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.

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A Retrospective Clinical Audit of Bracket Failure among Patients Undergoing Orthodontic Therapy

International Journal of Dentistry ◽

10.1155/2020/8810964 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Dashrath Kafle ◽

Rajeev Kumar Mishra ◽

Md Riasat Hasan ◽

Takashi Saito

Keyword(s):

Failure Rate ◽

Treatment Time ◽

Class Iii ◽

Chi Square ◽

Delayed Treatment ◽

Orthodontic Therapy ◽

Bonding Failure ◽

Significant Difference ◽

Chi Square Test ◽

Bracket Failure

Objective. Bonding failure is a problem in orthodontic therapy and has been associated with orthodontic emergencies and delayed treatment time. The aim of this study is to determine the bracket failure rate among patients undergoing orthodontic therapy. Materials and Methods. From the archives of posttreatment records, 200 total cases were selected, out of which 122 cases had detailed treatment records. Cases with incomplete records, large restorations, or enamel aberrations were excluded from the study. Descriptive statistics were applied to obtain sample characteristics, and a chi-square test was applied to compare the bracket failure between different categories. Result. Out of the 122 samples enrolled in the study, female and male patients comprised 71% and 29%, respectively. Class I malocclusions were the most common problem (56%), followed by Class II (41%) and Class III (3%). The bracket failure rate was 3.43%, and 32% of the patients had an incidence of bracket failure. There was no significant difference in bracket failure among genders ( p = 0.344 ), malocclusion types ( p = 0.191 ), or operators ( p = 0.188 ). The maxillary left quadrant was the most common site of bracket failure, followed by the mandibular right quadrant. Conclusion. Bracket failure is relatively uncommon. It is not affected by the gender or age of the patient or by malocclusion type. The maxillary left and mandibular right quadrants are the most common sites of bracket failure.

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Treatment time, outcome, and anchorage loss comparisons of self-ligating and conventional brackets

The Angle Orthodontist ◽

10.2319/041912-326.1 ◽

2012 ◽

Vol 83 (2) ◽

pp. 280-285 ◽

Cited By ~ 13

Author(s):

Ferdinand M. Machibya ◽

Xingfu Bao ◽

Lihua Zhao ◽

Min Hu

Keyword(s):

Treatment Time ◽

Peer Assessment ◽

Steel Wire ◽

Skeletal Changes ◽

Lateral Cephalograms ◽

Significant Difference ◽

Conventional Brackets ◽

Orthodontic Patients ◽

Anchorage Loss ◽

Mandibular Incisors

ABSTRACT Objective: To compare the treatment time, outcome, and anchorage loss among orthodontic patients treated by self-ligating brackets (SLBs) and conventional brackets (CBs). Materials and Methods: A retrospective cohort study compared 34 patients (SLB group) treated by SmartClip brackets (3M Unitek, Monrovia, Calif) to 35 patients (CB group) treated by conventional preadjusted Victory series brackets (3M Unitek) and ligated by stainless steel wire ligatures. Pretreatment (T1) and posttreatment (T2) lateral cephalograms were traced and analyzed using Pancherz sagittal-occlusion analysis to obtain skeletal and dental changes in the maxilla and the mandible. The dental cast models were assessed by the Peer Assessment Rating (PAR) Index for the treatment outcomes. Results: The mean treatment time for SLBs (19.19 months) did not show a statistically significant difference from 21.25 months of CBs; the treatment time and pretreatment PAR scores were strongly correlated. There was no difference in anchorage loss between the SLB and CB groups. There were significant dental and skeletal changes among adolescent orthodontic patients regardless of the bracket used. The lingual inclination of the mandibular incisors in the CB group was 3.62° more than in the SLB group (P < .01). Conclusions: The treatment time and anchorage loss are not influenced by the type of bracket used. There are significant dental and skeletal changes among adolescent orthodontic patients regardless of the bracket used. There is significantly greater lingual inclination of mandibular incisors in the CB group than in the SLB group.

