Bracket Positioning Techniques and Quality of Orthodontic Finishing

NCT07708363 | Completed

• 1 other identifier: FUE.REC(42)/10-2024
• Study Type: interventional
• Target: 39
• Locations: 1 country
• Sites: 1

Brief Summary

This three-arm randomized clinical trial compares three orthodontic bracket positioning techniques - Smile Arc Protection (SAP), Smile Arc and Marginal Ridge Approach (SAMRA), and the McLaughlin-Bennett-Trevisi (MBT) bracket placement chart (control) - in young patients with Angle Class I malocclusion and mild-to-moderate crowding treated non-extraction. The primary aim is to determine which technique yields the highest quality of orthodontic finishing, measured with the American Board of Orthodontics Objective Grading System (ABO-OGS). Secondary aims compare anterior tooth tip and torque (assessed by CBCT) and mini-esthetic smile parameters (gingival display, incisal display, buccal corridor, and smile arc, assessed on standardized posed-smile photographs) among the three techniques.

Conditions

Malocclusion, Angle Class I; Dental Crowding

Keywords

Bracket positioning; Smile arc; Indirect bonding; ABO Objective Grading System; Mini-esthetics; Tip and torque; Orthodontic finishing

Outcome Measures

Primary Outcomes (1)

• Quality of orthodontic finishing - ABO Objective Grading System (ABO-OGS) total score

  Total ABO-OGS score obtained on the Cast-Radiographic Evaluation (CRE) form. Seven parameters - alignment/rotations, marginal ridges, buccolingual inclination, occlusal contacts, occlusal relationships, overjet, and interproximal contacts - are scored on 3D-printed casts with the ABO measuring gauge; root angulation is scored on the panoramic radiograph. Point deductions are summed to give the total score (a lower total indicates better finishing).

  At completion of the levelling and alignment phase (T₁), after the 0.017 in × 0.025 in stainless steel arch wire has been maintained for 3 months - approximately 7 months after bonding.

Secondary Outcomes (6)

• Anterior crown angulation (tip) - CBCT

  Change from before bonding (T₀) to end of levelling and alignment (T₁), approximately 7 months after bonding

• Anterior crown inclination (torque) - CBCT

  Change from before bonding (T₀) to end of levelling and alignment (T₁), approximately 7 months after bonding

• Maxillary gingival display

  Change from before bonding (T₀) to end of levelling and alignment (T₁), approximately 7 months after bonding

• Maxillary incisal display

  Change from before bonding (T₀) to end of levelling and alignment (T₁), approximately 7 months after bonding

• Buccal corridor width

  Change from before bonding (T₀) to end of levelling and alignment (T₁), approximately 7 months after bonding

Study Arms (3)

Group SAP

EXPERIMENTAL

Bracket positioning by the Smile Arc Protection technique (anterior brackets placed relatively more gingival, referenced to canine crown height).

Procedure: Smile Arc Protection (SAP) bracket positioning

Group SAMRA

EXPERIMENTAL

Bracket positioning by the Smile Arc and Marginal Ridge Approach (digital workflow referencing the marginal-ridge line and facial axis).

Procedure: Smile Arc and Marginal Ridge Approach (SAMRA) bracket positioning; Procedure

Group MBT (Control)

ACTIVE COMPARATOR

Bracket positioning by the McLaughlin-Bennett-Trevisi bracket placement chart (bracket-to-incisal-edge distances from the standardized chart).

Procedure: McLaughlin-Bennett-Trevisi (MBT) chart bracket positioning

Interventions

Smile Arc Protection (SAP) bracket positioning PROCEDURE

Bracket positioning by the Smile Arc Protection technique (anterior brackets placed relatively more gingival, referenced to canine crown height).

Group SAP

Smile Arc and Marginal Ridge Approach (SAMRA) bracket positioning; Procedure PROCEDURE

Bracket positioning by the Smile Arc and Marginal Ridge Approach (digital workflow referencing the marginal-ridge line and facial axis).

Group SAMRA

McLaughlin-Bennett-Trevisi (MBT) chart bracket positioning PROCEDURE

Bracket positioning by the McLaughlin-Bennett-Trevisi bracket placement chart (bracket-to-incisal-edge distances from the standardized chart).

Group MBT (Control)

Eligibility Criteria

• Age: 14 Years - 25 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Males and females aged 14-25 years with a full permanent dentition.
• Mild to moderate crowding requiring non-extraction orthodontic treatment (2-6 mm per Graber's classification).
• Angle Class I malocclusion.
• Normal skeletal vertical dimension (SN-MP angle 32° ± 5°).

You may not qualify if:

• \. Medication that may cause gingival inflammation (e.g., cyclosporine, phenytoin).
• \. Impacted, extracted, or missing permanent teeth (except third molars). 3. Periodontal disease or parafunctional habits (bruxism, tongue thrusting, mouth breathing).
• \. History of previous orthodontic treatment. 5. Craniofacial anomalies, facial asymmetry, or skeletal discrepancy.

Sponsors & Collaborators

• Future University in Egypt: lead

Study Sites (1)

Department of Orthodontics, Faculty of Oral and Dental Medicine, Future University in Egypt, Cairo, Egypt

New Cairo, Cairo Governorate, 11835, Egypt

Location

MeSH Terms

Conditions

Malocclusion, Angle Class I; Crowding

Condition Hierarchy (Ancestors)

Malocclusion; Tooth Diseases; Stomatognathic Diseases; Spatial Behavior; Behavior

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Dr.

Study Record Dates

• First Submitted: July 7, 2026
• First Posted: July 16, 2026
• Study Start: July 1, 2024
• Primary Completion: July 1, 2026
• Study Completion: July 1, 2026
• Last Updated: July 16, 2026

Record last verified: 2026-07

Locations

EG (1)