Comparative Analysis of Canine Distalisation between Ceramic and Metal Brackets: A Systematic Review

Abstract

Introduction: Orthodontic treatment frequently entails the distalisation of canines to address various malocclusions, involving moving the canines towards the posterior region of the dental arch. A crucial consideration in this treatment is the type of bracket material utilised, as it can impact the efficacy and efficiency of Canine Distalisation (CD). Aim: To analyse various in-vivo studies to evaluate the comparison of the rate of maxillary CD between Ceramic Brackets (CB) and Metal Brackets (MB) during fixed orthodontic treatment. Secondary factors assessed include the loss of anchorage, canine rotation, and canine tipping. Material and Methods: Articles were searched in electronic databases such as Google Scholar, Scopus, and PubMed. The search strategy was designed by two authors, AK and RKJ. The search did not include date restrictions. The list of references for the included articles was also searched. The systematic review included two Controlled Clinical Trials (CCT) and one Randomised Control Trial (RCT). Two authors, AK and RKJ, independently screened the titles, abstracts, and full texts of the identified studies during the literature search and then combined their findings. The information considered from the short-listed studies included the first author, year of publication, rate of CD, CB, and MB. Cochrane’s Risk of Bias (RoB) tool, RoB2 tool, and the Newcastle Ottawa scale were used to analyse bias. Results: The present review incorporated three studies. The analysis of the RoB indicated low RoB in one study and fair RoB in the other two. The systematic review highlighted that there was no significant difference in the rate of CD between CB and MB. Conclusion: The available evidence was limited and of moderate quality, showing no difference in the rate of CD performed using ceramic and MB. Hence, clinically, there is no difference in using metal or CB, even though CBs are known to have higher SR in in-vitro evaluations.