About the Damon Q
Damon brackets are similar to conventional braces. You still have metal brackets bonded to your teeth, and a wire is used to align your teeth. Like conventional braces, the Damon system can be used to treat even the most severe cases of crowding, overbites, underbites, and even crossbites. The difference is that the Damon brackets have a metal door that opens and closes which holds the wire in place.
Are Damon Braces superior to other types of braces?
Are the Damon Corporations claims that their braces provide shorter treatment times, less pain, grow bone with better results really true?
I have listed some independent studies that have looked into answering these questions
Am J Orthod Dentofacial Orthop. 2010 Jun;137(6):726.e1-726.e18; discussion 726-7. doi: 10.1016/j.ajodo.2009.11.009.
Systematic review of self-ligating brackets.
Chen SS1, Greenlee GM, Kim JE, Smith CL, Huang GJ.
•1Department of Orthodontics, University of Washington, Seattle, 98195-7446, USA.
Self-ligating brackets have been gaining popularity over the past several decades. Various advantages for these systems have been claimed. The purposes of this systematic review were to identify and review the orthodontic literature with regard to the efficiency, effectiveness, and stability of treatment with self-ligating brackets compared with conventional brackets.
An electronic search in 4 data bases was performed from 1966 to 2009, with supplemental hand searching of the references of retrieved articles. Quality assessment of the included articles was performed. Data were extracted by using custom forms, and weighted mean differences were calculated.
Sixteen studies met the inclusion criteria, including 2 randomized controlled trials with low risk of bias, 10 cohort studies with moderate risk of bias, and 4 cross-sectional studies with moderate to high risk of bias. Self-ligation appears to have a significant advantage with regard to chair time, based on several cross-sectional studies. Analyses also showed a small, but statistically significant, difference in mandibular incisor proclination (1.5 degrees less in self-ligating systems). No other differences in treatment time and occlusal characteristics after treatment were found between the 2 systems. No studies on long-term stability of treatment were identified.
Despite claims about the advantages of self-ligating brackets, evidence is generally lacking. Shortened chair time and slightly less incisor proclination appear to be the only significant advantages of self-ligating systems over conventional systems that are supported by the current evidence.
Do you do Damon®? What is the current evidence base underlying the philosophy of this appliance system?
Wright N1, Modarai F, Cobourne MT, Dibiase AT.
•1King’s College London Dental Institute, London, UK.
•J Orthod. 2011 Dec;38(4):309.
Self-ligating bracket systems are increasing in popularity amongst orthodontists. This reflects their high quality engineering, improved reliability and relative ease of use. However, it might also be related to claims of superior function made by the manufacturers of these appliances. In particular, the Damon(®) appliance system claims to offer significant advantages to both orthodontist and patient over conventional-ligation and other forms of self-ligated appliances. We have reviewed current literature relating to use of the Damon(®) appliance system. There is some evidence to suggest this appliance may lead to reductions in chairside time for the orthodontist, particularly those experienced with this system, in comparison to conventional-ligation. However, evidence that pain experience is reduced for the patient when using Damon(®) brackets is not conclusive. In the presence of identical archwire sequences, there is no evidence that Damon(®) brackets can align teeth faster or in a qualitatively differently manner, when compared with conventional-ligation. There is no high quality evidence that treatment with the Damon(®) appliance takes place more rapidly or leads to a superior occlusal or aesthetic result. Indeed, the best available evidence would suggest there is no difference in treatment outcome or time, at least in extraction cases. There is no evidence that treatment with the Damon(®) appliance is more stable. Claims relating to improved clinical performance of the Damon(®) appliance system are currently being made to orthodontists and patients that are not substantiated in the scientific literature
Perception of discomfort during initial orthodontic tooth alignment using a self-ligating or conventional bracket system: a randomized clinical trial
Paul Scott, Martyn Sherriff, Andrew T. DiBiase, Martyn T. Cobourne
DOI: http://dx.doi.org/10.1093/ejo/cjm131 227-232 First published online: 13 March 2008
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The aim of this study was to compare the degree of discomfort experienced during the period of initial orthodontic tooth movement using Damon3™ self-ligating and Synthesis™ conventional ligating pre-adjusted bracket systems. Sixty-two subjects were recruited from two centres (32 males and 30 females; mean age 16 years, 3 months) with lower incisor irregularity between 5 and 12 mm and a prescribed extraction pattern, including lower first premolar teeth. These subjects were randomly allocated for treatment with either bracket system. Fully ligated Damon™ 0.014-inch Cu NiTi archwires were used for initial alignment in both groups. Following archwire insertion, the subjects were given a prepared discomfort diary to complete over the first week, recording discomfort by means of a 100 mm visual analogue scale at 4 hours, 24 hours, 3 days, and 1 week. The subjects also noted any self-prescribed analgesics that were taken during the period of observation. Data were analysed using repeated measures analysis of variance.
