Clinical evaluation of the failure rates of metallic brackets

The aim of this study was to evaluate in vivo the bonding of metallic orthodontic brackets with different adhesive systems. Material and methods: Twenty patients (10.5-15.1 years old) who had sought corrective orthodontic treatment at a University Orthodontic Clinic were evaluated. Brackets were bonded from the right second premolar to the left second premolar in the upper and lower arches using: Orthodontic Concise, conventional Transbond XT, Transbond XT without primer, and Transbond XT associated with Transbond Plus Self-etching Primer (TPSEP). The 4 adhesive systems were used in all patients using a split-mouth design; each adhesive system was used in one quadrant of each dental arch, so that each group of 5 patients received the same bonding sequence. Initial archwires were inserted 1 week after bracket bonding. The number of bracket failures for each adhesive system was quantified over a 6-month period. Results: The number of debonded brackets was: 8- Orthodontic Concise, 2- conventional Transbond XT, 9- Transbond XT without primer, and 1- Transbond XT + TPSEP. By using the Kaplan-Meier methods, statistically significant differences were found between the materials (p=0.0198), and the Logrank test identified these differences. Conventional Transbond XT and Transbond XT + TPSEP adhesive systems were statistically superior to Orthodontic Concise and Transbond XT without primer (p<0.05). There was no statistically significant difference between the dental arches (upper and lower), between the dental arch sides (right and left), and among the quadrants. Conclusions: The largest number of bracket failures occurred with Orthodontic Concise and Transbond XT without primer systems and few bracket failures occurred with conventional Transbond XT and Transbond XT+TPSEP. More bracket failures were observed in the posterior region compared with the anterior region.20222823

Análise do coeficiente de variação em testes de resistência da união ao cisalhamento e tração

The coefficient of variation is a dispersion measurement that does not depend on the unit scales, thus allowing the comparison of experimental results involving different variables. Its calculation is crucial for the adhesive experiments performed in laboratories because both precision and reliability can be verified. The aim of this study was to evaluate and to suggest a classification of the coefficient variation (CV) for in vitro experiments on shear and tensile strengths. The experiments were performed in laboratory by fifty international and national studies on adhesion materials. Statistical data allowing the estimation of the coefficient of variation was gathered from each scientific article since none of them had such a measurement previously calculated. Excel worksheet was used for organizing the data while the sample normality was tested by using Shapiro Wilk tests (alpha = 0.05) and the Statistical Analysis System software (SAS). A mean value of 6.11 (SD = 1.83) for the coefficient of variation was found by the data analysis and the data had a normal distribution (p>;0.05). A range classification was proposed for the coefficient of variation from such data, that is, it should be considered low for a value lesser than 2.44; intermediate for a value between 2.44 and 7.94, high for a value between 7.94 and 9.78, and finally, very high for a value greater than 9.78. Such classification can be used as a guide for experiments on adhesion materials, thus making the planning easier as well as revealing precision and validity concerning the data.O Coeficiente de variação é uma medida de dispersão que independe da escala de unidades, permitindo comparação de resultados experimentais de variáveis diferentes. Seu cálculo é imprescindível em experimentos laboratoriais de adesão, pois a partir dele é possível verificar a precisão e confiabilidade do experimento. O objetivo deste trabalho foi avaliar e sugerir uma classificação do coeficiente de variação (CV) em experimentos in vitro que envolveram testes de resistência ao cisalhamento e / ou tração. Foram analisados 50 trabalhos de periódicos nacionais e internacionais, sendo que todos avaliaram a adesão em ensaios laboratoriais. Foram coletados em cada artigo dados estatísticos que permitiram estimar o coeficiente de variação, pois nenhum deles apresentava esta medida calculada. Os dados coletados foram organizados em Planilha Excel, sendo a normalidade da amostra testada pelo teste de Shapiro Wilk (alfa=0,05) utilizando o programa Statistical Analysis System (SAS). Pela análise dos dados, tendo os mesmos apresentados distribuição normal (p>;0,05) foi encontrado um CV médio de 6,11 com desvio-padrão de 1,83. A partir destes dados foram propostas faixas de classificação para o coeficiente de variação, ou seja, este coeficiente deve ser considerado baixo até um valor de 2,44; médio entre 2,44 - 7,94, alto entre 7,94 - 9.78 e muito alto acima de 9,78. Esta classificação poderá ser usada como guia para experimentos de adesão, facilitando o planejamento, revelando a precisão e validade dos dados

