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.

Frequency of Bonded Bracket Failure in Patients, Undergoing Fixed Orthodontic Treatment

OBJECTIVE: The objective of our study is to determine frequency of bracket bond failure in relation to age, gender, most commonly involved tooth and quadrant. METHODOLOGY: In this descriptive cross-sectional study, a total of 100 patients with ages ranging from 10 to 30 years needing corrective orthodontic treatment were selected for the study. This survey was conducted at Altamash Institute of Dental Medicine, Karachi. The survey was initiated on 30th November 2019 and was concluded on 30th May 2020. A questionnaire was used to evaluate the frequency of bonded bracket failure in patients undergoing orthodontic treatment. The bonded metallic brackets were light cured for 40 seconds, and initial alignment arch wires were inserted. Bonded bracket failure was recorded over a period of six months. RESULTS: The initial debonding results of the present study demonstrated a high number of debonded brackets in mandibular dentition as compared to the maxillary dentition. Whereas, when the teeth were debonded for the second time, a greater number of maxillary teeth were found to be affected by the debonding of the brackets. Both genders demonstrated a greater rate of bracket debonding in the second premolar area and lowest in the molar area. In our study, age and gender had no significant relationship with bracket bond failure and teeth involved in debonding. CONCLUSIONS: The frequency of bonded bracket detachment during orthodontic treatment is very common. Our study concluded that females were more affected by the bracket bond failure as compared to the males along with the second premolar being the most commonly associated tooth during an active orthodontic treatment. KEYWORDS: Bonded brackets, Bracket failure, Frequency, Orthodontic treatment, Orthodontics

Comparison of Orthodontic Bracket Debonding Force and Bracket Failure Pattern on Different Teeth In Vivo by a Prototype Debonding Device

Objective. To compare the orthodontic bracket debonding force and assess the bracket failure pattern clinically between different teeth by a validated prototype debonding device. Materials and Method. Thirteen (13) patients at the end of comprehensive fixed orthodontic treatment, awaiting for bracket removal, were selected from the list. A total of 260 brackets from the central incisor to the second premolar in both jaws were debonded by a single clinician using a validated prototype debonding device equipped with a force sensitive resistor (FSR). Mean bracket debonding forces were specified to ten (10) groups of teeth. Following debonding, Intraoral microphotographs of the teeth were taken by the same clinician to assess the bracket failure pattern using a 4-point scale of adhesive remnant index (ARI). Statistical analysis included one-way ANOVA with post hoc Tukey HSD and independent sample t -test to compare in vivo bracket debonding force, Cohen’s kappa ( κ ), and a nonparametric Kruskal-Wallis test for the reliability and the assessment of ARI scoring. Results. A significant difference ( p < 0.001 ) of mean debonding force was found between different types of teeth in vivo. Clinically, ARI scores were not significantly different ( p = 0.921 ) between different groups, but overall higher scores were predominant. Conclusion. Bracket debonding force should be measured on the same tooth from the same arch as the significant difference of mean debonding force exists between similar teeth of the upper and lower arches. The insignificant bracket failure pattern with higher ARI scores confirms less enamel damage irrespective of tooth types.

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

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

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

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.

Fatigue life prediction of heavy vehicle suspension system under varying load conditions

Leaf spring experiences frequent cyclic loading during working conditions. When design stage itself it is very essential to assess the fatigue life of the suspension system. It is important to consider and evaluate the key aspects of fatigue failure and life by using Finite Element Analysis (FEA) techniques to overcome these failures. This paper serves to stimulate the premature failure of the existing and proposed bracket model with generalized force elements under dynamic load conditions. Scanning Electron Microscope (SEM) was used to identify the bracket failure prone areas which indicate that the cyclic load in the suspension system is caused by rural area road-induced vibrations and bumps. This contributes to the increase of the fatigue fracture, which ends up with a bracket failure. The results indicated that the fatigue life of existing bracket is low for rough road conditions; the modified bracket has been optimized for the safe load conditions of the heavy vehicle suspension system