Comparative analysis of passive play and torque expression in self-ligating and traditional lingual brackets

Introduction: The aim of this study was to determine and compare the play and torque expression of self-ligating and conventionally ligated lingual brackets, with square and rectangular slots, when engaged with archwires of different size, cross section and material. Methods: Passive play and torque expression of 3 types of archwires and 5 types of brackets from four different manufacturers were measured and compared using a dynamometer. Each archwire was tested five times in each bracket; passive play was compared to ideal values, while torque expression was tested at 5, 10 and 20 Nmm as clinically efficacious values. Results: Regarding full thickness stainless steel archwires, the lowest passive play was found in STb brackets (2.66 ± 0.89°, Ormco, Glendora, CA, USA), which was statistically significantly lower than for ALIAS brackets (4.44 ± 0.75°, Ormco), In-Ovation L brackets (6.14 ± 3.22°, Dentsply GAC, Bohemia, NY, USA), Harmony brackets (7.76 ± 2.94°, American Orthodontics, Sheboygan, WI, USA) and eBrace brackets (9.46 ± 3.94°, Riton Biomaterial, Guangzhou, China). Increasing the torsional load to the greatest torsional load clinically applicable, there were no statistically significant differences between STb, ALIAS, In-Ovation L and Harmony brackets. Conclusions: STb and ALIAS brackets generated the lowest passive play; STb and In-Ovation L brackets showed the lowest angle of play at the greatest torque expression. These measurements allow to understand the accuracy of lingual systems and at the same time the amount of overcorrections to be applied in the setup in order to obtain high quality orthodontic treatments.