Comparative assessment of clinical performance of esthetic bracket materials

Abstract

Objectives: To compare the alterations in esthetic appearance and slot morphology/integrity of two main types of esthetic brackets caused after clinical use. Materials and Methods: Sixteen ceramic (CR) and 16 plastic (PR) central incisor brackets were obtained from 16 young adult patients at the end of treatment in a prospective randomized manner. As controls, 12 ceramic (CC) and 12 plastic (PC) nonused brackets were also examined. Three representative slot width measurements were obtained through micrometric microscopy. Visual inspection of optical microscopy images, surface electron microscopy (SEM), and energydispersive x-ray spectroscopy (EDS) were also performed. Results: Intraoral exposure time varied from 5 to 20 months (mean, 12.4; P 5 .73). Two-way analysis of variance revealed significant differences in slot width among the different materials and a significant interaction between the material effect and its status (P , .001). Bonferroni post hoc tests on material 3 status effect showed significant differences between CC (95% confidence interval [CI]: 434.5, 447.0) vs PC (95% CI: 460.2, 472.8), CC vs CR (95% CI: 453.2, 464.4), and PC vs PR (95% CI: 448.8, 458.9). Interestingly, a significant difference was not detected for CR vs PR. Slot width was correlated with the time under clinical use only for plastic brackets (PR: r 5 2.64, P , .01). Visual inspection of the optical microscopy images did not reveal any major macroscopic morphological disfigurements or significant discolorations. However, a rough and irregular slot wall surface was evident after clinical use (also with SEM), especially in the bottom of the slot. Conclusions: Both bracket types presented adequate clinical performance at least for the time period studied and in terms of esthetic appearance and morphologic integrity. (Angle Orthod. 2012;82:691-697.)

Effect of time and pH on physical-chemical properties of orthodontic brackets and wires

“…Dark areas suggest the presence of elements with low atomic numbers, such as oxygen, consistent with the formation of crystalline particles from biofilm and food debris, and bright surface areas that may be related to silicon, barium, aluminum, iron, and silver. 3,12,13 There was also an increased amount of carbon element with time, but this was not significant, as seen in the oxygen element. The presence of silicon and barium may be attributed to contamination by adhesives or orthodontic composites, and inclusions of aluminum are strongly related to corrosion.…”

“…The presence of silicon and barium may be attributed to contamination by adhesives or orthodontic composites, and inclusions of aluminum are strongly related to corrosion. 3,12 The silver cannot be attributed to any clinical discovery, although the transfer of this element may occur through friction between metal surfaces. 3 A progressive increase in the element oxygen observed in BEI was found due to the deposition of debris on the surface of brackets, which explains the significant drop in the levels of chromium, iron, and nickel, the main elements responsible for the composition of these devices, corroborating the findings of previous studies.…”

Assessment of bracket surface morphology and dimensional change

“…[12] and Gkantidis et al . [16] would compromise the ideal fitting of the orthodontic wire within the slot walls.…”

Lower Anterior Crowding Correction by a Convenient Lingual Method

“…Esthetic considerations of patients, especially young adults, have become a crucial factor in selecting orthodontic treatment during the last decades. This has led to the widespread use and development of various esthetic labial appliances 1 and lingual orthodontic systems 2 . Nowadays, orthodontists can satisfy almost any esthetic demands of patients using labial esthetic or in more challenging cases, lingual nonvisible appliances 1,2 …”

“…2 Nowadays, orthodontists can satisfy almost any esthetic demands of patients using labial esthetic or in more challenging cases, lingual nonvisible appliances. 1,2 Lingual appliances are in general more expensive and less convenient for the patient and/or the doctor. 2,3 Most lingual systems require special equipment, training, and application protocols compared with conventional ones.…”