Bracket Failure Rate Research Articles

Single-component orthodontic adhesives: comparison of the clinical and in vitro performance.

To investigate the clinical and in vitro performance of single-component orthodontic adhesives under metal brackets. Bimaxillary orthodontic treatment was required for sixty patients and 60 premolar teeth were divided into three groups (n: 20). The single-component orthodontic adhesives Biofix and GC Ortho Connect (GC) that did not require primers were compared to the control group using Transbond XT, which was applied with a primer. For each patient, total bonding time was measured. The Adhesive Remnant Index (ARI(Bracket)) score was noted over 12months. In vitro tests were used to evaluate specimens, shear bond strength (SBS), ARI(Bracket), and Enamel Surface Index (ESI). After in vitro debonding, the enamel surface and bracket base were analyzed using scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX). Clinical failure rate with primer was 9.0%, while it was 8.0 and 10.0 for GC and Biofix, respectively. The mean in vitro SBS values of the Biofix, GC, and Transbond XT groups were 8.21, 8.07, and 7.37MPa, respectively. There were no statistically differences in clinical failure (p = 0.160) and SBS values (p = 0.158). Mean differences in bond-up time per jaw were 9.65, 10.51, and 11.97min, which were statistically significant (p = 0.0001). Single-component adhesives had acceptable SBS values and enamel effects according to SEM-EDX analysis. Clinically, bonding failure was not shown statistically inferior to bonding with primer. There was also a significant difference in bond-up times. Considering an intensely working clinic with bonding processes for at least two jaws per day, this means a saving of the chair time of 1 patient per week. However, better saliva contamination and moisture control with lack of the primer stage and, thereby, an acceptable bracket failure rate will bring clinically significant results with less chair time for clinicians.

Orthodontic Bracket Failure Rates in South-Eastern Nigeria

Orthodontic Bracket Failure Rates in South-Eastern Nigeria

A Retrospective Clinical Audit of Bracket Failure among Patients Undergoing Orthodontic Therapy

Objective Bonding failure is a problem in orthodontic therapy and has been associated with orthodontic emergencies and delayed treatment time. The aim of this study is to determine the bracket failure rate among patients undergoing orthodontic therapy. Materials and Methods From the archives of posttreatment records, 200 total cases were selected, out of which 122 cases had detailed treatment records. Cases with incomplete records, large restorations, or enamel aberrations were excluded from the study. Descriptive statistics were applied to obtain sample characteristics, and a chi-square test was applied to compare the bracket failure between different categories. Result Out of the 122 samples enrolled in the study, female and male patients comprised 71% and 29%, respectively. Class I malocclusions were the most common problem (56%), followed by Class II (41%) and Class III (3%). The bracket failure rate was 3.43%, and 32% of the patients had an incidence of bracket failure. There was no significant difference in bracket failure among genders (p=0.344), malocclusion types (p=0.191), or operators (p=0.188). The maxillary left quadrant was the most common site of bracket failure, followed by the mandibular right quadrant. Conclusion Bracket failure is relatively uncommon. It is not affected by the gender or age of the patient or by malocclusion type. The maxillary left and mandibular right quadrants are the most common sites of bracket failure.

A fogszabályozó bracketek ragasztásának módszerei, összehasonlításuk a bracketleválási ráta alapján

Fogszabályozó kezelés során sok esetben ív rögzítésére szolgáló bracketeket ragasztanak a fogzománcra. A keletkezőrendszernek ellen kell állnia az egész kezelési idő alatt az elmozdító erőknek (okklúzió, rágóerő, ív ereje), és amikor abracket eltávolításra kerül, lehetőleg sértetlen zománcfelületet kell hátrahagynia maga után. A bracket-ragasztás minőségéta választott technika határozza meg. Célunk a napjainkban használt különböző ragasztási technikák összehasonlítóelemzése a bracket-leválási ráta alapján a következő szempontok szerint: direkt-indirekt módszer, használt bracketragasztóanyagok és a fogzománc előkészítése. A szakirodalmi adatok, vizsgálatok felkutatására a PubMed és a GoogleScholar keresőmotorokat használtuk. Az összehasonlítás kiegészítéseként a Fogászati és Szájsebészeti Oktató Intézetbenfogszabályozó kezelésben résztvevő páciensekről gyűjtöttünk adatokat (direkt technika, kompozit alapú ragasztó,többlépéses zománc kondicionálás). A felhasznált bracketek megrendelési és utánrendelési számai alapján a leválásiráta 4,1%, ami a szakirodalom által elfogadott 10% alatti értéken belül helyezkedik el [24, 6].Összességében a direkt és indirekt bracket-ragasztást összehasonlítva a feldolgozott források alapján nem találtunkszignifikáns eltérést a kétféle módszer között. Ragasztóanyagok tekintetében a legnagyobb kötőerők a kompozit rezinekhasználatakor keletkeznek. A fogzománc hagyományos, többlépéses kondicionálása a legtöbb vizsgálat szerint kisebbleválási rátát eredményez, mint a self-etch rendszerek használata.

