Self-ligating Research Articles

Effects of Low-Level Laser Therapy and Bracket Systems on Root Resorption during Orthodontic Treatment: A Randomized Clinical Trial.

This study aimed to assess the outcomes of low-level laser therapy (LLLT) with the conventional bracket (CB) and self-ligating (SL) bracket systems on root resorption (RR) during orthodontic treatment. A total of 32 patients were included in this randomized clinical trial. All the patients were randomly divided into four individual groups (SLL: self-ligating laser, CBL: conventional bracket laser, SLNL: self-ligating non-laser, CBNL: conventional bracket non-laser). RR was measured from the cone-beam computed tomography (CBCT) radiographs which were taken at two stages of the orthodontic treatment: pre-treatment (T1) and after leveling and alignment stage (T2). Wilcoxon rank test for the comparison was conducted to compare the RR at T1 and T2 stages within each group and showed a significant difference (p < 0.05) for various variables. Mann Whitney test compared the RR in laser and non-laser groups irrespective of the bracket systems and exhibited no significant differences except the left lateral incisor. Moreover, CB and SL groups showed no significant difference in RR among any tooth. Kruskal Wallis test was performed to compare the RR among all groups which presented no significant differences. LLLT and bracket systems have no consequences on RR until the leveling and alignment stage of orthodontic treatment.

Cross sectional study on the analysis of periodontal parameters in adult patients with clear aligners orthodontics treatment versus three other types of brackets

Objective: To analyse the gingival parameters in the orthodontic treatment using clear aligners versus the three other types of brackets, i.e., conventional metal, conventional ceramic, and metal self‑ligating. Materials and methods: The current study comprised 80 individuals who came in for regular appointments and were receiving orthodontic treatment. They were then separated into four groups, each with 20 patients: Group 1 received traditional brackets (CB); Group 2 received traditional ceramic brackets (CCB); Group 3 received self-ligating (SL) brackets; and Group 4 received clear aligner (CA) treatment. The inclusion criteria were any patient under the age of 18 with a Class II or Class III skeletal link who was receiving orthodontic treatment for at least 6 months with fixed orthodontic appliances (FOA) on their teeth. Smokers, pregnant women, diabetics, and those using medications that impact gingival health or who have cardiovascular illnesses were all excluded from the study. Patients who had used antiseptic solutions or mouthwash in the previous six months, had any periodontal procedures in the previous six months, or had fixed bridges and crowns or extensive restorations adjacent to the gingival borders were also excluded.

Pain Perception and Rate of Canine Retraction Through Self-Ligating Brackets and Conventional Elastomeric Ligation System: A Split Mouth Study

Objective: To evaluate the rate of tooth movement and the pain perception via self-ligating (SL) and conventional elastomeric ligation brackets (CB) system. Material and Methods: This study has been conducted at the Orthodontic Department of Baqai Dental College, Baqai Medical University. The sample size of this study comprised 40 patients, falling between the age of 12-30 years without any sex discrimination. Shapiro-Wilk was used to check the distribution of data. Non-parametric Mann Whitney U test was applied to evaluate the pain associated with SL and CB brackets system. To analysis the canine retraction Wilcoxon test was applied for the comparison of CB and SL brackets system. For all statistical analyses, the p-value of <0.05 was considered significant . Results: Pain level associated with retraction via CB and SL shows significant differences. However, the rate of canine retraction via CB and SL shows no significant differences at stages T0-T1 and T1-T2. However, stage T2-T3 shows a significant difference . Conclusion: As pain during orthodontic treatment is mostly associated with the level of compression of the periodontal ligament, it may be hypothesized that lower frictional forces generate less compression of the periodontal ligament and blood vessels, and so alter the type of pain experienced.

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

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

Laser-Assisted Orthodontic Tooth Movement in Saudi Population: A Prospective Clinical Intervention of Low-Level Laser Therapy in the 1st Week of Pain Perception in Four Treatment Modalities.

