Bond Failure Rate Research Articles

Comparison of bond failure with resin-modified glass ionomer cement and visible light-cured composite bonding systems in orthodontic patients: A split-mouth randomized controlled trial.

Resin-modified glass ionomer cement (RMGIC) is considered a fluoride-releasing bonding agent. The aim of the study was to evaluate the rate of bracket bond failure with light-cured composite (LCC) and RMGIC, and to evaluate factors that contribute to the rate of bracket failure with both bonding agents. A randomized controlled trial was conducted on a sample size of 33 patients. The patients were randomly allocated for bonding with visible LCC (control group) or RMGIC (intervention group) using the lottery method. The study was double-blinded. The rate of bracket bond failure was assessed after a follow-up of minimum 3 months and evaluated using the survival regression analysis, taking into account the effects of bonding agents and other factors influencing bracket bond failure. A total of 33 participants were recruited for the study, and 66 quadrants for the intervention and control groups were randomly selected and analyzed. The data was normally distributed and the mean age of the subjects was comparable between both bonding systems. The results of the regression analysis indicated that there was no statistically significant difference between the rate of bracket bond failure with RMGIC and LCC (p = 0.081). However, after analyzing the mean days of survival, it was found that bracket survival was negligibly low with RMGIC, with a mean of 216.00 ±133.72 days as compared to LCC, with a mean survival of 224.11 ±124.59 days. No adverse effects were observed during the course of the trial. There was no difference in the rate of bracket bond failure between the intervention and control groups. The survival rate of brackets treated with RMGIC was found to be comparable to that of LCC, with a minimal difference.

Antimicrobial Effects of Orthodontic Molar Tube Coated with ZnO Nanoparticles Using Electrophoretic Deposition Method: A Randomized Clinical Trial.

This study aimed to evaluate the antimicrobial effect of coated orthodontic molar tubes (COMT) with zinc oxide nanoparticles (ZnO NPs) using an electrophoretic deposition method (EPD) and to evaluate the orthodontic molar tubes (OMT) bond failure rate. Seventy-two orthodontic molar tubes (OMTs) for second molars were divided into two groups 36 each; one group coated with ZnO NPs and the other control negative uncoated. The OMT was coated using the EPD method with ZnO NPs in a concentration of 10g/l. The OMTs were randomly allocated using a split-mouth, cross-quadrant design. After 2weeks of appliance placement, swabs were taken from the surface of the OMTs for microbial assessment against Streptococcus mutans, Lactobacillus acidophilus, and total bacterial counts; additionally, plaque and gingival indices were assessed. The patient was followed for 3months to evaluate the bond failure rate. The COMT showed a statistically significant reduction in total bacterial accounts, S. mutans, and L. acidophilus compared to UOMT (P < 0.001). Furthermore, the plaque and gingival indices near COMT were significantly less than that of UOMT. The bond failure rate was not significant between the COMT and UOMT. The COMT with ZnO NPs has potent antibacterial activity against the tested pathogens with a reduction in the amount of plaque accumulation. The use of the EPD method was feasible without adverse effects on theorthodontic molar tubes bond failure rate.

Factors Related to Bracket Bond Failure during Orthodontic Treatment: A Single-Centre Single-Operator Study.

This study aimed to investigate the influence of various patient-specific and bracket location-specific factors on bracket survival rates during comprehensive fixed appliance orthodontic treatment. A total of 197 patients (116 females, 81 males; mean age 16.3 years) having completed orthodontic treatment were included in this retrospective cohort study. Patients were treated using stainless steel non-self-ligating brackets, and the treatment duration was 23.7 months on average. The primary outcome was bracket bond failure. Potential predictors for bracket bond failure recorded included age, sex, oral hygiene, treatment duration, and several pre-treatment cephalometric characteristics such as overjet, overbite, and sagittal and vertical skeletal relationships. Factors associated with bracket failure were analysed with Cox regression, and proportional hazard assumptions were assessed using Kaplan-Meier tests. The overall failure rate was 4.4%. Bracket bond failure rates varied among tooth types and seemed to occur more on posterior teeth and on the right side of the arch. Bracket failure was more common in male patients and those with poor oral hygiene. Concerning dentofacial characteristics, bracket failure of anterior teeth was more common in those with an increased overjet and overbite.