Shear bond strength of orthodontic brackets to enamel under different surface treatment conditions

The purpose of the present study was to evaluate the shear bond strength to enamel and the adhesive remnant index (ARI) of both metallic and polycarbonate brackets bonded under different conditions. Ninety bovine permanent mandibular incisors were embedded in acrylic resin using PVC rings as molds and assigned to 6 groups (n=15). In Groups 1 (control) and 3, metallic and polycarbonate orthodontic brackets were, respectively, bonded to the enamel surfaces using Transbond XT composite according to the manufacturer's recommendations. In Groups 2 and 4, both types of brackets were bonded to enamel with Transbond XT composite, but XT primer was replaced by the OrthoPrimer agent. In Groups 5 and 6, the polycarbonate bracket bases were sandblasted with 50-mm aluminum-oxide particle stream and bonded to the enamel surfaces prepared under the same conditions described in Groups 3 and 4, respectively. After bonding, the specimens were stored in distilled water at 37ºC for 24 hours and then submitted to shear bond strength test at a crosshead speed of 0.5 mm/min. The results (MPa) showed no statistically significant difference between Groups 4 and 6 (p>;0.05). Likewise, no statistically significant differences (p>;0.05) were found among Groups 1, 2, and 5, although their results were significantly lower than those of Groups 4 and 6 (

Orthodontic-surgical treatment of class III malocclusion with mandibular asymmetry

Class III skeletal malocclusion may present several etiologies, among which maxillary deficiency is the most frequent. Bone discrepancy may have an unfavorable impact on esthetics, which is frequently aggravated by the presence of accentuated facial asymmetries. This type of malocclusion is usually treated with association of Orthodontics and orthognathic surgery for correction of occlusion and facial esthetics. This report presents the treatment of a patient aged 15 years and 1 month with Class III skeletal malocclusion, having narrow maxilla, posterior open bite on the left side, anterior crossbite and unilateral posterior crossbite, accentuated negative dentoalveolar discrepancy in the maxillary arch, and maxillary and mandibular midline shift. Clinical examination also revealed maxillary hypoplasia, increased lower one third of the face, concave bone and facial profiles and facial asymmetry with mandibular deviation to the left side. The treatment was performed in three phases: presurgical orthodontic preparation, orthognathic surgery and orthodontic finishing. In reviewing the patient's final records, the major goals set at the beginning of treatment were successfully achieved, providing the patient with adequate masticatory function and pleasant facial esthetics.A maloclusão esquelética de Classe III pode apresentar diversas etiologias, sendo a deficiência maxilar a mais frequente. Discrepâncias esqueléticas podem ter impacto estético desfavorável, muitas vezes agravadas pela presença de assimetrias faciais acentuadas. Este tipo de maloclusão é geralmente tratado com a associação de Ortodontia e cirurgia ortognática para a correção da oclusão e da estética facial. Este relato de caso apresenta o tratamento de um paciente com 15 anos e 1 mês de idade, com maloclusão esquelética de Classe III, atresia maxilar, mordida aberta posterior do lado esquerdo, mordida cruzada anterior e mordida cruzada posterior unilateral, acentuada discrepância dento-alveolar negativa acentuada no arco maxilar e desvios das linhas médias superior e inferior. Ao exame clínico o paciente também apresentava deficiência maxilar, aumento do terço inferior da face, perfil ósseo e facial côncavos e assimetria facial, com desvio da mandíbula para o lado esquerdo. O tratamento foi realizado em três fases: preparo ortodôntico pré-cirúrgico, cirurgia ortognática e finalização ortodôntica. Analisando os registros finais do paciente, os principais objetivos estabelecidos ao início do tratamento foram alcançados com sucesso, promovendo ao paciente adequada função mastigatória e estética facial agradável

