Bracket Failure Rate Research Articles

Orthodontic bracket failure rate after bonding with and without primer – A systematic review and meta-analysis

To compare the difference in failure rates between orthodontic brackets bonded with light-cured primer and those bonded without primer. An electronic search of five databases and additional manual searches were performed until January 2024. Randomized and prospective non-randomized controlled trials directly comparing the bracket failure rate with and without primer. Two authors independently collected study characteristics by extracting outcome data from pre-defined sheets. After evaluating the risk of bias, the odds ratio and 95% confidence intervals (CIs) were calculated with random-effects models. Four studies were evaluated using qualitative and quantitative analysis. The analysis included data from 199 patients (1691 brackets with primer and 1646 brackets without primer). Random effects of pooled meta-analysis demonstrated statistically significant differences in the bracket failure rates (odds ratio=1.50, p=0.010, [95% CI 1.10 to 2.05]). The risk of failure was 1.5 times greater when brackets were bonded without primer. The results should be interpreted in the context of the limited sample size, even though there was a substantial difference in the failure rates of brackets with and without a primer, favouring the use of a primer. Furthermore, the validity of the finding may be limited by potential variables such as patient factors, clinician expertise, and isolation. More extensive research is required to validate these findings (PROSPERO CRD42024593134).

Comparison of Bracket Failure with Resin Modified Glass Ionomer Cement and Resin-Based Adhesive

A high strength of bonding materials is needed for orthodontic attachments to sustain therapeutic forces and patients’ masticatory habits. Objectives: To compare the bond strength of the resin modified glass ionomer cement (RMGIC) and resign based adhesive system which leads to bracket failure in orthodontic treatment (failure to bracket attachment) for the duration of 6 months at the a tertiary care hospital at Hyderabad, Sindh Pakistan. Methods: This comparative cross-sectional study involved 30 patients, each with 20 brackets, using non-probability sampling. Participants were between the ages of 13 and 30 with fully erupted permanent teeth and mild skeletal discrepancies. Quadrants were randomized, and 120 attachments were placed in total, split evenly between the two types of materials. The study involved bonding orthodontic brackets using either composite resin or RMGIC. The teeth were prepared and cleansed, and the brackets were bonded following standard procedures. Patients were monitored each month for six months (six visits) to check for any debonded or missing brackets. Chi-Square test was run to compare bracket failure between two groups. Results: There were significant differences in bracket failure rates between the composite and RMGIC sides. Composite had a lower failure rate, with 90% of brackets remaining intact compared to 63.3% with RMGIC (p=0.04). Gender comparisons showed both male and female participants experienced more failures with RMGIC than with composite, with p-values of 0.039 and 0.038, respectively. Conclusion: RMGIC could not withstand the forces experienced during fixed appliance treatment as effectively as composite resin, resulting in a higher debonding rate.

Evaluation of correlation between compliance of a patient towards orthodontic treatment and plaque accumulation in lower anterior region with fixed orthodontic appliances. A cross-sectional study

BACKGROUND &OBJECTIVE: Using orthodontic appliances can offer new spots for the oral microbiota and dental plaque to attach. Poor oral hygiene can lead to gingivitis and tooth decay resulting in the removal of braces to repair damage and delay treatment. Orthodontic patients who are mindful of their oral health often show greater compliance with their treatment. They tend to miss fewer appointments and avoid losing brackets, demonstrating a strong commitment to their orthodontic care. This study aims to find a correlation between plaque accumulation and patients’ compliance with their orthodontic treatment. METHODOLOGY:50 orthodontic patients (20 males and 30 females, aged 11 to 25 years) were assessed at their 3rd, 4th, or 5th appointments. The plaque index for each patient was calculated on these appointments. Patient compliance like appointment follow-ups and bracket failures was recorded. A correlation was found between the plaque index and compliance of the patient. RESULTS: A statistical analysis revealed a significant, strong negative correlation between the rate of following appointment follow-ups and the plaque scoring index (r = -0.832, P value < 0.001), and a significant, strongly positive correlation between bracket failure rate and plaque scoring index (r = 0.795, P < 0.001). Patients who had good attendance at follow-up appointments and low bracket failure had lower mean plaque score indices. CONCLUSION: Patients with good compliance in terms of low bracket failure rate and attending follow-up appointments regularly tend to have lower plaque scores.

