Comparación de Brackets de Autoligado y Brackets Convencionales basada en la evidencia / Comparação baseada em evidências de colchetes autoligáveis ​​e colchetes convencionais / Evidence-based comparison of self-ligating and conventional brackets

Resumen Los brackets de autoligado son aquellos que incorporan un mecanismo de cierre que mantiene el arco en el interior de la ranura del bracket. Fueron creados principalmente para crear un sistema de menor fricción, permitiendo una mecánica de deslizamiento más eficiente y disminuir el tiempo de tratamiento. Objetivo: El objetivo de esta revisión es presentar de manera más estructurada y ordenada toda la información disponible respecto de los distintos aparatos de autoligado, ya sea activo o pasivo, comparando las cualidades entre sí y con los aparatos convencionales. Método: Se realizó una búsqueda mediante PubMed y Epistemonikos, sin importar idioma o año de publicación. Resultados: Se establecieron comparaciones tanto de brackets de autoligado activos con pasivos, como de brackets de autoligado con brackets convencionales en distintas situaciones clínicas. Conclusiones: Para la gran mayoría de situaciones clínicas, no existe una diferencia estadísticamente significativa, a excepción de la expresión de torque, en donde los brackets convencionales tienen una mayor ventaja.

Resumo Os braquetes autoligáveis são aqueles que incorporam um mecanismo de fechamento que mantém o fio dentro da ranhura do braquete. Eles foram criados principalmente para criar um sistema de menor atrito, permitindo uma mecânica de deslizamento mais eficiente e reduzindo o tempo de tratamento. Objetivo: O objetivo desta revisão é apresentar de forma mais estruturada e ordenada todas as informações disponíveis sobre os diferentes dispositivos autoligáveis, sejam eles ativos ou passivos, comparando as qualidades entre si e com os dispositivos convencionais. Método: A busca foi realizada usando PubMed e Epistemonikos, independentemente do idioma ou ano de publicação. Resultados: Foram comparadas braquetes autoligáveis ativos e passivos e braquetes autoligáveis convencionais em diferentes situações clínicas. Conclusões: Para a grande maioria das situações clínicas, não há diferença estatisticamente significativa, exceto para a expressão do torque, onde os braquetes convencionais apresentam maior vantagem.

Abstract Self-ligating brackets include a locking mechanism that holds the archwire in the bracket slot. They were created primarily to create a lower friction system, allowing for more efficient sliding mechanics and reducing treatment time. Objective: This review aims to present all the information available on different self-ligating devices, whether active or passive, in a structured and organized way. This paper sets out to compare their qualities with each other and with conventional devices. Method: A search was conducted in PubMed and Epistemonikos, regardless of language or year of publication. Results: Comparisons were made of both active and passive self-ligating brackets and self-ligating brackets with conventional brackets in different clinical situations. Conclusions No statistically significant difference was found in most clinical situations, except for torque expression, where conventional brackets have a more significant advantage.

Stability comparison of two different dentoalveolar expansion treatment protocols

ABSTRACT Objective: The aim of this study was to compare the longitudinal stability of the conventional straight-wire system after the use of a quad-helix appliance with Damon self-ligating system in patients with Class I malocclusion. Methods: 27 adolescent patients were evaluated at three different periods: pre-treatment (T1), post-treatment (T2) and three years post-treatment (T3). Group 1 included 12 patients (with a mean age of 14.65 year) treated with Damon 3MX bracket system; and Group 2 included 15 patients (with a mean age of 14.8 year) who underwent orthodontic treatment with Roth prescribed brackets after expansion with Quad-Helix appliance. Relapse was evaluated with dental cast examination and cephalometric radiograph tracings. Statistical analysis was performed with IBM-SPSS for Windows software, version 21 (SPSS Inc., Chicago, IL). A p-value smaller than 0.05 was considered statistically significant. Results: There were significant increases in all transverse dental and postero-anterior measurements (except for UL6-ML mm in Group 1) with active treatment. There was some significant relapse in the long-term in inter-canine width in both groups and in the inter-first premolar width in Group 2 (p< 0.05). Significant decrease in all frontal measurements from T2 to T3 was seen for both groups. Upper and lower incisors significantly proclined in T1-T2 (p<0.05), however no relapse was found for both groups. When two systems were compared, there was no significant difference for the long-term follow-up period. Conclusion: Conventional (quad-helix appliance with conventional brackets) and Damon systems were found similar with regard to the long-term incisor positions and transverse dimension changes of maxillary arch.

