Bracket System Research Articles

A Comparative Evaluation of Space Closure Rate Between Newer Generation Ceramic Brackets and Conventional Straight Wire Appliances

Background: With the emerging concept of aesthetics in orthodontics, ceramic brackets play a major role especially in the anterior region of the dental arch. However, the duration of the orthodontic treatment is one of the most important issues in treating patients with ceramic brackets. Objectives: This study is conducted to compare space closing rate between conventional MBT and Symetri ClearTM bracket systems. Methods: This study is comprised of 18 subjects who were equally separated into two groups. The first group was treated with conventional MBT pre-adjusted bracket and the second group with Symetri ClearTM brackets. Space closure was performed via 0.019 × 0.025 inch stainless steel wires using 9-mm nickel-titanium Sentalloy coil springs with a constant force of 150 g. The distance between the distal of the first molar buccal tube and the mesial of the canine bracket was measured by a digital caliper. The difference of the first and last values was determined to assess the sheer quantity of space closure. The value was then divided by the number of months during which the space closure was carried out to examine the ratio of space closure in mm per month. For the statistical analysis we used paired t test as well as independent t test and the P-value > 0.05 was deemed significant. Results: The MBT group showed a 0.85 mm/appointment retraction rate while the Symetri ClearTM bracket group had a 0.83 mm/appointment retraction rate. The difference in space closing between MBT and Symetri ClearTM groups was not statistically and clinically significant (P-value > 0.05). Conclusions: As the rate of space closure was almost similar in the two types of brackets, we can use Symetri ClearTM brackets instead of MBT brackets without any concern about the duration of treatment and use the esthetic benefits of these brackets simultaneously.

Diagnosis, treatment planning & management of patient undergoing orthodontic therapy with blunderbuss canal’s in relation to multiple teeth by endo- ortho interdisciplinary approach using PRF & MTA

Diagnosis, treatment planning & management of patient undergoing orthodontic therapy with blunderbuss canal’s in relation to one or multiple tooth requires a precise scientific approach based on sound principles. Interdisciplinary therapy integrates individual disciplines to function as a comprehensive unit providing consistent and predictable treatment results. A thorough logical diagnostic approach and treatment planning must be executed by each member of endodontic-orthodontic team when an esthetic and healthy makeover of a patient’s dentition is planned. Precise communication is important to provide patients with desired results. This case report presents one such approach for diagnosis, treatment planning & management of patient undergoing orthodontic therapy with blunderbuss canal’s in relation to one or multiple tooth. After careful clinical and radiographic evaluation, the patient was diagnosed with Angle’s Class I malocclusion with spacing in maxillary and mandibular arch, and blunderbuss canal’s irt 35 & 45. The treatment consisted of initial endodontic approach by starting treatment irt 35 and 45, followed by fixed orthodontic approach using passive self-ligating bracket system and by-passing the endodontically treated tooth. Regular follow-up to observe apexogenesis and continuous evaluation of the case is being done.

An Instrument for Seating Orthodontic Archwires

Full engagement of orthodontic archwires to permit gate closure in self-ligating brackets can be challenging in both the initial stages of alignment with crowded or rotated teeth and also during the later treatment stages with use of heavy rectangular wires. A handy, reliable tool has been developed to ensure complete seating of any archwire in slots of both conventional and self-ligating bracket (SLB) systems to overcome this problem.

Effects of adhesive type on the mechanical properties of adhesive joints between polyurethane top coats and polyurethane-based adhesives after accelerated atmospheric ageing

