INTRODUCTION

Orthodontic brackets are a crucial element of fixed orthodontic appliances, and there is a wide
range of bracket brands available, each with their own unique features such as wings, slots,
ligation mechanisms, and prescriptions of first, second, and third order. These brackets are
available in two sizes, either 0.018 inch or 0.022 inch, based on individual preference.
There have been numerous advancements in the sizes of orthodontic bracket slots over the years.
Currently, the two most widely used sizes in clinical practice are the 0.022” and 0.018” slots.
The 0.022” slot bracket was initially introduced for gold wires, which could be used either
singularly or in an intertwined configuration.1
It is important to mention that manufacturers rarely disclose the tolerances of bracket slot
dimensions, and variations may exist in all manufacturing techniques. Different machining
processes can result in varying irregularities. For example, the dimensions of MIM brackets are
highly prone to error due to volume changes during the heat treatment of the material.2
Upon evaluating orthodontic brackets, notable differences in bracket finish and slot geometry
were observed among different bracket groups. Practitioners ought to be cognizant that the
utilization of excessively large slot brackets may culminate in the forfeit of tooth positioning in
three dimensions. Previous studies that investigated bracket shape and slot dimensions had
certain limitations such as small sample sizes or examination of only one specific tooth bracket
from a series of brackets, such as the upper left central. Such limitations may not offer a
complete representation of all individual tooth brackets in the series, and therefore, further
research is warranted to address this knowledge gap3
Cash and colleagues1 conducted a research study on 11 different series of brackets, from six
manufacturers, focusing on five 0.022” maxillary left central incisors brackets. Their research
revealed that all brackets exhibited a varying degree in convergence of slot wall, ranging from
5% to 24%. Out of the systems that were examined, four had slot walls that were parallel, while
five showed slot walls that converged from the bottom to the top of the slot, and two had slot
walls that diverged. Similarly, Kusy and Whitley 4 analyzed 24 different bracket sets from eight
manufacturers. Their findings indicated that 15% of bracket slot sizes measured were smaller
than the labeled value, while increased slot size than the normal value by as much as 16% and
8% for nominal 18 and 22 slots, respectively.
In a study by Bhalla et al.5, five self-ligating 0.022” brackets from the upper left central region
were measured from each of six different bracket series representing four manufacturers. The
authors reported that the brackets varied between 5% to 15% more than the mean values, and the
walls of the slots diverged from the base to the top of all the brackets. In addition, brackets from
the same manufacturer also displayed variations in size.

1
The variances in orthodontic bracket slot profiles carry substantial implications for the
expression of third-order torque and torque play. Thus, manufacturers must furnish data on the
actual play in torque of the standard slot wire systems to allow operators to assess the efficacy of
applied torque.6
The variance observed between the anticipated and actual torque loss is attributed to the
manufacturing methodologies employed for both brackets and wires. The manufacturing of
brackets introduces grooves, metal particles and striations, which may hinder the wire from fully
engaging the walls of the slot, thereby compromising the efficacy of applied torque.7
Previous studies have demonstrated that there are variations between the stated dimensions of
bracket slots and their actual measurements, with certain brands demonstrating an oversized slot
size of up to 27%5,8,9
Due to manufacturing tolerances, the slot heights of 0.018 inches and 0.022 inches for
orthodontic brackets vary within a range of 0.0182 to 0.0192 inches and 0.0220 to 0.0230 inches,
respectively. This gives rise to a specific level of play for full-sized arch wires, although this
tolerance level also guarantees the consistent ease of insertion and removal of the arch wires 9
Errors in the bracket slots dimensions can result in the undesirable effect of lingual tipping of the
incisors during posterior teeth protraction, particularly when relying on moments generated by
rectangular archwires at the anterior brackets. Such outcomes are highly unsatisfactory, and their
severity amplifies when the archwires are smaller than their prescribed sizes.10
Although brackets are commonly used in orthodontic procedures, there is a scarcity of scientific
research on the allowable variances in bracket slot dimensions. The precision of slot sizes
assumes critical importance in the context of preadjusted appliances. Consequently, the
manufacture of brackets and tubes for edgewise appliances must be executed with utmost
precision to guarantee that the slot dimensions are accurate, with a minimum accuracy level of 1
mil (equivalent to 0.001 inches)11
During the past twenty years, there has been a notable increase in the manufacture and
introduction of self-ligating orthodontic appliances that provide either passive or active ligation
modes. These appliances are gaining increasing attention due to their time-efficient ligation
mode and potential ability to modify the load and moment expression during mechanotherapy.
Although some of these systems have demonstrated lower friction levels in vitro, their ability to
control torque remains uncertain 15
Passive self-ligating orthodontic brackets (PSL) are designed to be manufactured precisely
according to the manufacturer's specifications. The reason for this is that any discrepancies in the
machining of a bracket's slot dimensions can exert a significant impact on the positioning of
teeth in three dimensions. The influence of the ligation and the nature of the self-ligating
mechanism, whether passive or active, on the effective transmission of torque is minimal, in
comparison to the significant role played by the slot dimensions.16
Additional research is required on bracket slot size and built-in torque, as highlighted by A.
Matthew et al.'s 2020 study that examined MBT prescription brackets from multiple