Background This first-in-human study in Saudi orthodontic patients has evaluated the role of low-level laser therapy (LLLT) in pain perception (PP). The outcome of single application of LLLT with 4 different treatment modalities (TM) on PP are evaluated following orthodontic bracket bonding on maxilla. Materials and Methods A prospective clinical intervention with implementation of parallel technique in each group, 32 orthodontic patients with ectopic canine requiring fixed orthodontic appliance were enrolled and randomly allocated to the 4 groups: LLLT + self-ligating (SL) bracket, LLLT + conventional (Conv.) bracket, non-LLLT + SL bracket, and non-LLLT + Conv. bracket. Orthodontic bracket bonding from 1st molar to 1st molar and superelastic 0.012 inch NiTi were applied for the maxilla. For each patient, maxillary 1st molar to molar received a single application of LLLT using a 940 nm Ga-Al-As laser device on 5 different points labially/buccally and palatally. Main outcome measure was the degree of PP score during the 1st week of orthodontic tooth movement (OTM) after 4 hours, 24 hours, 3 days, and 7 days of both LLLT and non-LLLT treatment applications. A questionnaire with an 11-point numeric rating scale (NRS) was used for PP. Results Mean ± SD of PP in the LLLT + SL group was 3.33 ± 1.4, 3.58 ± 1.06, 2.31 ± 0.67, and 1.89 ± 0.54 in 4 hours, 24 hours, 3 days, and 7 days, respectively. Compared to all 4 TM groups, LLLT groups showed better PP. More statistically significant differences were found in LLLT groups. No harms were encountered. Limitations The intervention provider and the patient were not blinded to the intervention. Conclusion The LLLT + SL group revealed significantly promising benefits on PP during OTM.

Tooth movement rate and anchorage lost during canine retraction: A maxillary and mandibular comparison.

To investigate the canine retraction rate and anchorage loss during canine retraction using self-ligating (SL) brackets and conventional (CV) brackets. Differences between maxillary and mandibular rates were computed. Twenty-five subjects requiring four first premolar extractions were enrolled in this split-mouth, randomized clinical trial. Each patient had one upper canine and one lower canine bonded randomly with SL brackets and the other canines with CV brackets but never on the same side. NiTi retraction springs were used to retract canines (100 g force). Maxillary and mandibular superimpositions, using cephalometric 45° oblique radiographs at the beginning and at the end of canine retraction, were used to calculate the changes and rates during canine retraction. Paired t-tests were used to compare side and jaw effects. The SL and CV brackets did not show differences related to monthly canine movement in the maxilla (0.71 mm and 0.72 mm, respectively) or in the mandible (0.54 mm and 0.60 mm, respectively). Rates of anchorage loss in the maxilla and in the mandible also did not show differences between the SL and CV brackets. Maxillary canines showed greater amount of tooth movement per month than mandibular canines (0.71 mm and 0.57 mm, respectively). SL brackets did not show faster canine retraction compared with CV brackets nor less anchorage loss. The maxillary canines showed a greater rate of tooth movement than the mandibular canines; however, no difference in anchorage loss between the maxillary and mandibular posterior segments during canine retraction was found.

RANKL concentrations in early orthodontic treatment using passive self-ligating and preadjusted edgewise appliance bracket systems

The receptor activator of nuclear factor κ-B ligand (RANKL) is a cytokine that helps remodel bone by forming osteoclasts. During tooth movement phases, osteoclasts resorb the hyalinization areas of alveolar bone, triggering tooth movement. We determined the differences in RANKL concentrations in early orthodontic treatment between preadjusted edgewise appliances (PEA) and self-ligating (SL) bracket systems. Gingival crevicular fluid was retrieved before treatment and at 1, 24, and 168 hours after treatment from five maxillary anterior proximal sites on the mesiolabial side of the upper right-to-left canines. An enzyme-linked immunosorbent assay was used to determine RANKL concentrations. The results showed differences in RANKL concentrations between the SL and PEA groups at 1, 24, and 168 hours after bracket insertion. The RANKL concentration at 168 hours in the SL group was higher compared to that in the PEA group, whereas that in the PEA group decreased to the baseline value after 24 hours. RANKL concentration in the passive SL bracket system was higher compared to that in the PEA system due to differences in the force and mechanotherapy of the SL brackets.

