Self-ligating Orthodontic Brackets Research Articles

Effects of air abrasive polishing on chromium ion release from different metal self-ligating orthodontic brackets

Treatment with fixed orthodontic appliances compromises the oral hygiene and increases the risk of plaque related disorders and dental staining in addition to corrosion and corrosion byproduct: ions. The aims this study was assessment the effects of air polishing on Chromium ion (Cr) release from stainless steel self-ligating brackets.
 one hundred and sixty self-ligating stainless-steel brackets of four brands Damon® Q™ (Damon® Q™, Ormco, Orange, CA, USA), Discovery® SL 2.0 (Dentaraum, Ispringen, Germany), Leone® F1000 (SLB; F1000, Leone SpA, Sesto Florentino, Florentino, Italy) and Lotus Plus® (Lotus plus, Orthotechnology co., Brazil) were exposed to different time of air abrasion polishing (0, 5, 10, 20 seconds) then immersed in artificial saliva with pH value 6.75 and incubated at 37°C for 28 days. Cr ion release was assessed using atomic absorption spectrophotometer at 7, 14 and 28 days and accumulative effect was calculated. Scanning electron microscope (SEM) were used to assess the surface changes and microtopography after polishing for randomly selected sample. Analysis of variance test (ANOVA), and Tukey’s (HSD) test were used to identify the significant difference among the studied groups where the level of significance set as P ≤ 0.05.
 The results revealed that all brands showed significant increase in Cr ion release concomitant with an increase in the polishing time. Damon® Q™ show the greatest amount of Cr ion release
 Conclusion: The air polishing procedure enhanced the amount of Cr ion release to a subtoxic level and could be used in adult patients using 5 sec. recommended time of polishing with prolonged intervals between the visits.

TREATMENT OF SEVERE CROWDING WITH SELF-LIGATING FIXED ORTHODONTIC APPLIANCE

Introduction: Crowding in orthodontics presents a discrepancy between tooth size and dental arch length. Crowding of teeth is more often diagnosed in mandibular dental arch. Crowding was classified as moderate (-5.1 mm or more of discrepancy), mild (-0.1 and -5 mm) of discrepancy, and no crowding (zero or a positive discrepancy) by W. Proffit. Over the last few years, the use of self-ligating brackets in orthodontics has progressed considerably. According to some authors, selfigating appliances are more ef- fective in treating moderate crowding. Aim: To present the treatment of cevere crowing of both dental arches without premolar extractions, using self-ligating fixed orthodontic appliance. Material and method: Male patient 12 years old was diagnosed with severe crowding in both upper and lower dental arches. Study cast analysis showed severe crowding of 8 mm in the upper and 9 mm in the lower dental arch with dental class I. Lateral cephalometric analysis showed slight mandibular retrogna- thism (SNB 78°) with skeletal class I (ANB 4°). There were no significant vertical skeletal deviations (SpP/ MP 20°, Bjork’s sum 389°, Jarabak 67,7%). Both upper and lower central incisors were retroinclined (I/SpP 102°, IMPA 95°). There were no deviations in maxillar corpus and mandibular corpus and ramus length. Treatment with self-ligating fixed orthodontic appliance was indicated. The active phase of the treatment lasted 26 months. During the treatment, interproximal reduction (IPR) was performed on upper and lower front teeth. Results and conclussion: Stable class I occlusion was acheieved. Both upper and lower dental arches were slightly expanded. Severe crowding was treated successfully Treatment result was stable, with no signs of relapse, with the overjet of 2 mm and overbite of 3 mm. Severe crowding in young patients can be succsess- fully treated without extractions with self-ligating fixed orthodontic appliance in cases of horizontal growth pattern ,with retroinclined upper and lower incisors.

The Evolution of Self-Ligating Brackets in Orthodontics

Orthodontic treatment has significantly evolved with the introduction of self-ligating brackets, revolutionizing the use of fixed appliances. These brackets, first conceptualized in the early 1900s and gaining popularity in the 1970s, have undergone substantial design improvements, enhancing treatment efficiency and patient comfort. Self-ligating brackets, characterized by an internal mechanism like a sliding door or clip, eliminate the need for external ligatures, thus reducing friction and facilitating more precise tooth movement. This design not only improves patient comfort through easier hygiene maintenance but also potentially accelerates treatment progress. Despite these advantages, the clinical significance of self-ligating brackets, particularly in reducing treatment times, remains a subject of debate. Factors such as case complexity and the orthodontist’s skill play a crucial role in determining treatment outcomes. Furthermore, the higher initial cost of these brackets poses economic considerations for both practitioners and patients. Recent advancements have led to a diversity of self-ligating bracket systems, each with unique features focusing on low friction mechanics, torque control, or ease of use. Orthodontists now have the flexibility to choose systems aligning with their treatment philosophies and patient needs. Continuous research is essential to enhance our understanding of their biomechanics, long-term results, and comparative effectiveness. The ongoing development of self-ligating brackets represents a commitment to balancing treatment efficiency, patient comfort, and cost-effectiveness in orthodontic care.

