Das Verhalten von DAMON_MX – und konventionellen Brackets während der inizialen Behandlungsphase: eine prospektive In-vivo-Studie

Zusammenfassung

Das von den Herstellern selbstligierender Bracketsysteme propagierte bessere klinische Verhalten dieser Apparaturen ist in der klinischen Kieferorthopädie umstritten. Ziel der vorliegenden Arbeit war es, etwas mehr Licht ins Dunkel in der Diskussion um die Wirksamkeit der selbstligierenden Brackets zu bringen, indem deren Verhalten während der initialen Behandlungsphase bei 43 Patienten untersucht wurde. Dabei wurden die Unterschiede zwischen konventionellen (Synthesis^R,Ormco) und selbstligierenden Brackets (Damon_MX ^R, Ormco) bezüglich Art und Dauer der Nivellierung, der Stuhlzeiten und der Beeinträchtigung der Patienten während der ersten 4 Behandlungsmonate analysiert. Die Ergebnisse zeigen, dass selbstligierende Brackets bei der Engstandauflösung und Zahnbogennivellierung nicht effizienter sind als konventionelle Bracketsysteme. Der Vorteil für den Behandler besteht jedoch in signifikant kürzeren Stuhlzeiten durch schnellere Bogenwechsel und für den Patienten in einem höheren Tragekomfort durch geringere Weichgewebsirritationen bei Verwendung von Damon_MX ^R -Brackets.

Abstract

The manufacturers’ claims that self-ligating brackets show better clinical performance than conventional bracket systems is a controversial issue in clinical orthodontics. The aim of the present study was to shed some light on the discussion about the clinical efficacy of self-ligating brackets by analyzing their performance in 43 patients during the first 4 months of orthodontic treatment. The differences between a conventional (Synthesis^R, Ormco) and a self-ligating bracket system (Damon_MX ^R, Ormco) regarding mode and duration of initial leveling and alignment, chairtime and patient discomfort during the first 4 months of treatment were assessed. The results show that self-ligating brackets are not more efficient than conventional brackets in aligning and leveling of the dental arches during the first treatment stages. The advantage of using Damon_MX ^R brackets for the orthodontist lies in the significantly reduced chairtime due to faster archwire changes and for the patient in enhanced comfort because of less soft-tissue irritation.

