Adhesives for fixed orthodontic brackets

It is useful for a clinician to know the best adhesive for fixing orthodontic brackets, so they do not fail during treatment.
Bracket failure increases the time spent in surgery for repairs and the overall treatment time. At present orthodontics can choose between four groups of adhesives which may be set with a chemical reaction or curing light. Some adhesives may prevent early decay around brackets because they contain fluoride. There is only weak unreliable evidence that one adhesive may possibly have more failures associated with it and another adhesive may be more protective against early decay.

Authors' conclusions: 

It is difficult to draw any conclusions from this review, however, suggestions are made for methods of improving future research involving orthodontic adhesives.

Read the full abstract...

Bonding of orthodontic brackets to teeth is important to enable effective and efficient treatment with fixed appliances. The problem is bracket failure during treatment which increases operator chairside time and lengthens treatment time. A prolonged treatment is likely to increase the oral health risks of orthodontic treatment with fixed appliances one of which is irreversible enamel decalcification.


To evaluate the effectiveness of different orthodontic adhesives for bonding.

Search strategy: 

Electronic databases: the Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE.
Date of most recent searches: August 2002 (CENTRAL) (The Cochrane Library 2002, Issue 2).

Selection criteria: 

Trials were selected if they met the following criteria: randomised controlled trials (RCTs) and controlled clinical trials (CCTs) comparing two different adhesive groups. Participants were patients with fixed orthodontic appliances. The interventions were adhesives that bonded stainless steel brackets to all teeth except the molars. The primary outcome was debond or bracket failure.

Data collection and analysis: 

Data were recorded on decalcification as a secondary outcome, if present. Information regarding methods, participants, interventions, outcome measures and results were extracted in duplicate by pairs of review authors (Nicky Mandall (NM) and Rye Mattick (CRM); Declan Millett (DTM) and Joy Hickman (JH2)). Since the data were not presented in a form that was amenable to meta-analysis, the results of the review are presented in narrative form only.

Main results: 

Three trials satisfied the inclusion criteria. A chemical cured composite was compared with a light cured composite (one trial), a conventional glass ionomer cement (one trial) and a polyacid-modified resin composite (compomer) (one trial). The quality of the trial reports was generally poor.