ASSOCIATION BETWEEN PATIENTS AGE, GENDER, LEVEL OF COOPERATION AND COMPLIANCE WITH ORTHODONTIC BRACKETS FAILURE

Objective: To determine association between patients age, gender, motivation for orthodontic treatment, level of cooperation and compliance with orthodontic bracket failure. Materials and Methods: About 100 patients of age 14 to 40 years who were fulfilling the inclusion criteria were selected by lottery method at Khyber college of dentistry and were studied for 6 months( from February 2018 to August 2018). It was a cross sectional study. Sampling was done by non-probability consecutive sampling technique. Data was analyzed by spss 22. P value <0.05 was considered as significant. Results: Our result showed that the difference among gender in brackets debonding was significant in first three months (p value = 0.01) and was in significant in the next three months( P value=0.44, 0.21, 0.70 ) in 4th, 5th and 6th month respectively. Level of compliance showed siginificant results .no of brackets debonded after one month (31.48)having p value (0.00). The results for motivation for orthodontic treatment was significant ,no of brackets debonded after one month (109.442) having p value (0.01) and level of cooperation were also siginificant. No of brackets debonded after one month (129.47) having p value (0.01) .Differnt age groups showed that adult patients results in less number of brackets debonding. Conclusion: Patients of different age, gender and level of cooperation show different bracket failure rate. Adult patients with their own motivation and high compliance showed less brackets deboning. Similarly female patients showed less deboning.

The Herbst appliance combined with a completely customized lingual appliance: A retrospective cohort study of clinical outcomes using the American Board of Orthodontics Objective Grading System

In this retrospective study we aimed to evaluate the quality of treatment outcomes using the American Board of Orthodontics (ABO) scoring system with a completely customized lingual appliance used in combination with a Herbst appliance for Class II correction. Patient selection criteria for this study were Class II division 1, II/2 or subdivision treated with a WIN® lingual appliance combined with an L-pin Herbst device. Thirty-two consecutively debonded cases were included in this retrospective case series. Pre- and post- treatment dental casts, dental set-ups, panoramic X-rays, cephalometric analysis, photographs and clinical files were available for data collection. The primary outcome was the ABO score based on the Discrepancy Index (ABO DI) including: overjet, overbite, anterior open bite, lateral open bite, crowding, occlusion (Angle class), lingual posterior crossbite, buccal posterior crossbite, ANB, IMPA and SN-GoGN angles and the Cast-Radiograph Evaluation (ABO CR-Eval) comprising of alignment/rotations, marginal ridges, buccolingual inclination, overjet, occlusal contacts, occlusal relationship (Angle class), interproximal contacts and root angulation. In addition, overjet, overbite and Class II correction were also evaluated on pre- and post-treatment models. The secondary outcome was bracket failure and complications related to the Herbst device. The study cohort included 18 female and 12 male patients with a mean age of 15.8 (range 12, 6- 18, 5). Twenty patients were Class II division 1 and ten were Class II division 2. The mean pre-treatment value of ABO DI was 20.8 (range 10-39); more than two-thirds of the sample were rated as being either of moderate difficulty (ABO DI: 16-24) or severe (ABO DI: over 25). The average post-treatment ABO Cast-Radiograph Evaluation score was 15.0 (SD=4.4), which is considered a passing score. Twenty-six patients had a score equal or lower than 20 (undisputed passing score). The Class II discrepancy was effectively corrected from a score of 16.83 penalty points (SD: 3.65) pre-treatment to a score of 1.57 (SD: 1.70) post-treatment. No association was found between initial and final Class II occlusal relationships (P=0.42), indicating that regardless of the initial discrepancy, no difference in the success of Class II correction was observed. The mean bracket failure rate was 3.8 per patient. Herbst related complications were few: 1.6 per patient, with the majority of complications being of little consequence and with 43% of the patients having no breakages. The completely customized lingual appliance assessed in this study combined with an L-pin Herbst led to effective Class II correction regardless of the initial severity of the sagittal discrepancy. The average ABO CR-Eval score for this sample was well below the undisputed passing score indicating a high quality of treatment outcomes.