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LED vs Halogen Light-Curing of Adhesive-Precoated Brackets

The Angle Orthodontist ◽

10.2319/042707-211.1 ◽

2008 ◽

Vol 78 (5) ◽

pp. 935-940 ◽

Cited By ~ 10

Author(s):

Davide Mirabella ◽

Raffaele Spena ◽

Giovanni Scognamiglio ◽

Lombardo Luca ◽

Antonio Gracco ◽

...

Keyword(s):

Failure Rate ◽

Rank Test ◽

Fisher Exact Test ◽

Halogen Lamp ◽

Chi Square ◽

Halogen Light ◽

Significant Difference ◽

Chi Square Test ◽

Light Curing ◽

Bracket Failure

Abstract Objective: To test the hypothesis that bonding with a blue light-emitting diode (LED) curing unit produces no more failures in adhesive-precoated (APC) orthodontic brackets than bonding carried out by a conventional halogen lamp. Materials and Methods: Sixty-five patients were selected for this randomized clinical trial, in which a total of 1152 stainless steel APC brackets were employed. In order to carry out a valid comparison of the bracket failure rate following use of each type of curing unit, each patient's mouth was divided into four quadrants. In 34 of the randomly selected patients, designated group A, the APC brackets of the right maxillary and left mandibular quadrants were bonded using a halogen light, while the remaining quadrants were treated with an LED curing unit. In the other 31 patients, designated group B, halogen light was used to cure the left maxillary and right mandibular quadrants, whereas the APC brackets in the remaining quadrants were bonded using an LED dental curing light. The bonding date, the type of light used for curing, and the date of any bracket failures over a mean period of 8.9 months were recorded for each bracket and, subsequently, the chi-square test, the Yates-corrected chi-square test, the Fisher exact test, Kaplan-Meier survival estimates, and the log-rank test were employed in statistical analyses of the results. Results: No statistically significant difference in bond failure rate was found between APC brackets bonded with the halogen light-curing unit and those cured with LED light. However, significantly fewer bonding failures were noted in the maxillary arch (1.67%) than in the mandibular arch (4.35%) after each light-curing technique. Conclusions: The hypothesis cannot be rejected since use of an LED curing unit produces similar APC bracket failure rates to use of conventional halogen light, with the advantage of a far shorter curing time (10 seconds).

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Dimensional stability of distances between posterior teeth in maxillary complete dentures

Brazilian Oral Research ◽

10.1590/s1806-83242006000300011 ◽

2006 ◽

Vol 20 (3) ◽

pp. 241-246 ◽

Cited By ~ 4

Author(s):

Rafael Leonardo Xediek Consani ◽

Marcelo Ferraz Mesquita ◽

Lourenço Correr-Sobrinho ◽

Maurício Tanji

Keyword(s):

Dimensional Stability ◽

Storage Period ◽

Acrylic Resin ◽

The Other ◽

Complete Dentures ◽

Posterior Teeth ◽

Anterior Teeth ◽

Significant Difference ◽

Cooling Methods ◽

Made In

The aim of this study was to assess the displacement of posterior teeth in maxillary complete dentures stored in water at 37°C. Twenty acrylic resin-based maxillary complete dentures were constructed with the anterior teeth arranged in normal overlap and the posterior teeth in Angle class I. Metallic pins were placed on the labial cusp of the first premolars (PM), and on the mesiolabial cusp of the second molars (M). The final acrylic resin pressing was made in a metallic flask with aid of the RS tension system, and polymerized in a moist-hot cycle at 74°C for 9 hours. The dentures were deflasked after cooling in their own polymerizing water or after cooling in polymerizing water plus bench storage for 3 hours, and stored in water at 37°C for periods of 7, 30, and 90 days. Following deflasking and after each storage period tested, the PM-PM (premolar to premolar), M-M (molar to molar), LPM-LM (left premolar to left molar), and RPM-RM (right premolar to right molar) distances were measured with an STM Olympus microscope, with an accuracy of 0.0005 mm. Collected data were submitted to ANOVA and Tukey's test (5%). There was no statistically significant difference for the PM-PM, M-M, and LPM-LM distances after all storage periods when the flask cooling methods were considered. With exception of the RPM-RM distance after the 30-days water plus bench storage period, the other distances remained statistically stable.