There were no statistically significant differences in perceived discomfort levels between the two appliances; discomfort did not differ at the first time point and did not develop differently across subsequent measurement times. Overall, this investigation found no evidence to suggest that Damon3 self-ligating brackets are associated with less discomfort than conventional pre-adjusted brackets during initial tooth alignment, regardless of age or gender
Peter G. Miles, Robert J. Weyant, and Luis Rustveld (2006) A Clinical Trial of Damon 2™ Vs Conventional Twin Brackets during Initial Alignment. The Angle Orthodontist: May 2006, Vol. 76, No. 3, pp. 480-485.
A Clinical Trial of Damon 2™ Vs Conventional Twin Brackets during Initial Alignment
Peter G. Milesa, Robert J. Weyantb, and Luis Rustveldc
aPrivate practice, Caloundra, QLD, Australia
bChair, Dental Public Health and Head, Division of Pediatric & Developmental Dental Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pa
cResearch Assistant, Dental Public Health, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pa
Corresponding author: Peter G. Miles, 10 Mayes Avenue, Caloundra, QLD 4551, Australia (firstname.lastname@example.org)
The objective of this study was to compare the effectiveness and comfort of Damon 2 brackets and conventional twin brackets during initial alignment. Sixty consecutive patients participated in a split mouth design. One side of the lower arch was bonded with the Damon 2 bracket and the other with a conventional twin bracket. The sides were alternated with each consecutive patient. The irregularity index (II) was measured for each half of the arch at baseline, at 10 weeks at the first archwire change, and at another 10 weeks at the second archwire change. Any difference in discomfort was assessed within the first few days of archwire placement and again at the first archwire change. Comfort on the lips, preferred look, and bracket failure rates were also recorded. The twin bracket was more uncomfortable with the initial archwire (P = .04). However, at 10 weeks, substantially more patients reported discomfort with the Damon 2 bracket when engaging the archwire (P = .004). At both archwire changes at 10 and 20 weeks (P = .001), the conventional bracket had achieved a lower II than the Damon 2 bracket by 0.2 mm, which is not clinically significant. Patients preferred the look of the twin bracket over the Damon 2 (P < .0005) and more Damon 2 brackets debonded during the study (P < .0005). The Damon 2 bracket was no better during initial alignment than a conventional bracket. Initially, the Damon 2 bracket was less painful, but it was substantially more painful when placing the second archwire and had a higher bracket failure rate.
Acta Odontol Latinoam. 2014;27(3):120-4. doi: 10.1590/S1852-48342014000300004.
Gingival response in orthodontic patients: Comparative study between self-ligating and conventional brackets.
Folco AA1, Benítez-Rogé SC1, Iglesias M1, Calabrese D1, Pelizardi C1, Rosa A1, Brusca MI1, Hecht P1, Mateu ME1.
•1Department of Orthodontics, School of Dentistry, University of Buenos Aires, Argentina.
Orthodontic brackets contribute to the accumulation of bacterial plaque on tooth surfaces because they hinder oral hygiene. In contrast to conventional brackets, self-ligating brackets do not require additional parts to support the arches, thus improving dental hygiene. The aim of this study was to compare the gingival response in orthodontic patients wearing self-ligating or conventional brackets. A sample of 22 patients aged 16 to 30 years was divided into two groups: Group A, treated with selfligating brackets (Damon system) and Group B, treated with conventional brackets (Roth technique). The following were assessed during the treatment: Plaque Index (PI), Gingival Index (GI) and Probing Depth (PD), and sub-gingival samples were taken from teeth 14/24 for microbiological observation. No statistically significant difference was found between Groups A and B; p>0.05 (sign-ranked) or between PI, GI and PD at the different times (Friedman's Analysis of Variance), even though the indices were found to increase at 14 days, particularly for self-ligating brackets. The quantity and quality of microorganisms present were compatible with health on days 0, 28 and 56. As from day 14 there is a predominance of microbiota compatible with gingivitis in both groups. In the samples studied, orthodontic treatment increases bacterial plaque and inflammatory gingival response, but gingival-periodontal health can be maintained with adequate basic therapy. Self-ligating and conventional brackets produced similar gingival response.