2
manufacturers. So this study aimed to investigate and compare the slot dimensions and in built
torque of entire series of self-ligating brackets (passive) from five commercially available
manufacturers i.e 3M Unitek, Ormco, Ortho Organizers, JJ Orthodontics, Modern Orthodontics
and provide descriptive statistics of their measurements.
MATERIALS AND METHODS

This was a single-center, single-operator, cross-sectional analytical study that prospectively

evaluated and compared the bracket slot dimensions and built-in torque of a complete set of self-
ligating brackets from five different commercially available brands. The study was conducted in
vitro and did not involve any pharmacological interventions. It focused on self-ligating brackets
with a slot dimension of 0.022” x 0.028” from the selected companies The study design was
approved by the board members of the Institutional Ethical Committee and initiated after
obtaining the clearance.

Samples:

Self-ligating bracket series with 0.022-inch slot from the following companies:

1) Group 1 – Gemini SLTM 0.022″ × 0.028″ * (Fig.1)

2) Group 2 - Damon QTM 0.022″ × 0.028″ ** (Fig.2)

3) Group 3 - Carriere SLXTM 0.022″ × 0.028″ *** (Fig.3)

4) Group 4 - Selfy passive SLTM 0.022″ × 0.028″ # (Fig.4)

5) Group 5 - At Ease passive SLTM 0.022″ × 0.028″ # (Fig.5)

* 3MTM UnitekTM Monrovia, California, USA.

** OrmcoTM Brea, California, USA.

*** OrthoorganizerTM Carlsbad, CA, USA.

# JJ OrthodonticsTM Chalakudy, Kerela, India.

## Modern OrthodonticsTM Ludhiana, India.

3
AREA OF INTEREST

Measurements were taken at the following levels

1. Bracket slot dimensions: A) At base

B) At face (Fig. 14, 15)

2. In built torque (Fig. 13, 16)

CRITERIA FOR SAMPLE SELECTION:

INCLUSION CRITERIA:

1. New unused set of brackets.

2. Brackets obtained directly from the manufacturer.

3. Non recycled brackets.

4. Sharp well focused digital images.

EXCLUSION CRITERIA:

1. Unsealed packet of brackets.

2. Recycled brackets

4
 3. Blurry digital images.

Armamentarium

1. Stereomicroscope (ALCO 0745T Range/Capacity- 10x -450x) (Fig. 6)

2. Measuring software (QuickPHOTO MICRO 3.2) (Fig. 7, 13, 14)

3. Bracket holding tweezer (Orthodontic Supplies Ltd.) (Fig. 8)

4. Modeling wax (Dental Products of India) (Fig.9)

5. Slot opening tool. (Fig. 10)

Method:

The study utilized unused and sealed packets of 0.022" x 0.028" self-ligating brackets from five
distinct manufacturers. Brackets were randomly selected from each group and mounted onto a
stereomicroscope slide in a vertical profile view using strips of wax. (Fig. 11)

The slide was mounted on the microscope (ALCO 0745T Range/Capacity- 10x -450x) and
adjusted such that the line of view from the microscope was parallel to the slot axis. Each bracket
was zoomed in on at a magnification of 20x such that a sharp, clear image was viewed on the
screen and captured individually in the stereomicroscope to produce a digital image. (Fig. 12)

The images were then transferred and calibrated with QuickPHOTO MICRO 3.2 software. (Fig.
13, Fig 14) The software used was accurate up to a least count of 1 micron or up to 5 decimals in
inches.

