Evaluation of Bracket Positioning; A Customized System Versus the Conventional Method

To evaluate the positioning of brackets in customized and conventional bonding methods in accordance with Andrews' approach to bracket placement.

Twenty-six patients were enrolled; 11 were treated with the Insignia system and 15 with Kalange's method. Crown length was measured on a digital diagnostic model and the facial axis (FA) point was calculated. After leveling and alignment, a new digital model was created, and the bracket position was measured along the vertical axis. The distance between the bracket position and the FA point was calculated, and the deviation was determined according to Andrews' method. Teeth with significant deviation (TSD), i.e., >0.5 mm, were identified. Frequencies and percentages of TSD were calculated.

The TSD percentage was 56.65% in the Insignia group and 69.5% in the modified Kalange group; the difference between groups was significant (p=0.003). The anterior and posterior regions differed significantly within groups: in the Insignia group, this difference was observed in the maxilla (p=0.002), whereas in the modified Kalange group it was observed in both the mandible and maxilla (P < 0.001). In both groups, the anterior TSD percentage was higher than the posterior TSD percentage in both the maxilla and the mandible. The deviation was predominantly occlusal or incisal: Insignia group, 86.9%; modified Kalange group, 97.6%.

In the Insignia system and Kalange's method, brackets are positioned more incisally/occlusally relative to Andrews' FA point. In both methods, anterior brackets are positioned more incisally than posterior brackets.