Metallic vs Ceramic Bracket Failures After 12 Months of Treatment: A Prospective Clinical Trial

IntroductionOrthodontic treatment with fixed vestibular appliances is still widely used worldwide. When choosing the aesthetic alternative of ceramic brackets, the possibility of failure and cracking of braces should be considered. Therefore, the aim of the present study was to compare the failure rates of ceramic and metal brackets in a 12-month clinical study. MethodsEighty patients undergoing fixed orthodontic treatment with vestibular appliances were enrolled and divided into 2 equal groups: MET for metal brackets and CER for ceramic brackets. After bonding, bracket failures were recorded for 12 months, along with the archwire placed at the time of failure. Angle's dental class, skeletal class, Wits appraisal, Little's irregularity index, overjet, overbite, age, and gender of the patients were recorded from pretreatment cephalometric tracings and study casts. The data were statistically analysed (P < .05). ResultsSignificantly higher failure rates were found for ceramic brackets in the overall analysis, in the mandibular arch, and in the posterior region. Regression analysis revealed a significant influence of round nickel-titanium archwires on higher failure rates, whilst a significant influence of rectangular archwires was found on lower failure rates. ConclusionsCeramic brackets showed higher failure rates. Patients should be aware that orthodontic treatment with ceramic brackets may involve delays and inconvenience due to the higher failure rate compared to metal brackets.

Comparative in-vivo bond failure rate of orthodontic brackets when bracket base is treated with micro-abrasive blasting vs. acid etching: eighteen month randomized control trial and scanning electron microscope study.

The aim of this study was threefold. Firstly, it aimed to introduce and detail a novel method for chemically etching the bases of stainless-steel orthodontic brackets. Secondly, the study sought to investigate the structural alterations within the brackets' microstructure following chemical etching compared to those with sandblasted bases, using electron microscopy analysis. Lastly, the study aimed to evaluate and compare the long-term durability and survivability of orthodontic brackets with chemically etched bases versus those with sandblasted bases, both bonded using the conventional acid etch technique with Transbond XT adhesive, over an 18-month follow-up period. The study was a randomized clinical control trial with triple blinding and split-mouth study design and consisted of two groups. The brackets in the sandblasted group were prepared by sandblasting the intaglio surface of the base of the bracket with 50 µm SiO2 particles. Hydrofluoric acid was used to roughen the base in the acid-etched group. The bases of the brackets were viewed under an electron microscope to analyze the topographical changes. A total of 5,803 brackets (3,006 acid-etch, 2,797 sandblasted) in 310 patients were bonded, in a split-mouth design by the same operator. The patients were followed for 18 months. The failure rate of 2.59% and 2.7% was noted in an acid-etched and sandblasted group, respectively. There was a close approximation of curves in the Kaplan-Meier plot, and the survival distribution of the two groups in the log-rank (Mantel-Cox) test was insignificant; x2 = 0.062 (P value = 0.804). Acid etching if the bases of the brackets can be used as an alternative to sandblasting furthermore acid etching can be performed on the chair side.

The Influence of a Season on Bond Failure Rate of Metal Orthodontic Brackets: A Prospective Clinical Study

Objective: The aim of the study was to determine the influence of a season on bond failures of metal brackets using a modified method of direct bonding over a period of 12 months.\nMethods: The clinical study involved thirty patients, 8 men and 22 women, who had a total of 600 metal orthodontic brackets 022\" (Mini Sprint®, Forestadent, Germany) placed. Transbond XTTM (Transbond XT™ Paste and Primer, 3M, Monrovia, CA, USA) adhesive material was applied. All brackets and tubes were placed using a modified direct bonding method. Bond failures were monitored within 12 months from the initial bonding.\nResults: The results showed that out of the total number of the placed brackets, 10 (1.67%) brackets fell off. The highest number of bond failures, 3 (3%) cases, occurred if they were placed in February and March, respectively, while 4 (3.33%) cases of debonding occurred in October. In the period from May to September, as well as in January and November, there was no bond failures.\nConclusion: The results showed a difference in the number of bond failures depending on the season, where the largest number of failed brackets was in the winter period, i.e. in October and December.