Antimicrobial action of chlorhexidine digluconate in self-ligating and conventional metal brackets infected with Streptococcus mutans biofilm.

ObjectivesThe objectives of this study were to assess the adherence of Streptococcus mutans biofilms grown over conventional ligature (CL) or self-ligating (SL) metal brackets and their bacterial viability after 0.12% chlorhexidine (CHX) digluconate treatment.Materials and methodsThe sample consisted of 48 metallic orthodontic brackets divided randomly into two groups: CL (n=24) and SL brackets (n=24). S. mutans biofilms were grown over the bracket surface (96 h) and treated with CHX (positive control) or 0.9% phosphate-buffered saline (PBS) (negative control) for 1 min each. Quantitative analysis was assessed by colony-forming units, and fluorescence microscopy was performed aiming to illustrate the outcomes. The tests were done in triplicate at three different times (n=9). Data were analyzed using ANOVA and Tukey test (P<0.05).ResultsThere were significant differences in brackets’ biofilm formation, being CL largely colonized compared with SL, which was observed by colony-forming unit counting (P<0.05) and microcopy images. Significant reduction in the viability of S. mutans was found in both brackets treated with CHX compared to PBS (P<0.05).ConclusionThe antimicrobial activities of CHX were similar for CL and SL brackets (P>0.05). In conclusion, a lower colonization was achieved in SL brackets and S. mutans biofilms were susceptible to CHX treatment to both studied brackets.

Comparison of Tumor Necrosis Factor-α Concentrations in Gingival Crevicular Fluid between Self-Ligating and Preadjusted Edgewise Appliances in the Early Leveling Stage of Orthodontic Treatment.

Introduction:Tumor necrosis factor-α (TNF-α) is an important proinflammatory cytokine that regulates the early phase of inflammation reaction during orthodontic tooth movement. The aim of the present study was to compare TNF-α concentrations in the gingival crevicular fluid (GCF) between preadjusted edgewise appliance (PEA) and self-ligating (SL) systems during the early leveling stage of orthodontic treatment.Materials and Methods:Eighteen patients (aged 15–35 years) who participated in this study were divided into two experimental groups (PEA and SL) and control group (without orthodontic treatment). The GCF was taken at five sites in the maxilla anterior teeth from each participant just before bracket bonding and at 1, 24, and 168 h after the initiation of tooth movement. Cytokine levels were determined through ELISA.Results:The concentration of TNF-α was significantly higher in the experimental groups than in the control group at 24 h after force application. TNF-α levels were significantly decreased at 168 h after force application in the PEA group. Meanwhile, in the SL group, the level of TNF-α at 168 h was still increased, although there was no statistically significant difference.Conclusion:TNF-α concentration was increased at 1 h and 24 h after orthodontic force application in both the PEA and SL groups. In the PEA group, TNF-α concentration was significantly decreased at 168 h, meanwhile in the SL group, this value remained increased at this time point. The differences in TNF-α concentration between the PEA and SL groups may be caused by their different types of brackets, wires, and ligation methods.

Influence of long-term in vivo exposure, debris accumulation and archwire material on friction force among different types of brackets and archwires couples

The aim was to assess the influence of long-term in vivo exposure, debris accumulation and archwire material on static and kinetic friction force among different types of brackets and archwires couples. Friction testing was performed among four lower incisors' brackets, conventional and self-ligating (SL), coupled with either nickel-titanium or stainless steel archwires, as-received and in vivo exposed in 18 subjects. The friction testing was performed for a sliding distance of 14 mm at a speed of 10 mm/min, with a starting force of 0.2 N. Wear and quantitative assessment of debris accumulation was performed on pictures of brackets obtained using a scanning electron microscope. Non parametric tests were used for statistical analysis. Only bracket type, but not exposure duration, amount of debris accumulation, archwire material or their manufacturer, was significantly correlated with both static (rho = 0.602, P < 0.001) and kinetic (rho = 0.584, P < 0.001) friction force. Within each bracket type no significant difference was observed between as-received and in vivo exposed brackets for any friction parameter except for the SL brackets in which significantly higher static and kinetic (P = 0.001, at least) friction forces were seen in in vivo exposed SL brackets (164.9 cN and 217.63 cN, respectively) in comparison with as-received SL brackets (19.69 cN and 55.72 cN, respectively). The frictional testing was performed in the dry condition which might have influenced the results. A significant correlation was seen between friction force and bracket type, while treatment duration, amount of debris accumulation, archwire material or their manufacturer was not significantly correlated to it. Nevertheless, higher friction forces were measured among in vivo aged SL brackets in comparison with as-received ones.

