Adhesives for fixed orthodontic bands.
BACKGROUND
Orthodontic treatment involves using fixed or removable appliances (dental braces) to correct the positions of teeth. It has been shown that the quality of treatment result obtained with fixed appliances is much better than with removable appliances. Fixed appliances are, therefore, favoured by most orthodontists for treatment. The success of a fixed orthodontic appliance depends on the metal attachments (brackets and bands) being attached securely to the teeth so that they do not become loose during treatment. Brackets are usually attached to the front and side teeth, whereas bands (metal rings that go round the teeth) are more commonly used on the back teeth (molars). A number of adhesives are available to attach bands to teeth and it is important to understand which group of adhesives bond most reliably, as well as reducing or preventing dental decay during the treatment period.


OBJECTIVE
To evaluate the effectiveness of the adhesives used to attach bands to teeth during fixed appliance treatment, in terms of:(1) how often the bands come off during treatment; and(2) whether they protect the banded teeth against decay during fixed appliance treatment.


METHODS
Electronic databases were searched: the Cochrane Oral Health Group's Trials Register (July 2005), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2005), MEDLINE (1966 to July 2005) and EMBASE (1980 to July 2005). A search of the internet was also undertaken. There was no restriction with regard to publication status or language of publication.


METHODS
Randomised and controlled clinical trials (RCTs and CCTs) (including split-mouth studies) of adhesives used to attach orthodontic bands to molar teeth were selected. Patients with full arch fixed orthodontic appliance(s) who had bands attached to molars were included.


METHODS
All review authors were involved in study selection, validity assessment and data extraction without blinding to the authors, adhesives used or results obtained. All disagreements were resolved by discussion.


RESULTS
Five RCTs and three CCTs were identified as meeting the review's inclusion criteria. All the included trials were of split-mouth design. Four trials compared chemically cured zinc phosphate and chemically cured glass ionomer; three trials compared chemically cured glass ionomer cement with light cured compomer; one trial compared chemically cured glass ionomer with a chemically cured glass phosphonate. Data analysis was often inappropriate within the studies meeting the inclusion criteria.


CONCLUSIONS
There is insufficient high quality evidence with regard to the most effective adhesive for attaching orthodontic bands to molar teeth. Further RCTs are required.
Millett
D T
DT
University Dental School and Hospital, Oral Health and Development, Wilton, Cork, Ireland. d.millett@ucc.ie
Glenny
A M
AM
Mattick
C R
CR
Hickman
J
J
Mandall
N A
NA
D000269:Adhesives / Q000592:standards*; D001840:Dental Bonding; D003731:Dental Caries / Q000517:prevention & control*; D003738:Dental Cements / Q000592:standards*; D005899:Glass Ionomer Cements / Q000592:standards; D006801:Humans; D008963:Molar; D016910:Orthodontic Brackets; D009970:Orthodontics / Q000592:standards*; D019279:Resin Cements / Q000592:standards; D015036:Zinc Phosphate Cement / Q000592:standards
D000269:Adhesives; D003738:Dental Cements; D005899:Glass Ionomer Cements; D019279:Resin Cements; D015036:Zinc Phosphate Cement