The efficacy and effectiveness of customized CAD/CAM brackets in fixed orthodontic treatment: a systematic review and meta-analysis
Bibliographic record
Abstract
BACKGROUND: Recent advancements in computer-aided design and computer-aided manufacturing (CAD/CAM) technology have led to the development of customized brackets for personalized treatment. OBJECTIVE: Comparing customized CAD/CAM brackets for their efficacy and effectiveness in orthodontic patients using systematic review and meta-analysis of the literature. SEARCH METHODS: A comprehensive search was conducted in MEDLINE, Web of Science, EMBASE, Scopus, and Cochrane's CENTRAL up to June 2024, with no language or date restrictions. SELECTION CRITERIA: Studies that complied with PICO (population, intervention, comparison, outcome) questions were included, and the Cochrane Risk of Bias 2.0 and Newcastle-Ottawa Scale tools were used to assess the risk of bias in the included studies. DATA COLLECTION AND ANALYSIS: Using custom piloted forms, relevant data was retrieved from the included studies. Then a random-effects inverse variance meta-analysis was used to pool the results. The primary outcome was the effectiveness of orthodontic treatment measured by the American Board of Orthodontics cast-radiographic examination (ABO-CRE). Secondary outcomes were overall treatment time and mean number of appointments for CAD/CAM and conventional brackets. RESULTS: Six studies were included in our final review and meta-analysis. Based on the results of meta-analysis, no significant differences between CAD/CAM and conventional brackets for ABO-CRE score (Mean Difference (MD) = -0.49, Confidence Interval (CI)95% = -4.67, 3.68; P = .82) or number of appointments (MD = -1.88, CI95% = -5.91, 2.16; P = .36) could be found. However, significantly shorter overall treatment time for CAD/CAM brackets were reported (MD = -4.07, CI95% = -7.16, -0.99; P = .010). CONCLUSIONS: The findings of our meta-analysis indicate that both bracket types perform comparably in terms of treatment results and the number of clinical appointments required during treatment. Nevertheless, a distinct advantage of CAD/CAM brackets emerged concerning overall treatment duration. Notably, patients using CAD/CAM brackets experienced an average treatment period reduction of approximately 4 months, a clinically significant result. REGISTRATION: The protocol for this systematic review was registered at PROSPERO with the ID CRD42024605257.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.018 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.015 | 0.005 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".