The performance of a sealed stainless steel bracket system, adhesively bonded with two polyurethane-based adhesives (flexible adhesive, stiff adhesive) onto a marine polyurethane top coat, is investigated. The investigated joint connections on the coatings exhibited a high mechanical stability even after accelerated ageing (salt spray exposure, cyclic temperature variations, high relative humidity). The aged joints retained up to 81% of their tensile strength and up to 92% of their lap-shear strength. The torsional rigidity of the adhesive joint exceeded the required clamping torque of the designed bolt. A cyclical lifetime of >9·106 load cycles was estimated. Effects of cyclic ageing on the creep performance of the adhesive joint were found to be insignificant. Under tensile loads, the joints with stiff adhesive material exhibited a linear-elastic performance without the capability to deform prior to failure. The joints with the flexible adhesive material, in contrast, exhibited a behavior typically for ductile materials featuring a pronounced yield plateau prior to failure. Failure loads were higher, and displacement was notably lower, for the joints with stiff adhesive material. All joint connections met the requirements for a safety factor for the design for marine applications (11.6 for the flexible adhesive; 14.3 for the stiff adhesive). When the flexible adhesive is applied, the cohesive strength of the adhesive material is the limiting design factor. When the stiff adhesive is utilized, the load carrying capacity is higher, and the interface between priming coat and steel substrate is the limiting design area of the joints. The strength utilization of the adhesive materials depended on the particular structure of the entire joint configuration, particularly on the interface between steel substrate and the coating material. A number of assessment factors, namely stress limit factor, coating adhesion factor and safety factor, are introduced and discussed for tensile and shear loads.

Calculation of Transient Magnetic Field and Induced Voltage in Photovoltaic Bracket System during a Lightning Stroke

An effective method is proposed in this paper for calculating the transient magnetic field and induced voltage in the photovoltaic bracket system under lightning stroke. Considering the need for the lightning current responses on various branches of the photovoltaic bracket system, a brief outline is given to the equivalent circuit model of the photovoltaic bracket system. The analytic formulas of the transient magnetic field are derived from the vector potential for the tilted, vertical and horizontal branches in the photovoltaic bracket system. With a time–space discretization scheme put forward for theses formulas, the magnetic field distribution in an assigned spatial domain is determined on the basis of the lightning current responses. The magnetic linkage passing through a conductor loop is evaluated by the surface integral of the magnetic flux density and the induced voltage is obtained from the time derivative of the magnetic linkage. In order to check the validity of the proposed method, an experiment is made on a reduced-scale photovoltaic bracket system. Then, the proposed method is applied to an actual photovoltaic bracket system. The calculations are performed for the magnetic field distributions and induced voltages under positive and negative lightning strokes.

Comparison of Changes in Incisors Inclination and Dental Arch Dimensions in Damon and MBT Systems Using Dolphin Software

Background: There is great controversy regarding the effect of MBT and Damon bracket systems on dental arch dimensions and incisor position. Objectives: We aimed to study the effects of two different brackets (MBT and Damon) on dental arch dimensions and incisors position after orthodontic treatment. Methods: In this retrospective study, the records of 20 patients who underwent orthodontic treatment with MBT or Damon bracket systems were studied. All patients had class I skeletal and dental malocclusion and were treated without extraction. The patients were treated either with Damon or MBT bracket systems (n = 10). Lateral cephalograms were traced using the Dolphin software to determine the position of incisors. In addition, transverse dimensions of dental arches were measured on occlusal photographs. Fishers’ exact test, independent-test, Man-Whitney, paired t-test, and Wilcoxon were used for statistical analysis. P < 0.05 was set as significant. Results: There was no significant difference between the two groups regarding age, sex, and initial values of the variables studied. U1-Apog (mm), upper inter-canine, lower inter-second premolar distance showed a significant difference before and after treatment in the Damon system. However, no significant difference was observed between initial and post-treatment values in the MBT group. L1-Apog (°), IMPA (°), maxillary inter-first and second premolars, inter-canine, and mandibular inter-canine distance was higher in the Damon system after treatment compared to MBT. Changes of the upper and lower transverse dimensions of the dental arches and the incisor positional did not reveal a notable difference in the Damon and MBT systems (P > 0.05). Conclusions: There was no significant difference regarding changes in dental arches and incisor positions between the Damon and MBT systems.