Comparison Of The Fractional Characteristics Of Conventional Vs Self-Ligating Orthodontic Brackets - An invitro Observational Study

Comparison Of The Fractional Characteristics Of Conventional Vs Self-Ligating Orthodontic Brackets - An invitro Observational Study

Impact of self-ligating orthodontic brackets on dental biofilm and periodontal pathogens in adolescents.

The aim of the present prospective study was to evaluate periodontal health and subgingival microbiological alterations in adolescents treated with fixed self ligating orthodontic brackets in comparison to subject without any orthodontic appliance. A total of 40 adolescents (23 females and 17 males; mean age: 13.2 ± 3.2 years) were included: 30 subjects with self ligating brackets (test group) and 10 patients without orthodontic appliances (control group). Follow-ups were as follows: T1 (1 month), T2 (3 months), T3 (6 months) from the beginning of the orthodontic therapy. Clinical parameters (plaque index, gingival index and clinical attachment level) were measured for every patient and a microbiological analysis was performed. Mann Whitney test was performed to evaluate clinical parameters between test and control group and Friedman test and Fisher test were adopted to evaluate intra group differences at different follow-ups. Student T-test was performed to compare clinical attachment level between the two groups. Significance level was set at p<0.05. No periodontal pathogens and no clinical attachment loss were found in the whole sample. A slightly higher plaque index and gingival inflammation were recorded in the test group in comparison to the controls.

Frictional Resistance in Self-ligating Orthodontic Brackets and Conventionally Ligated Brackets (An In Vitro Study)

Aims: This study was aimed to compare static frictional forces generated by 3 types of brackets (conventional, active self-ligating and passive self-ligating) combined with 3 different sizes of stainless steel wire. Material and Methods: The sample consisted of three types of brackets (Equilibrium 2, Empower, discovery sl) with a slot size 0.022 inch were coupled with 0.020, 0.018×0.025 and 0.019×0.025 inches stainless steel wires, The testing model consists of 6 brackets used to represent lower anterior teeth. Ten tests were carried out for each group of bracket-wire combination in dry state, frictional force were measured by tensile testing machine. A significant P value of 0.05 was predetermined. Results: self-ligating brackets produced significantly lower value (P ≤0.05) of mean of static friction than elastomerically tied conventional bracket. The frictional force increased proportionally to the wire size. Conclusions: The method of ligation appears to be the primary variable responsible for the frictional resistance generated by these types of brackets.

Comparison of frictional coefficient and surface roughness between three different active self-ligating brackets: An experimental in vitro study

Aim: In orthodontic treatment, the high levels of friction may reduce the effectiveness of the mechanical and decrease tooth movement efficiency. The use of active self-ligating brackets is claimed to possibly reduce friction in orthodontic treatment. The aim of this study was to investigate the three-different active self-ligating orthodontic brackets in frictional coefficient and surface roughness. Materials and Methods: This study was true-experiment laboratory with posttest group design to collect the frictional coefficients data from three different active self-ligating brackets. Friction tests were performed on three different active self-ligating brackets—In-Ovation R, Empower, and BioQuick. Each group consists of seven samples of active self-ligating brackets—and stainless steel wire which has been stored in artificial saliva solutions for 14 days. After the friction coefficients of every sample obtained, the bracket clips were separated from the bodies and set on resin acrylic medias. Surface roughness of the bracket clips was evaluated using the atomic force microscope (AFM). A one-way analysis of variance (ANOVA) followed by Scheffe test for comparisons was performed statistically (P < 0.05). Results: BioQuick and Empower orthodontic brackets produced lower frictional coefficients compared to In-Oviation-R brackets. BioQuick showed least frictional coefficients. Based on the statistical analysis, there was no significant difference of frictional coefficients between Empower and BioQuick. Surface roughness test showed that the clip surface of In-Ovation R produced the maximum roughness, followed by Empower and BioQuick. Conclusion: In-Ovation R brackets offered more frictional coefficients and surface roughness than Empower and BioQuick brackets, whereas BioQuick brackets offered the least among all the brackets studied.