Comparative assessment of alignment efficiency and space closure of active and passive self-ligating vs conventional appliances in adolescents: a single-center randomized controlled trial.
Songra G1, Clover M2, Atack NE3, Ewings P4, Sherriff M5, Sandy JR6, Ireland AJ7.
•1Senior specialist registrar, School of Oral and Dental Sciences, University of Bristol, Bristol, United Kingdom. •2Private practice, Salisbury, United Kingdom. •3Consultant orthodontist, School of Oral and Dental Sciences, University of Bristol, Bristol, United Kingdom. •4Visiting professor, Medical School, University of Exeter, Exeter, United Kingdom. •5Visiting professor, School of Oral and Dental Sciences, University of Bristol, Bristol, United Kingdom. •6Professor, School of Oral and Dental Sciences, University of Bristol, Bristol, United Kingdom. •7Professor, School of Oral and Dental Sciences, University of Bristol, Bristol, United Kingdom. Electronic address: email@example.com.
The aim of this study was to compare the time to initial alignment and extraction space closure using conventional brackets and active and passive self-ligating brackets.
One hundred adolescent patients 11 to 18 years of age undergoing maxillary and mandibular fixed appliance therapy after the extraction of 4 premolars were randomized with stratification of 2 age ranges (11-14 and 15-18 years) and 3 maxillomandibular plane angles (high, medium, and low) with an allocation ratio of 1:2:2. Restrictions were applied using a block size of 10. Allocation was to 1 of 3 treatment groups: conventional brackets, active self-ligating, or passive self-ligating brackets. All subjects were treated with the same archwire sequence and space-closing mechanics in a district general hospital setting. The trial was a 3-arm parallel design. Labial-segment alignment and space closure were measured on study models taken every 12 weeks throughout treatment. All measurements were made by 1 operator who was blinded to bracket type. The patients and other operators were not blinded to bracket type during treatment.
Ninety-eight patients were followed to completion of treatment (conventional, n = 20; active self-ligating brackets, n = 37; passive self-ligating brackets, n = 41). The data were analyzed using linear mixed models and demonstrated a significant effect of bracket type on the time to initial alignment (P = 0.001), which was shorter with the conventional brackets than either of the self-ligating brackets. Sidak's adjustment showed no significant difference in effect size (the difference in average response in millimeters) between the active and passive self-ligating brackets (the results are presented as effect size, 95% confidence intervals, probabilities, and intraclass correlation coefficients) (-0.42 [-1.32, 0.48], 0.600, 0.15), but the conventional bracket was significantly different from both of these (-1.98 [-3.19, -0.76], 0.001, 0.15; and -1.56 [-2.79, -0.32], 0.001, 0.15). There was no statistically significant difference between any of the 3 bracket types with respect to space closure. Space-closure times were shorter in the mandible, except for the Damon 3MX bracket (Ormco, Orange, Calif), where active and total space-closure times were shorter in the maxilla. No adverse events were recorded in the trial.
Time to initial alignment was significantly shorter for the conventional bracket than for either the active or passive self-ligating brackets. There was no statistically significant difference in passive, active, or total space-closure times among the 3 brackets under investigation
Angle Orthod. 2014 Jul;84(4):615-22. doi: 10.2319/093013-712.1. Epub 2014 Jan 14.
An assessment of conventional and self-ligating brackets in Class I maxillary constriction patients.
Atik E1, Ciğer S.
•1a Research Assistant, Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.
To evaluate two different treatment systems with regard to incisor position, transverse dimension changes in maxillary arch, changes in maxillary molar inclinations, clinical periodontal parameters, and pain intensity in patients with a Class I malocclusion.