THREE DIMENSIONAL ASSESSMENT OF MOVEMENT OF SKELETALLY ANCHORED MOLARS DURING LEVELING AND ALIGNMENT STAGE OF FIXED ORTHODONTIC MECHANOTHERAPY

Introduction- Alignment and leveling has been dene as “The tooth movement needed to achieve passive engagement of a plain arch wire of 0.019x0.025 dimension having standard arch form in to a correctly placed 0.022˝ bracket system.''Anchorage is an important consideration in the alignment and leveling stage of orthodontic treatment. Loss of anchorage during this stage is to be considered in the three planes of space. Aims and objectives - Three dimensional assessment of the position of skeletally anchored rst molar teeth and three dimensional assessment of the position of rst molar teeth anchored with conventional trans palatal arch using lateral cephalogram and study models, at the end of leveling and alignment stage of xed orthodontic mechanotherapy and its comparison with pretreatment position.Utimately to nd out by comparing the above measurements whether skeletally anchored molars offer more anchorage than molars anchored with conventional transpalatal arches. Materials and methods- These 30 patients were asked to participate in this study out of which 20 consented. All pre-treatment(T ) patient records were made: o study models, standard lateral cephalograms (Satlec – Pano D), extra oral and intra oral photograph. Miniscrew anchored transpalatalarch (MATPA) was placed in 12 patients(group I) and conventional transpalatal arch in 8 patients (group II). 0.022” stainless steel M.B.T. prescription brackets and tubes ( Nu- Edge, TP Orthodontics) were used and treatment mechanics described by Mc. Laughin, Bennet and Trevisi were followed in all patients. Result - This study attempted a 3-dimensional assessment of molar movement during alignment and leveling stage. The mini screw anchored trans palatal arch (MATPA) was found to offered better anchorage than the conventional trans palatal arch (TPA) .In the sagittal plane angular and linear measurements were found to have signicantly changed after leveling and alignment for conventional TPA group whereas no signicant difference were found in MATPA group. In the vertical plane, the perpendicular distance of the mesiobuccal cusp tip to the platal plane was found to be signicantly changed in conventional TPA group whereas no signicant change was measured in MATPA group. ConclusionMiniscrew anchored trans palatal arch offered better anchorage control of maxillary rst molar teeth in sagittal, vertical and transverse plane, during the leveling & alignment stage of xed orthodontic mechanotherapy, when compared with conventional trans palatal arch.

Product advertisements in orthodontic journals: Are they evidence-based?

Previous research has suggested orthodontic advertisements are poorly supported by evidence. The primary aim of this study was to identify the type and quality of evidence supporting advertisement claims in leading orthodontic journals. A cross-sectional study was undertaken to assess all advertisements published between January 2015 and December 2017 in 6 major orthodontic journals. Only advertisements implying superior product performance in clinical practice or patient care were selected for further evaluation. Study variables were collected using a prespecified data collection form. In the presence of a supporting citation, the reference article was obtained, and the quality was assessed in duplicate. Associations between advertisement variables and quality of evidence were explored using contingency tables (Fisher exact test). A total of 1753 advertisements were identified. After the application of eligibility criteria, 124 were included in the final analysis. Advertisements promoting bracket systems predominated. Of these, 34.7% were supported by evidence, of which 10.5% (n=13) included accessible references. Only 6 out of 13 studies involved orthodontic patients. Primarily expert opinion and observational study types were referenced. Less than 2% of advertisements were supported by high-value evidence. There was an association between the quality of evidence in advertisements and the product category (P=0.003). There is a lack of both references and high-value evidence cited in orthodontic manufacturers' advertisements. Without critical appraisal of references cited in advertisements, clinicians need to be cautious before implementing manufacturers' recommendations in clinical practice. Efforts should be made to ensure appropriate high-value evidence is cited in advertisements to support manufacturers' claims.