Failure rates among metal brackets cured with two high-intensity LED light-curing lamps: an in vivo study.

The objective of this split-mouth clinical trial was to compare bonding failure rates of metal brackets bonded with two different light-emitting diode (LED) light-curing lamps with different high-intensity power outputs. Forty patients were included for a total of 800 brackets that were randomly bonded (left and right sides in a 1:1 ratio) in maxillary and mandibular arches using two different LED devices. An LED of 3200 mW/cm2 and an LED of 5000 mW/cm2 were used in this split-mouth clinical trial. Bonding failures during the initial 6 months of orthodontic treatment were recorded as maxillary versus mandibular, anterior teeth versus posterior teeth, and left side versus right side. Five dropouts were recorded for discontinuing orthodontic treatment and 700 brackets were analysed in total. The bonding failure rates for 3200 and 5000 mW/cm2 LEDs were 6.0 and 7.4 per cent, respectively (P = 0.450), which were not statistically significantly different. There were no significant differences in bracket survival rates between the LEDs used (P = 0.866). The posterior teeth presented a higher index of bond failures (odds ratio, 3.14; 95% confidence interval, 1.68-5.87; P < 0.001). Direct comparison was only done between two high-intensity LED lights rather than against conventionally used halogen lights. Similar bonding failures were recorded using both LED devices (3200 and 5000 mW/cm2). Significantly more bonding failures occurred in premolar teeth than in anterior teeth.

A Comparison of Bracket Failure Rate Between Direct and Indirect Bonding Techniques: A Prospective Clinical Study

A Comparison of Bracket Failure Rate Between Direct and Indirect Bonding Techniques: A Prospective Clinical Study

BOND FAILURE RATE OF AMORPHOUS CALCIUM PHOSPHATE CONTAINING (AEGIS ORTHO) AND FLUORIDE RELEASING (TRANSBOND PLUS COLOUR CHANGE) ORTHODONTIC ADHESIVES-A RANDOMIZED CLINICAL TRIAL

Background: The aim of the study was to compare the survival rate of brackets bonded with amorphous calcium phosphate containing adhesive and fluoride releasing orthodontic adhesive over 6 months period. White spot lesions were also evaluated prior to bonding, 3 months and 6 months from the date of bonding. Methods: Thirty six orthodontic patients were randomly divided into two equal groups using split mouth design. 592 brackets were bonded up to the premolars with either Aegis Ortho or Transbond Colour Change(TPCCA). Bracket failure rate and survival distribution were evaluated and compared using Kaplan- meier analysis and Log rank test with respect to adhesives, dental arches, segments , tooth types, gender and age groups. White spot lesion was assessed using WSL index. Results: There was no significant difference between the failure rate of Aegis Ortho(3.0%) and TPCCA(1.4%). Kaplan Meier analysis, Log rank test showed that the difference in the overall failure rate and survival time between the arches, gender, and different age groups were not statistically significant. Both adhesives had a high bond failure rate in the posterior segment especially in the premolar region. Three patients had white spot lesions in the upper premolar region bonded with Aegis ortho. Conclusion: Both Aegis ortho and Transbond plus colour change adhesive with a low bond failure rate can be used as an alternative orthodontic adhesive. Key words : bond failure, amorphous calcium phosphate, transbond colour change adhesive, white spot lesions.

