A Clinical Comparison of Failure Rates of Metallic and Ceramic Brackets: A Twelve-Month Study

Clinical comparison of the survival rates between stainless steel and ceramic brackets over a 12-month period.

The study involved 20 consecutive patients with diagnosed malocclusion that required two-arch fixed appliance treatment. The participants were randomly divided into two 10-member groups. Group 1 was treated with Abzil Agile (3M Unitek) stainless steel brackets; group 2 was treated with Radiance (American Orthodontics) monocrystalline ceramic brackets. All the brackets were bonded by the same operator. Over the next 12 months, all bracket failures were recorded with each appointment. The received data were processed statistically using the Mantel-Cox test, Kaplan-Meier method, and Cox hazard model.

A total of 381 brackets were bonded, 195 of which were metallic brackets and 186 were ceramic ones. In the 12-month observation period, there were 14 metal (7.2%) and 2 ceramic bracket (1.1%) failures. The overall failure rate was 4.2% (n = 16). The majority of failures (14 brackets; 87.5%) occurred during the first 6 months of the experiment, 12 (83%) of which were metal brackets and 2 (100%) were ceramic brackets. The statistical analysis revealed significant differences between the groups (p < 0.05).

Metal brackets demonstrated significantly higher failure rates than ceramic brackets for both 6- and 12-month observation periods (p < 0.05). The 6% difference between the brackets is clinically significant as it corresponds to one additional failure within 12 months.