Root resorption, treatment time and extraction rate during orthodontic treatment with self-ligating and conventional brackets

Collin Jacobs, Philipp F Gebhardt, Viviana Jacobs, Marlene Hechtner, Dan Meila, Heinrich Wehrbein, Collin Jacobs, Philipp F Gebhardt, Viviana Jacobs, Marlene Hechtner, Dan Meila, Heinrich Wehrbein

Abstract

Introduction: This study determined the amount and severity of EARR (external apical root resorption) after orthodontic treatment with self-ligating (SL) and conventional (Non-SL) brackets. Differences regarding rate of extraction cases, appointments and treatment time were evaluated.

Material and methods: 213 patients with a mean age of 12.4 ± 2.2 years were evaluated retrospectively. The treatments were performed with SL brackets (n = 139, Smartclip, 3 M Unitek, USA) or Non-SL brackets (n = 74, Victory Series, 3 M Unitek, USA). Measurements of the crown and root length of the incisors were taken using panoramic radiographs. Three-factor analysis of variance (ANOVA) was performed for an appliance effect.

Results: There was no difference between patients treated with Non-SL or SL brackets regarding the amount (in percentage) of EARR (Non-SL: 4.5 ± 6.6 vs. SL: 3.0 ± 5.6). Occurrence of severe EARR (sEARR) did also not differ between the two groups (Non-SL 0.5 vs. SL: 0.3). The percentage of patients with need of tooth extraction for treatment (Non SL: 8.1 vs. SL: 6.9) and the number of appointments (Non-SL: 12.4 ± 3.4 vs. SL: 13.9 ± 3.3) did not show any differences. The treatment time was shorter with Non-SL brackets (Non-SL: 18.1 ± 5.3 vs. SL: 20.7 ± 4.9 months).

Conclusions: This is the largest study showing that there is no difference in the amount of EARR, number of appointments and extraction rate between conventional and self-ligating brackets. For the first time we could demonstrate that occurrence of sEARR does not differ between the two types of brackets.

Figures

Figure 1
Figure 1
Intersection for incisors according to Linge and Linge. Reference points: 1 root apex, 2 distal dento-enamel junction, 3 mesial dento-enamel junction, 4 incisal edge. Dento-enamel conjunction (DEC) represents the conjunction between mesial and distal. Crown length (C) and root length (R) were measured perpendicular to DEC as the longest distance to the root apex and the incisal edge.
Figure 2
Figure 2
External apical root resorption (EARR) stages according to Malmgren et al. 1 irregular root contour, 2 EARR 2 mm to 1/3 of root length, 4 EARR >1/3 of root length.

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