Treatment outcomes, efficiency and complications of customized ceramic brackets compared with conventional fixed orthodontic appliances

To compare treatment outcomes, efficiency, and bracket-related complications between customized ceramic brackets (LightForce) and conventional appliances.

This retrospective study included 75 patients treated in a private orthodontic practice (LightForce, n = 36; conventional, n = 39). Pretreatment malocclusion severity was assessed using the American Board of Orthodontics Discrepancy Index (ABO-DI). The primary outcome, treatment outcome quality, was assessed using the American Board of Orthodontics Objective Grading System (ABO-OGS). Secondary outcomes related to treatment efficiency and bracket-related complications were assessed by treatment duration, number of scheduled and emergency visits, and bracket failures. Between-group comparisons were conducted using Wilcoxon rank-sum tests for continuous variables and Fisher's exact tests for categorical variables.

Pretreatment ABO-DI scores were comparable between groups. Total posttreatment ABO-OGS scores were similar between the LightForce and conventional groups (29.0 vs 25.0; P = .061), although marginal ridge scores were higher in the LightForce group (P < .001). LightForce treatment was completed in a shorter time (16.0 vs 19.0 months; P < .001) with fewer scheduled visits (P = .012). However, the LightForce group experienced more bracket failures and more bracket related emergency visits (both P < .001). The presence of at least one bracket failure was higher in the LightForce group (80.6% vs 43.6%; P = .002).

Customized ceramic brackets (LightForce) achieved overall treatment quality comparable to conventional fixed appliances, but with improved treatment efficiency; however, they were associated with a higher rate of bracket-related complications.