Assessment on the Precision of the Orthodontic Bracket Slot Dimensions Using Micro-computed Tomography (Micro-CT)

To evaluate the precision of the orthodontic bracket slot dimensions of 0.022 inch and to compare them with those of the manufacturers' specifications. The slots of upper-right central incisor brackets (n = 5) from 11 commercial bracket systems of three different manufacturers (3M Unitek: Victory Mini Metal, Clarity, SmartClip, Clarity SL; ORMCO/SYBRON: Mini Diamond Twin, Damon Q, Damon Clear; Dentsply/GAC: Ovation, Mystique, In-Ovation R, In-Ovation C) were measured. The orthodontic brackets were scanned using micro-computed tomography (micro-CT), and the bracket slots were measured using micro-CT images. The slot was measured at four different surfaces (occlusal, gingival, base, and face) for both mesial and distal sites. Data were subjected to ANOVA and unpaired t-tests. A p-value of ≤0.05 was considered statistically significant. All brackets had slot dimensions that were significantly larger (p < 0.05) than the stated 0.022 inch. 3M-victory were 11.99% larger (0.02509 inch) and the closest to the stated dimension and the ORM-Damon C were 24.07% larger (0.02948 inch) than the quoted slot size of 0.022 inch. Comparison between mesial and distal sides showed that 91% of the bracket slots were asymmetrical at their bases and 100% asymmetrical at their faces. All of the bracket system showed divergent walls from base to face with values ranging from 1.96 (3M-SmartClip) to 26.58% (ORM-Damon C). The actual measurements of 11 bracket systems from three different manufacturers were more substantial than the manufacturers' specifications, and the walls of the slots diverged from the bracket bases in all of the tested bracket system. Orthodontic bracket slots vary significantly from that of the manufacturers' specification. The orthodontist should anticipate such shortcomings and be able to modify treatment mechanics through additional wire bending in three spatial planes.

Various bidimensional techniques used in orthodontics: A systematic review

Maintaining torque with sliding mechanics in maxillary anterior teeth especially in presence of large extraction spaces has become a major concern among orthodontist. Loss of torque occurs owing to play between bracket system and arch wires. Thus, for torque control various arch wire twisting and torquing axillaries have been introduced. Not only do these techniques cause certain discomfort to patients but also extends patient chair time because of various chair side wire bending involved. Thus, a bidimensional technique in bracket system will be beneficial in controlling incisor torque simultaneously it will also assist in loss of anchorage in posterior teeth as it facilitates free sliding of arch wire through the bracket slot thus reducing friction. The aim of this article is to equip an overview of bidimensional technique in orthodontics. Keywords: Bimetric system.

A Comparison of the Effects of Extraction and Nonextraction Orthodontic Treatments on Cephalometric Parameters and Arch Widths

Objectives: To compare the effects of two different treatment approaches on cephalometric measurements and arch widths. Materials and Methods: The retrospective study evaluated pre- and post-treatment cephalometric radiograms and dental models of 45 patients with Class I malocclusions and moderate-severe dental tooth size arch length discrepancies that underwent extraction or nonextraction treatment between 2015 and 2020. Group I (n=22 [9 female, 13 male]; mean age, 18.0 ± 1.68 years) was treated with the Damon Q bracket system and Group II (n=23 [11 female, 12 male]; mean age, 17.9 ± 1.34 years) was treated with the conventional MBT bracket system. Pre- and post-treatment lateral cephalometric radiograms were obtained and arch widths were measured for each subject. Paired samples t-test was used to evaluate the treatment changes within each group. To compare the changes between groups, independent samples t-test was performed. Results: No significant change was detected in the sagittal and vertical skeletal parameters in both groups (p&amp;gt;0.05). The upper and lower incisors proclined significantly in Group I (p&amp;lt;0.01) and the mandibular incisors retroclined significantly in Group II (p&amp;lt;0.05). The lips protruded significantly and the upper lip thickness decreased significantly in Group I (p&amp;lt;0.01), whereas no significant difference was observed in Group II (p&amp;gt;0.05). All the transversal dimensions increased significantly in Group I (p&amp;lt;0.01), while only the intermolar distance decreased significantly in Group II (p&amp;lt;0.01). Conclusions: Both treatment methods provided significantly different outcomes with regard to soft tissue parameters and arch widths.