Study on the ultrasonic cavitation damage to early atherosclerotic plaque

Ultrasonic cavitation can damage surrounding material and be used for destruction of the target tissue. In this paper, we investigated the interaction between atherosclerotic plaque (AP) and cavitation bubbles to determine whether the mechanical effect of cavitation damage could be potentially useful in therapy for treating atherosclerotic plaques. A two-bubble–fluid–solid model was established to study the dynamic behavior of bubbles near the AP and the AP damage by ultrasound-induced cavitation. A low-intensity focused ultrasound (LIFU) transducer was used for testing cavitation-based AP damage. We found that the nonlinear oscillation of bubbles causes the relative positions of the bubbles to shift, either toward or away from one another, these phenomena lead to changes in the bond failure rate between the fiber bundles, and the value of BRF exhibits an upward trend, this is the reason why the fibers suffered from reversible stretching and compressing. However, the AP damage is irreversible and diminishes as the number of cycles in the ultrasonic burst. It appears that the bigger the radii, regardless of whether the bubble (3 − i)’s and bubble i's radii are equal, the greater the AP damage. Ultrasonic cavitation therapy may not be appropriate for advanced AP patients, and the calcified tissue has a greater impact on the stability of the plaque. The damage area should be strictly selected. Additionally, the tissue damage phenomenon was found in experimental results. This work shows that the severity of AP damage is correlated with acoustic parameters and the surrounding environment from both simulation and experimental perspectives. The results show that ultrasonic cavitation may provide a new choice for the treatment of AP.

In vivo comparative assessment of bracket bond failure rates of single-component adhesives.

Single-component adhesives do not require the application of a primer on the enamel surface that has been etched and has been reported to have acceptable shear bond strengths on in vitro evaluation. This split-mouth study aimed to examine and assess the rates of bracket bond failure of hydroxyethyl methacrylate (HEMA)-based (Aqualine LC) and bisphenol A-glycidyl methacrylate (BisGMA)-based (Orthofix SPA) single-component adhesives used to bond orthodontic brackets over 6 months. This in vivo study involved the participation of 50 adult subjects, with 1080 metallic brackets directly bonded to the labial/facial surface in a split-mouth design. After 6 months of treatment, 49 patients with 490 brackets bonded using a HEMA-based adhesive and 490 brackets bonded using a BisGMA-based adhesive were evaluated for bracket bond failures. Descriptive statistics and chi-square tests were done to compare the results. The overall bracket bond failure rate (BFR) with single-component adhesives was 6.02%. Bracket BFRs of HEMA-based and BisGMA-based adhesives were 4.16% and 7.8%, respectively, and the difference was statistically significant (P < 0.05). Significant differences in BFRs between maxillary teeth (4.28%) and mandibular teeth (7.75%) were noted (P < 0.05). No significant differences in bond failures between either side or region were noted. Bond failures were more in brackets bonded with BisGMA-based adhesive (Orthofix SPA) compared with HEMA-based adhesive (Aqualine LC). Bond failures were less in the maxillary arch.

Orthodontic bracket bonding techniques and adhesion failures

The introduction of glass ionomer cements in orthodontics aimed to address the drawbacks of the acid-etch technique using composite resins, including demineralization, enamel damage, and potential allergic reactions. These cements release fluoride over time, potentially protecting against demineralization. Glass ionomer cements, despite their benefits in reducing adhesive residue and protecting against demineralization, showed higher bond failure rates compared to composite resins. This is attributed to their sensitivity to application techniques and moisture, along with a delayed setting time. In contrast, light-cured composite resins, preferred over chemically-cured resins in recent years, offer advantages such as ease of use, consistent handling, and controlled setting. However, early trials indicated higher bond failure rates for light-cured resins, a finding not consistently replicated in later studies. While glass ionomer cements offer certain advantages, their higher bond failure rate poses a significant limitation. Light-cured composite resins, with their user-friendly characteristics, have become the preferred choice in orthodontic bonding despite initial concerns about higher bond failure rates.

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.

A new method of bonding an attachment to an impacted tooth

Orthodontic traction of impacted tooth requires surgical exposure followed by bonding an attachment on the exposed impacted tooth. In the past, various methods of attachment have been used for bonding an attachment. However, various problems like failure of bonding or tearing of mucosa due to prominent attachment have remained consistent. This proposed new attachment technique is simple and inexpensive that reduce the bond failure rates and discomfort to the patient during orthodontic traction.

Comparative Evaluation Of Bond Failure Rate Of Orthodontic Brackets Bonded With Resin Modified Glass Ionomer Cement And Composite- A Randomized Control Trial

