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Orthodontics with Customized versus Noncustomized Appliances: A Randomized Controlled Clinical Trial.

E W Penning¹, R H J Peerlings², J D M Govers³

¹1 Department of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, the Netherlands.

Journal of Dental Research

|July 26, 2017

Summary

This study found no significant difference in orthodontic treatment duration or outcome quality between customized and noncustomized fixed appliance systems. Orthodontist experience and initial treatment complexity impacted results more than appliance type.

Keywords:

clinical outcomes comparative effectiveness research (CER)orthodontic tooth movement outcomes research patient outcomes

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Area of Science:

Orthodontics
Biomaterials Science
Clinical Trials

Background:

Customized fixed appliance systems aim to improve orthodontic treatment efficiency and outcomes.
However, evidence comparing their effectiveness against traditional noncustomized systems is limited.
This study addresses the need for comparative data on treatment duration and quality.

Purpose of the Study:

To evaluate and compare the duration and quality of orthodontic treatment outcomes between a customized fixed appliance system and a noncustomized system.
To test the hypothesis that customized systems lead to significantly shorter treatment durations.

Main Methods:

A randomized controlled trial involving 180 patients comparing the Insignia customized system with the Damon Q noncustomized system.
Treatment outcomes were assessed using the Peer Assessment Rating (PAR) score from plaster casts.
Data collected included planning time, treatment duration, loose brackets, visits, and patient complaints.

Main Results:

No significant differences were found in treatment duration (1.29 vs. 1.24 years) or posttreatment PAR scores between the customized and noncustomized groups.
Orthodontist experience and initial treatment complexity (higher pretreatment PAR score) significantly influenced treatment duration, outcome quality, and visit frequency.
The customized group experienced more loose brackets, longer planning times, and more complaints.

Conclusions:

The customized orthodontic system did not demonstrate a significant reduction in treatment duration compared to the noncustomized system.
Treatment quality was comparable between the two systems, with individual orthodontist factors and initial case severity playing a more significant role.
Further research may be needed to identify specific patient populations or clinical scenarios where customized systems offer advantages.