Clinical Efficacy Of CAD/CAM Vs Conventional Self-Ligating Orthodontic Bracket System: A Randomised Trial

Abstract

Aim:

To evaluate the clinical effectiveness and efficiency of CAD/CAM designed custom orthodontic brackets vs. conventional pre-adjusted self-ligating brackets in patients receiving full fixed appliance treatment.

Material and Method:

This randomised trial included patients with mild to moderate crowding and require non-extraction or premolar extractions. 80 participants were allocated into two equal groups (n=40): Group A received CAD/CAM-designed customized brackets with indirect bonding and Group B received self-ligating brackets bonded directly. Total treatment time and number of visits required to complete orthodontic treatment were measured. Data were collected and analyzed using SPSS software. Normality was assessed using the Shapiro–Wilk test; intergroup comparisons used independent t-tests or Mann–Whitney U tests for continuous data, and chi-square or Fisher’s exact tests for categorical data.

Results:
Total treatment time was significantly shorter in the CAD/CAM group (18.2±3.1 months) than in the conventional group (21.7±3.8 months; p=0.001). CAD/CAM patients required fewer active visits (16.0±3.0 vs 18.5±3.5; p=0.01). There was a significant decrease in alignment and finishing duration when using CAD/CAM brackets, but space closure were similar in both groups. Final PAR scores and percentage of cases with ideal finish were not statistically significant. Bracket failure and adverse clinical events were low and statistically comparable. Patient satisfaction score was slightly higher in the CAD/CAM group than self-ligating group.

Conclusion:
CAD/CAM customized orthodontic bracket systems were highly effective in reducing total treatment time and number of appointments, whereas occlusals and bracket failure rates were similar between self-ligating and CAD/CAM systems.