Comparative Assessment of Bracket Bond Failure Rates of a Novel Chitosan-Based Orthodontic Primer: An In Vivo Split-Mouth Study.

Introduction An unavoidable side effect of orthodontic fixed appliance therapy is the demineralization of the enamel surface surrounding the bracket at the adhesive and tooth interface due to a microgap formation, which serves as a nidus for biofilm growth. Due to this, it is advantageous to include antibacterial agents in orthodontic primers without affecting their clinical properties. The aim of this study was to compare the in vivo bracket bond failure rates of a novel chitosan-based primer with a conventional orthodontic primer. Materials and methods Fifty-four subjects and 1,080 brackets were included in this study. At the end of six months, 45 subjects and 960 brackets bonded using novel chitosan-based primers and conventional primers (Anabond, Anabond Stedman Pharma Research Pvt Ltd, Chennai, India). Each was evaluated for a bracketed bond failure rate. Descriptive statistics and Chi-square tests were used for statistical analysis. Results The results revealed that the bracket bond failure rate in Group 1 (novel chitosan-based primer) was 27 brackets (3%) and 23 brackets in Group 2 (conventional primer) (2.5%), with no statistically significant difference between the two groups (p>0.05). There was a statistically significant difference in the bracket failure rate between the maxillary arch (2%) and the mandibular arch (3.5%) (p<0.05). Conclusion Brackets bonded with the chitosan-modified novel orthodontic primer showed no statistically significant difference in bracket bond failure rate when compared to the conventional primer. Bond failure rates were higher in the mandibular teeth when compared to the maxillary teeth.

Comparative evaluation of bracket bond failure rates of a novel non-primer adhesive with a conventional primer-based orthodontic adhesive - a pilot study.

Bonding is an important step in fixed orthodontic therapy and evaluation of bracket bond failures while using different bonding systems is required. The aim of the present study was to evaluate and compare bracket failure rates of a novel no primer adhesive with conventional primer-based orthodontic adhesives. This split mouth study was conducted among fifteen patients who underwent therapy with fixed orthodontic appliances using metal brackets. Total of 300 brackets were bonded and the bracket bond failure rates were assessed at the end of 3 months. The difference in bond failure rates between the two groups were assessed in different teeth. Descriptive statistics and chi-square test was performed. Evaluation of bracket bond failure rates showed a higher incidence of bond failures in the group bonded with the primerless adhesive (6.3%) compared to conventional adhesive (2.3%) but there was no statistically significant difference (P>0.05). No intergroup difference was found in the bracket failure rates of individual teeth (P>0.05). Higher incidence of bond failures were noted with brackets bonded with primerless adhesive when compared to primer-based adhesive but no significant difference was noted over a period of 3 months. Mandibular canine and premolars had a higher bracket failure rate with no significant difference between the adhesives.

Bracket Bond Failures: Incidence and Association with Different Risk Factors—A Retrospective Study

Bracket bonding failure is one of the relevant problems in fixed orthodontics therapy, which affects the total treatment and quality of treatment results. The purpose of this retrospective study was to evaluate the frequency of bracket bond failure and find out risk factors. A total of 101 patients with an age range of 11-56 years were included in this retrospective study and treated for a mean period of 30.2 months. Inclusion criteria were: males and females with permanent dentition and completed orthodontic treatment in both fully bonded dental arches. Risk factors were calculated using binary logistic regression analysis. The overall bracket failure rate was 14.65%. The bracket failure rate was significantly higher in the younger patients' group (p = 0.003). In most cases, patients experienced bracket failures in the first month of the treatment. Most of the bracket bond failures occurred on the left lower first molar (29.1%) and were twice as common in the lower dental arch (66.98%). Patients with increased overbite had an increased likelihood of bracket loss (p = 0.042). Class II malocclusion increased the relative risk of bracket failure, while Class III decreased the rate of bracket failure, but the difference was not statistically significant (p = 0.093). The bracket bond failure rate was higher in younger patients than in older patients. Brackets placed on mandibular molars and premolars had the highest failure rate. Class II was associated with an increased bracket failure rate. Increased overbite statistically significantly increases bracket failure rate.