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.

Plaque accumulation and Streptococcus mutans levels around self-ligating bracket clips and elastomeric modules: A randomized controlled trial

Aim To determine the effect of two different ligating systems that is, elastomeric modules and self-ligating (SL) bracket systems (Smartclip - 3M Unitek) with respect to harboring bacterial plaque in fixed orthodontic treatment. Objectives To assess, evaluate, and compare the amount of plaque accumulation and Streptococcus mutans colonization around elastomeric ligation and SL clips in the smart clip appliance. Materials and Methods A total of 111 orthodontic patients scheduled for fixed orthodontic treatments were selected for this split maxillary arch study. All the patients were bonded with smart-clip (3M Unitek) SL brackets, and the wire was placed into the bracket slots, on the randomly selected hemi arch, elastomeric modules were placed for the study to be conducted. Microbial and periodontal plaque accumulation was recorded at 3-time intervals post ligation. Plaque index-by Silness and Loe, modified Quigely Hein index, bleeding on probing were evaluated, and biofilm was collected from the tooth surface after 30 days and placed in petri dishes containing Mitis Salivarius agar for bacterial culturing. Result It was observed that the side where ligation was done with elastomeric modules accumulated more plaque and increase in S. mutans colony forming units as compared to the side without external ligation (P &lt; 0.05). Conclusion Reduced bacterial colonization and better plaque control was seen with SL orthodontic bracket appliance system as compared to conventional ligation method.

Influences of archwire size and ligation method on the force magnitude delivered by nickel-titanium alloy archwires in a simulation of mandibular right lateral incisor linguoversion.

The present study investigated the influence of archwire size and ligation method on the force magnitude delivered by nickel-titanium alloy archwires to 4 incisor brackets (42, 41, 31, and 32) in a simulation of mandibular right lateral incisor linguoversion. The force delivered by 0.014 and 0.016 inch nickel-titanium alloy archwires was measured using a newly developed multi-sensor measuring system and the mean force magnitudes were compared between different archwire sizes when using conventional ligation (CL) with elastic modules or self-ligating (SL) brackets by three-way ANOVA and post-hoc Bonferroni's tests. The mean force magnitudes for the brackets were significantly decreased in the order of 42, 41, 31, and 32 (p<0.01). The force magnitude was significantly larger in CL than SL at 42, 31, and 32 (p<0.05). In conclusion, the ligation method affected the force magnitude at 4 incisor brackets. Despite the ligation method, archwire size affected the force magnitude from 42 to 31.

Root resorption, treatment time and extraction rate during orthodontic treatment with self-ligating and conventional brackets

IntroductionThis study determined the amount and severity of EARR (external apical root resorption) after orthodontic treatment with self-ligating (SL) and conventional (Non-SL) brackets. Differences regarding rate of extraction cases, appointments and treatment time were evaluated.Material and methods213 patients with a mean age of 12.4 ± 2.2 years were evaluated retrospectively. The treatments were performed with SL brackets (n = 139, Smartclip, 3 M Unitek, USA) or Non-SL brackets (n = 74, Victory Series, 3 M Unitek, USA). Measurements of the crown and root length of the incisors were taken using panoramic radiographs. Three-factor analysis of variance (ANOVA) was performed for an appliance effect.ResultsThere was no difference between patients treated with Non-SL or SL brackets regarding the amount (in percentage) of EARR (Non-SL: 4.5 ± 6.6 vs. SL: 3.0 ± 5.6). Occurrence of severe EARR (sEARR) did also not differ between the two groups (Non-SL 0.5 vs. SL: 0.3). The percentage of patients with need of tooth extraction for treatment (Non SL: 8.1 vs. SL: 6.9) and the number of appointments (Non-SL: 12.4 ± 3.4 vs. SL: 13.9 ± 3.3) did not show any differences. The treatment time was shorter with Non-SL brackets (Non-SL: 18.1 ± 5.3 vs. SL: 20.7 ± 4.9 months).ConclusionsThis is the largest study showing that there is no difference in the amount of EARR, number of appointments and extraction rate between conventional and self-ligating brackets. For the first time we could demonstrate that occurrence of sEARR does not differ between the two types of brackets.

