Conventional Ceramic Brackets Research Articles

Performance of two laser motion modes versus conventional orthodontic ceramic brackets debonding technique on enamel surface topography.

The risk of enamel deterioration that frequently coexists with debonding of orthodontic teeth brackets elevates the mandate for finding an optimum approach for debonding them without harmful effects. This in-vitro study is intended to compare the effects of two different laser modes (scanning and circular) and a conventional method on the enamel surface after debonding orthodontic brackets. 66 extracted premolars were assigned into 3 groups. After that, light-cure composite resin was used to attach the ceramic brackets to the teeth. Amongst the test groups, Group I: specimens that were debonded using conventional debonding using pliers; Group 2: specimens that were debonded using Er, Cr: YSGG laser applications using the circular motion method; and Group 3: specimens that were debonded using Er, Cr: YSGG laser applications using the scanning motion method. Adhesive Remnant Index (ARI) assessment, intra-pulpal temperature increase, enamel surface roughness after polishing, and assessment of the microstructure of enamel were carried out with scanning electron microscopy. The gathered information was examined statistically. The conventional debonding method had a significantly higher proportion of adhesive remnant index (ARI) scores of 2 and 3 in comparison to the circular (p < .004) and scanning laser groups (p < .001). There was no significant difference in ARI scores between the circular and scanning laser groups (p > .05). Moreover, the circular and scanning laser debonding methods resulted in a significantly higher proportion of Enamel Surface Roughness (ESR) scores of 0 and a lower proportion of ESR scores of 3 compared to the conventional technique group (p < .001). However, there was no significant difference in ESR scores between the circular and scanning laser methods (p = .945). Lastly, the average intra-pulpal temperature was significantly higher in the circular laser group (1.9 ± 0.5 ) compared to the scanning laser group (0.9 ± 0.2) with p < .001. Er, Cr: YSGG laser irradiation is a tool that shows promise for debonding ceramic brackets with minimal harm to the enamel surface. The scanning laser technique is more desirable due to the lower intra-pulpal temperature increase.

Assessment of Enamel Surface Using Scanning Electron Microscope After Debonding Conventional and Self-Ligating Metal and Ceramic Brackets: An In Vitro Study

Assessment of Enamel Surface Using Scanning Electron Microscope After Debonding Conventional and Self-Ligating Metal and Ceramic Brackets: An In Vitro Study

Percentage of patients shifting to another treatment modality: An experience-guided decision.

This study aimed to assess the frequency with which orthodontic patients decided to shift to another type of orthodontic appliance, among conventional metal brackets, ceramic brackets, lingual brackets and clear aligner, based on their personal experiences of pain, ulcers, bad breath, hygiene issues and social difficulties. This study comprises of patients seeking orthodontic treatment. The sample (n = 500; age group = 19-25 years) was divided equally into four groups based on the treatment modality: conventional metal brackets, ceramic brackets, lingual brackets and clear aligner. Patients rated the questionnaire using a visual analogue scale, to assess variables (such as pain, ulcer etc) that impact various treatment modalities. Subsequently, patients from all groups provided feedback regarding their treatment experiences, and expressed their preference for an alternative modality. Intergroup comparison among the four groups was done using one-way analysis of variance with Tukey's HSD post-hoc test (p ≤ 0.05). Patients who received lingual brackets reported higher levels of pain and ulceration, as compared to those who received clear aligners. All four groups showed statistically significant differences for ulcers during treatment (p ≤ 0.05). Of the 125 patients who received conventional metal brackets, 28% expressed a preference for clear aligner therapy, while 20% preferred ceramic brackets. In the lingual group, 56% of 125 patients preferred clear aligner therapy, and 8% preferred ceramic brackets to complete their treatment. In the ceramic group, 83% did not want to switch, whereas 17% desired to switch to clear aligner, while in aligner group no patient desired to switch. A higher percentage of patients from lingual brackets group chose to shift to clear aligners, followed by conventional metal brackets group and by ceramic brackets group, in this descending order. The clear aligner group demonstrated fewer issues than the other treatment modalities.

