Damon® Clear™ and tooth wear
Hello, your site is rich in information.
I have a question regarding the Damon® Clear™ brackets.
Is it possible to have them in the mandible?
The Damon® Clear™ system is a passive self-ligating system and it is one of the reasons among many others why I do not use this system.
A visit on the Ormco manufacturer’s site reveals that this bracket is available in the upper maxilla from one second premolar to another (UR5 to UL5) and in the mandible from canine to canine (LR3 to LL3).
The Damon® Clear2™ bracket is made of polycrystalline alumina. The company performed in vitro tests to verify wear of the polycrystalline material by comparing it to Damon® 3 and In-Ovation® C brackets. Results show that after 300 000 cycles of simulated chewing, the Damon® 3 bracket shows significant wear.
The Damon® Clear2™ and In-Ovation® C brackets do not show any signs of wear and their structural integrity was comparable after 1 year in an artificial oral environment.
What does that mean?
This means that a Damon® or In-Ovation® polycrystalline bracket is so hard that it will not wear out.
Is it a benefit or a disadvantage?
If the bracket is placed on the upper teeth, this does not cause any major problems, except when the brackets are removed. If the bracket breaks under the force applied with debonding pliers, and believe me it happens, a diamond bur needs to be used to remove the residues instead of a carbide bur. The diamond bur can remove enamel whereas it is less probable with a carbide bur.
But if the brackets are placed on the mandibular incisors and canines, they can get in contact with the tip of the upper teeth. Wear tests show that the brackets are perfectly hard. Nevertheless, tooth enamel is made of hydroxyapatite that is a lot softer than polycrystalline alumina. If one rubs on the other, the hardest will wear out the softest. Thus the ceramic brackets will wear out the opposing upper teeth.
Do you really want to take the risk of having the Damon® Clear™ brackets bonded to the lower teeth wear out the tip of your upper incisors?
Having already seen this problem at the beginning of my career, I thus banned any ceramic bracket in the mandible.