Effectiveness of an antibacterial primer used with adhesive-coated brackets on enamel demineralization around brackets: an in vivo study

BackgroundThe aim of the study is to assess the clinical effect of an antibacterial monomer-containing primer on preventing white spot lesions (WSLs) during fixed orthodontic treatment.Subject and methodsThe study included 35 patients. A split-mouth design was used during bonding of the brackets. In Clearfil (CF) group, adhesive-coated brackets (APC Plus Victory series, 3M Unitek, Monrovia, CA, USA) were bonded with an antibacterial monomer-containing primer (Clearfil Protect Bond, Kuraray Medical, Okayama, Japan). In Transbond (TB) group, the same adhesive-coated brackets were bonded using a conventional primer (Transbond XT Primer; 3M Unitek, Monrovia, CA, USA). The mean duration of orthodontic treatment was 16 months. Digital images of each tooth were used to assess the WSLs. The areas of the WSLs were measured with a software. The bond failures during orthodontic treatment were also recorded.ResultsAfter fixed orthodontic treatment, 23 of the 35 patients showed one or more WSLs. Of the total of 666 teeth, 114 WSLs occurred over the orthodontic treatment time. Rates of WSL in the CF and TB groups were 8.03% and 9.24%, respectively. The difference in WSL rates between the two groups was not statistically significant. No significant difference was observed in the lesion areas between the groups. Moreover, the difference in bracket failure rates between the two groups was also not statistically significant.ConclusionThe results of this long-term clinical study indicated no significant difference between the antibacterial monomer-containing primer group and the control group in the efficacy of reducing demineralization throughout the orthodontic treatment.

Predicting the bracket bond failure rate in orthodontic patients: A retrospective cohort study

The aim of this study was to determine the risk factors associated with orthodontic bracket bond failure and to develop a prediction equation for orthodontic bracket bond failure rate using the risk factors. This was a retrospective cohort study conducted on a sample of 690 brackets in orthodontic patients aged 10 to 28 years old (mean age 17.97±5.11 years old) visiting a dental hospital. The effect of various parameters of orthodontic bond strength was assessed on bracket failure rate using survival analysis. Parametric (exponential) regression analysis was used to determine the risk factors associated with bracket failure and a prediction equation was formulated to predict the bracket failure rate. The overall mean survival time for the brackets was 3.04 (2.9-3.17) years. The univariate analysis showed a statistically significant (P<0.05) association of bracket material, site, overjet, overbite, incisor and molar classification and age. The multivariate analysis showed a significant interaction between site and side along with bracket material, jaw, overjet and overbite in the model. The risk of bracket failure on the right posterior region is 7.7 times that in the right anterior region when adjusted for all other variables in the model (HR: 7.7; 95% CI: 4.3-13.6). The model including bracket material, jaw, overjet, overbite and interaction between site and side can be used as a predictor of hazard rate for orthodontic bracket failure. Care should be taken in bonding brackets in the posterior region, as their debonding rate is higher as compared to anterior region.

Comparative assessment of bonding time and 1-year bracket survival using flash-free and conventional adhesives for orthodontic bracket bonding: A split-mouth randomized controlled clinical trial.