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Caries Prevalence, Severity, and Pattern in Preschool Children

The Journal of Contemporary Dental Practice ◽

10.5005/jcdp-9-3-24 ◽

2008 ◽

Vol 9 (3) ◽

pp. 24-31 ◽

Cited By ~ 32

Author(s):

Amjad H. Wyne

Keyword(s):

Preschool Children ◽

Anterior Tooth ◽

World Health ◽

Caries Prevalence ◽

Posterior Teeth ◽

Posterior Tooth ◽

Decay Component ◽

Anterior Teeth ◽

Significant Difference ◽

Health Organization

Abstract Aim To determine caries prevalence, severity, and pattern in preschool children of Riyadh, Saudi Arabia. Methods and Materials A total of 789 randomly selected preschool children, 379 (48%) male and 410 (52%) female, with mean age of 4.7 (SD 0.5) years were examined for dental caries using World Health Organization (WHO) diagnostic criteria. Results The overall caries prevalence among the sample was 74.8%. The mean decayed, missing, and filled (dmft) score was 6.1 (SD 3.9) with a decay component of 4.66, a missing component of 0.54, and a filled component of 0.92. There was no significant difference (p>.05) in caries prevalence and severity in relation to gender of the children. However, the caries prevalence and severity were significantly higher (p<.05) among children from government preschools as compared to those from private preschools. Among the posterior teeth, mandibular second molars (54.3%), and among anterior teeth, maxillary central incisors (27.9%) had the highest caries prevalence. Among the molars, caries prevalence was generally high in lower molars while among the anterior teeth, upper teeth generally had a higher caries prevalence. The majority of the children (50.3%) had both posterior and anterior tooth caries, 42.2% had posterior tooth caries only, while very few (7.5%) children had only anterior tooth caries. Conclusion Caries prevalence and severity are very high in the study population, and most children have posterior tooth caries. Clinical Significance Early measures such as fissure sealants, topical fluoride applications (as early as safely possible), and dietary fluoride supplements (where indicated) are needed to prevent caries of deciduous molars in high caries populations. Citation Wyne AH. Caries Prevalence, Severity, and Pattern in Preschool Children. J Contemp Dent Pract 2008 March; (9)3:024-031.

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Fracture Resistance of a Bulk-Fill and a Conventional Composite and a Combination of Both for Coronal Restoration of Severely Damaged Primary Anterior Teeth

Frontiers in Dentistry ◽

10.18502/fid.v16i1.1112 ◽

2019 ◽

Author(s):

Shahram Mosharrafian ◽

Maryam Shafizadeh ◽

Zeinab Sharifi

Keyword(s):

Fracture Resistance ◽

Treatment Time ◽

Testing Machine ◽

Anterior Teeth ◽

Significant Difference ◽

Group 3 ◽

The Mean ◽

Group 2 ◽

One Way Anova

Objectives: This study aimed to compare the fracture resistance of a bulk-fill and a conventional composite and a combination of both for coronal restoration of severely damaged primary anterior teeth. Materials and Methods: In this in vitro experimental study, 45 primary anterior teeth were randomly divided into three groups. After root canal preparation, the canals were filled with Metapex paste such that after the application of 1 mm of light-cure liner, 3 mm of the coronal third of the canal remained empty for composite post fabrication. Filtek Z250 conventional composite was used in group 1, Sonic-Fill bulk-fill composite was used in group 2 and Sonic-Fill with one layer of Filtek Z250 as the veneering were used in group 3. Adper Single Bond 2 was used in all groups. The teeth were thermocycled, and fracture resistance was measured by a universal testing machine. The mode of fracture was categorized as repairable or irreparable. Data were analyzed using one-way ANOVA. Results: The mean fracture resistance was 307.00±74.72, 323.31±84.28 and 333.30±63.96 N in groups 1 to 3, respectively (P=0.55). The mean fracture strength was 14.53±2.98, 15.08±2.82 and 15.26±3.02 MPa in groups 1 to 3, respectively (P=0.77). The frequency of repairable mode of failure was 80% for the conventional, 73.6% for the bulk-fill and 80% for the bulk-fill plus conventional group, with no significant difference (P>0.05). Conclusions: Bulk-fill composites can be used for coronal reconstruction of severely damaged primary anterior teeth similar to conventional composites to decrease the treatment time in pediatric patients.

