Bonded versus banded first molar attachments: a randomized controlled clinical trial

OBJECTIVE: To compare the clinical failure rates of bonded first molar tubes with those of cemented bands during fixed appliance therapy. DESIGN: Prospective randomized controlled clinical trial. SETTING: Two UK hospital orthodontic clinics, February 2001-December 2004. PARTICIPANTS: Hospital waiting list patients needing fixed appliances (n = 110). METHOD: Patients were randomly allocated to two groups. Experimental group patients (n = 55) received single first molar tubes (n = 181) bonded with a no-mix chemically cured composite (Rely-A-Bond) after a 30-second etch. Control group patients (n = 55) were treated with bands (n = 186) cemented with Intact glass ionomer cement (GIC). First-time failures were recorded together with the time of failure. All patients were followed to the end or discontinuation of treatment. RESULTS: First-time failures: bands = 18.8%; bonds = 33.7 %. Bonded tubes were more likely to fail [RR 2.4; 95% CI (1.4, 4.1)] compared with bands. Experimental group patients also had more bracket failures (P = 0.009), when analysed at patient level. CONCLUSION: First molar tubes bonded with Rely-A-Bond composite showed a significantly higher first-time failure rate than bands cemented with Intact GIC.