4 at a statistically significant level of 5%
Patient motivation represents an important factor for orthodontic treatment success, and it is directly associated with patient cooperation regarding care and hygiene instructions provided by the orthodontist
Summary
An efficient orthodontic treatment must aim the best occlusal result in the shortest possible time. All orthodontic advances of the last decade focus on optimizing the orthodontic treatment The search for such efficiency, accounting for protocols for finishing treatment in less time, and achieving the best possible outcomes have guided recent clinical researches. Besides the treatment duration, replacing brackets requires chair time and presents high cost, since it is not always possible to replace the same bracket [1,2,3,4,5] This bracket failure may occur because of several factors, from occlusal trauma to inappropriate bonding techniques [1, 6,7,8,9]. Patients that are less committed to treatment and present higher bracket failure rate could have longer treatment duration, a situation that affects patient quality of life, considering financial and satisfaction aspects [2, 10, 12, 15, 16]
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