Influence of resin modified glass ionomer cement incorporating protein-repellent and antimicrobial agents on supragingival microbiome around brackets: an in-vivo split-mouth 3-month study.

To explore the influence of resin modified glass ionomer cement (RMGIC) adhesives containing protein-repellent and quaternary ammonium salt agents on supragingival microbiome, enamel and gingival health around brackets. Ten patients (21.4 ±3.5 years) about to receive fixed orthodontics were enrolled in this study. Unilateral upper teeth bonded with RMGIC incorporating 2-Methacryloyloxyethyl phosphorylcholine (MPC) and Dimethylaminohexadecyl methacrylate (DMAHDM) were regarded as experimental group (RMD), while contralateral upper teeth bonded with RMGIC were control group (RMGIC), using a split-mouth design. Supragingival plaque was collected from both groups before treatment (T0), and at 1 month (T1) and 3 months (T2) of treatment. High-throughput sequencing was performed targeting v3-v4 of 16S rRNA gene. Streptococcus mutans and Fusobacterium nucleatum quantification was done by qPCR analysis. Bracket failures, enamel decalcification index (EDI), DIAGNODent scores (Dd), plaque index (PI) and gingival index (GI) were monitored at indicated time points. Within 3 months, alpha and beta diversity of supragingival plaque had no difference between RMGIC and RMD groups. From T0 to T2, the relative abundance of Streptococcus depleted in RMD but remained steady in RMGIC group. Streptococcus, Prevotella, and Fusobacterium became depleted in RMD, Haemophilus and Capnocytophaga became depleted in RMGIC group but Prevotella enriched. Quantification of Fusbacterium nucleatum and Streptococcus mutans showed significant difference between RMGIC and RMD groups at T2. Teeth bonded with RMD had significant lower plaque index (PI) and DIAGNODent (Dd) score at T2, compared with teeth bonded with RMGIC (p < 0.05). No difference in bracket failure rate was examined between both groups (p > 0.05). By incorporating MPC and DMAHDM into RMGIC, the material could affect the supragingival microbial composition, inhibit the progress of plaque accumulation as well as the key pathogens S. mutans and F. nucleatum in the early stage of orthodontic treatment.

Natural and synthetic photosensitizers activated by photodynamic therapy on enamel reconditioning rebonded to metallic brackets: an in vitro study.

To evaluate the bond efficacy and failure rates of rebonded metallic brackets after enamel reconditioning with chemical 37% phosphoric acid (PA) and natural and synthetic photosensitizers activated by PDT. A total of 50 non-cavitated, and cautiously extracted human premolars were congregated after sample size calculation. The enamel exterior was etched, washed, dried for adhesive application, and cured. Metallic brackets were then oriented and adapted to enamel surface using composite. Later, brackets were debonded from the surface via a Weingart plier. Enamel was finished for ensuing surface reconditioning. Ultimately, specimens were randomly distributed into five groups (n=10). Enamel surface before rebonding was reconditioned with curcumin photosensitizer (CP), riboflavin photosensitizer (RP), rose bengal photosensitizer (RBP), methylene blue photosensitizer (MBP), and 37% PA (control) respectively. After following reconditioning protocol, brackets were rebonded to the enamel exterior employing a composite adhesive system. Then, specimens were subjected to the universal testing machine for analyzing shear bond strength (SBS), and bond failures were predicted using an ARI index. One-way ANOVA and Tukey multiple comparison tests were used for statistical analysis at a variance value of p < 0.05. Enamel reconditioned with 37% PA demonstrated the highest SBS for bracket rebonding, and the lowest SBS was presented by CP actuated by PDT. Enamel reconditioned with RP and RBP corroborated the analogous SBS outcome to 37% PA. Likewise, enamel surface treatment with MBP revealed a statistically significant result to CP for metallic bracket rebonding. The most prevalent failure scores anticipated among groups were 0 and 1 indicating an adhesive failure with the exemption of group 5 (control) that encountered more score 2 cohesive failure on debonding metallic brackets from enamel exterior. Rose bengal and riboflavin photosensitizers activated by photodynamic therapy with low ARI scores have the potential to be used as viable enamel reconditioning alternatives to 37% phosphoric acid for rebonding metallic brackets.