RESUMO Objetivo: comparar a estabilidade longitudinal após o tratamento de pacientes com má oclusão de Classe I usando o sistema Straight-wire convencional - depois da expansão com aparelho quadri-hélice - e o sistema autoligável Damon. Métodos: 27 pacientes adolescentes foram avaliados em três períodos distintos: pré-tratamento (T1), pós-tratamento imediato (T2) e três anos pós-tratamento (T3). O Grupo 1 incluiu 12 pacientes (com idade média de 14,65 anos) tratados com o sistema de braquetes Damon 3MX e o Grupo 2 incluiu 15 pacientes (com idade média de 14,8 anos), submetidos a tratamento ortodôntico com braquetes prescrição Roth após expansão com aparelho quadri-hélice. A recidiva foi avaliada por meio de exame dos modelos de estudo e traçados cefalométricos. A análise estatística foi realizada com o software IBM-SPSS para Windows, versão 21 (SPSS Inc., Chicago, IL). Valores de p< 0,05 foram considerados estatisticamente significativos. Resultados: após o tratamento ativo, ocorreu aumento significativo em todas as medidas transversais dentárias e posteroanteriores (exceto para a UL6-ML mm, no Grupo 1). Em longo prazo, ocorreu recidiva significativa (p< 0,05) na distância intercaninos em ambos os grupos, e na distância interprimeiros pré-molares no Grupo 2. De T2 para T3, observou-se diminuição significativa em todas as medidas frontais, para ambos os grupos. De T1 para T2, os incisivos superiores e inferiores sofreram vestibularização significativa (p< 0,05); porém, nenhuma recidiva ocorreu em qualquer um dos dois grupos. Ao se comparar os dois sistemas, não foi encontrada qualquer diferença significativa no período de acompanhamento em longo prazo. Conclusão: o sistema convencional (aparelho quadri-hélice e braquetes convencionais) e o sistema Damon apresentaram desempenho semelhante, em longo prazo, em termos das posições dos incisivos e das mudanças ocorridas na dimensão transversal da arcada superior.

Mandibular changes during initial alignment with SmartClip self-ligating and conventional brackets: A single-center prospective randomized controlled clinical trial / 대한치과교정학회지

OBJECTIVE: To test the null hypothesis that SmartClip self-ligating brackets are more effective than conventional brackets for initial mandibular alignment and identify influential factors. METHODS: Fifty patients were randomly allocated to two equal treatment groups by using an online randomization program: self-ligating group (SmartClip brackets) and conventional group (Gemini brackets). The archwire sequence was standardized. Changes in anterior irregularity index, intercanine width, and intermolar width were assessed on plaster models at 8th and 16th weeks. Changes in incisor position and inclination were assessed on lateral cephalometric radiographs at 16 weeks. Intragroup and intergroup comparisons were performed with paired t-test and Student's t-test, respectively. Multiple linear regression was performed to identify variables affecting improvement in anterior ambiguity. RESULTS: Data of 46 patients were analyzed; those missing an appointment (n = 2) or showing bracket breakage (n = 2) were excluded. Incisor inclination (p 0.05) increased at 8 and 16 weeks in both the groups; no significant intergroup differences were noted (p > 0.05). Initial anterior irregularity index and intercanine width change were significantly associated with improvement in anterior irregularity (p < 0.001). CONCLUSIONS: The null hypothesis was rejected. Bracket type has little effect on improvement in anterior ambiguity during initial mandibular alignment.

Mandibular changes during initial alignment with SmartClip self-ligating and conventional brackets: A single-center prospective randomized controlled clinical trial / 대한치과교정학회지

OBJECTIVE: To test the null hypothesis that SmartClip self-ligating brackets are more effective than conventional brackets for initial mandibular alignment and identify influential factors. METHODS: Fifty patients were randomly allocated to two equal treatment groups by using an online randomization program: self-ligating group (SmartClip brackets) and conventional group (Gemini brackets). The archwire sequence was standardized. Changes in anterior irregularity index, intercanine width, and intermolar width were assessed on plaster models at 8th and 16th weeks. Changes in incisor position and inclination were assessed on lateral cephalometric radiographs at 16 weeks. Intragroup and intergroup comparisons were performed with paired t-test and Student's t-test, respectively. Multiple linear regression was performed to identify variables affecting improvement in anterior ambiguity. RESULTS: Data of 46 patients were analyzed; those missing an appointment (n = 2) or showing bracket breakage (n = 2) were excluded. Incisor inclination (p 0.05) increased at 8 and 16 weeks in both the groups; no significant intergroup differences were noted (p > 0.05). Initial anterior irregularity index and intercanine width change were significantly associated with improvement in anterior irregularity (p < 0.001). CONCLUSIONS: The null hypothesis was rejected. Bracket type has little effect on improvement in anterior ambiguity during initial mandibular alignment.

Pain experience during initial alignment with self-ligating and conventional brackets

The aim of this study was to compare the pain experience among orthodontic patients treated with self-ligating brackets SmartClip® (3M Unitek, Monrovia, California, USA) and conventional brackets Victory series® (3M Unitek, Monrovia, California, USA). We used a controlled clinical trial study design to compare 69 patients treated with self-ligating to 70 patients treated by conventional brackets. The nickel-titanium archwires 0.012-in were engaged after bonding both arches on the first day; and the visual analogue scale (VAS) was used to assess the pain experience of subjects for the first seven treatment days. The pre-treatment dental study models were assessed by the Little’s irregularity index to quantify the groups’ malalignment characteristics. The self-ligating brackets reported lower pain experience than the conventional group on the first five treatment days. However, the sixth day showed 1.75 mm higher visual analogue score than conventional brackets, with almost equal pain level on the seventh day. The group differences throughout the first week were neither clinically nor statistically significant. The pain experiences in both groups decreased steadily from the third treatment day to the end of the first week of treatment. Based on the study findings, the pain experience during initial alignment is not influenced by the brackets’ ligation type. The pain experience tends to decrease steadily from the third treatment day to the end of the first week of treatment irrespective of the bracket type used.