From conventional to self-ligating bracket systems: Is it possible to aggregate the experience with the former to the use of the latter?

INTRODUCTION: Orthodontics, just as any other science, has undergone advances in technology that aim at improving treatment efficacy with a view to reducing treatment time, providing patients with comfort, and achieving the expected, yet hardly attained long-term stability. The current advances in orthodontic technology seem to represent a period of transition between conventional brackets (with elastic ligatures) and self-ligating brackets systems. Scientific evidence does not always confirm the clear clinical advantages of the self-ligating system, particularly with regard to reduced time required for alignment and leveling (a relatively simple protocol), greater comfort for patients, and higher chances of performing treatment without extractions - even though the number of extractions is more closely related to patient's facial morphological pattern, regardless of the technique of choice. Orthodontics has recently and brilliantly used bracket individualization in compensatory treatment with a view to improving treatment efficacy with lower biological costs and reduced treatment time. OBJECTIVE: This paper aims at presenting a well-defined protocol employed to produce a better treatment performance during this period of technological transition. It explores the advantages of each system, particularly with regards to reduced treatment time and increased compensatory tooth movement in adult patients. It particularly addresses compensable Class III malocclusions, comparing the system of self-ligating brackets, with which greater expansive and protrusive tooth movement (maxillary arch) is expected, with conventional brackets Capelozza Prescription III, with which maintaining the original form of the arch (mandibular arch) with as little changes as possible is key to yield the desired results.

引言：口腔正畸学（Orthodontics）同其他学科一样，历经了多项旨在提升治疗效能、缩短治疗周期、改善患者舒适度，并实现预期却往往难以达成的长期治疗稳定性的技术革新。当前正畸技术的发展正处于传统弹性结扎圈托槽（conventional brackets with elastic ligatures）与自锁托槽（self-ligating brackets）矫治系统的转型过渡期。现有科学证据尚未能完全证实自锁托槽系统具备明确的临床优势，尤其是在缩短排齐整平所需时长（一项相对简易的操作流程）、提升患者舒适度，以及提高非拔牙矫治概率等维度——尽管拔牙与否实则与患者的面部形态模式关联更为紧密，而非取决于所选用的矫治技术。近期，口腔正畸学领域已成功将个性化托槽应用于代偿性治疗，以期以更低的生物代价、更短的治疗周期提升治疗效能。研究目的：本文旨在阐述一套规范明确的矫治方案，以在这一技术转型期实现更优异的治疗效果。本方案探讨了两类矫治系统各自的优势，尤其聚焦于缩短治疗周期与提升成年患者的代偿性牙齿移动效果。本文特别针对可代偿的安氏III类错𬌗畸形（Class III malocclusions）展开对比分析：对比了可实现更显著上颌牙弓（maxillary arch）扩弓与牙齿前伸移动的自锁托槽系统，与主张尽可能维持下颌牙弓（mandibular arch）原始形态、通过最小化改动达成预期治疗目标的传统卡佩洛扎III型处方托槽（Capelozza Prescription III）系统。