ABSTRACT
Objective@#Controlling the incisal inclination is fundamental in orthodontics. However, the relationship between the inclination prescription and its clinical outcome is not obvious, and the incisal inclination changes generated by different bracket prescriptions were investigated. @*Methods@#Twenty-eight nonextraction dental Class II patients (15 females, 13 males; mean age = 12.9) were retrospectively analyzed. Patients were treated using passive self-ligating fixed appliances with three inclination prescriptions for maxillary incisors (high, standard, low), and two for mandibular incisors (standard, low). Clinical outcomes were compared among different prescriptions, and regression analysis was used to explain the effects of bracket prescriptions and to understand the prescription selection criteria (α = 0.05). @*Results@#For maxillary central incisors, low and high prescriptions were related to linguoversion (p = 0.046) and labioversion (p = 0.005), respectively, while standard prescription maintained the initial dental inclination. Maxillary lateral incisors did not show significant changes. For mandibular incisors, low prescription led to linguoversion (p = 0.005 for central incisors, p = 0.010 for lateral incisors), while standard prescription led to labioversion (p = 0.045 for central incisors, p = 0.005 for lateral incisors). The factors affecting inclination changes were the imposed change and selected prescription, while prescription selection was influenced by the initial dental inclination and initial intercanine distance. @*Conclusions@#The direction of correction of incisal inclination can be controlled by choosing a certain prescription, but the final inclination may show limited consistency with it. The amount of imposed inclination change was the most relevant predictor of the clinical outcome.
ABSTRACT
Resistance to sliding (RS) between the bracket, wire, and ligature has been largely debated in orthodontics. Despite the extensive number of published studies, the lack of discussion of the methods used has led to little understanding of this phenomenon. The aim of this study was to discuss variables affecting RS in orthodontics and to suggest an operative protocol. The search included PubMed©, Medline©, and the Cochrane Library©. References of full-text articles were manually analyzed. English-language articles published between January 2007 and January 2017 that performed an in vitro analysis of RS between the bracket, wire, and ligature were included. Study methods were analyzed based on the study design, description of materials, and experimental setup, and a protocol to standardize the testing methods was proposed. From 404 articles identified from the database search and 242 records selected from published references, 101 were eligible for the qualitative analysis, and six for the quantitative synthesis. One or more experimental parameters were incompatible and a meta-analysis was not performed. Major factors regarding the study design, materials, and experimental setup were not clearly described by most studies. The normal force, that is the force perpendicular to the sliding of the wire and one of the most relevant variable in RS, was not considered by most studies. Different variables were introduced, often acting as confounding factors. A protocol was suggested to standardize testing procedures and enhance the understanding of in vitro findings.