Open bite: diagnosis, treatment and stability

Open bite has fascinated Orthodontics due to the difficulties regarding its treatment and maintenance of results. This anomaly has distinct characteristics that, in addition to the complexity of multiple etiological factors, have aesthetic and functional consequences. Within this etiological context, several types of mechanics have been used in open bite treatment, such as palatal crib, orthopedic forces, occlusal adjustment, orthodontic camouflage with or without extraction, orthodontic intervention using mini-implants or mini-plates, and even orthognathic surgery. An accurate diagnosis and etiological determination are always the best guides to establish the objectives and the ideal treatment plan for such a malocclusion. This report describes two cases of open bite. At the end of the treatment, both patients had their canines and molars in Class I occlusion, normal overjet and overbite, and stability during the posttreatment period

Clinical evaluation of the failure rates of metallic brackets

OBJECTIVES: The aim of this study was to evaluate in vivo the bonding of metallic orthodontic brackets with different adhesive systems. MATERIAL AND METHODS: Twenty patients (10.5-15.1 years old) who had sought corrective orthodontic treatment at a University Orthodontic Clinic were evaluated. Brackets were bonded from the right second premolar to the left second premolar in the upper and lower arches using: Orthodontic Concise, conventional Transbond XT, Transbond XT without primer, and Transbond XT associated with Transbond Plus Self-etching Primer (TPSEP). The 4 adhesive systems were used in all patients using a split-mouth design; each adhesive system was used in one quadrant of each dental arch, so that each group of 5 patients received the same bonding sequence. Initial archwires were inserted 1 week after bracket bonding. The number of bracket failures for each adhesive system was quantified over a 6-month period. RESULTS: The number of debonded brackets was: 8- Orthodontic Concise, 2- conventional Transbond XT, 9- Transbond XT without primer, and 1- Transbond XT + TPSEP. By using the Kaplan-Meier methods, statistically significant differences were found between the materials (p=0.0198), and the Logrank test identified these differences. Conventional Transbond XT and Transbond XT + TPSEP adhesive systems were statistically superior to Orthodontic Concise and Transbond XT without primer (p<0.05). There was no statistically significant difference between the dental arches (upper and lower), between the dental arch sides (right and left), and among the quadrants. CONCLUSIONS: The largest number of bracket failures occurred with Orthodontic Concise and Transbond XT without primer systems and few bracket failures occurred with conventional Transbond XT and Transbond XT+TPSEP. More bracket failures were observed in the posterior region compared with the anterior region

Análise do coeficiente de variação em testes de resistência da união ao cisalhamento e tração

