Accidental debondings: Buccal vs fully individualized lingual multibracket appliances

IntroductionThe aim of this study was to retrospectively assess the frequency and localizations of bond failures (BFs) in patients treated with either lingual (TOP-Service für Lingualtechnik GmbH, a 3M Company, Bad Essen, Germany) or buccal (Mini Diamond brackets/Accent molar tubes; Ormco, Orange, Calif) full multibracket appliances in both dental arches.MethodsData were acquired by an independent investigator from the patient records of 3 practitioners. To establish a standardized observation period, the first year of treatment was analyzed for each patient. Statistical analysis comprised the Kruskal-Wallis, Wilcoxon, Mann-Whitney U, and Fisher exact tests. The significance level was set at P <0.05.ResultsThe mean number of BFs per patient in the first year of treatment did not differ significantly between the lingual group (n = 59; mean age, 31.1 years; mean BFs per patient, 2.63; SD, 2.77; minimum, 0; maximum, 13) and the buccal group (n = 44; mean age, 15.14 years; mean BFs per patient, 2.61; SD, 3.41; minimum, 0; maximum, 14) (P = 0.428) or with respect to sex (lingual group, P = 0.251; buccal group, P = 0.414) or practitioner (lingual group, P = 0.755; buccal group, P = 0.060), but molar attachments were more prone to BFs than were premolar brackets (lingual group, P = 0.015; buccal group, P = 0.049), and premolar brackets were more prone to BF than anterior brackets (lingual group, P = 0.005; buccal group, P = 0.004).ConclusionsWith both appliances, a mean of 2.62 BFs per patient in the first year of treatment can be expected; this benchmark provides a reference for patient briefing, which is very important considering the large interindividual variances and budgeting considerations.