Original Article

Debris and friction of self-ligating and conventional orthodontic

brackets after clinical use
Raı́ssa Costa Araújoa; Lı́via Monteiro Bicharab; Adriana Monteiro de Araujob; David Normandoc

ABSTRACT
Objective: To compare the degree of debris and friction of conventional and self-ligating
orthodontic brackets before and after clinical use.
Materials and Methods: Two sets of three conventional and self-ligating brackets were bonded
from the first molar to the first premolar in eight individuals, for a total of 16 sets per type of
brackets. A passive segment of 0.019 3 0.025-inch stainless steel archwire was inserted into each
group of brackets. Frictional force and debris level were evaluated as received and after 8 weeks
of intraoral exposure. Two-way analysis of variance and Wilcoxon signed-rank test were applied at
P , .05.
Results: After the intraoral exposure, there was a significant increase of debris accumulation in
both systems of brackets (P , .05). However, the self-ligating brackets showed a higher amount of
debris compared with the conventional brackets. The frictional force in conventional brackets was
significantly higher when compared with self-ligating brackets before clinical use (P , .001).
Clinical exposure for 8 weeks provided a significant increase of friction (P , .001) on both systems.
In the self-ligating system, the mean of friction increase was 0.21 N (191%), while 0.52 N (47.2%)
was observed for the conventional system.
Conclusion: Self-ligating and conventional brackets, when exposed to the intraoral environment,
showed a significant increase in frictional force during the sliding mechanics. Debris accumulation
was higher for the self-ligating system. (Angle Orthod. 2015;85:673–677.)
KEY WORDS: Orthodontic brackets; Self-ligating brackets; Friction

INTRODUCTION Several factors can determine the friction resistance

between the archwire and orthodontic brackets such
Friction is a force that resists motion between
as the angulations between the wire and bracket,7,8 the
objects in contact, and it is tangential to the common
size and materials of the archwire,9,10 the ligation
boundary between them.1 The friction between the
bracket system,11–13 saliva,14,15 and the width and
orthodontic bracket and the archwire can cause more materials of the brackets.2,16 Furthermore, studies
than 50% loss of orthodontic force initially applied, have shown that debris accumulation on the wire
resulting in decreased or even an inhibition of desired surface increases roughness and generates higher
tooth movement.1–5 However, during the orthodontic levels of friction.17,18
treatment, friction is always present; therefore, it is Self-ligating brackets were designed to eliminate
desirable to have a level of friction as low as possible.6 elastomers and steel ligature wires based on the
concept that this system would create an environment
a
Resident, Department of Orthodontics, Brazilian Association
with lower friction, allowing a more efficient mechanical
of Dentistry, Belém, Pará, Brazil.
b
Graduate student, Department of Orthodontics, School of sliding that might reduce treatment time.19 Although the
Dentistry, Federal University of Pará, Belém, Pará, Brazil. friction produced by self-ligating brackets is a contro-
c
Associate Professor, Department of Orthodontics, School of versial issue,20 some in vitro studies have reported a
Dentistry, Federal University of Pará, Belém, Pará, Brazil. significant reduction in friction when as-received self-
Corresponding author: Dr David Normando, Rua Boaventura
ligating brackets are compared with conventional
da Silva, 56-1201, 66055-090, Belém-Pa, Brazil
(e-mail: davidnormando@hotmail.com) brackets.21 Such friction reduction does not seem to
have a significant influence on treatment time in
Accepted: August 2014. Submitted: January 2014.
Published Online: September 24, 2014 orthodontics.22–24 This different behavior between
G 2015 by The EH Angle Education and Research Foundation, clinical and in vitro studies could be related to the
Inc. effects of intraoral aging on orthodontic materials.14

DOI: 10.2319/012914-80.1 673 Angle Orthodontist, Vol 85, No 4, 2015

674 ARAÚJO, BICHARA, ARAUJO, NORMANDO

Figure 2. Images used to determine debris score before (T0) and

after clinical use.