MATERIALS AND METHODS:
Seventeen patients (with a mean age of 14.5 years) underwent orthodontic treatment with the Roth prescribed edgewise bracket systems after expanding the maxillary arch with a quad-helix appliance, and 16 patients (with a mean age of 14.8 years) underwent orthodontic treatment with the Damon 3MX bracket system. Each subject's lateral cephalometric and posteroanterior radiographs and dental casts were obtained at the beginning of the treatment and after debonding. In addition to these, the periodontal index and pain scores were taken.
Cephalometric data showed that in both treatment systems, overjet value decreased and maxillary and mandibular incisors proclined. Posteroanterior measurements demonstrated a greater increase in the maxillary molar inclination in the Damon group. Significant increase of maxillary intercanine, interpremolar, and intermolar widths was shown in both systems. Periodontal index and pain score changes between different observation periods were the same.
The conventional and Damon systems were found similar with regard to the incisor position, transverse dimension changes in maxillary arch, clinical periodontal parameters, and pain intensity. The only significant difference was that the Damon system inclined the maxillary molars more buccally than the conventional group
Am J Orthod Dentofacial Orthop. 2013 Aug;144(2):185-93. doi: 10.1016/j.ajodo.2013.03.012.
Comparison of maxillary arch dimensional changes with passive and active self-ligation and conventional brackets in the permanent dentition: a multicenter, randomized controlled trial.
Fleming PS1, Lee RT, Marinho V, Johal A.
•1Queen Mary University of London, Institute of Dentistry, Barts and the London School of Medicine and Dentistry, London, United Kingdom. firstname.lastname@example.org
The purpose of this study was to compare maxillary arch dimensional and inclination changes during alignment with conventional brackets and self-ligation.
Ninety-six patients, ages 16 years and above, were included in this multicenter, 3-group parallel randomized trial. The main outcome measures were changes in maxillary intercanine, interpremolar, and intermolar dimensions, and molar and incisor inclination changes. The patients were randomly allocated in permuted blocks of 12 subjects into 3 equal groups with the allocations concealed in opaque sealed envelopes. Each participant underwent alignment with a standard Damon Q (Ormco, Orange, Calif) wire sequence for a minimum of 34 weeks. Blinding of clinicians and patients was not possible. Data were analyzed on a per-protocol basis, since losses to follow-up were minimal.
Complete data were obtained from 87 subjects. Bracket type had no significant effect on any of the transverse dimensional changes. No difference in molar inclination was found between passive self-ligation and conventional brackets (0.67°; 95% CI, -2.24, 3.58; P = 0.65) or active self-ligation (0.91°; 95% CI, -1.95, 3.78; P = 0.53). Similarly, incisor inclination changes with the Damon Q could not be differentiated from those developing with either conventional system (0.44°; 95% CI, -1.93, 2.8; P = 0.71) or In-Ovation C (-0.22°; 95% CI, -2.58, 2.14; P = 0.85). No harms were encountered.
No difference in the arch dimensional or inclination changes during alignment can be expected between conventional brackets and either active or passive self-ligation.
Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
Am J Orthod Dentofacial Orthop. 2013 Apr;143(4 Suppl):S72-7. doi: 10.1016/j.ajodo.2012.07.017.
Colonization of Streptococcus mutans on esthetic brackets: self-ligating vs conventional.
do Nascimento LE1, Pithon MM, dos Santos RL, Freitas AO, Alviano DS, Nojima LI, Nojima MC, Ruellas AC.
•1Department of Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Self-ligating orthodontic brackets rely on clips, rather than ligatures, to hold the archwire in place. It is unknown whether replacing ligatures with clips affects the adherence of Streptococcus mutans. The aim of this research was to evaluate whether self-ligating brackets have an advantage over conventional brackets as determined by the adherence of S mutans.
The sample consisted of 50 esthetic brackets, divided into 3 experimental groups and 2 control groups of 10 brackets each. Two experimental groups were active self-ligating brackets (QuicKlear; Forestadent, Pforzheim, Germany; and In-Ovation C; Dentsply GAC, Bohemia, NY); the other was a passive self-ligating bracket (Damon 3; Ormco, Glendora, Calif). The 2 control groups were conventional brackets (Mystique; Dentsply GAC; and Clarity; 3M Unitek, Monrovia, Calif). The brackets were randomly bonded to the canines, first and second premolars, and first and second molars in the mandibular left hemiarch of 10 male participants. Biofilm was collected from the tooth surfaces before bonding and from the brackets on day 21 and placed in Petri dishes containing Mitis salivarius agar. The brackets were removed on day 28 and examined by using scanning electron microscopy. Statistical analysis, analysis of variance, and the Tukey correction with a P value of 0.05 were used.