Study Comparing the Shear Bond Forte of Ceramics with Metal Reinforcement to Unreinforced Ceramic Brackets

Background: In an effort to address the growing need for more aesthetic appliances, ceramic brackets were introduced into orthodontics. The need for more aesthetic and less obvious appliances has risen as a result of adult orthodontic therapy. Aim: To assess the shear bond strength of the Clarity and Transcend 6000 brackets as well as the bracket breakdown mechanism while utilising shear force with Schimadzu testing equipment, information from this study will be useful for orthodontic participants as well as practitioners. Methodology: This comparative study was conducted at Orthodontic Department, Bacha Khan College of Dentistry, Mardan from 1st July 2021 to 31st December 2022. A total of 150 brackets (75 reinforced ceramic brackets and 75 conventional ceramic brackets in each cluster) were enrolled. The first premolar teeth that had been pulled in their entirety for orthodontic treatment were chosen to be bonded. Only the first maxillary premolar teeth with undamaged surfaces that had recently been removed and preserved were used. Premolars that had broken down or decayed were eliminated. Result: There was no statistically significant difference amongst the two brackets evaluated, according to an independent t-test associating the clarity and transcends 6000 ceramic brackets. Conclusion: The differences in adhesive remnant index ratings and shear bond forte between the Transcend 6000 ceramic and Clarity were negligible. Key words: Adhesive remnant index (ARI), De-bonding, Shear bond strength

Precision of slot widths and torque transmission of in-office 3D printed brackets : An in vitro study.

To investigate anovel in-office three-dimensionally (3D) printed polymer bracket regarding slot precision and torque transmission. Based on a0.022″ bracket system, stereolithography was used to manufacture brackets (N = 30) from ahigh-performance polymer that met Medical Device Regulation(MDR) IIa requirements. Conventional metal and ceramic brackets were used for comparison. Slot precision was determined using calibrated plug gages. Torque transmission was measured after artificial aging. Palatal and vestibular crown torques were measured from 0to 20° using titanium-molybdenum(T) and stainless steel(S) wires (0.019″ × 0.025″) in abiomechanical experimental setup. The Kruskal-Wallis test with posthoc test (Dunn-Bonferroni) was used for statistical analyses (significance level p < 0.05). The slot sizes of all three bracket groups were within the tolerance range according to DIN13996 (ceramic[C]: 0.581 ± 0.003 mm; metal[M]: 0.6 ± 0.005 mm; polymer[P]: 0.581 ± 0.010 mm). The maximum torque values of all bracket-arch combinations were above the clinically relevant range of 5-20 Nmm (PS: 30 ± 8.6 Nmm; PT: 27.8 ± 14.2 Nmm; CS: 24 ± 5.6 Nmm; CT: 19.9 ± 3.8 Nmm; MS: 21.4 ± 6.7 Nmm; MT: 16.7 ± 4.6 Nmm). The novel, in-office manufactured polymer bracket showed comparable results to established bracket materials regarding slot precision and torque transmission. Given its high individualization possibilities as well as enabling an entire in-house supply chain, the novel polymer brackets bear high potential of future usage for orthodontic appliances.

Evaluation of pain in patients undergoing fixed dental appliance

Introduction: Pain is experienced by patients during various fixed orthodontic procedures such as placement of separators, insertion of arch wire and its activations, orthopedic appliances such as headgear, and debonding of the appliance. This study was formulated with the background that the level of pain sensation differs between conventional metal and ceramic brackets, arch wire being the same pain is an important aspect of oral health-related quality of life (OHRQOL). Understanding how patients' pain experiences during their treatment affect their quality of life (QOL) is important and the absence of pain/discomfort is important for achieving a high QOL. Aim and Objective: The objective of this study was to assess the relationship between pain and OHRQOL among patients wearing fixed orthodontic appliances and to evaluate whether patient motivation and counseling had an effect on the pain and discomfort. Materials and methods: The data collection was done , the obtained data were tabulated and entered in the MS excel sheet. Data collection were imported to SPSS, variable definition process was done using tables and graphical illustration.

Flash-free and conventional adhesive ceramic brackets in patients undergoing orthodontic treatment: A systematic review and meta-analysis.