Schlüsselwörter

konventionelle Brackets - selbstligierende Bracketsysteme - klinisches Verhalten

Key words

conventional brackets - self-ligating bracket systems - clinical performance

Literatur

• 1 Loftus BP, Artun J. A model for evaluating friction during orthodontic tooth movement.  Eur J Orthod. 2001;  23 253-261
• 2 Kapila S, Angolkar PV, Ducanson Jr MG. et al . Evaluation of friction between edgewise stainless steel brackets and orthodontic wires of four alloys.  Am J Orthod Dentofacial Orthop. 1990;  98 (2) 117-126
• 3 Jost-Brinkmann P, Miethke RR. Effects of tooth mobility on friction between bracket and wire.  Fortschr Kieferorthop. 1991;  52 102-109
• 4 Hixon EH, Aasen T, Arango J. et al . On force and tooth movement.  Am J Orthod Dentofacial Orthop. 1970;  57 476-489
• 5 Liew CF.. Thesis Univ. of Queensland, Australia 1993; 
• 6 O’Reilly D, Dowling PA, Lagerstrom L. et al . An in vivo investigation into the effect of bracket displacement on the resistance to sliding.  Br J Orthod. 1999;  26 219-227
• 7 Braun S, Bluestein M, Moor BK. et al . Friction in perspective.  Am J Orthod Dentofacial Orthop. 1999;  115 (6) 619-627
• 8 Kusy RP, Whitley BS, Prewitt MJ. Comparison of the frictional coefficients for selected archwire-bracket slot combinations in the dry and wet states.  Angle Orthod. 1991;  61 (4) 293-302
• 9 Thorstenson GA, Kusy RP. Effect of ligation type and method on the resistance to sliding of novel orthodontics brackets with second-order angulation in the dry and wet states.  Angle Orthod. 2003;  73 (4) 418-430
• 10 Thorstenson GA, Kusy RP. Influence of stainless steel inserts on the resistance to sliding of esthetic brackets with second-order angulation in the dry and wet states.  Angle Orthod. 2003;  73 (2) 167-175
• 11 Taloumis LJ, Smith TM, Hondrum SO. et al . Force decay and deformation of orthodontic elastomeric ligatures.  Am J Orthod Dentofacial Orthop. 1997;  111 (1) 1-11
• 12 Whitley JQ, Kusy RP. Resistance to sliding of titanium brackets tested against stainless steel and beta-titanium archwires and second-order angulation in the dry and wet states.  Am J Orthod Dentofacial Orthop. 2007;  131 (3) 400-411
• 13 Harradine NWT. Self-ligating brackets and treatment efficiency.  Clin Orthod Res. 2001;  35 304-308
• 14 Harradine NWT. Self-ligating brackets: where are we now?.  J of Orthod. 2003;  30 262-273
• 15 Eberting JJ, Straja SR, Tucay OC. Treatment time, outcome, and patient satisfaction comparisons of Damon and conventional brackets.  Clin Orthod Res. 2001;  4 (4) 228-234
• 16 Miles PG, Weyant RJ, Rustvelt L. A clinical trial of Damon 2 vs. conventional twin brackets during initial alignment.  Angle Orthod. 2006;  76 (3) 480-485
• 17 Miles PG. SmartClip versus conventional twin brackets for initial alignment: is there a difference?.  Aust Orthod J. 2005;  21 (2) 123-127
• 18 Pandis N, Polychronopoulou A, Eliades T. Self-ligating vs. conventional brackets in the treatment of mandibular crowding: A prospective clinical trial of treatment duration and dental effects.  Am J Orthod Dentofacial Orthop. 2007;  132 (2) 208-215
• 19 Scott P, DiBiase AT, Sherriff M. et al . Alignment efficiency of Damon3 self-ligating and conventional orthodontic bracket system: a randomized clinical trial.  Am J Orthod Dentofacial Orthop. 2008;  134 (4) 470.e1-470.e8
• 20 Fleming PS, DiBiase AT, Sarri G. et al . Efficiency of mandibular arch alignment with 2 preadjusted edgewise appliances.  Am J Orthod Dentofacial Orthop. 2009;  135 597-602
• 21 Turnbull NR, Birnie DJ. Treatment efficiency of conventional vs. self-ligating brackets: effects of archwire size and material.  Am J Orthod Dentofacial Orthop. 2007;  131 (3) 395-399
• 22 Breger J, Byloff FK. The clinical efficiency of self-ligated bracets.  J Clin Orthod. 2001;  35 (5) 304-308
• 23 Pandis N, Eliades T, Partowi S. et al . Forces exerted by conventional and self-ligating brackets during simulated first- and second-order corrections.  Am J Orthod Dentofacial Orthop. 2008;  133 (5) 738-742
• 24 Fleming PS, DiBiase AT, Sarri G. et al . Pain experience during initial alignment with self-ligating and a conventional fixed orthodontic appliance system.  Angle Orthod. 2009;  79 (3) 46-50
• 25 Scheuer PA, Allen RF, Burgin WB. Perception of pain as a result of orthodontic treatment with fixed appliances.  Eur J Orthod. 1996;  18 349-357
• 26 White L. Pain and cooperation in orthodontic treatment.  J Clin Orthod. 1984;  18 572-575
• 27 Scott P, Sherriff M, DiBiase AT. et al . Perception of discomfort during initial orthodontic tooth alignment using self-ligating or conventional bracket system: a randomized clinical trial.  Eur J Orthod. 2008;  30 227-232
• 28 Ngan P, Kess B, Wilson S. Perception of discomfort by patients undergoing orthodontic treatment.  Am J Orthod Dentofacial Orthop. 1989;  96 47-53
• 29 Jones M, Chan C. The pain and discomfort experienced during orthodontic treatment. A randomised controlled clinical trial of two initial aligning archwires.  Am J Orthod Dentofacial Orthop. 1992;  102 373-381

Korrespondenzadresse