The greatest numbers of colonies were found in an active self-ligating bracket group (In-Ovation C), and the fewest colonies were in a conventional bracket group (Clarity). The largest colonies formed on active self-ligating brackets. In the slot, the greatest formation was in a control group (Mystique).
Self-ligating esthetic brackets do not promote greater or lesser S mutans colonization when compared with conventional brackets. Differences were found to be related to the material composition of the bracket
Shanghai Kou Qiang Yi Xue. 2012 Aug;21(4):460-5.
[Comparative study on the apical root resorption between self-ligating and conventional brackets in extraction patients].
Liu XQ1, Sun XL, Yang Q, Fan CH, Chen XJ.
•1Department of Orthodontics, the Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, Shandong Province, China. email@example.com
To explore whether orthodontic light force with self-ligating brackets can reduce the amount of external apical root resorption (EARR).
Thirty patients with Class I or II crowding malocclusion were selected. Four first premolars of all patients were extracted in orthodontic treatment. 15 patients were treated with self-ligating brackets (Damon 3MX) and 15 patients with conventional ligation brackets, respectively. Patients in two groups were comparable in gender, age, crowded degree and malocclusion classification at the commencement of treatment. EARR of the maxillary and mandible incisors was evaluated on panoramic radiographs and models taken before and after treatment, and measured in millimeters. Student's t test was performed using SPSS19.0 software package.
Overall, no difference was found in the amount of EARR between the two groups. The amount of EARR in maxillary central incisor was (2.05±1.51) mm in Damon group and (2.08±1.21) mm in conventional group(P=0.973>0.05); (1.77±1.01) mm in maxillary lateral incisor in Damon group and (1.91±1.59) mm in conventional group(P=0.848>0.05); (2.06±1.62) mm in mandibular central incisor in Damon group and (1.98±1.50) mm in conventional group(P=0.926>0.05); (1.94±1.45) mm in mandibular lateral incisor in Damon group and (1.84±1.17) mm in conventional group(P=0.888>0.05).
No difference should be expected for root resorption between self-ligating and conventional brackets in orthodontic extraction treatment
Eur J Orthod. 2014 Jun;36(3):245-54. doi: 10.1093/ejo/cjr119. Epub 2011 Oct 31.
Evaluation of rotational control and forces generated during first-order archwire deflections: a comparison of self-ligating and conventional brackets.
Pesce RE1, Uribe F2, Janakiraman N1, Neace WP3, Peterson DR4, Nanda R5.
•1Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut School of Dental Medicine, Farmington, CT. •2Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut School of Dental Medicine, Farmington, CT Furibe@uchc.edu. •3Department of Psychology, University of Hartford, CT. •4Biodynamics Laboratory, University of Connecticut School of Medicine, Farmington, CT. •5Alumni Endowed Chair, Division of Orthodontics, Department of Craniofacial Sciences, School of Dental Medicine, University of Connecticut, Farmington, CT, USA.
The purpose of this study was to compare the activation and deactivation forces generated during first-order archwire deflections when different sizes and types of NiTi wires are paired with conventional and self-ligating brackets (SLBs) and to evaluate the rotational control between these same archwire and bracket combinations. Four maxillary premolar SLBs (Damon 3MX, SmartClip, Carriere, and In-Ovation R) and one conventional twin bracket (Victory) were paired with seven archwires [0.014, 0.016, 0.018, 0.016 × 0.022 Ultra Therm (thermal A f 80-90°F), 0.016, 0.018 SPEED Supercable, and 0.017 × 0.025 Turbo]. A cantilever test design was used and 10 trials per bracket/archwire combination were performed. Load/deflection data were captured over 4 mm fi rst-order archwire deflections. Forces generated were compared across all bracket/archwire combinations. Among thermal archwires, for a given deflection, forces increased with increasing archwire size. Supercable archwires displayed less force than their same size thermal counterparts. The Turbo archwire generated force values in between those of 0.016 and 0.018 thermal archwires. Rotational control improved with increasing wire dimensions and for a given archwire size. Rotational control among brackets generally ranked as follows: In-Ovation R > SmartClip > Carriere and Damon 3MX.
