Bracket de-bonding and breakage prevalence in orthodontic patients

ABSTRACT

The aim of this study was to investigate the prevalence of orthodontic bracket breakage and de-bonding amongst orthodontic patients at Jinnah Medical and Dental College, Karachi. The study stretched over a 13-month period from April 2008 to May 2009. For this cross sectional study 470 routine patients undergoing fixed orthodontic treatment at the Department of Orthodontics were examined. The male to female ratio was 225245 with a mean age of 16.4 years. The patients were divided into 4 age groups namely A [8-10 years], B [11-13 years], C [14-16 years] and D [>18 years] respectively. In this study, 150 patients had skeletal class 1, 265 had skeletal class II division one and 55 had skeletal class II division two malocclusions, respectively. All patients were bonded with 3M Transbond XT[TM] light cure orthodontic syringe adhesive system. Prior to bonding, the enamel was polished with 10-15 seconds slurry of pumice paste on slow-speed rotation rubber cup. The teeth were washed and dried, followed by 15-30 seconds enamel etch time per tooth with Coltene Whaledent Swiss-Tec_ 35% ortho-phosphoric acid gel. The results of the present study demonstrated more mandibular dentition bracket de-bonding as compared to the maxillary dentition. Both sexes demonstrated greater lower buccal segment bracket breakage followed by the lower anterior segment, with males having slightly higher de-bonding rate as compared to their female counterparts. Furthermore, the lower age groups demonstrated greater breakage compared to older age groups. It was concluded that both sexes had affinity for bracket de-bonding during active orthodontic treatment especially in the mandibular buccal segments. Teenage subjects had more bracket breakage compared to adults. This could be due to greater self-awareness self-motivation and proper oral care in adults during treatment. However, further studies are required to investigate the reasons for bracket breakage and to compare chemically and light-cured composite systems in orthodontics