Results of orthodontic treatment of a child with asymmetrical micrognathia and the congenital mandibular condylar hyperplasia

Aim. To analyze the results of orthodontic treatment of a child with asymmetrical micrognathia and mandiblar condylar hyperplasia.&#x0D; Methods. The configuration of a face in the photos was evaluated and diagnostic models of the jaws were analyzed by using the Ponts and Korkhaus methods in treatment dynamics. The physiological status of bone tissue, temporomandibular joints and teeth was studied by using orthopantomography and computed tomography. Functional disorders were detected by using special tests, including EschlerBittner's test and Ilyina-Markosyans test. Orthodontic treatment and stimulation of mandibular growth in the mixed dentition stage were undertaken with the single jaw removable appliances and the appliance improved by us for correction of the distal occlusion. The Damon Q bracket system with archwires was used in permanent dentition period.&#x0D; Results. The child's convex facial profile was typical for distal occlusion and micrognathia. The facial asymmetry, increasing with mouth opening, and a decrease in mandibular range of motion indicated lesion of the right temporomandibular joint. The right condyle was enlarged on the orthopantomogram. The computed tomography showed that it was asymmetrically enlarged and had a cellular structure. There was detected asymmetric micrognathia. The comprehensive rehabilitation plan included orthodontic treatment, myotherapy, speech therapy, mechanotherapy. The use of removable orthodontic appliances led to the normal size of the dentition and their relation, significantly reduced functional disorders and improved facial aesthetics. Five years after completion of orthodontic treatment, the physiological occlusion and amplitude of the mandibular movements remained, but the right mandibular angle was flattened.&#x0D; Conclusion. The comprehensive rehabilitation of a child with asymmetrical micrognathia and mandibular condylar hyperplasia started in mixed dentition stage provided conditions for the formation of normal permanent dentition and the improvement of functional disorders and facial aesthetics; our results allow us to suggest the positive effect of our tactics for treatment of the patient.

Comparative evaluation of T-Loop with different amount of pre-activation curvatures in lingual orthodontics- A finite element study

IntroductionThree-dimensional analysis of the moment, force and M/F ratio generated at the anterior and posterior region of the T-loop in five different groups of pre-activation curvatures using the finite element method. Materials and methodIn this study, the geometric model of maxilla was constructed using a CBCT scan. The bracket system simulated was of the STb lingual bracket system from Ormco (0.18slot) with specified tip and torque values of all maxillary teeth and the arch wire used was 0.016″x 0.016″ TMA (Ormco) for fabrication of T-loop with dimensions of 6 ​× ​2 ​× ​7 ​mm. There were five different models generated with pre-activation of: 20°,30°,40°,50° and 60° in T-loop. The software used for the post-processing of the model was ANSYS Workbench 19.2. ResultWhen the amount of pre-activation of T-loop increased there was an increase in the moment, force and M/F ratio in all the five groups in lingual biomechanics. ConclusionAlthough, the M/F ratio depicts the type of movement that will take place is uncontrolled tipping in all the five pre-activation groups, clinically we should give pre-activation ranging from 30° to 60° in T-loop in lingual orthodontics.

Influence of orthodontic treatment on the state of dental hard tissues, prevention of complications

