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Perceptions of Orthodontists on Bracket Dislodgement During Fixed Orthodontic Treatment (A Cross Sectional Study)

Hadi M. Ismail*
 *Pedodontic, Orthodontic, and Preventive Dentistry Department, College of Dentistry, University of Sulaimani, Sulaimani, Iraq.
Submitted: November 29, 2020, Accepted: December 7, 2020, Published: June 1, 2021.


ObjectivesBracket failure is one of the problems that happen during fixed orthodontic treatment, which slows treatment progression and is costly in time, material, and patient inconvenience. The present study aimed to assess orthodontic professionals' perceptions regarding bracket failure during fixed orthodontic treatment.          

MethodsThis cross-sectional study was conducted by distributing a self–administered questionnaire among orthodontic professionals. The validity and reliability of the questionnaire were tested before study conduction. In total, 158 orthodontic professionals were approached across Iraq. The questionnaire included eight questions on practice, nine on perceptions, and three on awareness with regard to the prevention and management of bracket failure. Data were analyzed by the Kruskal-Wallis test and Dunn-Bonferroni post hoc test.      

Results: The majority of the participants either agreed (58.2%) or strongly agreed (27.8%) that instruction on appropriate food consumption is the best way to prevent bracket debonding. Years of experience were shown to have a statistically significant association with the rate of bracket failure and number of appointments per week for bracket rebonding, at p=0.01 and p=0.001, respectively. A postgraduate orthodontics degree was shown to have a statistically significant association with perception and awareness within the study population, at p= 0.0005 and p=0.01, respectively.  

ConclusionsOrthodontic professionals regarded orthodontists as having the least responsibility for bracket failure. It is recommended to have special practice guidelines for the management of bracket failure.

Keywords: Bracket dislodgement, Orthodontists, Orthodontics.                                                                                                                                                                                                                                                                      Full Article - PDF                                                                                                                                                                                     


1.  Mui B, Rossouw PE, Kulkarni G V. Optimization of a procedure for rebonding dislodged orthodontic brackets. Angle Orthod. 1999;69(3):276–81. 
2. Krishnan S, Pandian S, Rajagopal R. Six-month bracket failure rate with a flowable composite: A split-mouth randomized controlled trial. Dental Press J Orthod. 2017;22(2):69–76. 
3. McDougall NI, McDonald J, Sherriff A. Factors associated with discontinued and abandoned treatment in primary care orthodontic practice part 2: a practice-based study. Orthod Update. 2017;10(2):52–8. 
4. Almosa N, Zafar H. Incidence of orthodontic brackets detachment during orthodontic treatment: A systematic review. Pakistan J Med Sci. 2018;34(3):744–50. 
5. Eminkahyagil N, Arman A, Cetinşahin A, Karabulut E. Effect of resin-removal methods on enamel and shear bond strength of rebonded brackets. Angle Orthod. 2006;76(2):314–21. 
6. Barbosa IV, Ladewig V de M, Almeida-Pedrin RR, Cardoso MA, Santiago Junior JF, Conti AC de CF. The association between patient’s compliance and age with the bonding failure of orthodontic brackets: a cross-sectional study. Prog Orthod. 2018;19(1):1-5. 
7. Janiszewska-Olszowska J, Szatkiewicz T, Tomkowski R, Tandecka K, Grocholewicz K. Effect of orthodontic debonding and adhesive removal on the enamel - current knowledge and future perspectives - a systematic review. Med Sci Monit Int Med J Exp Clin Res. 2014;20:1991– 2001. 
8. Baherimoghadam T, Akbarian S, Rasouli R, Naseri N. Evaluation of enamel damages following orthodontic bracket debonding in fluorosed teeth bonded with adhesion promoter. Eur J Dent. 2016;10(2):193–8. 
9. Abed Al Jawad F, Cunningham SJ, Croft N, Johal A. A qualitative study of the early effects of fixed orthodontic treatment on dietary intake and behaviour in adolescent patients. Eur J Orthod. 2012;34(4):432–6. 
10. Li X, Xu Z-R, Tang N, Ye C, Zhu X-L, Zhou T, et al. effect of intervention using a messaging app on compliance and duration of treatment in orthodontic patients. Clin Oral Investig. 2016;20(8):1849–59. 
11. Mehra T, Nanda RS, Sinha PK. Orthodontists’ assessment and management of patient compliance. Angle Orthod. 1998;68(2):115–22. 
12. Bordea IR, Sîrbu A, Lucaciu O, Ilea A, Câmpian RS, Todea DA, et al. Microleakage-the main culprit in bracket bond failure? J Mind Med Sci. 2019;6(1):86–94. 
13. Sergl HG, Zentner A. Predicting patient compliance in orthodontic treatment. Semin Orthod. 2000;6(4):231–6. 
14. Conrad DA, Lee RS-Y, Milgrom P, Huebner CE. Estimating determinants of dentist productivity: new evidence. J Public Health Dent. 2010;70(4):262–8. 
15. Mavreas D, Athanasiou AE. Factors affecting the duration of orthodontic treatment: a systematic review. Eur J Orthod. 2008;30(4):386–95. 
16. Skidmore KJ, Brook KJ, Thomson WM, Harding WJ. Factors influencing treatment time in orthodontic patients. Am J Orthod Dentofac Orthop. 2006;129(2):230–8. 
17. Popowich K, Nebbe B, Heo G, Glover KE, Major PW. Predictors for Class II treatment duration. Am J Orthod Dentofac Orthop. 2005;127(3):293–300. 
18. O’Brien KD, Read MJ, Sandison RJ, Roberts CT. A visible light-activated direct-bonding material: an in vivo comparative study. Am J Orthod Dentofac Orthop. 1989;95(4):348–51. 
19. Qabool H, Sukhia RH, Fida M. Assessment of cooperation and compliance in adult patients at three stages of orthodontic treatment at a tertiary care hospital: A cross-sectional study. Int Orthod. 2020; (in press) S1761-7227. 
20. Dickens S, Beane RA, Caplan DJ, Vann William J. Comparison of treatment result and compliance between private practice medicaid and non- medicaid orthodontic patients – a brief communication. J Public Health Dent. 2008;68(3):167–9. 
21. Starnbch HK, Kaplan A. Profile of an Excellent Orthodontic Patient. Angle Orthod. 1975;45(2):141–5. 
22. McDougall NI, McDonald J, Sherriff A. Factors associated with discontinued and abandoned treatment in primary care orthodontic practice part 1. Orthod Update. 2017;10(1):8–14. 
23. Liu CH, Shao JL. Effect of the adolescents’ psychological behavior disposition to orthodontic brackets bond failure. Chinese J Aesthetic Med. 2004;13(6):723–5. 
24. Wendl B, Muchitsch P, Pichelmayer M, Droschl H, Kern W. Comparative bond strength of new and reconditioned brackets and assessment of residual adhesive by light and electron microscopy. Eur J Orthod. 2011;33(3):288–92. 
25. Nicolás AI, Vicente A, Bravo LA. The in vitro effect of repeated bonding on the shear bond strength with different enamel conditioning procedures. Eur J Orthod. 2010;32(3):291–6. 
26. Ahrari F, Poosti M, Akbari M, Sadri K. Early versus delayed rebonding of orthodontic brackets. Prog Orthod. 2012;13(1):17–22.

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