To investigate whether flash-free adhesive ceramic brackets (FFA) have a better clinical performance than conventional adhesive ceramic brackets (CVA) in patients undergoing multi-bracket orthodontic treatment. PubMed, CENTRAL, Web of Science, Scopus, Embase, CNKI and Grey-literature were searched without restrictions up to January 2022. Both randomized controlled trials (RCTs) and controlled clinical trials (CCTs) were included. Risk of bias assessment was performed using the RoB 2.0 and ROBINS-I cochrane risk of bias tools. Eight articles, for seven studies, were included in this systematic review, and four split-mouth trials (SMT) were included in the meta-analysis. A random-effects meta-analysis found a statistically significant faster bonding time with FFA (mean difference [MD]=-93.85 seconds/quadrant, P=.002, 2 SMT), and no statistically significant difference regarding bracket failure rate at 6months (risk ratio [RR]=1.05; P=.93, 3 SMT), adhesive removal time (MD=-18.26 seconds/quadrant, P=.50, 2 SMT), and amount of remnant adhesive (MD=-0.13/bracket, P=.72, 2 SMT) between FFA and CVA. No difference (P > .05, 3 SMT) was found in enamel demineralization and periodontal measurements. CVA showed a statistically significant higher debonding pain score (P=.004, 1 SMT). Both flash-free and conventional adhesive ceramic brackets had a similar clinical performance, except for the faster bonding with FFA. Further, well-designed clinical trials are still required.

Reducing Friction in Orthodontic Brackets: A Matter of Material or Type of Ligation Selection? In-Vitro Comparative Study.

(1) Background: Orthodontic appliances have changed and improved with the increasing demand for orthodontic treatment of the general population. Patients desire for shorter orthodontic treatments and for the wearing of more aesthetic devices has led to the technological development of orthodontic brackets; these were manufactured from aesthetic materials (ceramics, composite polymers) and presented different designs regarding the way archwires are ligated to the bracket. The aim of this study was to determine whether there were any differences between the static frictional forces generated by stainless steel (metallic) and polycrystalline alumina (ceramics) conventional and self-ligating brackets. (2) Methods: Static friction assessment was carried out in vitro with a universal testing machine, HV-500N-S (Schmidt Control Instruments, Hans Schmidt & Co. GmbH), intended for measuring compression and traction forces. (3) Results: The study revealed significant differences in static frictional forces at the bracket-archwire interface between the tested brackets. Stainless steel brackets produced lower static friction forces than polycrystalline alumina and self-ligating brackets generally produced lower static frictional forces than conventional brackets. The reduction of frictional forces was noticeable in the first stages of treatment, when thin, flexible orthodontic archwires (0.016” NiTi) are used. Engaged with large rectangular stainless steel archwires, (0.019 × 0.025” SS), the frictional forces produced by conventional and self-ligating metal brackets were similar, no significant differences being observed between the two types of metallic design. However, in the case of tested ceramic brackets, the results showed that the self-ligating type allows a reduction in frictional forces even in advanced stages of treatment compared to conventionally ligation. (4) Conclusions: From the perspective of an orthodontic system with low frictional forces, metal brackets are preferable to aesthetic ones, and self-ligating ceramic brackets are preferable to conventional ceramic brackets.

Comparison of Shear Bond Strengths and Fiction Forces Among Various Self-ligating Ceramic Brackets

Purpose: Ceramic self-ligating brackets were developed recently, however, only few comparative studies had been reported about their bond strengths and friction. The aim of the study was to compare shear bond strengths and friction forces of various self-ligating ceramic brackets. Materials and methods: The present study is divided into two parts. In shear bond strength test, bovine teeth were used as a substitute for human teeth. Five groups of brackets (three ceramic self-ligating brackets including ClippyC, GeniusCrystal, DamonClear2, ClarityAdvanced (conventional ceramic bracket), Damon3MX (metal self-ligating bracket), were used and debonded with 12 brackets in each group. The shear bond strengths and adhesive remnant index (ARI) scores were compared. In the friction test, several parameters were investigated, including five kinds of bracket, two wire sizes (0.014" Cu-NiTi and 0.016" × 0.022" NiTi) and three angulations (0°, 5°, and 10°). Each bracket/wire/angulation combination was tested five times in 30 settings. A total of 150 runs were performed.