SummaryOrthodontic treatment of dentoalveolar anomalies is car-ried out using fixed and removable appliances, which af-fects the homeostasis of the oral cavity and increases the risk of developing carious lesions of the enamel. Purpose of the study: comparative assessment of the level of oral hygiene and the prevalence of enamel carious lesions at the stage of orthodontic treatment using removable and non-removable appliances. Materials and methods:90 patients aged 18 to 35 years were examined: 45 patients of the 1st group, who were treated with aligners, and 45 patientsof the second group, who were treated with a bracket system. In all patients, the level of oral hygiene was determined by the OHI-S (Green-Vermillion) index, as well as the level of CPU before and after 12 months of orthodontic treatment. Results: before the start of orth-odontic treatment, the OHI-S index in patients of the first and second groups was 0.86±0.67 and 0.89±0.74 points, respectively. After 12 months, there was a deterioration in the parameters of oral hygiene to a greater extent in patients of the second group who were treated with a fixed technique: the OHI-S index was 1.98±0.79 points. The value of the CPU index before the start of orthodontic treatment in patients of the first and second groups was 7.1±1.32 and 6.9±1.46, respectively. After 12 months of orthodontic treatment, there was an increase in the CPU index in the studied persons of the second group, who were treated with a bracket system: the CPU index was 13.6±1.78. In patients of the first group, the CPU indica-tor practically did not change and amounted to 7.9±1.25. Conclusion: with high caries susceptibility and the pre-sence of non-carious enamel lesions, orthodontic treat-ment with removable appliances should be preferred in order to avoid the development of complications.

Algorithm for treatment of patients with class II malocclusion rejecting orthognathic surgery

Orthodontic treatment of 60 patients with class II malocclusion at the age of 18 to 44 years, using the bracket system, FFTA and orthodontic miniscrews was performed. In order to assess the results of treatment, cone-beam computed tomography were obtained at the beginning and at the end of treatment. As a result of the treatment normalization of lower jaw position, dental position and occlusion were achieved, the lower incisors protrusion was eliminated and the facial profile was improved, reliably confirmed by lateral cephalograms. The proposed treatment algorithm proved to be effective for stable correction of skeletal class II malocclusion in patients rejecting orthognathic surgery.

An In-Vitro Evaluation of Microbial Adhesion on Different Types of Orthodontic Brackets

Introduction: Information regarding the adhesion of bacterial species and plaque accumulation to bracket material is limited. Adequate information is needed in order to offer patients orthodontic treatment without significantly increasing their risk of developing white spots, caries, or gingival inflammation. Aim: To determine the levels of the caries-inducing S. mutans species on metallic, self-ligating and ceramic brackets and to compare the total bacterial counts and counts of species present on these bracket materials. Materials and Methods: By means of an in-vitro study, six commercially available bracket systems {3M Gemini (A), American Ortho (B), Ormco (C), Begg (D), Ceramic (E) and Self-ligating (F)} were compared. The brackets were bonded in the cell well culture plate and the agar plates were prepared. Brain heart infusion medium including bacteria and artificial saliva was introduced to each bracket system containing 10 premolar brackets and were incubated. After 72 hours, the adherent bacteria were then detached by sonication and the Colony-Forming Units (CFU) of Streptococcus mutans were calculated on each bracket and were analysed using Statistical Package for the Social Sciences (SPSS) software version 17.0 for Windows. Results: Between the different bracket types, significant differences were found in terms of biofilm formation. The Begg brackets showed the least bacterial adhesion and the self-ligating brackets showed the highest bacterial adhesion and was statistically significant among all the groups (p&lt;0.05). Ceramic brackets also showed a higher bacterial adhesion after the self-ligating brackets. Among the three groups of metallic brackets, 3M brackets showed the least bacterial adhesion but was statistically insignificant (p&gt;0.05). Conclusion: Different orthodontic brackets serve as different loci for biofilm formation showing that the Begg brackets are the most hygienic among all the brackets taken in this study.

Improving the effectiveness of treatment of the adult patients with dentoalveolar anomalies and deformities using Er,Cr:YSGG laser: a clinical study

Of the work is to develop and substantiate the method of minimally invasive complex orthodontic treatment of patients with constriction and deformation of the upper jaw in the period of permanent bite with the combined use of a bracket system, orthodontic devices for the expansion of the upper jaw and fractional photothermolysis to improve the effectiveness of complex treatment. The results of complex treatment of patients with the deficiency of the upper jaw in the period of permanent bite are presented. Complex treatment consisted of orthodontic treatment using a bracket system, laser corticotomy, orthodontic devices for the expansion of the upper jaw. Ultrasound examination before and after the procedure was performed to obtain reliable results of laser impact on bone tissue. After conducting a clinical and radiological examination (using cone-beam computed tomography) of all patients and analyzing the data obtained, we have developed algorithms for therapeutic measures. As a result of orthodontic treatment aimed at the expansion of the upper jaw patients who underwent fractional photothermolysis procedure achieved the expansion of the upper jaw at both the dentoalveolar and skeletal levels. It was found that a comprehensive approach with minimally invasive effects can improve the effectiveness of treatment of patients with constriction and deformation of the upper jaw during the period of permanent bite and achieve stable treatment results.