segment of stainless steel wire of 0.019 3 0.025 inches

Figure 1. Intraoral view of randomized split-mouth grouping.
(Unitek, Monrovia, Calif) was inserted into the bracket.
For the conventional ligation group (n 5 16), the
brackets were tied with elastic ligature (diameter of
Meanwhile, recent studies have reported that conven- 0.120 inches; Unicycles, MASEL, Carlsbad, Calif). The
tional brackets favor a lower aggregation of microor- sets of brackets and wires remained in the oral
ganisms when compared with self-ligating brackets.25,26 environment for 8 weeks (Figure 1).
Despite the existence of some information about the We used brackets bonded on the second premolar
effect of intraoral exposure on friction and accumulation since this is a bracket in which the wire slides during
of debris in orthodontic wires,17,18 there is no information retraction mechanics.
about the changes produced by intraoral exposure
regarding the set of bracket and wires. Our aim is Debris Accumulation
to evaluate debris and friction of conventional and
self-ligating orthodontic brackets before and after Images were obtained through a magnifying lens of
clinical use. 203 (Model MV 200 mm, Miviewcap, Shenzhen,
China) to evaluate debris accumulation on the bracket
MATERIALS AND METHODS and wire set before and after clinical use (Figure 2).
The amount of debris was scored by a single
This study was approved by the Ethics Committee examiner according to a previous published method.17,18
and Research to Science Health Institute of Brazilian Assessment of the amount of debris on the bracket
Federal University of Pará under number 039773/ surface was performed by a single examiner. The
2012. following scores were used: 0 5 total absence of debris;
The sample size was calculated to observe the 1 5 some debris, involving less than one-fourth of the
differences between as-received brackets (T0) and image analyzed; 2 5 moderate presence of debris
after 8 weeks of clinical use (T1). A power of 80% was involving one-fourth to three-fourths of the image; and 4
assumed to detect a difference of 0.5 N of force, with 5 presence of a large amount of debris involving more
standard deviations of 0.3 (T0) and 0.6 (T1) and a than three-fourths of the image examined.
bilateral alpha level of 5%. Standard deviations were For the analysis of error, two blinded readings of
determined by a pilot study involving six pairs of as- each bracket were performed with an interval of
received and clinical exposed brackets obtained from 1 week. Reliability was evaluated using Spearman’s
three patients. The sample size was determined to be correlation test at P , .05.
n 5 8 (T0) and n 5 16 (T1), as the variance was
Scoring the level of debris before and after clinical
doubled after clinical use.17
use was performed for all 32 brackets, 16 conventional
The effects of intraoral exposure on friction were
and 16 self-ligating, and compared through a Wilcoxon
examined in eight adults (four men and four women).
signed-rank test at P , .05.
The four hemi-arches of each patient received a set
of three brackets from the first molar to the first
Friction Test
premolar (32 hemi-arches). Groups were randomized
(Figure 1). In two hemi-arches, from each patient, the To evaluate the influence of bracket deformation
conventional metallic bracket slots of 0.022 3 caused by debonding, 10 as-received brackets (5
0.028 inches (Kirium LINE-Abzil, São José dos conventional and 5 self-ligating) were bonded in
Campos, SP, Brazil) were bonded; the other ones human premolars and then removed using thin cutting
received self-ligating bracket slots of 0.022 3 pliers (Pin and Ligature Cutter-Standard, Straight-,
0.028 inches (PORTIA-Abzil, São José dos Campos, Orthopli Corporation, Philadelphia, Penn). Friction was
SP, Brazil). Both were Roth prescriptions. A straight evaluated in both groups, before and after debonding,

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ORTHODONTIC BRACKETS AFTER CLINICAL USE 675

