Bonded versus banded first molar attachments: a randomized controlled clinical trial.

OBJECTIVE

To compare the clinical failure rates of bonded first molar tubes with those of cemented bands during fixed appliance therapy.

DESIGN

Prospective randomized controlled clinical trial.

SETTING

Two UK hospital orthodontic clinics, February 2001-December 2004.

PARTICIPANTS

Hospital waiting list patients needing fixed appliances (n = 110).

METHOD

Patients were randomly allocated to two groups. Experimental group patients (n = 55) received single first molar tubes (n = 181) bonded with a no-mix chemically cured composite (Rely-A-Bond) after a 30-second etch. Control group patients (n = 55) were treated with bands (n = 186) cemented with Intact glass ionomer cement (GIC). First-time failures were recorded together with the time of failure. All patients were followed to the end or discontinuation of treatment.

RESULTS

First-time failures: bands = 18.8%; bonds = 33.7 %. Bonded tubes were more likely to fail [RR 2.4; 95% CI (1.4, 4.1)] compared with bands. Experimental group patients also had more bracket failures (P = 0.009), when analysed at patient level.

CONCLUSION

First molar tubes bonded with Rely-A-Bond composite showed a significantly higher first-time failure rate than bands cemented with Intact GIC.