Do you do Damon^®? What is the current evidence base underlying the philosophy of this appliance system?

Abstract

Self-ligating bracket systems are increasing in popularity amongst orthodontists. This reflects their high quality engineering, improved reliability and relative ease of use. However, it might also be related to claims of superior function made by the manufacturers of these appliances. In particular, the Damon(®) appliance system claims to offer significant advantages to both orthodontist and patient over conventional-ligation and other forms of self-ligated appliances. We have reviewed current literature relating to use of the Damon(®) appliance system. There is some evidence to suggest this appliance may lead to reductions in chairside time for the orthodontist, particularly those experienced with this system, in comparison to conventional-ligation. However, evidence that pain experience is reduced for the patient when using Damon(®) brackets is not conclusive. In the presence of identical archwire sequences, there is no evidence that Damon(®) brackets can align teeth faster or in a qualitatively differently manner, when compared with conventional-ligation. There is no high quality evidence that treatment with the Damon(®) appliance takes place more rapidly or leads to a superior occlusal or aesthetic result. Indeed, the best available evidence would suggest there is no difference in treatment outcome or time, at least in extraction cases. There is no evidence that treatment with the Damon(®) appliance is more stable. Claims relating to improved clinical performance of the Damon(®) appliance system are currently being made to orthodontists and patients that are not substantiated in the scientific literature.

A prospective randomized split-mouth study on pain experience during chairside archwire manipulation in self-ligating and conventional brackets

“…In regards to individual differences in the perception of pain, 8,9 the present study used a split-mouth design to investigate patient discomfort during chairside archwire manipulation in self-ligating and conventional brackets. Regardless of archwire type, the patients only rated disengagement as being significantly more painful on the side bonded with self-ligating brackets, whereas engagement and disengagement of rectangular SS, TMA, and CoCr archwires caused more pain on the self-ligating bracket side.…”

“…Two prospective, randomized clinical trials showed either significantly lower maximum and mean pain intensities 6 or no differences 7 for the same type of self-ligating bracket compared with a conventional bracket. Individual variation and subjectivity in pain experience 8,9 may explain inconsistent findings in the literature, especially when bracket systems are compared across different patients.…”

Are self-ligating brackets an advantageous alternative for non-extraction treatments?

“…The research findings failed to prove that self-ligating brackets caused less pain than conventional brackets 3,9,40 .…”

“…There is no evidence that teeth align faster or in a different manner with Damon self-ligating brackets 40 .…”

“…If the length of treatment time is identical, there is in fact some clinical timesavings with Damon Ò self-ligating brackets but only when used by experienced practitioners 40 .…”