Table 1. Friction Mean, Standard Deviation (SD), and P Value (ANOVA) for As-Received and New Debonded Brackets
As-Received (n 5 5) Debonded (n 5 5)
Mean SD Mean SD
Conventional brackets 1.19 0.23 1.37 0.25
Self-ligating brackets 0.19 0.13 0.14 0.2
P value ..05

and compared through one-way analysis of variance The mean frictional force to conventional brackets,
(ANOVA). before clinical use, was 1.1 N (SD 5 0.24), while the
The friction test was performed using acrylic plates mean friction for self-ligating brackets was significantly
(area 5 4 3 5.5 cm and thicknesses 5 0.5 cm) lower (P , .001), with a mean of 0.11 N (SD 5 0.11).
according to a previous published methodology.17,22 Only After intraoral exposition for 8 weeks, there was a
second premolar brackets of each hemi-arch and the significant increase in the level of friction for both
entire intraoral exposed wire were bonded in individual systems of brackets (P , .001; Table 3). Compared
plates. Each bracket was bonded with 4 mm between with baseline, the increase in friction was 0.52 N
and 2 mm from the extremities of each plate. The acrylic (47.3%) higher for conventional brackets and 0.21 N
plates containing brackets and wire segments were fixed (191%) for self-ligating system. The interaction among
in the universal testing machine (EMIC DL 2000, São variables was also significant (P , .05).
José dos Pinhais, Brazil) and positioned at a 90u angle
relative to the ground. The machine was enabled and DISCUSSION
the upper grip slid at a speed of 0.5 mm/min for a
The assessment of material properties after ortho-
distance of 5 mm. The mean dynamic frictional force
dontic clinical use is routinely reported as a necessi-
was measured in Newtons (N).
ty,4,27 but few studies have investigated the properties of
Normal distribution was checked through D’Agostino
orthodontic materials after clinical aging. Some studies
statistical test. Two-way ANOVA was used to observe
have evaluated the effect of clinical use on friction17,18,27
differences between T0 3 T1 and the influence of the
and bacterial aggregation25,26; however, there are no
type of bracket ligation (conventional 3 self-ligating).
published papers comparing friction of conventional and
All statistics were analyzed at P , .05 using BioEstat
self-ligating brackets after intraoral exposure.
5.3 software (Mamirauá’s Institute for Sustainable
Recent studies have demonstrated that self-ligating
Development, Belém, PA, Brazil).
brackets favor a higher colonization of Streptococcus
mutans25,26 and accumulate more biofilm compared with
RESULTS
conventional brackets with steel wire ligation.28 Also,
No significant difference in friction level was ob- there is some evidence that the amount of debris is
served when as-received and debonded brackets, associated with frictional force during orthodontic sliding
without intraoral aging, were compared. This finding mechanics.17,18,27 Thus, the changes arising from
showed that the technique used to debond brackets intraoral exposure could explain the different behavior
did not cause a significant increase in frictional force of self-ligated brackets since their better in vitro
(P , .05; Table 1). efficiency21 has not been proven in clinical trials.22–24
The microscopic analysis of debris accumulation after The frictional force of conventional and self-ligating
intraoral exposure showed a significant increase in debris brackets increased by 0.52 N (47%) and 0.21 N
residues on both conventional and self-ligating bracket (191%), respectively, after clinical use for 8 weeks.
systems (P , .05). Moreover, self-ligating brackets This finding showed that self-ligating brackets suffered
demonstrated a doubled increase of debris amount when a higher percentage increase in friction than conven-
compared with conventional brackets (Table 2). tional brackets. On the other hand, the friction increase

Table 2. Median, Interquartile Range (IQR), and P Value (Wilcoxon Signed-Rank Test) for Debris Score in As-Received (T0) and Clinical
Exposed Brackets (T1)
As-Received (T0) Clinically Used (T1)
Median IQR Median IQR P Value
Conventional brackets 0 1 1 0 ,.05
Self-ligating brackets 0.5 1 2 1 ,.05
P value ,.05

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676 ARAÚJO, BICHARA, ARAUJO, NORMANDO

Table 3. Friction Mean, Standard Deviation (SD), and P Value (Two-Way ANOVA) for As-Received (T0) and Clinical Exposed Brackets (T2)
As-Received (T0) Clinically Used (T1)
Mean SD Mean SD P Value
Conventional brackets 1.1 0.24 1.62 0.53 ,.001
Self-ligating brackets 0.11 0.11 0.32 0.14 ,.001
P value ,.001 ,.001

was 0.31 N higher in the conventional ligated brackets intraoral exposure for 8 weeks. Accumulation of
(Table 3). debris was higher for self-ligating brackets.
Our results confirm the well-established knowledge21
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