Customized Ceramic Brackets Shortened Treatment but Nearly Doubled Bracket Failures

Edited by Orthotown staff

Orthodontic patients treated with customized ceramic brackets finished about three months sooner than patients in conventional fixed appliances, but far more of them experienced at least one bracket failure, according to a retrospective study published online Sept. 11 in The Angle Orthodontist.

The study compared 36 patients treated with LightForce customized ceramic brackets against 39 patients treated with conventional fixed appliances, all in a single private orthodontic practice. Pretreatment American Board of Orthodontics Discrepancy Index scores were comparable between the two groups.

Median treatment time was 16 months in the customized bracket group and 19 months in the conventional group, at P less than .001. The customized group also required fewer scheduled visits, at P = .012.

Bracket failures ran the other direction. At least one bracket failure occurred in 80.6% of customized bracket patients and 43.6% of conventional patients, at P = .002. Total bracket failures and bracket-related emergency visits were both higher in the customized group, each at P less than .001.

Finishing quality was broadly similar. Total posttreatment American Board of Orthodontics Objective Grading System scores were 29.0 for the customized group and 25.0 for the conventional group, a difference that did not reach significance at P = .061. Higher scores on that index indicate greater deviation from the ideal. One component did separate the groups: marginal ridge scores were significantly worse in the customized bracket group, at P less than .001.

Behnoosh Hormozi and colleagues conducted the study. Between-group comparisons used Wilcoxon rank-sum tests for continuous variables and Fisher’s exact tests for categorical variables.

The design was retrospective and drew on 75 consecutively treated patients in one practice, so it cannot establish that the appliance itself produced the shorter treatment times. Case selection, operator familiarity, and practice scheduling patterns could all have contributed.

Sources:
The Angle Orthodontist, “Treatment outcomes, efficiency and complications of customized ceramic brackets compared with conventional fixed orthodontic appliances,” published online Sept. 11, 2026. PubMed record, PMID 42730520: pubmed.ncbi.nlm.nih.gov/42730520