Reflections on twelve years of breakages – lessons to be learnt

Abstract

This paper describes the nature and extent of emergencies and breakages recorded in one clinician's orthodontic practice over a 12-year period. As this long-term audit progressed the author's bonding regimen changed to reduce an initially high failure rate and then to cope with even greater bond failure rates as self-ligating brackets and self-etch primer were introduced. Overall, the bracket failure rate was reduced 61% over the 12-year period and 73% from its peak value. This was achieved by rigorous cleaning of the enamel, higher quality etchant, uncontaminated dry air, compomer to protect brackets from occlusal forces, as well as the occasional use of a Nola dry system. CPD/Clinical Relevance: All orthodontic practices need to reduce emergency appointments and breakages at routine visits. This paper, by highlighting the use of a breakage book, gives the clinician a strategy to improve both.