A new flash-free adhesive promises to eliminate the flash removal step in bonding and to reduce bonding time by as much as 40% per bracket, with a bond failure rate of less than 2%. The aim of this trial was to compare bonding time and bracket failure rate over a 1-year period between the flash-free adhesive and a conventional adhesive for orthodontic bracket bonding. Forty-five consecutive patients had their maxillary incisors, canines, and premolars bonded with ceramic brackets (Clarity Advanced; 3M Unitek, Monrovia, Calif) using a flash-free adhesive (APC Flash-Free Adhesive Appliance System; 3M Unitek) on 1 side and a conventional adhesive (APCII Adhesive Appliance System; 3M Unitek) on the other side. The side allocation was randomized. Bonding was timed to the nearest second. Bond failure was recorded at standardized intervals of 4weeks. The primary outcome was bonding time (average per tooth for each patient and per quadrant). Secondary outcomes were bracket failure rate within 1year, time to first-time failure of a bracket, and bond failure type (adhesive remnant index score). Bonding times and adhesive remnant index scores upon bond failure were compared using paired t tests, with P<0.05 considered statistically significant. The adhesives were considered equivalent if the confidence interval for the difference between bracket failure rates fell within a margin of equivalence of ±5%. The bonding times were significantly shorter with the flash-free adhesive than with the conventional adhesive, both per tooth (P<0.001) and per quadrant (P<0.001). Compared with the conventional adhesive, the average bonding times per tooth and per quadrant with the flash-free adhesive were 37.3% and 32.9% shorter, respectively. The bracket failure rates at 1year were 3.7% for the flash-free adhesive and 0.9% for the conventional adhesive. This was statistically equivalent. The average times to first-time failure of a bracket were 25weeks for the flash-free adhesive and 11weeks for the conventional adhesive. Although there were no significant differences in the adhesive remnant index scores upon failure (P>0.05), the flash-free adhesive tended to fail more often at the enamel-adhesive interface than did the conventional adhesive. The use of the flash-free adhesive may result in bonding time savings of approximately one third compared with the conventional adhesive. With regard to bracket survival, a statistically significant difference was not found between the 2 adhesives when ceramic brackets were bonded. This trial was registered on December 3, 2013 (ClinicalTrials.gov ID, NCT02030002). The protocol was not published before trial commencement.

A comparative assessment of bracket survival and adhesive removal time using flash-free or conventional adhesive for orthodontic bracket bonding: A split-mouth randomized controlled clinical trial.

To compare bracket survival and adhesive removal time between a flash-free and a conventional adhesive for orthodontic bracket bonding. Forty-five consecutive patients had their maxillary incisors, canines, and premolars bonded with ceramic brackets using a flash-free adhesive (APC Flash-Free Adhesive, 3M Unitek, Monrovia, Calif) on one side and a conventional adhesive (APCII Adhesive, 3M Unitek) on the other side. The side allocation was randomized. Bracket failure was recorded at 4-week intervals. The adhesive remnant index (ARI) was scored on debond and adhesive removal timed to the nearest second. The primary outcome was adhesive removal time per quadrant. Secondary outcomes were bracket failure rate, time to first-time failure of a bracket, and ARI score on debond. Paired t-tests were used to compare adhesive removal times and ARI scores between the adhesives with P < .05 considered statistically significant. Bracket failure rates were 4.3% for the flash-free adhesive and 1.9% for the conventional adhesive, with mean times to first-time failure of 31 weeks for the flash-free adhesive and 42 weeks for the conventional adhesive; neither failure rates nor times to first failure were significantly different. Although the flash-free adhesive left significantly more adhesive on the tooth surface after debonding, the adhesive removal times were 22.2% shorter than with the conventional adhesive. Bracket survival with the flash-free adhesive was equivalent to the conventional adhesive when ceramic brackets were bonded. Adhesive removal was significantly faster when using the flash-free adhesive, which may result in time savings of more than 20% compared with the conventional adhesive.

Bond strength of pre-coated flash-free adhesive ceramic brackets. An in vitro comparative study on the second mandibular premolars

Clinical studies show a mean bond failure rate of orthodontic brackets, which ranges between 6% and 8%, with a predominance for the second mandibular premolars. The pre-coated flash-free adhesive ceramic brackets allow to obtain, according to their manufacturer, a low bond failure rate, while ensuring a simplified implementation. The aim of this study was to measure the shear bond strength of ceramic brackets bonded with the direct method using a pre-coated flash-free adhesive system, and to compare it with the shear bond strength of the old generation precoated brackets and that of operator coated brackets to the buccal surface of the second mandibular premolars. 45-second mandibular premolars extracted for orthodontic purposes were randomly distributed into 3 groups of 15 teeth each. In the first group, the brackets were precoated with the APC™ Flash-Free® system (3M Unitek; in the second group, with the APC Plus® system (3M Unitek), and in the third group, the brackets were bonded manually with the Transbond XT® composite (3M Unitek). The enamel surface was prepared in the same way for the 3 groups: etching using 36% orthophosphoric acid, followed by the application of the Transbond XT® primer adhesive (3M Unitek). Each sample was submitted to shear bond strength forces using a Universal Testing Machine LRX® (Lloyd Instruments LTD., Fareham, UK) in shear mode with a crosshead speed of 1.0mm/min. The bond strength values of the brackets were recorded in megapascals (MPa) for each tooth. The mean values were then compared using the one-way ANOVA test. Although the mean shear bond strength value for the APC Flash-Free® group was lower than those of the two other groups, this difference was not statistically significant (P=0.276). Given the experimental conditions of this in vitro study, the shear bond strength of the brackets precoated with the APC Flash-Free® system is comparable to the two other conventional systems.