Clinical bracket failure rates between different bonding techniques: a systematic review and meta-analysis.

Bracket failure increases the treatment time of orthodontic therapy and burdens patients with unnecessary costs, increased chair time, and possible new appointments. To compare the bond failures of different orthodontic materials based on the results of available clinical studies. A systematic search of clinical trials was performed in the Cochrane, Embase, and Pubmed databases with no limitations. The list of investigated techniques contained conventional acid-etch primer (CM-AEP), self-etch primer (SEP), self-cure resin (SCR), and simple or resin-modified glass ionomer (RM-GIC) materials and procedures. Clinical studies reporting the failure rate of bonded brackets after using direct adhesive techniques on buccal sites of healthy teeth were included. Bracket failure rates from eligible studies were extracted by two authors independently. Risk ratios (RRs) were pooled using the random-effects model with DerSimonian-Laird estimation. Thirty-four publications, involving 1221 patients, were included. Our meta-analysis revealed no significant difference in the risk of bracket failures between SEP and CM-AEP. After 6, 12, and 18 months of bonding, the values of RR were 1.04 [95% confidence interval (CI), 0.67-1.61], 1.37 (95% CI, 0.98-1.92), and 0.93 (95% CI, 0.72-1.20), respectively. At 18 months, bracket failure was 4.9 and 5.2% for SEP and CM-AEP, respectively. Heterogeneity was good or moderate (I2 < 42.2%). The results of RM-GIC at 12 months indicated a 57% lower risk of bracket failure using SCR as compared with RM-GIC (RR: 0.38; 95% CI, 0.24-0.61). At 18 months, bracket failures for SCR and RM-GIC were 15.8 and 36.6%, respectively (RR: 0.44; 95% CI, 0.37-0.52, I2 = 78.9%), demonstrating three to six times higher failure rate than in the case of etching primer applications. A major limitation of the present work is that the included clinical trials, with no exceptions, showed variable levels of risk of bias. Another possible problem affecting the outcome is the difference between the clustering effects of the split mouth and the parallel group bracket allocation methods. The results revealed no significant difference between SEP and CM-AEP up to 18 months after application. RM-GIC had much worse failure rates than acid-etching methods; additionally, the superiority of SCR over RM-GIC was evident, indicating strong clinical relevance. Prospero with CRD42020163362.

Comparison of Bracket Failure Rate between Two Different Materials Used to Fabricate Transfer Trays for Indirect Orthodontic Bonding

Various techniques have been advocated for over half a century for the fabrication of transfer trays for indirect orthodontic bonding. Authors have aimed to provide better light curing and accuracy of bracket positioning to avoid bracket failure and get the best possible results. This study is aimed to compare bracket failure rate when transfer trays were fabricated with a glue gun material and polylactic acid (PLA) filament for an indirect bonding procedure. Customized transfer trays were fabricated using a glue gun material and PLA filament, and an indirect bonding procedure was performed. Bracket failure was assessed at regular intervals with adhesive remnant index (ARI) scoring, and reasons for bracket failure were assessed. Kolmogorov-Smirnov test was employed to test the normality of data. A Chi-square test was performed for the quantitative variables. Results showed higher bracket failure in the PLA transfer tray groups and in the mandibular arch, especially in the posterior region. Adhesive remnant index scores of 2 followed by 3 were prevalent, and the most common reason for bracket failure was an excessive force during PLA transfer tray retrieval followed by masticatory forces. Both the transfer tray methods are effective for an indirect bonding procedure. Polylactic acid transfer trays showed more bracket failure as compared to glue gun transfer trays, especially in the mandibular posterior region due to excessive force applied during tray retrieval. This study aims to provide valuable information regarding the efficiency of various in-house methods of fabricating customized transfer trays and their effect on bracket failure rates.