Am J Orthod Dentofacial Orthop. 2010 Aug;138(2):138.e1-7; discussion 138-9. doi: 10.1016/j.ajodo.2010.03.020.
Efficiency of self-ligating vs conventionally ligated brackets during initial alignment.
Ong E1, McCallum H, Griffin MP, Ho C.
•1Discipline of Orthodontics, School of Dentistry, University of Queensland, Brisbane, Queensland, Australia.
The aim of this study was to compare the efficiency of self-ligating (SL) and conventionally ligated (CL) brackets during the first 20 weeks of extraction treatment.
Study models of 50 consecutive patients who had premolar extractions in the maxillary and/or mandibular arch, 0.022 x 0.028-in slot brackets, and similar archwire sequences were examined. Forty-four arches received SL Damon 3MX brackets (Ormco, Glendora, Calif), and 40 arches received either CL Victory Series (3M Unitek, Monrovia, Calif) or Mini-Diamond (Ormco) brackets. The models were evaluated for anterior arch alignment, extraction spaces, and arch dimensions at pretreatment (T0), 10 weeks (T1), and 20 weeks (T2).
There were no significant differences between the SL and CL groups at 20 weeks in irregularity scores (mandibular arch, P = 0.54; maxillary arch, P = 0.81). There were no significant differences in passive extraction space closures between the SL and CL groups (mandibular arch, T0-T2, P = 0.85; maxillary arch, T0-T2, P = 0.33). Mandibular intercanine widths increased from T0 to T2: 1.96 and 2.86 mm in the SL and CL groups, respectively. This was not significant between the groups (P = 0.31). Logistic regression did not show a difference between the SL and CL bracket groups.
SL brackets were no more efficient than CL brackets in anterior alignment or passive extraction space closure during the first 20 weeks of treatment. Ligation technique is only one of many factors that can influence the efficiency of treatment. Similar changes in arch dimensions occurred, irrespective of bracket type, that might be attributed to the archform of the archwires.
Angle Orthod. 2010 Jul;80(4):438-45. doi: 10.2319/060809-322.1.
Canine retraction rate with self-ligating brackets vs conventional edgewise brackets.
•1Department of Orthodontics, University of North Carolina School of Dentistry, Chapel Hill, NC, USA. firstname.lastname@example.org
To compare the rates of retraction down an archwire of maxillary canine teeth when bracketed with a self-ligating bracket was used on one side and a conventional bracket on the other.
MATERIALS AND METHODS:
In 43 patients requiring maxillary premolar extraction, a self-ligating bracket (Damon3, SmartClip) was used on the maxillary canine on one side and a conventional bracket (Victory Series) on the other. The teeth were retracted down a 0.018-inch stainless steel archwire, using a medium Sentalloy retraction spring (150 g). The rates of retraction were analyzed using a paired t-test.
The mean movement per 28 days for the conventional bracket was 1.17 mm. For the Damon bracket it was 0.9 mm and for the SmartClip bracket it was 1.10 mm. The differences between the conventional and self-ligating brackets were statistically significant: paired t-test, SmartClip, P < .0043; Damon3, P < .0001).
The retraction rate is faster with the conventional bracket, probably because of the narrower bracket width of the self-ligating brackets
Active or passive self-ligating brackets? A randomized controlled trial of comparative efficiency in resolving maxillary anterior crowding in adolescents.
Pandis N1, Polychronopoulou A, Eliades T.
•1Private practice, Corfu, Greece.
Our aim was to compare the time required to complete the alignment of crowded maxillary anterior teeth (canine to canine) between Damon MX (Ormco, Glendora, Calif) and In-Ovation R (GAC, Central Islip, NY) self-ligating brackets.