The slot dimension was calculated by marking two points on base of the slot B1, B2 and drawing
a line joining the two points, followed by marking two points on the face of the slot, F1, F2
which were then joined similarly. The linear distance of the lines drawn were then measured
using the software. (Fig. 15)

5
In order to obtain torque measurements, two points were marked at the base of bracket B1 and
B2, along with two points on the base of slots C1 and C2 in the images. Subsequently, line B and
line C were formed by connecting points B1 and B2, and C1 and C2, respectively. These lines
were then extended to intersect, and the angle between them was used to determine the torque
value. (Fig. 16)

The collected data was utilized to evaluate discrepancies in slot dimensions and built-in torque
both within and between the series.

RESULTS

Statistical analysis was conducted using the SPSS software package (version 20.0) for Microsoft
Windows. One-way analysis of variance (ANOVA) and post-hoc Tukey's test were utilized for
statistical analysis. A p-value of .05 or lower was regarded as statistically significant, while a p-
value equal to or less than .01 was deemed highly significant.

ANOVA showed a significant difference (p < .05) in the bracket slot sizes of all the
manufacturers and this difference was present at the base as well as the face. Since a significant
difference was found, one to one comparison was done between the values using post-hoc
Tukey’s test for groupwise comparisons.

One-way ANOVA test revealed a significant statistical difference (p<0.05) between the five
groups concerning both the base and face dimensions. (Table 2, Table 6)

The Post-hoc Tukey's test yielded statistically significant outcomes when comparing the slot
dimensions at the base across different groups, as shown in Table 3. The slot sizes varied among

6
the brackets, ranging from a minimum of 0.023" at the base of 3M Unitek brackets to a
maximum of 0.026" on the face of Modern Orthodontics brackets.

Means & standard deviations of measured in-built torque values of preadjusted edgewise bracket
groups tabulated in Table:9 show that all values are lesser than those claimed by the
manufacturer with all brackets showing a variation of 5-7% from the standard value.

The independent t-test for intra-group comparison of slot dimensions at the base between Series
A and B of Group 1, Series A and B of Group 4, and Series A and B of Group 5 revealed a
significant difference statistically (p<0.05). (Table:4)

Inferential statistics for intergroup and intra group comparison by ANOVA for slot dimension at
base show significant values for both inter and intra group comparisons from ANOVA for slot
dimensions at face (Table:8)

Means and standard deviations of measured in-built torque values of preadjusted edgewise
bracket groups tabulated in Table 9 show that all values are lesser than those claimed by the
manufacturer with all brackets showing a variation of approximately 1 to 24% from the standard
value.

7
 DISCUSSION

The advent of Andrews' straight wire philosophy during the 1970s was a revolutionary
breakthrough in orthodontics. Despite the advancements in orthodontic techniques, preadjusted
edgewise appliances with standard size, siamese, stainless steel brackets that are conventionally
ligated are still widely used by orthodontists worldwide.

However, using brackets with oversized slots can have negative effects on anterior torque loss, as
demonstrated by Siatkowski10. When these appliances are used for protracting posterior
segments during space closure, unexpected torque loss in upper and lower incisors can occur.
During space-closing protraction, a loss of torque in the anterior teeth can lead to a backward
movement of the incisal edges by around 1.9 mm, with the torque loss ranging from 5 to 10
degrees.

The process of manufacture is a significant determinant of the slot dimensions and built-in torque
precision of brackets. Metal Injection Moulding (MIM) is presently the most commonly utilized
method for manufacturing bracket bodies. This is because milling or machining and investment
casting are less prevalent due to their longer production cycles and lower cost-effectiveness.

According to Gioka and Eliades'7 systematic review, the slot surfaces of brackets exhibited
striations and microstructural defects, which appear to be a result of milling techniques and may
prevent complete wire insertion in the slot of the bracket due to the rough surface produced.
Molding could also contribute to this problem.

Subsequent research could investigate the effects of varying bracket alloys, debinding
techniques, and sintering parameters on the precision of orthodontic bracket slot size and built-in
torque. The present study's objective was to assess the slot dimensions and built-in torque of five

8
distinct brands of orthodontic brackets, namely 3M Unitek, Ormco, Ortho Organizer, JJ
Orthodontics, and Modern Orthodontics.

The study analyzed a total of 200 brackets, with 40 brackets from each manufacturer. The
measured slot dimensions were assessed using ANOVA and post hoc analysis. This study is
distinctive in comparing self-ligating brackets from five different brands, which is a criterion that
has not been explored in many studies.

The study findings indicate that the measured slot heights of the brackets were greater than the
intended size, and a significant difference was observed in the slot size of JJ Orthodontics &
Ortho Organizer brackets when compared to the ideal slot size of 0.022". The cause of this
difference may be attributed to manufacturing errors.