The efficiency and benefit of using, the halogen light source used for bleaching of teeth, in bonding of orthodontic brackets (an in vivo study)

Background: The property of the bleaching light sources is the wide and curved(the negative of the mouth curve) head of exposure. The aim of this study was to,test the efficiency of this devise to bond orthodontic brackets, via unique exposurefor the whole teeth, by comparing the rate of the brackets failure with thetraditional led light source used in orthodontic brackets bonding which utilizeslight exposure for every tooth separately, and evaluating the benefit of time savingthrough contrasting the time required for bonding with the ordinary led andhalogen light sources.Materials and methods: 856Roth 0.22 stainless steel brackets were bonded to 39patients by using one of the two light sources in the form of three groups;bleaching light group (13 patients / 225 brackets) , ordinary led light group (13patients /237 brackets), split mouth group( by using combination of the twosources, 13patients / 229 brackets).Results: There is no statistically significant difference between the light source usedfor bleaching and traditional led light source in bracket failure rates, and the timerequired for bonding by the bleaching light source is 22% and 5% of that requiredby ordinary led light and ordinary halogen light respectively.Conclusion: the light sources used for bleaching can be used effectively in bonding oforthodontic brackets with given advantage of saving time and effort.

Failure patterns of different bracket systems and their influence on treatment duration: A retrospective cohort study.

To compare the failure pattern of four different bracket types and to assess its effect on treatment duration. A total of 78 white patients (28 male, 50 female) with a mean age of 12.6 years were included in this retrospective cohort study and treated for a mean period of 30.6 months. The patients were treated in a private practice with stainless steel conventionally ligated brackets, ceramic conventionally ligated brackets, stainless steel self-ligating brackets, or nickel-free self-ligating brackets. The loss of at least one bracket during the course of treatment was analyzed with Cox proportional hazards survival analyses and generalized linear regression. The overall bracket failure rate at the tooth level was 14.1% (217 brackets), with significant differences according to tooth type (between 8.0%-23.4%) and bracket type (between 11.2%-20.0%). After taking confounders into account, patients treated with ceramic brackets lost more brackets (hazard ratio = 1.62; 95% confidence interval = 1.14-2.29; P = .007) than patients with stainless steel brackets. On average, treatment time increased by 0.6 months (95% confidence interval = 0.21-1.05; P = .004) for each additional failed bracket. Bracket failure was more often observed with ceramic brackets and was associated with increased treatment duration.

Reflections on twelve years of breakages – lessons to be learnt

Abstract: This paper describes the nature and extent of emergencies and breakages recorded in one clinician's orthodontic practice over a 12-year period. As this long-term audit progressed the author's bonding regimen changed to reduce an initially high failure rate and then to cope with even greater bond failure rates as self-ligating brackets and self-etch primer were introduced. Overall, the bracket failure rate was reduced 61% over the 12-year period and 73% from its peak value. This was achieved by rigorous cleaning of the enamel, higher quality etchant, uncontaminated dry air, compomer to protect brackets from occlusal forces, as well as the occasional use of a Nola dry system. CPD/Clinical Relevance: All orthodontic practices need to reduce emergency appointments and breakages at routine visits. This paper, by highlighting the use of a breakage book, gives the clinician a strategy to improve both.

The effect of conventional versus figure-of-eight module ligation on mandibular incisor alignment: a randomised controlled trial.

