Forces in the Presence of Ceramic Versus Stainless Steel Brackets with Unconventional vs Conventional Ligatures

Abstract

Abstract Objective: To compare the forces resulting from four types of bracket/ligature combinations: ceramic brackets and stainless steel brackets combined with unconventional elastomeric ligatures (UEL) and conventional elastomeric ligatures (CEL) during the leveling and aligning phases of orthodontic therapy. Materials and Methods: The testing model consisted of five 0.022-inch preadjusted brackets (second premolar, first premolar, canine, lateral incisor, and central incisor) for each of the two bracket types. The canine bracket was welded to a sliding bar that allowed for different amounts of offset in the gingival direction. The forces generated by a 0.014-inch superelastic nickel titanium wire in the presence of either the UEL or CEL bracket/ligature systems at different amounts of upward canine misalignment (1.5 mm, 3 mm, 4.5 mm, and 6 mm) were recorded. Results: Significant differences were found between UEL and CEL systems for all tested variables (P < .01) with the exception of the canine misalignment of 1.5 mm. The average amount of recorded force in the presence of CEL was negligible with 3.0 mm or greater of canine misalignment. On the contrary, during alignment, a force available for tooth movement was recorded in the presence of both ceramic and stainless steel brackets when associated with UEL. Conclusions: The type of ligature used influenced the actual amount of force released by the orthodontic system significantly more than the type of bracket used (stainless steel vs ceramic).