Clinical and Salivary Findings in Patients with Metal and Crystalline Conventional and Self-Ligating Orthodontic Brackets.

AimData regarding different types of orthodontic brackets and ligation and various clinical and salivary findings are scarce. Therefore, the aim of this study was to compare clinical and salivary findings in patients with different types of fixed orthodontic appliances.Subjects and methodsDecayed, missing and filled teeth index (DMFT) and plaque index, salivary flow rate, salivary pH and prevalence of white spot lesions were determined in 83 patients with different types of orthodontic brackets and ligation (metal passive self-ligating brackets, conventional metal brackets, mono-crystal brackets and polycrystalline active self-ligating brackets), before and six months after the beginning of fixed orthodontic treatment. The patients were recruited in a private dental office, in the period of two years. The group comprised 83 patients (mean age: 15.14 ± 1.66 years), including 52 women (mean age: 15.08 ± 1.68) and 31 men (15.24 ± 1.64). Statistical analysis was performed by use of dependent and independent samples t-test as well as one way ANOVA, Wilcoxon signed rank test and the Kruskal Wallis test. P-values below 0.05 (p<0.05) were considered significant.ResultsDMFT and salivary flow have shown a significant increase, while salivary pH has shown a significant decrease in the observed time interval, in all patients irrespective of type of brackets and ligation. Among patients with different bracket material, no significant differences were found in any of the observed parameters.ConclusionAlthough salivary flow rate is increased in patients with fixed orthodontic appliances which can have caries-protective effect, DMFT also increases and salivary pH decreases six months after the beginning of the treatment independently of bracket material or ligation type. All patients should receive instructions for precise oral hygiene and dietary habits before the beginning of fixed orthodontic therapy and at every dental check-up.

Self-Ligating Brackets in Orthodontics- A Narrative Review

Self-Ligating Brackets in Orthodontics- A Narrative Review

Therapeutic efficacy of self-ligating brackets: A systematic review.

Over the last few years, the use of self-ligating brackets in orthodontics has progressed considerably. These systems have been the subject of numerous studies with good levels of evidence making it possible to evaluate their efficacy and efficiency compared to conventional brackets. The aim of this study was to evaluate the therapeutic efficacy of self-ligating brackets by means of a systematic review of the scientific literature. A systematic study was undertaken in the form of a recent search of the electronic Pubmed database, oriented by the use of several keywords combined by Boolean operators relating to the therapeutic efficacy of self-ligating brackets through the study of tooth alignment, space closure, expansion, treatment duration and degree of discomfort. The search was limited to randomized controlled studies, and two independent readers identified studies corresponding to the selection criteria. The chosen articles comprised 20 randomized controlled trials. The studies analyzed revealed the absence of significant differences between the two types of system on the basis of the clinical criteria adopted, thereby refuting the hypothesis of the superiority of self-ligating brackets over conventional systems.

In vitro evaluation of the influence of velocity on sliding resistance of stainless steel arch wires in a self-ligating orthodontic bracket.

Of the variables used by in vitro studies of resistance to sliding (RS) in orthodontics, sliding velocity (SV) of the wire is often the one farthest from its clinical counterpart. We investigated whether velocity influences the RS at values approximating the orthodontic movement. A SS self-ligating bracket with a NiTi clip was fixed onto a custom-made model. Different shaped orthodontic SS wires of four sizes and two types (round, 0.020″ and 0.022″; rectangular, 0.016″×0.022″ and 0.017″×0.025″) were tested using an Instron® testing machine. Wires were pulled at four velocities (1×10-2 mm/s, 1×10-3 mm/s, 1×10-4 mm/s, 1×10-5 mm/s). Shapiro-Wilk test was used to evaluate the normal distribution of the data; two-way ANOVA was performed to compare means in the RS with wire characteristics and SV. Significance level was set at P<.05. RS was higher for rectangular wires, and for those with larger diameters. Lower SV was associated with lower RS, with wire type and size having an interaction effect. The RS relatively to SV can be represented as: RS ∝ α[ln(SV)]+β, where α and β are constants. At very low SV and low normal forces, SV influences the RS of SS archwires in orthodontic brackets, and the proportionality is logarithmic. Although respecting these parameters in vitro is challenging, quantitative evaluations of RS should be carried out at clinically relevant velocities if aiming at translational application in the clinical scenario.

Torque expression in self-ligating orthodontic brackets and conventionally ligated brackets: A systematic review.