To determine whether using figure-of-eight modules affects the rate of lower incisor alignment compared with conventionally tied modules. Prospective randomised controlled trial. Orthodontic department at Queen's Hospital, Burton upon Trent, UK. One hundred and twenty participants were randomly allocated to conventional module or figure-of-eight module groups, stratified for extraction or non-extraction lower arch treatment. Eligibility criteria included patients who were 12-15 years of age at the start of treatment, in the permanent dentition, and had mandibular incisor irregularity of 5-10 mm (clinical observation). The primary outcome was the rate of lower incisor alignment during the first 12 weeks of orthodontic treatment. The secondary outcome was bracket failure rate. Lower labial segment alignment was measured on study models using the Little's Irregularity Index at the start (T0) of treatment, at 6 weeks (T1) and 12 weeks (T2). Case records were analysed to assess the number of bracket failures. The four groups were well matched at baseline with respect to gender, age and irregularity. All patients completed the trial and data were analysed on an intention to treat basis. In both ligation groups, the lower teeth aligned significantly faster when the treatment involved extractions, for the time periods T0-T1 and T0-T2 (p < 0.05). There were no statistically significant differences between conventional module and figure-of-eight module ligation on the rate of alignment (per month) for all three-time periods. The bracket failure rate was also similar in both test groups; 4.08% for conventional and 3.21% for figure-of-eight ligation. Ligation with figure-of-eight modules has no clinically significant effect on the rate of lower incisor alignment; it does not seem to hinder or quicken the alignment of teeth. There were no differences in the mean number of bracket failures per person.

Do hemostatic agents affect shear bond strength and clinical bond failure rate of orthodontic brackets?

To evaluate the effects of different hemostatic agents on the shear bond strength (SBS) in vitro and clinical bond failure rate of orthodontic metal brackets in vivo. A total of 100 human premolar teeth were randomly divided into five groups: control, blood, Viscostat, hydrogen peroxide (H2O2), and epinephrine. Teeth were bonded with same light-cured adhesive and composite. After storage in distilled water for 24 h, thermal cycling was used as an aging procedure on all samples. The brackets were subjected to an SBS test at a speed of 0.5 mm/min until bracket debonding. SBS values and the adhesive remnant index were evaluated. Ninety-nine patients (52 female, 47 males) undergoing routine orthodontic treatment were recruited for this controlled clinical study at bonding stages. All patients with bleeding on the buccal surface of any premolar tooth or teeth at bonding were included in this study. Over 6 months, the bond failure rate was calculated. Data were analyzed using one-way analysis of variance (ANOVA) and Tukey’s post-hoc test (p < .05). The McNemar test was used to compare bracket-bond failure. ANOVA showed a significant difference (p < .001) between the groups. No significant differences were found between the hemostatic agent groups (p > 0.05) in the in vitro part. The lowest failure rate was obtained in the control group rather than the hemostatic agent groups during clinical follow-up (p < 0.05). Each of the hemostatic agents (Viscostat, H2O2, and epinephrine) can be used for bleeding management during the orthodontic bonding process. Epinephrine application showed a high bond-failure rate at clinical follow-up.

Six-month bracket failure rate with a flowable composite: A split-mouth randomized controlled trial.

ABSTRACTINTRODUCTION: The use of flowable composites as an orthodontic bonding adhesive merits great attention because of their adequate bond strength, ease of clinical handling and reduced number of steps in bonding. OBJECTIVE: The aim of this Randomized Controlled Trial was to comparatively evaluate over a 6-month period the bond failure rate of a flowable composite (Heliosit Orthodontic, Ivoclar Vivadent AG, Schaan) and a conventional orthodontic bonding adhesive (Transbond XT, 3M Unitek).METHODS: 53 consecutive patients (23 males and 30 females) who fulfilled the inclusion and exclusion criteria were included in the study. A total of 891 brackets were analyzed, where 444 brackets were bonded using Heliosit Orthodontic and 447 brackets were bonded using Transbond XT. The survival rates of brackets were estimated with the Kaplan-Meier analysis. Bracket survival distributions for bonding adhesives, tooth location and dental arch were compared with the log-rank test.RESULTS: The failure rates of the Transbond XT and the Heliosit Orthodontic groups were 8.1% and 6% respectively. No significant differences in the survival rates were observed between them (p= 0.242). There was no statistically significant difference in the bond failure rates when the clinical performance of the maxillary versus the mandibular arches and the anterior versus the posterior segments were compared.CONCLUSIONS: Both systems had clinically acceptable bond failure rates and are adequate for orthodontic bonding needs.