Does atropine sulphate improve orthodontic bond survival? A randomized clinical trial

Introduction: The antisialagogue atropine sulphate has been used for many years as an adjunct to orthodontic bonding to reduce moisture contamination. The aims of this study were to investigate the effect of atropine sulphate premedication on orthodontic bond failures and to evaluate the attitudes of patients and parents toward its use in orthodontics. Methods: After ethics committee approval, 51 patients (mean age, 14 years 7 months) were enrolled in this clinical trial. They were randomized to receive 2 interventions, atropine sulphate premedication (600 μg) or no premedication (control) with a Battenburg design (split-mouth). Overall, 852 brackets and 362 molar tubes were bonded. Bond failure data were collected over a 12-month period and analyzed with Kaplan-Meier survival probabilities and the log rank and Wilcoxon tests. Patient-centered outcome measures included a questionnaire relating to treatment with antisialagogues. Results: The results showed no statistically significant difference in the bond survival rates between the 2 interventions-antisialagogue premedication or no premedication (P >.05). From the questionnaire, 94.1% of the subjects said they took the atropine sulphate before the bond appointment. Approximately 76% of them thought that taking medication before placement of orthodontic appliances was an acceptable part of treatment. Conclusions: Although the use of a premedication to induce hypo-salivation before orthodontic bonding appears to be an acceptable procedure to most patients and their parents, we did not find a statistically significant effect on the observed bond failure rates. There is no evidence to support the routine use of atropine sulphate before orthodontic bonding.