Introduction: Successful orthodontic treatment depends on the adhesive used for bonding orthodontic brackets and patient cooperation. Resin based adhesives are conventionally used but have drawbacks like white spot lesions and technique sensitivity. To overcome these problems, Resin modified glass ionomer cements (RMGIC) were introduced to utilise the fluoride releasing characteristic of GIC. Aim: To compare and evaluate bond failure rate and type of bond failure between brackets bonded with RMGIC and composite. Materials and methods: 25 patients undergoing orthodontic treatment were included and evaluated for 6 months. Bonding was done with RMGIC and composite. Patients were recalled every month and bond failure rate and type of bond failure was evaluated. Results: A total of 526 teeth were bonded out of which 263 were bonded with RMGIC and 263 with composite. Statistical analysis was done with Chi-square test (p&gt;0.05). Maximum debonding was seen in RMGIC group (6.46%) compared to composite (3.42%). Maximum debonding was seen in 1st molars bonded with RMGIC (35.3%). Majority bond failure type observed was Adhesive enamel failure in brackets bonded with RMGIC. Conclusion: From the study, it can be concluded that bond failure was commonly seen in RMGIC group in comparison with composite group. Adhesive enamel failure was the most commonly seen bracket failure type. RMGIC had majority bracket failure but within acceptable range and hence can be used as a substitute adhesive for bonding.

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.

Molar tubes and failure rates–A review

Objectives: To review the failure rates of molar tubes and the effect of molar tube base design, adhesive type, and bonding technique on the failure rates of molar tubes. Data: The revolution of molar bonding greatly impacted fixed orthodontic appliance treatment by reducing chair-side time and improving patient comfort. Even with the many advantages of molar bonding, clinicians sometimes hesitate to use molar tubes due to their failure rates. Sources: Internet sources, such as Pubmed and Google Scholar. Study selection: studies testing the bond failure rate of molar tubes. Conclusions: The failure rate of the molar tubes can be reduced and the bond strength of the molar tubes can be improved by changing the design of the molar tube base, the adhesive type, and the bonding technique

Evaluation of the Flash-Free Adhesive System for a 6-month Period: A Split-Mouth Trial.

To compare the adhesive pre-coated (APC) flash-free (FF) appliance system (3M Unitek) with an operator-coated (OC) system (Transbond XT Light Cure Adhesive Paste; 3M Unitek) in terms of bond failure, bracket survival, and chair time. This single-center study was planned with 30 non-extraction patients, 22 females and 8 males with an average age of 17 years and 5 months. A split-mouth design was used, and bonding time, failed brackets, reasons for failure, and adhesive remnant index (ARI) scores were noted. The data were analyzed with the chi-square, Kaplan-Meier, log-rank, and Mann-Whitney U tests. OC and FF adhesive-coated brackets demonstrated bond failure rates of 0.7% and 3.0%, respectively. Failure rates and survival rates presented a statistically significant difference (p=0.033). Although higher bond failure for the lower arch along with higher bond failure for the incisor teeth compared with the premolar teeth were found, these findings were not statistically significant (p=0.128; p=0.261, respectively). The effect of gender on the bond failure rate (p=0.463) and survival rate (p=0.473) was not statistically significant. A significant difference was obtained for the ARI scores (p=0.011). The bonding time for each bracket type (64.43 seconds for FF versus 98.97 seconds for OC) demonstrated a significant difference (p=0.174). The bond failure rate was higher for the FF APC brackets, but the chair time reduction during bonding was recorded. Therefore, it seems that FF APC brackets are promising. Trial registration: ISRCTNand ISRCTN26731749. Registered October 7, 2020-Retrospectively registered, https://doi.org/10.1186/ISRCTN26731749.

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.

Effect of self-etch primer application on the bond failure rate of a mandibular bonded lingual retainer

BackgroundThe aim of this study was to examine the effect of self-etch primer (SEP) application on the bond failure rate of a mandibular bonded lingual retainer over 24 months.MethodsThe average age of the 86 individuals included in this study was 17 years 4 months. After the removal of the orthodontic appliances, the lingual retainers, which were made of six-stranded stainless steel wire, were bent and bonded onto the lingual surface of all mandibular anterior teeth. The study was performed using a split-mouth design. In the study group, the SEP was administered to the teeth’s lingual surfaces. In the control group, they were etched using 37% phosphoric etchant liquid gel. After etching, the primer was applied. The adhesive resin was applied and the retainer was fitted. The patients were re-evaluated over 24 months. The first bond failures and the amount of adhesive remaining on the tooth were recorded as the adhesive remnant index (ARI) scores. The chi-square test was used to compare the bond failure rates (P = 0.231) and ARI scores between the groups (P = 0.162). The survival rates of the retainers were estimated using the Kaplan–Meier test (P = 0.237). The significance level was P < 0.05.ResultsThe bond failure rates, ARI scores, and survival rates did not differ significantly between the groups.ConclusionsThe results of this study demonstrated that an SEP can be used successfully in mandibular lingual retainer bonding. In situations where saliva isolation is difficult, bonding a fixed lingual retainer with SEP is recommended.

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.

Comparison of flash-free and conventional bonding systems: A systematic review and meta-analysis.

