Predictors of Bracket Bond Failure among Orthodontic Patients undergoing Fixed Orthodontic Treatment in Lagos, Nigeria
Keywords:
Orthodontics, Bond failure, Brackets, Fixed appliances, Orthodontic patientsAbstract
Background: Bracket bond failure is a common complication of fixed orthodontic treatment and can prolong treatment duration and increase patient burden. Reported bond failure rates vary widely, and the relative contribution of patient- and treatment-related factors remains inconsistent across studies.
Objective: This audit aimed to identify predictors of bracket bond failure, with particular emphasis on age-related differences and treatment variables, including bracket system and treatment duration.
Methods: A retrospective audit was conducted of 103 patients who completed fixed appliance therapy over a three-year period. Demographic data and treatment characteristics were extracted from clinical records. Bracket failures were defined as debonding events requiring rebonding. Patients were classified into low (<2) and high (?2) failure groups. Statistical analyses included bivariate tests and multivariable logistic regression to identify independent predictors of failure.
Results: The mean patient age was 24.7 ± 9.9 years, with adolescents comprising 30.1% of the cohort. Overall, 81.6% of patients experienced at least one bond failure, and 75.7% sustained two or more failures. The mean failure rate was 0.2 ± 0.2 per treatment month. Age category was significantly associated with failure, with adolescents experiencing proportionally more failures than adults. Gender, bracket system, and dental anomalies were not significantly associated with failure occurrence or burden. Treatment duration was not associated with overall failure occurrence; however, in multivariable analysis, longer treatment duration was a modest but significant predictor of high failure risk, with each additional month increasing the odds by 7% (OR 1.07, p = 0.028).
Conclusion: Bracket bond failure was frequent in this cohort. Age category and treatment duration were the most relevant predictors, while bracket system and gender showed no independent effects. These findings highlight the importance of patient-related factors and prolonged treatment exposure in managing bond failure risk.