Seventy patients from the first author's office were included in this randomized controlled trial by using the following inclusion criteria: nonextraction treatment on both arches, eruption of all maxillary teeth, no spaces in the maxillary arch, no high canines, maxillary irregularity index greater than 4 mm, and no therapeutic intervention planned involving intermaxillary or other intraoral or extraoral appliances including elastics, maxillary expansion appliances, or headgear. The patients were randomized into 2 groups: the first received a Damon MX bracket; the second was bonded with an In-Ovation R appliance, both with a 0.022-in slot. The amount of crowding of the maxillary anterior dentition was assessed by using the irregularity index. The number of days required to completely alleviate the maxillary anterior crowding in the 2 groups was investigated with statistical methods for survival analysis, and alignment rate ratios for appliance type and crowding level were calculated with the Cox proportional hazard regression. An analysis of each protocol was performed.
No difference in crowding alleviation was found between the 2 bracket systems. Higher irregularity index values were associated with the increased probability of delayed resolving of crowding.
The use of passive or active self-ligating brackets does not seem to affect treatment duration for alleviating initial crowding
Biomed Tech (Berl). 2009 Apr;54(2):89-97. doi: 10.1515/BMT.2009.009.
[Biomechanical analysis of orthodontic brackets with different closing mechanisms].
[Article in German]
Morina E1, Keilig L, Jäger A, Bourauel C.
•1Stiftungsprofessur für Oralmedizinische Technologie, Zentrum für Zahn-, Mund- und Kieferheilkunde, Universitätsklinikum, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Deutschland.
The aim of the present study was to investigate the biomechanical characteristics of orthodontic bracket systems made of metal, ceramics or plastics. Six different types of brackets were studied, including the Hanson Speed- and Damon 2-Brackets, both of which are equipped with specialised closing mechanisms. In addition, two conventional metal brackets (Ultratrimm), Discovery, the ceramics bracket Fascination 2 and the polycarbonate bracket Brillant were investigated. Stainless steel wires with the dimensions 0.40 mmx0.56 mm, 0.46 mmx0.56 mm, 0.46 mmx0.64 mm and 0.48 mmx0.64 mm were used with each bracket type simulating the clinical rotational movement of an upper central incisor in a biomechanical set-up. A buccal crown torque of 20 degrees was applied and the correction of the malposition was simulated experimentally. Each bracket/wire combination was analysed five times. The following parameters were analysed: maximum torquing moment, torque angle correction, and moment/torque ratio. Combining a 0.48 mmx0.64 mm steel wire with the ceramics brackets (Fascination 2) delivered the highest torquing moment (35 Nmm). The best torque correction was achieved with plastic brackets (17 degrees ). The lowest moments were approximately 5.2 Nmm (Damon) 2, 0.40 mmx0.56 mm steel wire), being in the range of the recommended minimum torquing moment (5 Nmm). Discovery brackets delivered similar low moments. Overall, only minor differences exist between the various bracket systems with regard to their efficiency in torque correction. Clinically, the wire/slot play seems to be more important than differences in the bracket designs
J Orofac Orthop. 2009 Jul;70(4):285-96. doi: 10.1007/s00056-009-9916-z. Epub 2009 Aug 2.
The leveling effectiveness of self-ligating and conventional brackets for complex tooth malalignments.
[Article in English, German]
Fansa M1, Keilig L, Reimann S, Jäger A, Bourauel C.
•1Endowed Professorship for Oral-medical Technology, Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany.
BACKGROUND AND OBJECTIVE:
The transfer of forces and moments between the bracket and archwire is decisive in the multi-band/bracket technique. New developments in bracket design and ligation method aim to optimize the transfer of forces and moments and improve leveling effectiveness. We thus aimed in this study to investigate whether leveling behavior is influenced by different bracket systems, or by the ligation method. The baseline situation for this examination was a complex tooth malalignment.
MATERIAL AND METHODS:
Using the orthodontic measurement and simulation system (OMSS), we tested the leveling effectiveness of nine self-ligating bracket systems made by various manufacturers (Forestadent-Quick, in active and passive variants, Dentsply GAC In-Ovation, adenta TIME, Ormco Damon 2 and Damon 3MX, UP-Dental Opal-M and Opal-2, Strite SPEED) in the 0.022 inch slot system. A conventional bracket system (Dentaurum discovery) was used for reference purposes. We also used a multistranded steel archwire (Ormco Tripleflex, 0.44 mm round) and four nickel-titanium archwires of various diameters (Forestadent BioStarter 0.30 mm round, BioStarter 0.40 mm round, Titanol Low Force 0.40 x 0.40 mm(2) and Titanol Low Force 0.40 x 0.56 mm(2)). The leveling task consisted of correcting a complex malalignment (infraocclusion and vestibular displacement, each of 2 mm) of tooth 21. We analyzed the forces and torque movements that arose during the leveling phase.