Effects of a ceramic active self-ligating bracket on retraction/tipping/rotation of canine, premolar mesialization, and transverse arch dimensions: A preliminary single-blind split-mouth randomized clinical trial

There is no clinical study on ceramic self-ligating brackets (SLBs). Therefore, this preliminary study was conducted for the first time to address its effects. This split-mouth randomized trial was performed on 32 quadrants in 16 orthodontic patients needing extraction of maxillary premolars and distalization of canines. In each blinded patient, right/left sides were randomized into control (ceramic bracket) and experimental (ceramic SLB) groups. Dental stone models were taken before canine retraction and 3 months into retraction. Models were digitized as three-dimensional models. Changes were measured on superimposed models. Groups were compared using Wilcoxon signed-rank test (α = 0.05, β = 0.1). Both bracket types caused significant changes after 3 months in terms of all assessed clinical outcomes (P ≤ 0.002). Compared to conventional ceramic brackets (control), ceramic SLBs reduced retraction rate (P = 0.001), canine rotation (P = 0.001), canine tipping (P = 0.002), and arch expansion at the canine site (P = 0.003). However, the extents of anchorage loss (P = 0.796) and arch constriction in the premolar area (P = 0.605) were not statistically different between the bracket types. Compared to conventional metal-lined ceramic brackets, active ceramic SLB can increase the duration of canine distalization, while reducing canine rotation and tipping (inducing more bodily movements). The loss of anchorage with ceramic SLB was similar to that of conventional ceramic bracket after 3 months of treatment (considering the lower rate of SLB canine retraction during that time). Both brackets similarly constricted the arch at the premolar site. In the canine area, they expanded the arch, with the SLB causing smaller extents of expansion.

Primer-Treated Ceramic Bracket Increases Shear Bond Strength on Dental Zirconia Surface.

The purpose of this study is to evaluate the shear bond strength (SBS) of a primer-treated ceramic bracket on dental zirconia and to compare it with conventional ceramic bracket bonding on surface-treated zirconia. Sintered and finished dental zirconia was sandblasted. Samples were divided according to the treated surfaces: no treatment (X), ceramic primer on zirconia (Z), ceramic primer on bracket base (B), and ceramic primer on both zirconia and bracket base (ZB). The ceramic bracket was bonded on zirconia and SBS was measured before (T0) and after 10,000 cycles of thermocycling (Tf). The failed surfaces were examined under field emission scanning electron microscope (FE-SEM), and adhesive remnant index (ARI) was evaluated. SBS was significantly higher in ZB and significantly lower in X in both T0 and Tf. There was no significant difference between Z and B. In X and B, adhesive failure occurred while ZB showed mixed failures. There was no apparent change in the zirconia surface except for the existence of some adhesive and resin remnants. The application of ceramic primer on the bracket base increased the bonding strength to the level of conventional bonding with fewer adhesive remnants. The highest bonding strength was obtained when the primer-treated bracket was bonded on the primer-treated zirconia.

Effects of adhesive flash-free brackets on debonding pain and time: A randomized split-mouth clinical trial.

To evaluate the effects of adhesive precoated (APC) flash-free brackets on the level of pain, amount of remnant adhesive, and removal time during the debonding procedure. Thirty patients (20 female, 10 male) aged 12 to 18 years undergoing nonextraction fixed orthodontic treatment were included in this study. APC flash-free and conventional ceramic brackets were bonded with a split-mouth study design. Bracket types were randomly allocated to quadrants. During the removal of the brackets, the visual analogue scale (VAS) was used to assess the level of pain for each tooth. The adhesive remnant index (ARI) was used to determine the amount of adhesive remaining on the tooth surface. Adhesive removal times were calculated per quadrant. The data were analyzed using the Wilcoxon test for comparisons between groups. Pain scores were generally higher for the conventional group than for the flash-free group. There were no differences in VAS scores across most tooth types during debonding. Overall, ARI results showed more adhesive remnants in the conventional bracket group (P < .001). Except for the right maxillary quadrant, the times required to remove the adhesive were significantly longer for the flash-free brackets than the conventional brackets (P ≤ .005). Although removal time was slightly longer for the flash-free adhesive than for the conventional adhesive, lower pain scores were generally observed for the flash-free adhesive brackets during the debonding procedure. Both time and pain differences could be considered clinically insignificant.

Effects of adhesive flash-free brackets on enamel demineralization and periodontal status.

