Title Evidence is Inconclusive with Regard to Efficiency of Tooth Movement When Ceramic Orthodontic Brackets Are Employed Versus Traditional Metal Orthodontic Brackets
Clinical Question How do ceramic orthodontic brackets compare to traditional metal brackets for speed of orthodontic tooth movement in healthy adolescents?
Clinical Bottom Line The best evidence is inconclusive with regard to efficiency of orthodontic tooth movement with ceramic brackets compared to traditional metal brackets.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
24352389Melo/201370 successfully treated adultsRetrospective records review
Key resultsBracket type, whether traditional metal or ceramic, had no bearing on the length of time required for treatment. When a stepwise regression analysis was performed, the variable "type of bracket" displayed only a 1.65% influence on the total treatment time, whereas "breakages" and "missed appointments" contributed a 43.75% collective influence on the total time of treatment.
1763839Tanne/1991Metal teeth in wax and water bathLaboratory study
Key resultsTooth movement resulting from ceramic brackets was 30% to 50% less than that observed with traditional metal brackets, and amount of tooth movement decreased substantially as the size of the wire increased. There was significant difference shown at a .01 and .05 level of confidence.
Evidence Search "ceramics" AND "dental alloys" AND "orthodontic brackets" AND "tooth movement"; "ceramic orthodontic bracket" AND "metal orthodontic brackets" AND " orthodontic tooth movement" or "orthodontic treatment time"
Comments on
The Evidence
Validity: There is no evidence of bias or competing interest, and groups were similar and treated the same. The studies were not double blind. Perspective: One study is a well-controlled laboratory simulation of orthodontic tooth movement with metal teeth in wax and a hot water bath. This study showed ceramic brackets having significantly reduced efficiency compared to metal brackets. The other study is a retrospective comparison using clinical records of patients that finds no significant difference between metal and ceramic brackets with regard to length of treatment. Neither study provides strong evidence. Randomized control trials are needed to provide conclusive evidence.
Applicability Patients whose primary concern is esthetics may opt for ceramic brackets instead of traditional metal brackets due to the tooth color of ceramics.
Specialty (Orthodontics)
Keywords Ceramics, dental alloys, orthodontic brackets, tooth movement, adult, orthodontics, time factors
ID# 2852
Date of submission 04/08/2015
E-mail hallums@livemail.uthscsa.edu
Author Darren Hallums
Co-author(s)
Co-author(s) e-mail
Faculty mentor Dubravko Pavlin, DMD, PhD
Faculty mentor e-mail PAVLIN@uthscsa.edu
   
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)
None available