Adhesives for fixed orthodontic brackets.
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.


OBJECTIVE
To evaluate the effectiveness of different orthodontic adhesives for bonding.


METHODS
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 Issue 2, 2002).


METHODS
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.


METHODS
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 reviewers (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.


RESULTS
Three trials satisfied the inclusion criteria. A chemical cured composite was compared with a light cure 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.


CONCLUSIONS
It is difficult to draw any conclusions from this review, however, suggestions are made for methods of improving future research involving orthodontic adhesives.
Mandall
N A
NA
Orthodontics, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester, UK, M15 6FH. nicky@fs1.den.man.ac.uk
Millett
D T
DT
Mattick
C R
CR
Hickman
J
J
Macfarlane
T V
TV
Worthington
H V
HV
D003738:Dental Cements; D006801:Humans; D016910:Orthodontic Brackets; D016032:Randomized Controlled Trials as Topic
D003738:Dental Cements