Increased buccolingual dimension of maxillary second premolar bracket : Is it necessary ?

Introduction : Small-sized maxillary second premolars pose a challenge for the orthodontist with regards to alignment of the contact point with the maxillary first molar. To overcome this discrepancy, Dentaurum Discovery Smart brackets have been developed with thicker buccopalatal dimension.
Aim of the study : The aim of this study was to compare between two bracket systems (Dentaurum Discovery Smart) and conventional (American Orthodontics/Ormco) brackets regarding the effect of differential in-out buccopalatal thickness on the alignment of the contact points of maxillary premolars and molars as well as bond failure rate.
Materials and Methods : This prospective study consisted of 24 patients with an age range of 20-30 years old and a mean age of 24.5 years selected from a private practice in Cairo, Egypt.
The patients had full permanent dentition and were non-syndromic with no previous orthodontic treatment. At least one maxillary second premolar had a reduced buccopalatal dimension. The patients were randomly divided into two groups, each group containing 12 patients. Group 1 were treated with Discovery smart Dentaurum brackets and Group 2 were treated with American Orthodontics /Ormco mini diamond brackets. Treatment was continued with fixed appliances for 2 years until rectangular stainless steel wires were reached.
Results : There was a statistically significant difference between Group 1 and Group 2 regarding proximal contact point discrepancy (P<0.05) with 50% of Group 2 having at least 0.5 mm buccal contact point discrepancy between upper second premolar and upper permanent first molar. No contact point discrepancy was observed for Group 1 (0%). However bond failure rate was significantly higher in Group 1 (80%) compared to (20%) in Group 2.
Conclusions : The Dentaurum Discovery Smart brackets are highly effective in achieving adequate buccopalatal alignment of small sized maxillary second premolars with maxillary first premolars and permanent first molars. However they have the drawback of frequent bond failures due to their thicker buccopalatal dimension.