To evaluate the effects of adhesive precoated (APC) flash-free brackets on enamel demineralization and periodontal status in patients during fixed orthodontic treatment. Thirty patients, age 12 to 18 years, who had Angle Class I or Class II malocclusion with mild to moderate crowding in the permanent dentition were selected for this study. APC flash-free and conventional ceramic brackets were bonded for a split-mouth study design. The quadrant allocation was randomized. Demineralization records were obtained immediately after bonding (T0), 1 month after bonding (T1), and 6 months after bonding (T2). Clinical periodontal measurements, including gingival index, plaque index, and bleeding upon probing, were obtained before bonding (T0) and at the same time points (T1 and T2). Data were analyzed using Mann-Whitney U and Friedman tests to compare parameters between groups and times. Demineralization values decreased on most sides of the brackets for both groups between T0 and T1. In the conventional group, there was significantly higher demineralization on more sides compared with flash-free brackets between T1 and T2. With one exception, the decreased values were found in the incisal/occlusal sides of all brackets at T2. All periodontal parameters showed significant increases after 6 months of treatment in both groups. Intergroup comparison showed no significant differences in demineralization or periodontal measurements at any of the time points. The effects of APC flash-free and conventional brackets on enamel demineralization and periodontal health did not differ from each other.

Evaluation of Enamel Topography after Debonding Orthodontic Ceramic Brackets by Different Er,Cr:YSGG and Er:YAG Lasers Settings.

In the last decade, the success of lasers in simplifying many dental procedures has heightened the need for research in the orthodontic field, in order to evaluate the benefits of laser-assisted ceramic brackets debonding. Conventional ceramic brackets removal delivers a high shear bond strength (SBS), which might lead to enamel damage. Nowadays, debonding ceramic brackets by Er:YAG laser seems a viable alternative technique; however, there is no data on the use of Er,Cr:YSGG in the literature. We aimed to evaluate the difference in enamel topography derived from different erbium laser settings used during debonding. One hundred and eighty bovine incisors teeth were randomly divided into fifteen experimental groups, according to different erbium laser settings using scanning methods. SBS testing was performed after debonding; stereomicroscopic and SEM analyses were done after cleaning the remaining adhesive so as to assess the incidence of enamel microcracks formation and enamel loss. There were no statistically significant differences between the proportions of teeth with normal enamel topography within the control group when compared with any of the Er:YAG groups. However, the proportion of teeth with a normal enamel topography in Er,Cr:YSGG was 4 W/20 Hz (83.3%) and in Er:YAG was 5 W/20 Hz (91.7%), which was statistically significantly higher than the control group (41.7%). The selection of erbium lasers’ optimal parameters during debonding influences the enamel topography. When considering the evaluation of both microscopic and statistical analyses, irradiation by Er:YAG (120 mJ/40 Hz) displayed a significant reduction in microcracks compared with conventional debonding, even though some microstructural changes in the enamel could be noted. Er,Cr:YSGG (4 W/20 Hz) respected the enamel topography the most out of the studied groups.

Periodontal parameters in adult patients with clear aligners orthodontics treatment versus three other types of brackets: A cross-sectional study.

OBJECTIVE:To assess the gingival parameters in the clear aligner treatment versus the three other types of brackets, i.e., conventional metal, conventional ceramic, and metal self-ligating.MATERIALS AND METHODS:Eighty patients coming for regular appointments undergoing orthodontic treatment were included. They were further divided into four groups with 20 patients in each: Group one underwent conventional brackets (CB) treatment; Group two had conventional ceramic brackets (CCB); Group three was treated with self-ligating (SL) brackets; Group four underwent with clear aligner (CA) treatment. Inclusion criteria were any patient with a minimum age of 18 years having Class II, Class III skeletal relationship, undergoing orthodontic treatment for at least 6 months with fixed orthodontic appliances (FOA) on both arches. While smokers, pregnant, diabetics, or those taking medication affecting gingival health or having cardiovascular diseases were excluded. Also excluded were patients who used antiseptic solutions or mouthwash during the past 6 months, underwent any periodontal treatments in the past 6 months, or who had fixed bridges and crowns or extensive restorations close to the gingival margins. Seven indices, namely plaque index, gingival index, gingival bleeding index, sulcus bleeding index, papillary bleeding index, basic periodontal examination index, and bleeding on probing index, were recorded for all groups.RESULTS:Mean age for Group 1 with CB was 26.65 ± 5.15 years, whereas it was 27.65 ± 8.15 years for Group 2 with CCB, and 26.85 ± 5.19 for Group 3 with SB. Group-4 with CA treatment had a mean age of 26.85 ± 4.83 years. Multivariate analysis and a Bonferroni correction was performed (P = 0.008). CA treatment has better periodontal parameter values compared with the CB and the CCB groups, and no significance difference with the SL brackets group.CONCLUSION:CA treatment has better periodontal indices levels compared to other types of orthodontic treatments such as CB and the CCB groups; no significant difference with the SL brackets group. Importance should be given to oral hygiene instructions before, during, and after the treatment.