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Influence of different width/height ratio of maxillary anterior teeth in the attractiveness of gingival smiles

Dental Press Journal of Orthodontics ◽

10.1590/s2176-94512012000500016 ◽

2012 ◽

Vol 17 (5) ◽

pp. 115-122 ◽

Cited By ~ 4

Author(s):

Ana Carolina Guimarães Borges ◽

Mayra Reis Seixas ◽

Andre Wilson Machado

Keyword(s):

Visual Analog Scale ◽

Statistical Difference ◽

Height Ratio ◽

Analog Scale ◽

Significant Statistical Difference ◽

Anterior Teeth ◽

Significant Difference ◽

Caucasian Women ◽

Lower Arch ◽

Exposure Methods

OBJECTIVE: To evaluate, among laypersons and orthodontists, the influence of the width/height proportions of upper anterior teeth on the smile attractiveness, in photographs of close up smile from three adult Caucasian women, with 4 mm of gingival exposure. METHODS: The photographs of close up smiles were digitally manipulated and six images were created from each smile with teeth's width/height proportions in 65%, 70%, 75%, 80%, 85% and 90%. Then, all these images were manipulated again and a black mask covering all teeth from the lower arch was created. The figures were then assessed by 60 evaluators, 30 orthodontists and 30 laypersons, who assigned, in a visual analog scale, the level of attractiveness of each image. RESULTS: The obtained results, in general, showed that the proportions of 75%, 80% and 85% received the highest scores while the proportion of 65% received the lowest scores, for both groups of examiners (p < 0.05). When orthodontists and laypersons were compared, it was not found, in most situations, a significant statistical difference between their assessments (p > 0.05). Yet, the comparison between scores assigned to smiles with and without inferior teeth showed that, for all situations, there was no statistically significant difference between them (p > 0.05). CONCLUSION: For patients with gingival smile, the width/height proportions of upper anterior teeth considered more esthetic were the ones of 75%,80% and 85% for laypersons and orthodontists, and the presence or absence of inferior teeth did not affect the attractiveness level of the assessed smiles.

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Orthodontic debonding and tooth sensitivity of anterior and posterior teeth:

The Angle Orthodontist ◽

10.2319/022620-134.1 ◽

2020 ◽

Vol 90 (6) ◽

pp. 766-773

Author(s):

Andrea Scribante ◽

Simone Gallo ◽

Razvan Lucian Celmare ◽

Vincenzo D'Antò ◽

Cristina Grippaudo ◽

...

Keyword(s):

Cold Water ◽

Control Group ◽

Trial Group ◽

Tooth Sensitivity ◽

Posterior Teeth ◽

Anterior Teeth ◽

Significant Difference ◽

Group 2 ◽

Thermal Stimuli ◽

Group 1

ABSTRACT Objectives To assess whether orthodontic debonding and onset of tooth sensitivity were related and if anterior and posterior teeth showed different sensitivity. Materials and Methods 40 patients were divided into a trial group (group 1, at the end of the multibracket treatment) and a control group (group 2, not under treatment). After the application of compressed air and cold water to mandibular incisors and first molars, participants were asked to report the pain felt for each tooth using a 100-mm visual analogue scale. In group 1, assessment was performed just before debonding (T0), immediately after completion of debonding (T1) and 7 days after (T2). In group 2, values were assessed at the beginning of a follow-up visit (T0), at the end of the same visit (T1) and 7 days after (T2). Results Considering overall teeth, statistical analyses showed significantly higher values in the trial group at T1 after both stimuli, especially after cold water, besides a significant difference between T0 and T2 values in the same group. Anterior teeth showed significantly higher VAS scores than posterior after the two thermal stimuli, except after air stimulation in group 1 at T2 and in group 2. Conclusions Orthodontic debonding leads to sensitivity to thermal stimuli especially in the anterior teeth, however pain level is restored within 7 days.