BackgroundTo evaluate the torque expression of self ligating (SL) orthodontic brackets and conventionally ligated brackets and the torque expression in active and passive SL brackets.Material and MethodsOur systematic search included MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus, and key journals and review articles; the date of the last search was April 4th 2016. We graded the methodological quality of the studies by means of the Quality Assessment Tool for Quantitative Studies, developed for the Effective Public Health Practice Project (EPHPP).ResultsIn total, 87 studies were identified for screening, and 9 studies were eligible. The quality assessment rated one of the study as being of strong quality, 7 (77.78%) of these studies as being of moderate quality. Three out of 7 studies which compared SL and conventionally ligated brackets showed, conventionally ligated brackets with highest torque expression compared to SL brackets. Badawi showed active SL brackets with highest torque expression compared to passive SL brackets. Major and Brauchli showed no significant differences in torque expression of active and passive SL brackets.ConclusionsConventionally ligated brackets presented with highest torque expression compared to SL brackets. Minor difference was recorded in a torque expression of active and passive SL brackets. Key words:Systematic review, self ligation, torque expression, conventional ligation.

The Study of Frictional Force in Self-Ligating Orthodontic Brackets

The Study of Frictional Force in Self-Ligating Orthodontic Brackets

Decrowding of lower anterior segment with and without photobiomodulation: a single center, randomized clinical trial.

The aim of this study was to evaluate the effect of low-level light therapy using light-emitting diodes (LEDs) on the speed of tooth movements that were required for the leveling and aligning of the lower anterior segment during non-extraction orthodontic treatment. The sample was comprised of patients (n = 40) with lower anterior crowding who were treated with self-ligating orthodontic brackets and a standardized wire sequence. A test group of patients (n = 20) who were treated with extraoral infrared light therapy for 20min daily with at least 80% compliance was compared to a control group (n = 20). The date of the first arch wire placement was recorded as T1, and the date of the completion of the lower anterior segment decrowding was recorded as T2. A final impression was also taken at T2. The time between T1 and T2 was significantly reduced by 22% in the test group compared to the control group (68.3 vs. 87.8days, respectively, p < 0.043). The use of photobiomodulation for 20min daily at a wavelength of 850nm might reduce the time required to resolve lower anterior crowding. This trial and its protocol were not registered on a publicly accessible registry.

Treatment time with self-ligating orthodontic brackets: a literature review

AIM: The aim of this study was carry out a literature review on the self-ligating brackets (SLB), identifying publications which evaluated the treatment time with these systems comparing them to the conventional brackets (CB). MATERIAL AND METHODS: The following indexing bases were researched: Medline (Medicine online – International Literature on Health Sciences), LILACS (Latin-American and Caribbean Literature on Health Science), IBECS (Spanish Bibliographic on Health Sciences), SciELO (Scientific Electronic Library Online) and Cochrane Library, available on the virtual librarian web site on Health of the Medicine Regional Library – BIREME (www.bireme.br). The following describers were researched: orthodontic brackets and self-ligating brackets and its correspondents in Spanish and English languages. In this study were covered the scientific researches published in the last ten years, available on their complete form. CONCLUSION: It was concluded that the treatment time seems not showing clinical significant differences when compared the SLB and CB systems, and that researches as control case studies and randomized clinical trials, with rigorous methodology, should be developed to accurate investigation of concepts and results which involve the matter.

Effect of different ligation designs of self-ligating orthodontic brackets on friction

The purpose of this study was to investigate the effect of three different ligation designs of self-ligating orthodontic bracket systems (SLBs) on friction, under wet and dry conditions. Universal testing machine was used to slide forty brackets of four different bracket types (twenty passive self-ligating brackets PSLBs, ten active self-ligating brackets ASLB, and ten preadjusted brackets with conventional elastomeric O-ties) along 0.019×0.025 stainless steel (SS) wire segments at crosshead speed 8mm/min. Testing was done under dry and wet conditions. Statistical analysis of collected data revealed that all three tested SLB types displayed significantly lower frictional forces (FF) than conventional brackets with conventional elastomeric O-ties (CEL) under both dry and wet conditions. Both tested PSLB types displayed significantly lower frictional forces than tested ASLB type, under both dry and wet conditions.