Construction of an In Vivo Debonding Device and Comparison of Bracket Failure Rate and Debonding Force for Indirect Orthodontic Bonding

A major limitation of indirect bonding is incomplete penetration of the curing light through transfer trays, leading to inadequate curing of light-cure adhesive resin, causing bracket bond failure. Dual-cure adhesive resin is both light and chemically cured, which reduces the requirement of light for curing of the composite. Comparative evaluation of bracket failure rate and bond strength between dual-cure composite and light-cure composite for indirect orthodontic bonding of brackets. A split-mouth randomized clinical study was carried out in 51 patients (30 females and 21 males). Indirect orthodontic bonding using Erkogum as adhesive to attach the bracket to cast and glue gun material was utilized to form a transfer tray. Conventional light-cure and dual-cure adhesive resins were compared with regard to their bracket failure rate, adhesive remnant index score, and in vivo clinical bond strength. Kolmogorov-Smirnov test was employed to test the normality of data. Mann-Whitney U test and Chi-square test were performed for the quantitative variables and it was observed that both the groups showed similar results for the parameters being measured. The mandibular arch showed more bracket failure, the dual-cure composite group showed more bracket failure, however, the adhesive remnant index (ARI) score for both the groups was similar. No statistically significant difference was seen concerning the clinical bond strength between the two adhesive resins. Dual-cure adhesive system can be used for indirect bonding in orthodontics. The mandibular arch had a higher bond failure in the second premolar region. The sequence of bond failure was concordant among both the adhesive groups. However, dual-cure adhesive invariably showed more bracket failure. The highest bond strength was observed for the maxillary canine brackets in the light-cure group, and mandibular canine brackets in the dual-cure group. Whereas, the weakest bond strength in the light-cure group was observed for the mandibular second premolar brackets and for maxillary second premolar brackets in the dual-cure group. There was no significant difference between the in vivo clinical bond strength between the two adhesive systems. On debonding, majority of the adhesive was observed to be on the tooth surface. This study signifies that both light-cure and dual-cure resins can be used for indirect bonding procedures but light-cure composite resin shows a lower bracket failure rate as compared to dual-cure composite resin.

Effect of different enamel pretreating agents on bonding efficacy and survival rates of orthodontic brackets: In vitro study and split-mouth randomized clinical trial

This double invitro study and randomized clinical trial aimed to investigate the bonding failure rates of orthodontic brackets after enamel pretreatment with agents showing different particle sizes. For the invitro study, 80 bovine teeth were randomly divided into 4 groups according to the pretreating method used and their particle sizes: erythritol (14 μm), glycine (18-22 μm), sodium bicarbonate (70 μm), and no pretreatment. Scanning electron microscopy microphotographs were performed after pretreatment. Then, brackets were bonded, and shear bond strength was calculated. For the clinical study, agents with low (erythritol) and high (sodium bicarbonate) particle sizes were chosen. Twenty consecutive patients willing to start fixed orthodontic treatment with vestibular stainless steel brackets were enrolled. Patients were randomly divided into 2 groups following a split-mouth design. Group A underwent a 5-second enamel pretreatment procedure with erythritol for teeth belonging to maxillary left and mandibular right quadrants, whereas the remaining quadrants were pretreated for 5 seconds with sodium bicarbonate powder. In group B, quadrants were inverted. Then, brackets were bonded on the vestibular surfaces of teeth, and patients were visited monthly for 12 months to assess bond failures. Periodontal evaluation of probing pocket depth, bleeding on probing, plaque index, and papilla bleeding index was conducted before bonding and after 1, 3, 6, and 12 months. The invitro study showed that erythritol and control presented significantly higher shear bond strength values for other agents. Bicarbonate showed the lowest values. In the clinical study, 20 patients (aged 16.4 ± 3.9 years) were enrolled, and all completed the study. Erythritol showed a significantly lower failure rate (3%) than sodium bicarbonate (7.5%). Kaplan-Meier survival plots showed statistically significant differences in risk of failure between the 2 groups during the 12-month follow-up. Enamel pretreatment with erythritol can be a viable technique to reduce failure rates of orthodontic brackets. The trial was not registered. The protocol was not published before trial commencement. No funding or grant was received for this research.

