Prevalence and Risk Factors of Bracket Failure in Fixed Orthodontic Treatment: A Retrospective Cohort Study
DOI:
https://doi.org/10.52206/jsmc.2025.15.4.1322Abstract
Background: Bracket bond failure is one of the most frequent complications encountered during orthodontic treatment. It prolongs treatment duration, increases the number of emergency appointments, and adds to the clinical workload, thereby reducing efficiency. Identifying the prevalence and associated risk factors is essential for improving treatment outcomes and minimizing preventable failures.
Objective: To determine the frequency and factors associated with bracket failure among patients undergoing orthodontic treatment with fixed appliances.
Methodology: A retrospective cohort study was conducted on 300 patients treated at the Department of Orthodontics, Saidu College of Dentistry, Swat, between February and May 2025. A non-probability consecutive sampling technique was used. Patients aged 14–45 years, bonded with 0.022 × 0.028-inch metallic brackets using Transbond XT adhesive, and treated by postgraduate trainees or consultants were included. Data were collected from orthodontic records on age, gender, tooth position, dental arch, wire type, treatment duration, and overbite status. Statistical analysis was performed using Chi-square or Fisher’s exact tests, with significance set at p < 0.05.
Results: The mean age of the patients was 28.3 ± 8.88 years, with 51.3% males and 48.7% females. Bracket failure occurred in 33 patients (11%). Failures were significantly higher in posterior teeth (66.7%, p < 0.001), the mandibular arch (51.5%, p < 0.001), among patients using light wires (75.8%, p < 0.001), those aged 14–20 years (60.6%, p < 0.001), patients with increased overbite (48.5%, p < 0.001), and during the first six months of treatment (93.9%, p < 0.001). No significant association was observed with gender (p = 0.13).
Conclusion: The overall bracket failure rate was 11%. Failures were more likely in younger patients, posterior mandibular teeth, during early treatment with light wires, and in cases with increased overbite. These findings emphasize the importance of close monitoring and preventive strategies in high-risk groups.
Keywords: Age factors, Bond strength, Bracket failure, Orthodontic treatment, Overbite, Treatment duration, Wire type.
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