Colonization of Streptococcus mutans on esthetic brackets: Self-ligating vs conventional

Self-ligating orthodontic brackets rely on clips, rather than ligatures, to hold the archwire in place. It is unknown whether replacing ligatures with clips affects the adherence of Streptococcus mutans. The aim of this research was to evaluate whether self-ligating brackets have an advantage over conventional brackets as determined by the adherence of S mutans. The sample consisted of 50 esthetic brackets, divided into 3 experimental groups and 2 control groups of 10 brackets each. Two experimental groups were active self-ligating brackets (QuicKlear; Forestadent, Pforzheim, Germany; and In-Ovation C; Dentsply GAC, Bohemia, NY); the other was a passive self-ligating bracket (Damon 3; Ormco, Glendora, Calif). The 2 control groups were conventional brackets (Mystique; Dentsply GAC; and Clarity; 3M Unitek, Monrovia, Calif). The brackets were randomly bonded to the canines, first and second premolars, and first and second molars in the mandibular left hemiarch of 10 male participants. Biofilm was collected from the tooth surfaces before bonding and from the brackets on day 21 and placed in Petri dishes containing Mitis salivarius agar. The brackets were removed on day 28 and examined by using scanning electron microscopy. Statistical analysis, analysis of variance, and the Tukey correction with a P value of 0.05 were used. The greatest numbers of colonies were found in an active self-ligating bracket group (In-Ovation C), and the fewest colonies were in a conventional bracket group (Clarity). The largest colonies formed on active self-ligating brackets. In the slot, the greatest formation was in a control group (Mystique). Self-ligating esthetic brackets do not promote greater or lesser S mutans colonization when compared with conventional brackets. Differences were found to be related to the material composition of the bracket.

Shear bond strength of self-ligating orthodontic brackets on different types of porcelain crowns

Aim: The aim of this study is to compare shear bond strength (SBS) and adhesive remnant index (ARI) of self-ligating orthodontic brackets bonded to different porcelain crowns. Materials and Methods: Three groups of different types of porcelain crowns, each containing 12 crowns were fabricated by the same technician and allocated to one of the study groups as follows: Group I - IPS porcelain crowns (Ivoclar Vivadent AG, Schaan, Liechtenstein), Group II - Porcelain fused to zirconia crowns (Zirkonzahn GmbH, Gais, Italy, Noritake Co., Tokyo, Japan) and Group III - Conventional porcelain fused to metal crowns (Ceramco3, Densply, PA, USA). The orthodontic brackets were bonded to these crowns using hydrofluoric acid (HFA) + silane etching protocol. After bonding, the SBS of the brackets were tested with a universal testing machine under standard test conditions. Results: Statistical evaluation using analysis of variance showed a significant difference between the groups (P 0.05). Chi-square comparison revealed no significant difference in ARI scores between groups (P > 0.05). Conclusions: When HFA + silane etching protocol were used, IPS crowns showed the greatest SBS of orthodontic brackets. The ARI score was non-significant. Therefore, if there is a need to place crowns over teeth then these crowns can be used for restoration of teeth before orthodontic treatment.

Self-ligating brackets in orthodontics: current concepts and techniques (2011)

Self-ligating brackets in orthodontics: current concepts and techniques (2011) Editors: Bjoern Ludwig, Dirk Bister, and Sebastian Baumgaertel Publisher: Thieme Price: ₤163.99 ISBN: 978-3131547019 Self-ligating bracket systems are not a new concept, but they have gained a lot of popularity and are now widely accepted. Self-ligating brackets eliminate the use of steel or elastomeric ligatures. Manufactures claim that this system reduces the friction between the bracket and the wire and consequently provides more efficient tooth movement. However, the efficiency and effectiveness of self-ligating brackets are still controversial. This textbook provides extensive information about current concepts on the clinical use of self-ligating brackets with a series of references. The book contains nine chapters divided into two main …

Deformation and warping of the bracket slot in select self-ligating orthodontic brackets due to an applied third order torque

To measure the plastic deformation of three different self-ligated brackets as a result of third order torque by analysing slot dimensions and determine its impact on torque play. Three different self-ligating orthodontic brackets (0·022-inch slot) were investigated: Damon Q®, In-Ovation R®, and Speed® (30 per group). A digital SLR camera coupled to a microscope was used to capture images of the slot profile of each bracket before and after torquing. Each bracket was torqued to 63° in the same manner using a 0·019×0·025-inch SS wire. The mean change in slot height as measured at the top of the slot was 0·013 mm (SD 0·020), 0·007 mm (SD 0·010) and 0·070 mm (SD 0·03) for Damon Q®, In-Ovation R® and Speed®, respectively. Slot taper increased 0·75° (SD 0·96), 0·41° (SD 1·05) and 9·30° (SD 4·24), respectively. Increase in torque play was calculated to be 0·9, 0·6 and 7·7° respectively, as calculated using the novel formula presented in this study. Damon Q® and In-Ovation R® maintain high levels of linearity in the shape of the slot walls and experience small, but significant amounts of plastic deformation that are physically insignificant. Speed® demonstrates the most plastic deformation with visually identifiable warping in the bracket slot.