Cochrane · intervention · CD002282

Adhesives for fixed orthodontic brackets

Mandall, NA, Hickman, J, Macfarlane, TV, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library

Oral Health Orthodontics2 versionsAMSTAR 2: not assessed

Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.

Questions

current version

GRADE rated

No studies

Included studies

as reported

No studies 2 · 33.3%Ungraded 4 · 66.7%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

Element	Planned (methods)	Found (results)
Population	Patients with fixed appliances attached to their teeth. Patients with cleft lip or palate or both or any other syndrome were excluded. Additionally patients involved in any type of surgery including surgical uncovering (exposure) of buried teeth, but not surgical extraction of teeth as part of the orthodontic treatment plan were excluded.	The three trials recruited between 45 and 60 patients who were between 10 years 8 months and 29 years of age
Intervention	Adhesives used to fix orthodontic appliances to teeth (attach the metal brackets to the front teeth, not the metal bands to the molar teeth). Groups compared: Conventional composite; Conventional glass ionomer cement (GIC); Polyacid-modified composites (compomers); Resin-modified glass ionomer cement. Comparisons made between these groups and within groups, between chemical and light cured adhesives.	Chemical cured composite (n=3)
Comparison	Light cured adhesives/Chemical cured adhesives/A different group of adhesives	Light cured composite (n=1); Conventional glass ionomer cement (n=1); Compomer (n=1)
Outcomes	Primary outcome: binary data on the failure of each adhesive (whether the metal bracket stays stuck to the tooth or not); annualised failure rate where available (no trial reported it). Secondary outcome: binary data on the presence or absence of decay (decalcification) associated with or around the brackets.	Bracket/adhesive failure (n=3); Decalcification (n=1)
Study designs	Only randomised controlled trials (RCTs) and controlled clinical trials (CCTs) (using quasi-methods of randomisation e.g. alternation) that compared adhesives to attach fixed orthodontic appliances to teeth; the fixed appliance should be attached to most of the teeth in at least one jaw; trials should compare at least two different groups of adhesives.	RCT (n=2); CCT (n=1)
Timing	Patients followed to the end of appliance treatment (studies not following patients to the end of treatment were excluded)	Split-mouth trials followed to end of appliance treatment; specific follow-up times not reported

Search date: 2017-09. Databases: Cochrane Oral Health's Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE Ovid; Embase Ovid

Questions and results

Show all 2 versions

Chemical cured composite vs Light cured composite

Population: Patients with fixed orthodontic appliances attached to their teeth

1 question

Outcome	Effect	Evidence	Status / GRADE
Bracket (bond) failure To end of appliance treatment same question in other reviews	Additional Table 1 summarises the proportion of bracket failures for a CC and LC composite with two different bracket bases (O'Brien 1989). The paper reported the results of applying a Mantel-Haenszel Chi2 test which…	1 study · 52 participants	Ungraded

Chemical cured composite vs Conventional (chemical cured) glass ionomer cement

Population: Patients with fixed orthodontic appliances attached to their teeth

2 questions

Outcome	Effect	Evidence	Status / GRADE
Decalcification To end of appliance treatment same question in other reviews	It was surprising that decalcification rates were not reported as a secondary outcome, as clinically it is suggested that GIC is protective against decalcification; the…	0 studies	No studies
Bracket (bond) failure To end of appliance treatment same question in other reviews	The one trial article for this adhesive comparison reported the results of paired t-tests comparing different sides of the mouth. No standard deviations were presented, so we were unable to reproduce the data. The…	1 study · 60 participants	Ungraded

Chemical cured composite vs Compomer (polyacid-modified resin composite)

Population: Patients with fixed orthodontic appliances attached to their teeth

2 questions

Outcome	Effect	Evidence	Status / GRADE
Decalcification To end of appliance treatment same question in other reviews	However the paper reported that the compomer offered better protection against decalcification when compared by a sign test (P = 0.0075) (Millett 2000). No effect estimate or confidence interval was reported.	1 study · 45 participants	Ungraded
Bracket (bond) failure To end of appliance treatment same question in other reviews	OR 0.86 [0.24, 2.98]	1 study · 45 participants	Ungraded

Composite (chemical or light cured) vs Resin-modified glass ionomer cement

Population: Patients with fixed orthodontic appliances attached to their teeth

1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR To end of appliance treatment same question in other reviews	No included studies involved a comparison with resin-modified glass ionomer cement (a planned adhesive group). The authors recommended future randomised controlled trials involving resin-modified light cured glass…	0 studies	No studies