A Study of the Objective and Subjective Evaluation of Three Different Bracket Prescriptions (Roth vs MBT vs Damon) Used in a Graduate Orthodontic Program

Objective: To identify the objective and/or subjective difference between three different bracket prescriptions used in the comprehensive orthodontic treatment of patients at the MUSC residency program. The ABO scoring system was utilized to classify the objective final result of cases treated. In addition, experienced orthodontists provided their expert subjective analysis of the completed cases to examine differences in the final result and determine if orthodontists can reliably determine which bracket prescription was used in each case. Secondary data examined included differences in treatment time, the number of adjustments, and the number/type of arch wires utilized. Materials and Methods: A retrospective review of 60 patient records in the permanent dentition was performed. Pre-treatment records (radiographs and casts) were used to determine the DI score and identify any exclusion criteria. Final models and panoramic radiographs of the cases selected were used in the objective ABO and subjective scoring. Treatment records were used to determine length of active treatment time, the number of adjustment appointments, and type/number of arch wires used. Results: Sixty cases non-extraction, non-surgical cases evenly distributed between the three bracket groups consisted of 66% female and 33% male with a majority of Class I malocclusions were included in the study. There was a statistically significant difference in the type but not the number of arch wires utilized in the Damon group. There was a statistically significant difference in the number of adjustment appointments but not the overall treatment time in the Damon group. Overall, there was no statistical difference in the total ABO objective score. However, there was a statistical difference in alignment, overjet, and root positioning for the cases treated with Damon and for canine occlusion in the cases treated with Roth. The categories that were statistically significant for the subjective evaluation were the lower incisor torque for the MBT group and both upper canine torque for the Damon group. Evaluators incorrectly determined which prescription was utilized in the cases 83% of the time with those treated by Roth and Damon incorrectly identified twice as often then they were correctly identified. Conclusions: The cases evaluated were all treated to clinically acceptable standards by all three bracket prescriptions. Overall, the cases did not have statistically significant differences in the total objective and subjective scores and orthodontic specialists could not identify which bracket prescription was used in the case. However, when examined closely by category significant differences were found. Most notable, the MBT group controlled lower incisor torque most effectively and the Damon group had on average facially over-torqued canines