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Comparative assessment of dental and basal arch dimensions of passive and active self-ligating versus conventional appliances

A randomized clinical trial

Vergleichende Bewertung der Dimensionen des Zahn- und des Kieferbogens von passiven und aktiven selbstligierenden gegenüber konventionellen Apparaturen

Eine randomisierte klinische Studie

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Purpose

In this parallel, three-arm, single-center randomized trial, the dental and basal arch dimensions after orthodontic treatment using conventional brackets and passive and active self-ligating (SL) brackets were compared.

Methods

Patients needing comprehensive orthodontic treatment were randomly allocated to the active SL, passive SL, or conventional brackets (control) group. All patients were treated with a standardized arch wires sequence. Eligibility criteria included class I malocclusion in the permanent dentition, crowding (4–6 mm), and adequate oral hygiene. The primary outcome was intermolar width, based on cone beam computed tomography (CBCT) scans. Secondary outcomes were maxillary and mandibular widths in the canines and premolars regions, dental arch depth, buccolingual inclination, and alignment duration. Blinding of outcome assessment was implemented. Patients were followed every 4 weeks until insertion of the stainless steel 0.019 × 0.025 wire. Mean values were computed from CBCT sections, and data were analyzed using a one-way analysis of variance.

Results

In all, 66 patients (ages 18–25 years) were randomized into a 1:1:1 ratio; 7 patients dropped out before treatment initiation. Examining dental arch dimensions in the canine and premolar regions showed that expansion of the maxillary dental arch was greatest in the passive SL brackets group, less in the active SL brackets group, and lowest in the control group (P < 0.01). Changes in maxillary intermolar width between the three groups were not significant, and changes in basal arch dimensions, depth of dental and basal arches, buccolingual inclination, and alignment duration were similar in the three groups.

Conclusions

Self-ligating brackets were not more effective than conventional brackets when examining intermolar width, basal transverse dimensions, depth of the arch, and alignment duration.

Zusammenfassung

Zielsetzung

In dieser parallelen, dreiarmigen, randomisierten Studie wurden die dentalen und basalen Bogendimensionen nach kieferorthopädischer Behandlung mit konventionellen Brackets sowie passiven und aktiven selbstligierenden (SL) Brackets verglichen.

Methoden

Patienten, die eine umfassende kieferorthopädische Behandlung benötigten, wurden nach dem Zufallsprinzip der aktiven SL-, der passiven SL- oder der konventionellen Bracketgruppe (Kontrollgruppe) zugewiesen. Alle Patienten wurden mit einer standardisierten Sequenz von Bogendrähten behandelt. Zu den Zulassungskriterien gehörten eine Klasse-I-Malokklusion im bleibenden Gebiss, Engstand (4-6 mm) und eine angemessene Mundhygiene. Der primäre Endpunkt war die intermolare Breite, basierend auf DVT(digitale Volumentomographie)-Scans. Sekundäre Endpunkte waren die Ober- und Unterkieferbreite im Bereich der Eckzähne und Prämolaren, die Tiefe des Zahnbogens, die bukkolinguale Inklination und die Dauer der Nivellierung. Die Bewertung der Ergebnisse wurde verblindet durchgeführt. Die Patienten wurden alle 4 Wochen bis zum Einsetzen des Edelstahldrahtes 0,019 × 0,025 nachuntersucht. Die Mittelwerte wurden aus den DVT-Schnitten berechnet, und die Daten wurden mit einer einseitigen Varianzanalyse analysiert.

Ergebnisse

Insgesamt wurden 66 Patienten (im Alter von 18 bis 25 Jahren) in einem Verhältnis von 1:1:1 randomisiert; 7 Patienten schieden vor Beginn der Behandlung aus. Die Untersuchung der Zahnbogenmaße im Eckzahn- und Prämolarenbereich zeigte, dass die Erweiterung des Oberkieferzahnbogens in der Gruppe mit passiven SL-Brackets am größten, in der Gruppe mit aktiven SL-Brackets kleiner und in der Kontrollgruppe am geringsten war (p < 0.01). Die Veränderungen der intermolaren Breite im Oberkiefer zwischen den 3 Gruppen waren nicht signifikant, und die Veränderungen der Dimensionen des Basalbogens, der Tiefe der Zahn- und Basalbögen, der bukkolingualen Neigung und der Ausrichtungsdauer waren in den 3 Gruppen ähnlich.

Schlussfolgerungen

Selbstligierende Brackets waren bei der Untersuchung der intermolaren Breite, der transversalen Dimension, sowie der Tiefe des Kieferbogens und der Nivellierungsdauer nicht effektiver als konventionelle Brackets.

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Acknowledgements

The trial was approved by the Scientific Research Committee of the University of Damascus.

Funding

The University of Damascus funded this project. The funders had no role in study design, decision to publish or preparation of the manuscript.

Author information

Authors and Affiliations

  1. Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic

    Mohannad M. Alabdullah DDS MSc PhD,  Ahmad S. Burhan DDS MSc PhD & Alaa Nabawia DDS MSc

  2. Department of Pediatric Dentistry, Syrian Private University, Damascus, Syrian Arab Republic

    Fehmieh Nawaya DDS MSc PhD

  3. Orthodontic Graduate Program, School of Dentistry, 5-476, Edmonton Clinic Health Academy (ECHA), University of Alberta, 11405-87 Ave, T6G 1C9, Edmonton, AB, Canada

    Humam Saltaji DDS MSc FRCD(C) PhD

Authors
  1. Mohannad M. Alabdullah DDS MSc PhD
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  2. Ahmad S. Burhan DDS MSc PhD
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  3. Alaa Nabawia DDS MSc
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  4. Fehmieh Nawaya DDS MSc PhD
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  5. Humam Saltaji DDS MSc FRCD(C) PhD
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Contributions

MMA carried out the data analysis and manuscript editing. MMA, ASB, and AN participated in the data acquisition. MMA, ASB, AN, FN, and HS participated in the manuscript correction. MMA, ASB, AN, FN, and HS participated in the design of the study. MMA, ASB, AN, FN, and HS authors read and approved the final manuscript.

Corresponding author

Correspondence to Humam Saltaji DDS MSc FRCD(C) PhD.

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Conflict of interest

M.M. Alabdullah, A.S. Burhan, A. Nabawia, F. Nawaya and H. Saltaji declare that they have no competing interests.

Ethical standards

The trial was approved by the Ethics Committee of the University of Damascus; the protocol of this trial was also registered as NCT02996292 in ClinicalTrials.gov. Written informed consent was obtained from the participants before their recruitment.

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Availability of data and materials

The data that support the findings of this study are available on request from the corresponding author (HS). The data are not publicly available for containing information that could compromise research participant privacy/consent.

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Alabdullah, M.M., Burhan, A.S., Nabawia, A. et al. Comparative assessment of dental and basal arch dimensions of passive and active self-ligating versus conventional appliances. J Orofac Orthop 84 (Suppl 2), 74–83 (2023). https://doi.org/10.1007/s00056-022-00407-5

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  • DOI: https://doi.org/10.1007/s00056-022-00407-5

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