![]() In addition to the occurrence of WSLs, apical external root resorption is a much feared side-effect of fixed orthodontic therapy which, based on meta-analyses, is well known to increase significantly in both severity and frequency, the longer MB treatment duration is. ![]() However, also a certain percentage of subjects achieving an adequate standard of daily oral hygiene are prone to develop enamel decalcifications with increasing treatment duration. Inadequate oral hygiene during MB is known to promote the formation of white-spot lesions (WSLs). Nonetheless, patient compliance is needed to avoid the problem of enamel decalcification and incipient caries. Multi-bracket treatment (MB) is considered to be the most rational orthodontic treatment approach, as it enables the correction of tooth position three-dimensionally, with a minimum or often even no need for patient compliance in order to achieve good occlusions. Consequently, subjects treated with the WIN appliance are expected to be exposed to lower risks of the typical side-effects associated with longer multi-bracket treatment durations, such as root resorption and enamel decalcification. In terms of treatment duration, the WIN appliance performed significantly better than the Incognito appliance. Therefore, the null-hypothesis was rejected. ANOVA revealed a significant influence of the main effects ‘appliance type’, and ‘severity’, independent of each other. Overall, mean treatment duration was 21.7 (SD 7.2) months, which was significantly shorter for WIN for both sub-groups of treatment complexity (S1: 17.96 mo S2: 20.49 mo) compared to Incognito (S1: 22.7 mo S2: 29.79 mo). We used four-factorial ANOVA to assess the impact of the following factors: initial degree of severity of malocclusion (mild to moderate, S1 severe, S2), appliance type (Incognito WIN), sex, and age group (16 Y) on the duration of lingual multi-bracket treatment. Of 402 potentially eligible participants, a population sample of n = 376 subjects (n Incognito = 220 n WIN = 156 m/f 172/204 mean age ± SD 17.3 ± 7.7Y) treated in one orthodontic center (Bad Essen, Germany) with completely customized lingual appliances in upper and lower permanent dental arches was recruited with the inclusion criterion of initiated and completed lingual multi-bracket treatment within the assessment period of April 1st 2010 – Nov 30, 2013, and the exclusion criterion of less than 24 bracketed teeth. ![]() The null-hypothesis was that there would be no significant difference in active orthodontic treatment duration between them. ![]() The aim of this non-randomized clinical trial was to compare treatment duration with each of two types of customized lingual orthodontic appliances (Incognito, 3 M-Unitek WIN, DW LingualSystems), taking into account treatment complexity. Multi-bracket treatment should be as short as possible, in order to minimize the risks of collateral damage to teeth. The occurrence of side-effects of fixed orthodontic therapy, such as white-spot lesions and root resorption, are known to be significantly more frequent with increasing duration of treatment. ![]()
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