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Nonsurgical Correction of Skeletal Class III Malocclusion by Multibends Edgewise Archwire Technique in an Adult

International Journal of Experimental Dental Science ◽

10.5005/jp-journals-10029-1113 ◽

2015 ◽

Vol 4 (2) ◽

pp. 137-142

Author(s):

Jian-hong YU ◽

Chien-Chih YU ◽

Chang Yuan-Chieh ◽

Tsai Ya-Yu ◽

Pan Po-Wei

Keyword(s):

Orthognathic Surgery ◽

Orthodontic Treatment ◽

Niti Alloy ◽

Class Iii ◽

Class Iii Malocclusion ◽

Posterior Teeth ◽

Skeletal Class ◽

Anterior Teeth ◽

Nonsurgical Correction ◽

Lower Arch

ABSTRACT Skeletal class III malocclusion treated with orthognathic surgery usually can achieve a better facial profile and stable occlusion outcome. We describe a 37-year-old patient who sought orthodontic treatment for skeletal class III, but refused recommendations for orthognathic surgery because of personal considerations. After careful analysis of the X-ray images and study models, this patient was subjected to active orthodontic treatment to correct malocclusion using upper and lower arch with improved superelastic NiTi alloy wire (ISW) for efficient leveling of the teeth. In the lower arch, the multibends edgewise archwire (MEAW) technique was used to tip back and intrude the canine and posterior teeth. After the completion of treatment, anterior teeth crossbite was successfully corrected and proper occlusal relationships were reestablished. How to cite this article Chang YC, Jian-Hong YU, Tsai YY, Chien-Chih Y, Pan PW. Nonsurgical Correction of Skeletal Class III Malocclusion by Multibends Edgewise Archwire Technique in an Adult. Int J Experiment Dent Sci 2015;4(2): 137-142.

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Factors influencing treatment efficiency:

The Angle Orthodontist ◽

10.2319/050220-379.1 ◽

2020 ◽

Vol 91 (1) ◽

pp. 1-8

Author(s):

Min-Ho Jung

Keyword(s):

Regression Analysis ◽

Treatment Duration ◽

Stepwise Regression ◽

Treatment Time ◽

Stepwise Regression Analysis ◽

Analysis Of Covariance ◽

Related Factors ◽

American Board Of Orthodontics ◽

Significant Difference ◽

Patient Cooperation

ABSTRACT Objectives The purpose of this cohort study was to evaluate the effect of self-ligating brackets (SB) and other related factors that influence orthodontic treatment time. Materials and Methods This was a two-armed prospective study. Consecutively treated patients who were recruited from a private practice were enrolled and asked to choose between SB and conventional brackets (CB). If the patient did not have a preference, that patient was randomly allocated. An identical archwire sequence was used, and all patients were treated by a single orthodontist. Treatment duration, number of bracket failures, poor oral hygiene, poor elastic wear, whether or not to orthodontic mini-implants (OMI) were used, OMI failure, extraction, American Board of Orthodontics Discrepancy Index, and arch length discrepancy were measured and statistically analyzed using t-tests, correlation analysis, and analysis of covariance (ANCOVA). Stepwise regression analysis was conducted to generate an equation to predict treatment duration. Results A total of 134 patients with an average age of 22.73 years were included. The average treatment duration was 28.63 months. ANCOVA showed no significant difference in treatment duration between CB and SB. Stepwise regression analysis could explain 64.6% of the variance in treatment duration using five variables. Conclusions SB did not exhibit a significant reduction in treatment time as compared with CB. Patient cooperation, extractions, and malocclusion severity had a significant impact on treatment duration.

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