The coefficient of variation is a dispersion measurement that does not depend on the unit scales, thus allowing the comparison of experimental results involving different variables. Its calculation is crucial for the adhesive experiments performed in laboratories because both precision and reliability can be verified. The aim of this study was to evaluate and to suggest a classification of the coefficient variation (CV) for in vitro experiments on shear and tensile strengths. The experiments were performed in laboratory by fifty international and national studies on adhesion materials. Statistical data allowing the estimation of the coefficient of variation was gathered from each scientific article since none of them had such a measurement previously calculated. Excel worksheet was used for organizing the data while the sample normality was tested by using Shapiro Wilk tests (alpha = 0.05) and the Statistical Analysis System software (SAS). A mean value of 6.11 (SD = 1.83) for the coefficient of variation was found by the data analysis and the data had a normal distribution (p>0.05). A range classification was proposed for the coefficient of variation from such data, that is, it should be considered low for a value lesser than 2.44; intermediate for a value between 2.44 and 7.94, high for a value between 7.94 and 9.78, and finally, very high for a value greater than 9.78. Such classification can be used as a guide for experiments on adhesion materials, thus making the planning easier as well as revealing precision and validity concerning the data.O Coeficiente de variação é uma medida de dispersão que independe da escala de unidades, permitindo comparação de resultados experimentais de variáveis diferentes. Seu cálculo é imprescindível em experimentos laboratoriais de adesão, pois a partir dele é possível verificar a precisão e confiabilidade do experimento. O objetivo deste trabalho foi avaliar e sugerir uma classificação do coeficiente de variação (CV) em experimentos in vitro que envolveram testes de resistência ao cisalhamento e / ou tração. Foram analisados 50 trabalhos de periódicos nacionais e internacionais, sendo que todos avaliaram a adesão em ensaios laboratoriais. Foram coletados em cada artigo dados estatísticos que permitiram estimar o coeficiente de variação, pois nenhum deles apresentava esta medida calculada. Os dados coletados foram organizados em Planilha Excel, sendo a normalidade da amostra testada pelo teste de Shapiro Wilk (alfa=0,05) utilizando o programa Statistical Analysis System (SAS). Pela análise dos dados, tendo os mesmos apresentados distribuição normal (p>0,05) foi encontrado um CV médio de 6,11 com desvio-padrão de 1,83. A partir destes dados foram propostas faixas de classificação para o coeficiente de variação, ou seja, este coeficiente deve ser considerado baixo até um valor de 2,44; médio entre 2,44 - 7,94, alto entre 7,94 - 9.78 e muito alto acima de 9,78. Esta classificação poderá ser usada como guia para experimentos de adesão, facilitando o planejamento, revelando a precisão e validade dos dados.24324

Bacterial endotoxin adhesion to different types of orthodontic adhesives

Bacterial endotoxin (LPS) adhesion to orthodontic brackets is a known contributing factor to inflammation of the adjacent gingival tissues. Objective The aim of this study was to assess whether LPS adheres to orthodontic adhesive systems, comparing two commercial brands. Material and Methods Forty specimens were fabricated from Transbond XT and Light Bond composite and bonding agent components (n=10/component), then contaminated by immersion in a bacterial endotoxin solution. Contaminated and non-contaminated acrylic resin samples were used as positive and negative control groups, respectively. LPS quantification was performed by the Limulus Amebocyte Lysate QCL-1000™ test. Data obtained were scored and subjected to the Chi-square test using a significance level of 5%. Results There was endotoxin adhesion to all materials (p;0.05). There was no significant difference (p>;0.05) among commercial brands. Affinity of endotoxin was significantly greater for the bonding agents (p=0.0025). Conclusions LPS adhered to both orthodontic adhesive systems. Regardless of the brand, the endotoxin had higher affinity for the bonding agents than for the composites. There is no previous study assessing the affinity of LPS for orthodontic adhesive systems. This study revealed that LPS adheres to orthodontic adhesive systems. Therefore, additional care is recommended to orthodontic applications of these materials

Clinical evaluation of the failure rate of metallic brackets bonded with orthodontic composites

The purpose of the present study was to evaluate in vivo the failure rate of metallic brackets bonded with two orthodontic composites. Nineteen patients with ages ranging from 10.5 to 38.7 years needing corrective orthodontic treatment were selected for study. The enamel surfaces from second premolars to second premolars were treated with Transbond Plus-Self Etching Primer (3M Unitek). Next, 380 orthodontic brackets were bonded on maxillary and mandibular teeth, as follows: 190 with Transbond XT composite (3M Unitek) (control) and 190 with Transbond Plus Color Change (3M Unitek) (experimental) in contralateral quadrants. The bonded brackets were light cured for 40 s, and initial alignment archwires were inserted. Bond failure rates were recorded over a six-month period. At the end of the evaluation, six bond failures occurred, three for each composite. Kaplan-Meyer method and log-rank test (Mantel-Cox) was used for statistical analysis, and no statistically significant difference was found between the materials (p=0.999). Both Transbond XT and Transbond Plus Color Change composites had low debonding rates over the study period