Effect of applied moment on resistance to sliding among esthetic self-ligating brackets

To determine the effect of mode of ligation and bracket material on resistance to sliding (RS) by comparing various esthetic brackets of conventionally ligated and self-ligating (SL) designs under an increasing applied moment in the second-order dimension. Eight different commercially available esthetic brackets of SL and conventional elastomeric-ligated (CL) designs were mounted on a testing apparatus to simulate canine retraction using sliding mechanics and the application of a moment on 0.019″×0.025″ stainless steel archwire. The samples examined were the CL brackets Clarity™, Inspire Ice™, SpiritMB™, and Mystique™, and the SL brackets ClaritySL™, In-OvationC™, In-OvationR™, and Smartclip™. The RS at calculated moments of 2000 g-mm and 4000 g-mm was determined and compared between the various brackets. Descriptive measures and one-way analysis of variance were used to calculate means and statistical differences among the bracket types. The CL monocrystalline bracket displayed significantly greater (P < .05) RS than all other brackets tested. Among the other brackets, the range of RS values was 145.8-191.7 g and 291.9-389.2 g at moments of 2000 g-mm and 4000 g-mm, respectfully, though these differences were not significant (P < .05). All brackets tested displayed greater levels of RS (P < .05) at 4000 g-mm than at 2000 g-mm. With the exception of the CL monocrystalline bracket, all brackets displayed comparable amounts of RS regardless of mode of ligation or bracket slot material.

Labio-lingual root control of lower anterior teeth and canines obtained by active and passive self-ligating brackets

To investigate the torque capabilities of passive and active self-ligating (SL) brackets on mandibular incisors and canines using three-dimensional (3D) imaging analysis. Two types of SL bracket systems were analyzed: a passive and an active. Both brackets had a 0.022 × 0.028-inch slot size. Treatment protocol and wire sequences were followed as recommended by the manufacturers. Twenty-six patients were included in the passive group and 20 were included in the active group; all received pretreatment and posttreatment cone-beam computed tomography (CBCT) scanning. Based on the CBCT scans, a customized 3D analysis was developed to assess labiolingual inclination of the roots of mandibular canines and incisors with respect to the occlusal plane before and after treatment. Following treatment, a statistically significant labiolingual proclination of the teeth was seen in both groups. Moreover, in both SL systems the roots exhibited a large variation in labiolingual inclination between adjacent teeth even after treatment. A significant proclination was seen for the mandibular front teeth; the claimed third-order torque control of SL systems could not be demonstrated. Therefore, a considerable play between the wire and the brackets could be hypothesized, even more in relation to the passive than the active SL brackets.

In vitroevaluation of resistance to sliding in self-ligating and conventional bracket systems during dental alignment

ObjectiveTo investigate the resistance to sliding (RS) in self-ligating and conventional ligation bracket systems at 5 different second-order bracket angulations by using low-stiffness alignment wires in a 3-bracket experimental model and to verify the performance of the main RS components in both systems when these wires are used.MethodsInteractive self-ligating brackets with closed and open slides were used for the self-ligating (SL) and conventional ligation (CL) groups, respectively; elastomeric ligatures (1 mm inner diameter) were used in the latter system. The alignment wire used was 0.014 inch heat-activated NiTi (austenitic finish temperature set at 36℃ by the manufacturer). A custom-made testing machine was used to measure frictional resistance. Tests were repeated 5 times at every angulation simulated. All data were analyzed statistically.ResultsThe RS increased significantly with increasing angulation in both SL and CL groups (p < 0.0001). However, the RS values were significantly higher at every angulation (p < 0.0001) in the CL group.ConclusionsDespite the relevance of the binding phenomenon, ligation forces predominantly affect the RS when low-stiffness alignment wires are used.