To review the literature systematically to compare the performance of adhesive precoated flash-free bonding systems with conventional adhesive precoated (APC) and operator-coated (OPC) bonding systems. PubMed, Cochrane Library, Web of Science, and Embase were searched for potential eligible studies. Study selection and data collection were conducted independently. Statistical analysis was performed by Review Manager 5.3. The Cochran Q test was used to test heterogeneity in the included studies. Risk of bias was evaluated using Cochrane RoB 2.0 tool for randomized controlled trials. Six studies were included and the overall risk-of-bias judgment was low risk of bias to some concerns. The results of the meta-analyses showed that flash-free required significantly less bonding time than APC (mean difference [MD]: -1.56; 95% confidence intervals [CIs]: -2.56 to -0.56), and no significant differences were found in bond failure rates (risk ratio [RR]: 1.54; 95% Cis: 0.27 to 8.89) and adhesive remnant index (ARI) (MD: -0.50; 95% CIs: -1.14 to 0.14) between them. Qualitative analysis showed that flash-free might have a positive effect on enamel demineralization compared to APC but the quantity of plaque did not differ between them. The flash-free bonding system significantly reduced bonding time and it had comparable bond failure rates with APC. So far, there is not enough evidence to support its positive effect on reducing enamel demineralization and the pathogenic bacteria around brackets. In summary, flash-free might be a better choice for clinical bracket bonding.

Comparison of bracket bond failure with the aerosol-generating and novel non-aerosol-generating bonding techniques during the SARS-CoV-2 pandemic among orthodontic patients: A retrospective cohort study.

As per the Centers for Disease Control and Prevention (CDC) guidelines, dentists must avoid the aerosol-generating procedures during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. This study aimed to compare the rate of bracket bond failure with the aerosol-generating and non-aerosol generating bonding techniques. A retrospective cohort study was conducted during the SARS-CoV-2 pandemic on a sample of 44 patients (880 teeth), equally divided into 2 groups: the conventional aerosol-generating bonding technique (ABT); and the novel non-aerosol-generating bonding technique (NABT). The rate of bracket survival and total number of bracket breakages in the 2 groups were assessed by means of the survival regression analysis. The influence of pre-treatment factors, such as the sagittal jaw relationship (ANB), the Frankfort-mandibular plane angle (FMA), overjet, overbite, and upper and lower crowding, on the rate of bracket survival was also evaluated. There was a statistically significant difference between ABT and NABT in terms of bracket survival. The mean bracket survival with ABT was 176.21 ±77.89 days and with NABT it was 162.53 ±83.34 days. The novel technique showed a hazard ratio of bracket survival of 2.99 as compared to the conventional method. There was a statistically significant influence of overjet on the rate of bracket survival (p = 0.010). The posterior segment had a higher rate of bracket failure as compared to the anterior segment in NABT, which was statistically significant (p < 0.001). However, this difference was statistically non-significant in the case of ABT. There was an increased rate of bracket failure with NABT as compared to ABT. The rate of bracket breakages in the anterior quadrants was comparable for both bonding techniques.

For Indirect Orthodontic Attachment Placement, Adding a Custom Composite Resin Base Is Not Beneficial: A Split-Mouth Randomized Clinical Trial

Aim The aim of this study was to compare the chairside time, bond failure rate, and accuracy of bonding between two orthodontic attachment indirect bonding techniques. Methods and Materials Two indirect bonding techniques were studied: unaltered base attachment (UA) and custom base attachment (CBA) methods. Eighty-four orthodontic attachments were bonded on six patient stone models. Preoperative models were digitally scanned, and subsequently, attachments were transferred with the aid of a single but sectioned vacuum-formed tray to their corresponding patients. Finally, participants were scanned after attachment bonding to make the postoperative digital replicas. Chairside time and immediate bond failure rates were measured and compared between both techniques. Postoperative and preoperative digital models were then superimposed in order to measure the accuracy of bonding in the three dimensions of space. Results No differences existed between the two techniques regarding chairside time (P=0.87) and bond failure rates (P=0.37). There were also no differences found for the total attachment movement (P=0.73), mesiodistal (P=0.10), occlusogingival (P=0.31), torquing (P=0.21), and rotational measurements (P=0.18). The UA technique, however, proved to be more accurate for buccopalatal linear directions (P=0.04), whilst the CBA technique showed more accuracy for tipping angular deviations (P < 0.01). There was a statistically significant directional bias for the UA towards the occlusal (P < 0.01) and palatal (P=0.02) directions with mesial-out angular deviation (P=0.02). Conclusion The two indirect bonding techniques were comparable for chairside time, bond failure rates, and most linear and angular measurements. The UA technique was, however, superior in buccopalatal directions, while the CBA method showed more tipping accuracy. Both techniques were efficient and reliable for indirect bonding.