Correction of Bimaxillary Protrusion with Four First Premolar Extractions and T-Loop Mechanics – A Case Report

Bimaxillary protrusion is a condition characterized by proclined upper and lower incisors with an increased prominence of the lips. This is a case of a 18-year-old with bimaxillary protrusion, mild crowding on the maxilla and mandible, and mandibular dental midline shift to the left by 1 mm. The four first premolars were extracted using a pre-adjusted bracket. This bracket had in-built prescriptions of torque, tip, and in-out for orthodontic cases. There were three pre-adjusted orthodontic bracket systems: Andrews, Roth, and MBT. T-loop was also used to achieve controlled space closure. After 26 months of orthodontic treatment, the patient’s profile was straighter and a pleasant smile was achieved at the end of treatment.

Non-extraction Orthodontic Treatment with Damon System: Two Case Reports

Self-ligating braces offer shorter orthodontic treatment, more comfortable follow-up and less chair time. Passive braces are more preferred in self-ligating systems as they cause less friction. Damon system is also one of the most popular passive self-ligating braces. In addition to protrusion of incisors, it is one of the most important advantages of this bracket system that it provides expansion in dental arches. The purpose of these case reports is to present the treatments of two patients treated with Damon System. It can be concluded as; thanks to the Damon braces system, moderate and severe crowding cases were successfully treated in appropriate cases. Treatment times were also shorter compared to average orthodontic treatments. Instead of stripping and tooth extraction, which are among the methods of gaining space in orthodontics, success can be achieved in suitable cases.

Orthodontic Diagnostic Tools and Material Usage in Saudi Arabia

Introduction: The evaluation of changes in orthodontic practice over the years, is essential for defining treatment efficacy. Accordingly, shedding light on the profile of orthodontic practice in Saudi Arabia is crucial. Aim: To investigate current trends in orthodontic practice in Saudi Arabia and the factors affecting choices regarding materials and techniques among orthodontists. Materials and Methods: This cross-sectional study was conducted from July 2019 to December 2019 at the College of Dentistry, King Saud University, Riyadh, Saudi Arabia. An electronic survey of 29 objective questions was sent to 1,500 orthodontic members of the Saudi Orthodontic Society. The survey collected demographic data, diagnostic records and information on the fixed orthodontic appliances used by the respondents. Frequency and percentages were calculated for all variables. Chi-square test was used to determine the effects of factors, including years of experience and place of work, on the choice of diagnosis protocol and fixed appliance material, with the significance set at p-value ≤0.05. Results: Two hundred and nine respondents completed the survey. The respondents reported a highly significant use of computers for digitising cephalometric analysis, with the traditional method of obtaining study models reported as highly significant (p&lt;0.001). Orthodontists routinely used the MBT preadjusted bracket system (52.6%) and performed direct bonding of the bracket (91.4%). Bonding of the first molars was preferred by 36.4% of the clinicians. Glass ionomer cement was the most frequently used band cement (55.5%), and the most popular archwire material was nickel–titanium shape memory. Clinicians with less than five years of experience used significantly more postcephalometric radiographs (p=0.006) and postorthodontic treatment models (p=0.028). Senior orthodontists (10-15 years of experience) had a higher use of indirect bonding techniques (p=0.05). Conclusion: This study provides information on the relevant aspects of orthodontists in Saudi Arabia in terms of their individuality, training and techniques used. The findings can be used as a reference for future national surveys to evaluate changes in orthodontic practice in Saudi Arabia.