Particulate production during debonding of fixed appliances: Laboratory investigation and randomized clinical trial to assess the effect of using flash-free ceramic brackets.

The aim of this laboratory and randomized clinical trial was to investigate particulate production at debonding and enamel clean-up following the use of flash-free ceramic brackets and to compare them with non-flash-free metal and ceramic brackets. In the laboratory study, brackets were bonded to bovine teeth. After 24hours of immersion in water, the brackets were debonded, the adhesive remnant scores noted, and the enamel cleaned with the use of rotary instruments. Four bracket-adhesive combinations and 2 different enamel pretreatment regimens were tested, including metal and ceramic brackets (conventional, adhesive precoat [APC], and APC flash-free) and conventional acid etch and self-etching primer. Quantitative (mg/m3) and qualitative analysis of particulate production was made in each case. In the clinical trial, 18 patients treated with the use of fixed appliances were recruited into this 3-arm parallel-design randomized controlled trial. They were randomly allocated to 1 of 3 groups: experimental flash-free ceramic bracket or non-flash-free ceramic or metal bracket group. Eligibility criteria included patients undergoing nonextraction maxillary and mandibular fixed appliance therapy. At completion of treatment, the brackets were debonded, and the primary outcome measure was particulate concentration (mg/m3). Randomization was by means of sealed envelopes. Data were analyzed with the use of quantile plots and linear mixed models. The effect of etch, bracket, and stage of debonding of clean-up on particle composition was analyzed with the use of mixed-effects regression. In the laboratory study, the APC brackets produced the highest particulate concentration. Although statistically significantly higher than the metal and conventional ceramic brackets, it was not significantly higher than the ceramic flash-free brackets. In the clinical study, there was no statistically significant effect of bracket type on particulate concentration (P=0.29). This was despite 3 patients with APC flash-free and 1 patient with conventional Clarity (with 1 bracket) having 1 or more ceramic bracket fracture at debonding requiring removal. No adverse events reported. Particulates in the inhalable, thoracic, and respirable fractions were produced at enamel clean-up with all bracket types. Although APC and APC flash-free brackets produced the highest concentrations in the laboratory study, there was no difference between any of the brackets in the clinical trial. The trial was not registered. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Comparison of the Perception of Pain during Fixed Orthodontic Treatment with Metal and Ceramic Brackets.

Introduction:Pain is experienced by patients during various fixed orthodontic procedures such as placement of separators, insertion of arch wire and its activations, orthopedic appliances such as headgear, and debonding of the appliance. This study was formulated with the background that the level of pain sensation differs between conventional metal and ceramic brackets, arch wire being the same.Materials and Methods:The sample comprised 40 patients. The patients were separated into two groups: Group A (metal brackets) and Group B (ceramic brackets). In Group A, the brackets were bonded with 0.022” conventional stainless steel brackets (Unitek Gemini, 3M, Monrovia, California). In Group B, the brackets were bonded with ceramic brackets (Unitek Gemini Clear Brackets, 3M, Monrovia, California). The bonding of the brackets was carried out according to the conventional etching, priming, and curing technique. A 0.016” NiTi (nickel titanium) arch wire was used as the first arch wire. The intensity of pain was documented in a figure containing two 100-mm visual analog scales (VASs).Results:The level of pain reduced in intensity in due course. During 1 month, VAS scores increased at the end of day 1 (24 h) for the metal and ceramic group. The pain then decreased for up to 5 days. The average pain intensity reached 4.44 in the ceramic group, whereas it was 2.7 in the metal group for the upper anterior region. It decreased up to 1 in the ceramic and 0.22 in the metal group.Conclusion:Patients bonded with ceramic brackets experienced a higher and more severe pain of longer duration than individuals treated with conventional brackets.

A Comparative Evaluation of Canine Retraction Using Ceramic Bracket and Ceramic Bracket with Metal Slot with Conventional Preadjusted Edgewise Appliance Bracket Systems: A Clinical Study.

