Impact resistance of ceramic brackets according to ophthalmic lenses standards.

The overall resistance to accidental blows of the many ceramic brackets that are sold today has not been explored. Facing a similar diversity, the eyeglasses industry has chosen to standardize the testing of lenses by subjecting them to the drop of a steel ball. By slightly modifying this test, 10 brands of ceramic brackets were examined. In most cases, the findings coincided with those found by other authors when duplicating debonding. Thus, polycrystalline ceramics with bulkier structures and glazed surfaces were found to be more resistant to impact than the monocrystalline brackets, the loftier real "twins," and the less dense attachments. Protruding tie wings and bases were liabilities, and domed configurations seemed to deflect the blows. Bulkier "single" designs alone did not offer a guarantee of impact resistance when not accompanied by an appropriate microstructure and a smooth surface. The ceramic brackets most resistant to impact were found to be 20/20 by American Orthodontics and Fascination by Dentaurum. Medium resistance was displayed by Lumina by Ormco, Allure III and Allure by GAC, Transcend 2000 and Transcend by Unitek/3M; the last was not as good as the other four. The least resistant were Illusion by Ortho-Organizers, Intrigue by Lancer Orthodontics, and Starfire TMB by "A"-Co. Probably because of its real twin design, the last bracket lends itself to the highest probability for accidental breakage. Although resistance to impact and accidental debonding is desirable from the point of view of treatment, the advantage should be weighted against the chance of enamel fracture. Indeed a weak bracket attached with a soft adhesive may be preferable when the chance of an increased exposure to accidental blows is probable. In such cases, the ceramic may take the brunt of the force, instead of the tooth.