Expectations and Reality

10.1055/b-0034-75514

Expectations and Reality

NOTE

The most important advantages that self-ligating brackets are expected to provide are:

  1. Reduced friction

  2. Shorter overall treatment time

  3. Longer intervals between visits

  4. Reduced chairside time14 , 17 , 21 , 26

More and more ‘ligature-free’ bracket systems have been introduced that claim to offer improved and more efficient treatment, particularly during leveling and alignment ( Table 1.1 ). Another proposed advantage is the ability to reduce the forces acting on the teeth, which supposedly improve patient safety by reducing adverse effects such as root resorption resulting from high force levels. Other advantages claimed include reduced patient discomfort.1 Previous in-vitro studies have shown that active systems are associated with slightly greater friction than passive ones. However, active self-ligating brackets are slightly better at dealing with rotation and torque.7 , 26 , 27 Further details comparing active and passive self-ligation brackets are provided in Chapter 2. The effectiveness of distalization for class II treatment due to reduced friction is another advantage that has been claimed for self-ligating systems.8 , 28 However, scientific proof that self-ligating brackets have improved friction characteristics in comparison with standard brackets is still lacking.3 , 4 An investigation by Fucket al.7 showed on the contrary that conventional twin brackets with “loose” steel ligatures are associated with the least friction in comparison to self-ligation. However, elastic elements and tight steel ligatures are routinely used for treatment with twin brackets, so that the friction characteristics of self-ligation can be expected to be beneficial for this type of treatment. Some clinical studies have shown that the overall treatment time is significantly shorter with self-ligating brackets.6 , 11 , 15 The locking mechanisms of self-ligating brackets are not subject to biological degradation, as elastomeric ligatures are, and in this case intervals between routine checkups can sometimes be increased. Most self-ligating brackets are very small, and this should make cleaning easier and hence reduce the risk of demineralization. Avoiding elastomeric ligatures may also further reduce the risk of plaque retention.21 Some authors have also claimed that patient comfort is improved, as there are fewer hooks and ligatures that irritate the lips or cheeks.

Table 1.1 A selection of self-ligating brackets developed between 1935 and 2008

Year

Developer/company

Name

Ligation principle

Design

1935

Stolzenberg

Russell

Passive

Metal

1972

Wildman/Ormco

EdgeLok

Passive

Metal

1973

Sander/Forestadent

Mobil-Lock

Passive

Metal

1980

Hanson/Strite Industries

SPEED

Active

Metal

1986

Plechtner/A-Company

Activa

Passive

Metal

1994

Heiser/Adenta

Time

Active

Metal

1996

Damon/A-Company

Damon

Passive

Metal

1997

Voudouris/GAC

In-Ovation

Active

Metal

1998

Wildman/Ormco

Twin Lock

Passive

Metal

1999

Damon/A-Company/Ormco

Damon 2

Passive

Metal

2002

Voudouris/GAC

In-Ovation R

Active

Metal

2004

Abels/Ultradent

Opal

Passive

Aesthetic

2004

3M Unitek

SmartClip

Passive

Metal

2004

Damon/Ormco

Damon 3

Passive

Aesthetic

2005

Adenta

Flair

Active

Metal

2005

Forestadent

Quick

Active

Metal

2005

American Orthodontics

Vision LP

Passive

Metal

2007

Abels/Ultradent

Opal M

Passive

Metal

2007

GAC

In-Ovation C

Active

Aesthetic

2007

3M Unitek

Clarity SL

Passive

Aesthetic

2008

Dentaurum

Discovery SL

Passive

Metal

2008

Forestadent

QuicKlear

Active

Aesthetic

NOTE

Small self-ligating brackets and completely tooth-colored brackets are now also commercially available that may be able to satisfy patients’ esthetic requirements.

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Jul 7, 2020 | Posted by in Orthodontics | Comments Off on Expectations and Reality
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