The test of the ten bracket systems revealed no significant difference in terms of their leveling effectiveness. Both selfligating brackets and conventional brackets behaved similarly, and we observed roughly 80% of the infraocclusions to have been corrected. Vestibular displacement was corrected with all the bracket systems by as much as 100% or even more due to a developing torque movement. The influence of wire material and wire diameter became apparent in relation to existing forces durconvening the leveling stage; those factors' influence was clearly greater than that of the ligation method.
This study's results demonstrate that bracket selection has a negligible influence on leveling effectiveness. Although self-ligating brackets are easier for the orthodontist to manipulate and provide patients with esthetic and wearing comfort advantages, they are not superior to conventional brackets in terms of their biomechanical characteristics
World J Orthod. 2009 Winter;10(4):290-4.
Maxillary arch width changes during orthodontic treatment with fixed self-ligating and traditional straight-wire appliances.
Tecco S1, Tetè S, Perillo L, Chimenti C, Festa F.
•1Department of Oral Science, University G. D’Annunzio, Chieti/Pescara, Italy. email@example.com
To evaluate the transverse dimensions of the maxillary arch induced by fixed self-ligating and traditional straight-wire appliances during orthodontic therapy.
PATIENTS AND METHODS:
Forty consecutive patients (age range 14 to 30 years) with normal or low mandibular plane angle, normal overbite, and mild crowding were included. The traditional appliance was composed of Victory Series MBT brackets (3M Unitek), and the self-ligating appliance of Damon-3MX brackets (Ormco). The leveling and aligning phase with round archwires lasted 6 months and was followed by another 6 months of rectangular archwires. The archwire sequence with the MBT appliance was 0.016-inch and 0.019 3 0.025-inch Ni-Ti form II (3M Unitek), while in the Damon-3MX, it was 0.014-inch and 0.016-inch followed by 0.016 3 0.025-inch copper nickel-titanium (Ormco). Intercanine, first and second interpremolar, and intermolar widths in the maxilla were recorded before treatment (T0) and 12 months later (T1).
In both groups, a significant increase from T0 to T1 was recorded for all transverse measurements, but no significant difference was observed between groups.
Within 12 months of treatment, both appliances increased maxillary dentoalveolar widths
Self-ligating bracket systems have challenged several aspects of conventional orthodontic thought and this has been both stimulating and uncomfortable. The long but rapidly accelerating rise to prominence of self-ligation has therefore raised a plethora of questions about bracket design, treatment technique, and treatment goals. Some questions are relatively easy to investigate. Others are more difficult to quantify, but are attracting much closer and more skillful attention because their clinical relevance is much greater. Unfortunately, at this time, there is very little hard scientific evidence available to justify many of the claims made by those advocating the use of self-ligating brackets Still more research need to be carried to substantiate the claims being made about SLBs.
So, are the claims of the Damon Corporation and some orthodontists that their braces provide shorter treatment times, less pain, grow bone with better results really true?
Unfortunately the independent research does not support the claims of the studies performed by the Damon or Ormco Company, which would have to be considered biased due to their substantial financial investment.
Damon braces are no better or worse than any of the hundreds of other braces on the market today. Any Orthodontist can purchase and treat with the Damon bracket if they determine that that bracket will provide the best results for their patients.
The Damon bracket like any other orthodontic brace is just a handle that is glued to the tooth, which is manipulated by forces produced by the arch wire by your orthodontist. The quality and results obtained through your orthodontic treatment are the direct result of the skill and diagnosis of your orthodontist and not by which braces are used.
I do use the Damon bracket in my office but I do not hold my treatment up as being superior to any other orthodontist due to the fact that I use “Damon Brackets.”
There is nothing wrong with using self-ligating brackets like the Damon appliance. But I believe there is something wrong with claiming certain doctors are better Orthodontists than their peers because they use them and their peers do not, or in making claims that the bracket can provide certain results that are not supported by sound scientific research.