Adhesives for fixed orthodontic brackets

Mandall NA, Hickman J, Macfarlane TV, Mattick RCR, Millett DT, Worthington HV

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Summary

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.

This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This record should be cited as: Mandall NA, Hickman J, Macfarlane TV, Mattick RCR, Millett DT, Worthington HV. Adhesives for fixed orthodontic brackets. Cochrane Database of Systematic Reviews 2003, Issue 2. Art. No.: CD002282. DOI: 10.1002/14651858.CD002282.

This version first published online: April 22. 2003

Abstract

Background

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.

Objectives

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.

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.

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