Department of Orthodontics and Dentofacial Orthopaedics, Nair Hospital Dental College, Mumbai Central, Mumbai 400008, India.
Department of Orthodontics and Dentofacial Orthopaedics, Nair Hospital Dental College, Mumbai Central, Mumbai 400008, India.
Int Orthod. 2023 Sep;21(3):100788. doi: 10.1016/j.ortho.2023.100788. Epub 2023 Jul 11.
Bracket debonding is an undesirable problem during fixed orthodontic treatment. As ceramic brackets have no flexibility, there is no change in the slot dimension. So, reconditioning a ceramic bracket can be done without compromising the quality of treatment and could be a cost-effective measure. The objective of this systematic review is to deduce and validate the best method of reconditioning ceramic bracket in order to get optimum clinical shear bond strength.
Studies such as randomized controlled trials (RCTs); In vitro studies comparing different interventions with control group, cross sectional studies were included. Electronic databases such as Cochrane database, PubMed, Web of Science, Embase were searched up to July 2022. Grey literature search and cross-referencing/snowballing methods were also used. Two reviewers independently selected studies and assessed the risk of bias using amalgamation of five tools for in vitro studies. Then meta-analysis was performed using random effects model.
Eleven studies were included in which ten studies were considered as good quality studies. According the meta-analysis performed, the best performance in terms of shear bond strength was of new brackets. Among the different reconditioning methods, the meta-analysis showed that the method with the closest bond strength to the new brackets was silicatisation with a mean difference of 6.35MPa (95% CI between 2.39 and 10.31) followed by sandblasting+silane application with a mean difference of 3.36MPa (95% CI between 0.3 and 6.96) compared to other methods.
Due to the lack of in vivo studies, only in vitro studies were evaluated. The data available from the in vitro studies was considered to be of good quality, leading to the conclusion that the best method for reconditioning debonded ceramic brackets is silicatisation followed by sandblasting and silane application.
在固定正畸治疗过程中，托槽脱粘是一种不理想的问题。由于陶瓷托槽没有弹性，槽尺寸没有变化。因此，在不影响治疗质量的情况下，可以对陶瓷托槽进行再处理，这可能是一种具有成本效益的措施。本系统评价的目的是推断和验证再处理陶瓷托槽的最佳方法，以获得最佳的临床剪切粘结强度。
包括随机对照试验（RCT）在内的研究；体外研究比较了不同干预措施与对照组的关系，横断面研究也包括在内。电子数据库如 Cochrane 数据库、PubMed、Web of Science、Embase 被搜索到 2022 年 7 月。还使用了灰色文献搜索和交叉引用/滚雪球方法。两名审查员独立选择研究，并使用五种体外研究综合工具评估偏倚风险。然后使用随机效应模型进行荟萃分析。
共有 11 项研究纳入其中，其中 10 项研究被认为是高质量的研究。根据荟萃分析，在剪切粘结强度方面表现最好的是新托槽。在不同的再处理方法中，荟萃分析显示，与新托槽粘结强度最接近的方法是硅化处理，平均差异为 6.35MPa（95%置信区间为 2.39 至 10.31），其次是喷砂+硅烷应用，平均差异为 3.36MPa（95%置信区间为 0.3 至 6.96），与其他方法相比。
由于缺乏体内研究，仅评估了体外研究。从体外研究中获得的数据被认为是高质量的，得出的结论是，再处理脱粘陶瓷托槽的最佳方法是硅化处理，其次是喷砂和硅烷应用。