Aims and Objectives:The introduction of ceramic brackets was a much-heralded development in the field of orthodontics. However, the increased frictional resistance with these brackets led to the development of ceramic brackets with metal slots, which claimed to combine the esthetics of ceramic brackets with the low frictional resistance of metal brackets. Hence, this study was undertaken to evaluate the rate of canine retraction and the amount of anchor loss while using ceramic brackets and ceramic brackets with metal slots and with conventional preadjusted edgewise appliance (PEA) metal brackets.Materials and Methods:The patient sample consists of 12 patients. Six patients received ceramic brackets on one canine and conventional PEA metal brackets on the opposite canine within the same arch. The other six patients received ceramic brackets with metal slot on one canine and conventional PEA metal brackets on the opposite canine within the same arch. Unpaired t-test was used to analyze the data using SPSS version 20 (3M Unitek, Bangalore, Karnataka, India). The rate of retraction was calculated for individual canine retraction after initial leveling and aligning. Anchor loss was also calculated using the pterygoid vertical to the mesiobuccal cusp of the upper first molar on the lateral cephalograms.Results:The result of this study showed that the difference in the rate of retraction between ceramic brackets with metal slot and conventional PEA metal brackets and ceramic bracket while clinically significant was not statistically significant. The difference in the amount of loss of anchorage of both the groups was not statistically significant.Conclusions:Incorporation of the metal slot in ceramic brackets has reduced frictional resistance for more efficient and desired tooth movement. Ceramic brackets with metal slot generate lower frictional forces than ceramic brackets but higher than conventional PEA metal brackets.

Air-powder polishing on self-ligating brackets after clinical use: effects on debris levels.

ABSTRACTIntroduction: Debris buildup on brackets and arch surfaces is one of the main factors that can influence the intensity of friction between bracket and orthodontic wire. Objective: This study sought to evaluate the effect of air-powder polishing cleaning on debris levels of self-ligating ceramic brackets at the end of orthodontic treatment, compared to the behavior of conventional brackets. Methods: Debris levels were evaluated in metal conventional orthodontic brackets (n = 42) and ceramic self-ligating brackets (n = 42) on canines and premolars, arranged in pairs. There were brackets with and without air-powder polishing. At the end of orthodontic treatment, a hemiarch served as control and the contralateral hemiarch underwent prophylaxis with air-powder polishing. Debris buildup in bracket slots was assessed through images, and Wilcoxon test was used to analyze the results. Results: The median debris levels were statistically lower in the conventional metal brackets compared to self-ligating ones (p = 0.02), regarding brackets not submitted to air-powder polishing. Polishing significantly reduced debris buildup to zero in both systems, without differences between groups. Conclusions: Ceramic self-ligating brackets have a higher debris buildup in comparison to conventional metal brackets in vivo, but prophylaxis with sodium bicarbonate jet was effective in reducing debris levels in self-ligating and also in conventional brackets.

Comparison of the Load-Deflection Characteristics of Aesthetic and Conventional Super Elastic Ni-Ti Orthodontic Arch Wires in Conventional and Metal-Insert Ceramic Brackets.

Coated arch wires and ceramic brackets have been introduced to improve aesthetics during orthodontic treatment. The aim of this study was to determine the effects of coating on the physical properties of aesthetic orthodontic wires. Five round wires (0.016 inch) were obtained from each of three brands: conventional uncoated super elastic Nickel Titanium (Ni-Ti) (Rematitian Lite; Dentaurum, Ispringen, Germany), HUBIT (Teflon Coated, Korea), G&H (Epoxy Coated, Greenwood, Indiana, USA) which belonged to maxillary arch. Two types of standard ceramic brackets (conventional and metal-insert type, Ortho Technology, Tampa, Florida, USA) with the slot size of 0.022×0.028 inches were used. A simulation device was fabricated to resemble a model of human dental arch and each of the specimen was tested in three-point bending test. The test was conducted in the buccolingual plane with crosshead speed of 1mm/minute pressure from metal pole. Each sample was loaded until a deflection of 3.0 mm was produced. The mean values of maximum loading force, unloading force and clinical plateau length were recorded. One-way ANOVA and Tukey tests were used at p<0.05. Uncoated Ni-Ti arch wire showed higher mean values of maximum loading and unloading force than that of coated aesthetic wires similar to ceramic brackets while G&H wire and metal-insert ceramic brackets presented the lowest values. The longest clinical plateau length was observed in G&H wires and metal-insert ceramic bracket. The coating processes for HUBIT (Teflon Coated, Korea), G&H (Epoxy Coated, Greenwood, Indiana, USA) wires might influence bending behaviour which can cause decrease in loading and unloading force.