Korean J Orthod.  2021 Nov;51(6):397-406. 10.4041/kjod.2021.51.6.397.

Effects of self-ligating brackets and other factors influencing orthodontic treatment outcomes: A prospective cohort study

• Jung MH

• KMID: 2522502
• DOI: http://doi.org/10.4041/kjod.2021.51.6.397

Abstract

Objective
The purpose of this study was to evaluate the effects of self-ligating brackets (SBs) and other factors that influence orthodontic treatment outcomes.
Methods
This two-armed cohort study included consecutively treated patients in a private practice. The patients were asked to choose between SBs and conventional brackets (CBs); if any patient did not have a preference, he or she was randomly allocated to the CB or SB group. All patients were treated using an identical archwire sequence. Evaluated parameters were as follows: treatment duration, number of bracket failures, poor oral hygiene, poor elastic wear, extraction, use of orthodontic mini-implants (OMI), OMI failure, American Board of Orthodontics (ABO) Discrepancy Index (DI), arch length discrepancy, and ABO Cast-Radiograph Evaluation (CRE) score. Stepwise regression analysis was performed to generate the equation for prediction of the CRE.
Results
The final sample comprised 134 patients with an average age of 22.73 years. The average DI, CRE, and treatment duration were 21.81, 14.25, and 28.63 months, respectively. Analysis of covariance showed a significant difference in CRE between the CB and SB groups after adjusting for the effects of confounding variables. Stepwise regression analysis using four variables, namely extraction, SB use, poor elastic wear, and additional appliance use, could explain only 25.2% of the variance in the CRE.
Conclusions
Although the CRE was significantly better for CBs than for SBs, the clinical significance of this result seems to be limited. Extraction, SB use, poor elastic wear, and additional appliance use may have significant effects on treatment outcomes.

Keyword

Bracket; Cast-Radiograph Evaluation; Orthodontic Index; Compliance

Figure

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  Figure 1 The size of a bracket and tooth control. A, Because of the “play,” the tooth cannot be perfectly controlled even if the point of force application is located on the tooth surface. B, If the size of the bracket is large and the tooth surface is further away from the slot base, the inaccuracy of tooth control increases. Red circle, point of force application; Purple line, archwire; Light blue rectangle, bracket.

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  Figure 2 Typodonts with two types of brackets. A, Conventional bracket (ClarityTM; MBT prescription, 3M Unitek, Monrovia, CA, USA). B, Self-ligating bracket (Clippy-CTM; MBT prescription, Tomy, Tokyo, Japan).

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  Figure 3 Flow chart of this study. CB, conventional bracket; SB, self-ligating bracket.

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