A comparison of resistance to sliding of self-ligating brackets under an increasing applied moment

To test the null hypotheses that at clinically relevant amounts of applied moment, there are no differences in the amount of resistance to sliding (RS) between self-ligating (SL) and conventionally ligated (CL) brackets on both stainless steel (SS) and nickel-titanium (NT) archwire. Three different SL brackets and one CL bracket, all 0.022″ slot, were tested on a custom-built device to simulate canine retraction mechanics in the second-order dimension. The setup allowed for simultaneous and continuous measurement of RS and applied moment at the bracket-archwire interface. The brackets tested were Damon3, In-Ovation R, Smartclip, and Victory, all of which were tested with 0.019″ × 0.025″ SS and NT archwires. The RS at calculated moments of 2000 g-mm and 4000 g-mm was determined and compared between the various brackets and both archwire types. Descriptive measures, analysis of variance, and Tukey-Kramer post-test comparisons were used to calculate results. All brackets displayed a greater amount of RS with NT than with SS archwires. At the higher moment levels (4000 g-mm), no significant reduction in RS was found between CL and SL brackets on both SS and NT archwires. At lower levels of applied moment (2000 g-mm), reductions in RS of 18% (42.7 g) and 18% (38.5 g) were found between the CL bracket and the best performing SL bracket on NT and SS, respectively. At low values of applied moment, some statistical differences were found; however, in general, the differences in RS amongst the various SL and CL brackets tested may not be clinically relevant.

Effect of Saliva Moistening on Shear Bond Strength of Self Ligating Orthodontic Brackets

Problem statement: The purpose of the present study was to compare Shear Bond Strength (SBS) and bond failure site of conventional and Self-Ligating (SL) orthodontic brackets, bonded on dry and saliva contaminated enamel. Approach: One conventional and three different types of self ligating stainless steel brackets were bonded onto 160 bovine permanent mandibular incisors, divided randomly into 8 groups, using Transbond XT adhesive system. For each type of bracket, 20 samples were bonded on dry enamel and 20 after saliva contamination. After 24 h all specimens were tested for SBS using an instron universal testing machine and Adhesive Remnant Index (ARI) were evaluated. Results: Saliva contamination significantly lowered SBS of conventional brackets. For self-ligating brackets no significant strength reduction was recorded. Conclusion: All the groups showed clinically adequate mean shear bond strengths. ARI scores in contaminated groups resulted lower than in dry groups.

Efficiency of self-ligating vs conventionally ligated brackets during initial alignment

The aim of this study was to compare the efficiency of self-ligating (SL) and conventionally ligated (CL) brackets during the first 20 weeks of extraction treatment. Study models of 50 consecutive patients who had premolar extractions in the maxillary and/or mandibular arch, 0.022 x 0.028-in slot brackets, and similar archwire sequences were examined. Forty-four arches received SL Damon 3MX brackets (Ormco, Glendora, Calif), and 40 arches received either CL Victory Series (3M Unitek, Monrovia, Calif) or Mini-Diamond (Ormco) brackets. The models were evaluated for anterior arch alignment, extraction spaces, and arch dimensions at pretreatment (T0), 10 weeks (T1), and 20 weeks (T2). There were no significant differences between the SL and CL groups at 20 weeks in irregularity scores (mandibular arch, P = 0.54; maxillary arch, P = 0.81). There were no significant differences in passive extraction space closures between the SL and CL groups (mandibular arch, T0-T2, P = 0.85; maxillary arch, T0-T2, P = 0.33). Mandibular intercanine widths increased from T0 to T2: 1.96 and 2.86 mm in the SL and CL groups, respectively. This was not significant between the groups (P = 0.31). Logistic regression did not show a difference between the SL and CL bracket groups. SL brackets were no more efficient than CL brackets in anterior alignment or passive extraction space closure during the first 20 weeks of treatment. Ligation technique is only one of many factors that can influence the efficiency of treatment. Similar changes in arch dimensions occurred, irrespective of bracket type, that might be attributed to the archform of the archwires.