Saturday, December 18, 2010

Markham and Toronto Orthodontist Discusses Recent Article about Damon Braces, Self-Ligating Braces, etc.

At MCO Markham and Stouffville Orthodontics, we want to present all of the relevant information to our patients so that they can make the most informed decision.  We get many inquiries about Damon braces or SL brackets.  We have not found these brackets to provide any superior results, comfort, or speed, and have been able to provide excellent, on-time care, with our current modern bracket system. We plan treatment well, so we can see our patients every 8 weeks and still often complete treatment ahead of schedule!

In the August 2010 issue of the American Journal of Orthodontics and Dentofacial Orthodpedics, an article was written about claims made by manufacturers of various self-ligating braces.  The American Association of Orthodontics' Council on Scientific Affairs looked at this topic from the stand point of what evidence there is about these claims.  They looked at:

1.  Does lateral expansion of the dental arch by SL brackets "grow" buccal alveolar bone? There is no peer reviewed material on this subject.

2.  Is lateral expansion of the dental arch by SL brackets comparable with the lateral expansion gained by rapid maxillary expansion followed by conventional brackets?  There is no peer reviewed material on this subject.

3.  Is lateral expansion of the dental arch gained by SL brackets stable in the long term?  There is no peer reviewed material on this subject.

4.  Are SL brackets more efficient and more effective than conventional bracket systems?  Current evidence DOES NOT support this assertion.

5.  So SL brackets provide less friction between the archwire and bracket?  Current evidence shows this under specific lab conditions, but does not represent real life situations.

6.  Do SL brackets produce lower clincial forces compared with traditional brackets?  No in-vivo studies ahve been shown to answer this question.

7.  Do patients treated with SL brackets experience less pain during treatment?  There is not a lot of data to compare, yet this is a study reporting that patients with SL brackets experienced greater pain than those with traditional brackets.

8.  Are conventional brackets less hygienic than SL brackets?  Evidence does not support this claim.

Most of the notable assertions made by SL bracket companies are not backed up by evidence in scientific studies.  Unfortunately, many orthodontists continue to make these claims.  Ultimately, it is not the type of brace that is going to determine the outcome of your treatment.  It is the skill of the orthodontist, his/her team, treatment plan, and diagnosis that will be the difference.


staci said...

If only every orthodontist had your voice of reason. Lysle Johnston, one of my favorite orthodontic speakers of all time, gave a lecture entitled "Slippery Braces for Smiling Faces" in which he poked gentle fun at Ormco's ridiculous claims by providing peer reviewed studies. It was sad to read a recent interview with him where he lamented the value of academic research is becoming insignificant because so many orthodontists get their "science" from companies whose goal is to sell them product...

MCO Markham Orthodontist said...

Thanks for your comment! Unfortunately, you don't have to look far online to find orthodontists claiming faster treatment, pain-free braces, no tightening, etc with SL brackets.

A bracket is not the magic bullet in orthodontics. Diagnosis and treatment planning is much more important that a bracket. You could give the worst orthodontists the "perfect" bracket and still have terrible results. At the same time, you could give excellent orthodontists subpar brackets and still get fantastic outcomes. This is the same reason why Invisalign hasn't killed orthodontics.

The profession is such because of our own research. As marketing from these companies continues to become our "research", the public and our profession suffer.

Edward said...

Hi I am actually planning to get a clarity SL backets I am 30 years old and have an overbite and 1 semi bicuspid missing. Upon reading your blog, I feel a little discouraged using the SL barcket. This does mean that SL backets are no different from the regular ones?

Jason Tam said...

Hi Edward. Please do not feel discouraged with your choice. SL brackets can work well when used correctly. The point of this blog entry is to show that most of the claims of superiority of SL brackets are overstated and come from manufacturers. All the best!

Afg gh said...

How is it that no one at FDA, government, association or someotherwhere will not stop these outlandish claims such as "no pain with Damon brackets"! I mean, if you have any idea about ortho and tooth movements, you are amazed by these amazing claims.

Jason Tam said...

It is unfortunate that this type of marketing is allowed. It is even worse when orthodontic professionals repeat these non-truths to their patients for whatever reason.