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.

Bracket Failure in Orthodontic Patients: The Incidence and the Influence of Different Factors.

Failure of brackets is a common problem in orthodontics. This affects the treatment time, cost, and compliance of the patient. This study was conducted to estimate the bracket failure rate and the related factors for the long term. Methodology. This ambidirectional cohort study included 150 nonsyndromic orthodontic patients undergoing fixed appliance therapy for the last two years. The same patients were followed for 7 months. Different variables related to bracket failure were evaluated. The available data were analyzed descriptively, and the Kaplan-Meier estimate was used to measure the bracket survival rate from the date of bonding to failure. Results. A total of 180 bracket bond failures in the 150 included patients (52.2% males and 47.8% females) with a median age of 17 years (range 10-25 years). 69% of brackets failures were reported within the first 6 months after bonding. About 58.3% of bracket failure was noticed in adolescent patients before the age of 18 years. The majority of the cohort (81.1%) has good oral hygiene. The failure rate in patients with normal overbite was 41.1%, in decreased overbite cases was 15%, while in deep bite cases the failure rate was 43.9% with a statistically significant difference. Adults show less bracket failure (41.7%) than adolescent patients (58.3%). More bracket failure was noted in the lower arch (55%) than the upper arch (45%), and there were more bond failures posteriorly (61%) than on the anterior teeth (39%). Majority (41.1%) of the bracket failed on round NiTi wires. Conclusion. The bracket failure rate was 6.4%, with most bracket failure occurring in the first 6 months after bonding with individual difference. There was more incidence of bond failure in an increased overbite, adolescents, lower arch, posterior teeth, and lighter alignment wires.

Effect of Enamel Pretreatment with Pastes Presenting Different Relative Dentin Abrasivity (RDA) Values on Orthodontic Bracket Bonding Efficacy of Microfilled Composite Resin: In Vitro Investigation and Randomized Clinical Trial.

Bonding failure is a clinical issue frequently encountered in orthodontic practice. The aim of this study was to evaluate enamel pretreatment both in vitro and clinically using agents with different RDA values before brackets’ bonding, to assess if RDA can affect the Shear Bond Strength (SBS), Adhesive Remnant Index (ARI) and clinical failure rate of orthodontic brackets. For the in vitro study, 220 bovine teeth were pretreated with agents with different RDA values. Subsequently, brackets were bonded. For the clinical study, 20 patients underwent bonding of 20 brackets each with a split-mouth design. Low and high RDA toothpastes were used for enamel pretreatment. SBS, ARI and failures were recorded. Higher SBS values were found for teeth pretreated with lower RDA agents; conversely, lower SBS values were found for teeth pretreated with higher RDA agents (p < 0.05). For high ARI values, RDA increased too (p > 0.05). In the clinical study, a significantly lower failure rate was reported for teeth pretreated with low RDA toothpaste (2.5% in low RDA group, 7.0% in high RDA group; p < 0.05). No significant differences were assessed comparing the two dental arches and anterior and posterior sites. Enamel pretreatment with low RDA toothpastes could increase brackets’ survival rate. Further in vitro and clinical studies would be welcomed to confirm these findings.

Comparative Study of the Shear Bond Strengths and Bracket Failure Rates of Two Orthodontic Adhesive Systems

Comparative Study of the Shear Bond Strengths and Bracket Failure Rates of Two Orthodontic Adhesive Systems

Influence of Patient Attitude on Bracket Failure Rate: A Prospective Study

Objective:The aim of this study is to assess the influence of general attitude and attitude toward orthodontic treatment on bracket failure rate.Methods and Materials:The sample comprised 128 orthodontic patients of both genders (82 women and 46 men), divided into two groups—adolescents (12-18 years old) and adults (19-25 years old), who underwent fixed orthodontic treatment with metallic braces. Two questionnaires were handed out—one before beginning the treatment and, the second, 6 months after the start of treatment. Both the questionnaires consisted of 12 questions with 5 options each, in which the attitude was scored from 1 to 5.Conclusion:Patients with poor attitude scoring had higher bracket failure rate and vice versa.