Arezoo Jahanbin, Nadia Hasanzadeh, Sara Khaki, Hooman Shafaee
What did the authors aim to do in this study?
The main purpose of this study was to compare the alignment efficiency and pain experience of Damon self-ligating and MBT pre-adjusted brackets in the initial alignment stage.
How did the authors evaluate?
This randomized clinical trial was conducted in 30 patients aged 14‒20 years, who needed non-extraction treatment in both maxillary and mandibular arches. They were randomly assigned to two groups. Among these, 15 patients were treated with MBT pre-adjusted brackets, and 15 patients received Damon self-ligating brackets. Both patient groups were treated with one orthodontist in a private office setting. In both groups, before bonding the brackets, the impressions for the maxillary and mandibular dentitions were taken using alginate impression material (T0). Self-ligating Damon 3 or conventional MBT pre-adjusted brackets were bonded on the teeth for the upper and lower arches at the same visit. An 0.014-inch round Copper NiTi archwire was first used for the alignment, followed by an 0.016-inch Cu NiTi wire at the second visit in both groups. The conventional MBT brackets were fully ligated using elastomeric ligatures. No auxiliaries, such as lingual arches, bite plates or intermaxillary elastics, were used during the study period. During four months of study, the patients were recalled at the end of each month, and impressions of both arches were taken using alginate impression material (T1, T2, T3, and T4).
Fig 1. Assessment of Little's irregularity Index
Little’s irregularity index was used to assess the changes in dental alignment throughout the study. All the measurements were made on the study models taken at T0, T1, T2, T3, and T4 using an electronic digital caliper with an accuracy of 0.01 mm. Intra-examinerreliability was assessed by randomly re-measuring five pairs of dental casts after four weeks by the same examiner. The patients were asked to record their pain experience immediately after wire insertion, at 4 hours, 24 hours, 3 days, 7 days, and immediately after each monthly visit, using a 10-cm-long visual analog scale (VAS) in which the left end represented “no pain” at all and the right end signified the “worst pain imaginable” (one pain score for both arches). The patients were advised not to use any pain killers.
What did the authors find?
The rate of upper dental alignment between T0 and T4 was significantly higher with the Damon compared to MBT brackets. Although significantly more changes in the lower LII scores were observed during the first three months with the Damon system, the rate of improvement in the irregularity of lower teeth over the 4-month period was not significantly different between the two groups. The patients’ pain experience was not significantly different between the bracket groups.
What did the authors conclude?
The results of the present study indicated that over a 4-month alignment stage, more correction of the upper crowding occurred with the self-ligating Damon MX system compared with conventional MBT brackets.
Although significantly more correction of lower irregularities occurred with Damon MX brackets during the first three months, the overall rate of dental alignment in the lower arch was not significantly different between the two groups.
The type of bracket system resulted in no significant effect on subjective pain experience during the initial alignment stage of orthodontic treatment.
What do we think about it?
The presence of different prescriptions in orthodontics aids in carrying out the treatment for the patient efficiently and in an ideal manner. Because each needs of the patient varies from an orthodontic point of view, there is always a debate regarding which of the prescriptions are the most superior and what are the advantages that it has over the rest of the available prescriptions. This study gives us a detailed comparison between the Damon & MBT prescriptions, especially their efficiency during the alignment phase & the pain tolerance between both the bracket groups. Although the study had numerous drawbacks, such as, a split mouth design was not used which causes the patient to not localize the pain near the midlines. Apart from this, even the rate of bracket debonding and breakage also affects the efficiency of treatment, and in this study, the rate of bracket breakage was not recorded. Another limitation of this study is that, the arch length and inter-canine and intermolar widths were not measured at the beginning or after the alignment to determine whether dental alignment was due to the proclination or mesiodistal movement of the teeth. Inspite of all these drawbacks, the study is still reliable to state that Damon self ligating brackets help in aligning the teeth faster in comparison to MBT brackets.
Jahanbin A, Hasanzadeh N, Khaki S, Shafaee H. Comparison of self-ligating Damon3 and conventional MBT brackets regarding alignment efficiency and pain experience: A randomized clinical trial. J Dent Res Dent Clin Dent Prospects. 2019 Fall;13(4):281-288.
Comentarios