The Application Of Self-Ligated Bracket Appliance In The Adult Malocclusion Deformity Correction

Objective: To investigate the clinical effect of self-ligating bracket in the adultmalocclusion deformity correction.Methods: A case of24years old female patient admitted to Dalian Dr. DentalClinic in2010.Clinical findings revealed the convex facial profile, dental fluorosis,maxillary4-4repaired with labial resin veneer, malformed upper and lower posteriorteeth, metal crown on left mandibular first and second molar, bilateral mesial molar andcanine relationship, severe anterior proclination, incompetent lips, reduced overbitewith localized openbite in the maxillary right central incisor,5mm overjet, congenitallyabsent mandibular central incisor, midline shift,8mm maxillary crowding andmandibular crowding of10mm..The Damon-3MX self-ligating bracket was used with the super bond adhesive forbonding.The treatment was carried out by extracting all the first premolars, additionalenhanced anchorage device was not used and the extraction spaces were closed bysliding. Patient’s pre and post treatment models, cephalometric X-ray films, the toothaxis changes, overbite and overjet of anterior teeth,soft tissue profile changes wereassesed.Results: The treatment duration was18months. Dentition was properly aligned,gaps were closed, anterior overbite and overjet was corrected and molar relationshipwas completely mesial. The cephalometry reveals no significant changes in the SNAwhile SNB decreases slightly, ANB and mandibular plane angle is slightly increased,U1-SN, U1-NA, U1-NA, L1-NB, the L1-NB were significantly reduced, U1-L1°,NLAincreased, the tooth axis were corrected; the FCA, ULP, LLP reduced, soft tissueprofile was improved.the initial levelling stage took five months,closing stage took sixmonths time and finishing adjustment stage took7months (tooth moves faster than theconventional straight wire fixed appliances). The total number of appointment is12 which is less than what is required for the conventional treatment. After eachappointment while increasing the force, the patient basically has no pain and only milddiscomfort ocassionally as compared to the traditional ligation appliance. As ligaturewire or elastic module is not used, the bracket surroundings is easy to clean thus oralhygiene is better with healthy gingiva.Conclusion:1. Self--ligated bracket provides continuous light force for the correction of adultmalocculsion with an advantage of long intervals in the appointments.2. The self--ligated brackets use a low-friction system,giving small force to theanchorage tooth and minimize the loss of anchorage.3. Light force of self--ligated brackets reduces patient’s discomfort or pain and isgood for the health of the periodontal tissue.