In addition, a comparison between the nominal prescription values and the torque values
measured revealed that JJ Orthodontics & Modern Orthodontics brackets had significantly lower
torque values than the prescribed values

CONCLUSION

The study's conclusions are:

 The ideal value for slot dimensions at base and at face are 0.022”. However, in the
present study, the mean values of the slot dimensions at base and face was found to be
0.02514±0.000746 and 0.02514±0.000775 respectively.

 Slot dimension values at base and at face were found to be coinciding except in Group 3
where the mean value at face was found to be higher than at base, indicating divergence
in slot profile.

 In all groups, the slot dimensions at the base and face were found to exceed the
manufacturer's stated standards with the maximum variation seen in Group 3 (Otho
Organizer) (11-12%) followed by Group 5 (Modern Orthodontics) (11.7%), Group 4 (JJ
Orthodontics) (11.5%), Group 2 (Ormco) & the least variation in Group 1 (3M Unitek)
(10%)

9
  On analysis of in-built torque, all brackets were found to have lesser values of torque
than those declared by the manufacturer, with all the brackets showing a variation of
approximately 1 to 24% from the standard values.

 The maximum variation in built in torque was seen in group 5 (Modern Orthodontics)
(24%) followed by Group 3 (Ortho organizer) (18%), Group 4 (JJ Orthdontics) (15%),
Group 1 (3M Unitek) (13%) & the least variation in Group 2 (Ormco) (1%)

REFERENCES:

1. Cash AC, Good SA, Curtis RV, McDonald F. An evaluation of slot size in orthodontic
brackets—are standards as expected? Angle Orthod. 2004 Aug;74(4):450-3.

2. Park JS, Song IT, Bae JH, Gil SM, Kang KH. Comparison of slot sizes and parallelism of
metal brackets manufactured through metal injection molding and computerized numerical
control. Korean J. Orthod.2020 Nov 25;50(6):401-6.

3. Brown P, Wagner W, Choi H. Orthodontic bracket slot dimensions as measured from entire
bracket series. Angle Orthod. 2014 Sep 29;85(4):678-82.

10
4. Kusy RP, Whitley JQ. Assessment of second-order clearances between orthodontic
archwires and bracket slots via the critical contact angle for binding. Angle Orthod.
1999;69(1):71–80.
5. Bhalla NB, Good SA, McDonald F, Sherriff M, Cash AC. Assessment of slot sizes in self-
ligating brackets using electron microscopy. Aust. Orthod. J. 2010 May;26(1):38.

6. Fischer-Brandies H, Orthuber W, Es-Souni M, Meyer S. Torque transmission between

square wire and bracket as a function of measurement, form and hardness parameters. J
Orofac Orthop 2000;61(4):258–65.

7. Gioka C, Eliades T. Materials-induced variation in the torque expression of preadjusted

appliances. Am J Orthod Dentofacial Orthop. 2004;125(3):323–328.

8. Meling TR, Ødegaard J, Seqner D. On bracket slot height: a methodologic study. Am J

Orthod Dentofacial Orthop. 1998;113(4):387– 93.

9. Creekmore TD, Kunik RL. Straight wire: the next generation. Am J Orthod Dentofacial
Orthop. 1993;104(1):8–20.

10. Siatkowski RE. Loss of anterior torque control due to variations in bracket slot and
archwire dimensions. J Clin Orthod 1999;33(9):508–10.

11. Proffit W. Contemporary Orthodontics. 4th ed. St. Louis, Mo:Mosby Elsevier; 2007.

12. Bennett J. Fundamentals of Orthodontic Treatment Mechanics. 1st ed. London,

UK:LeGrande Publishing; 2014.

13. Tangri K, Kumar P, Sharma P, Kumar K, Bagga DK, Sharma R. A Comparison of the
Accuracy of 0.022 Slots at Face, Base and Mesial and Distal Surface of Brackets marketed
by Different Manufacturers. J. Indian Orthod. Soc 2012 Jul 1;46(3):132.

11
14. Sebance J, Brantley WA, Pincsak JJ, Conover JP. Variability of effective root torque as a
function of edge bevel on orthodontic arch wires. Am J Orthod Dentofacial Orthop.
1984;86:43-50.

15. Attia KH, Elkordy SA, ElKoussy M, Abouelezz AM. Are self-ligating brackets’ slots
dimensions accurate? Int. Orthod. 2018 Dec 1;16(4):613-22.

16. Huang Y, Keilig L, Rahimi A, Reimann S, Eliades T, Jäger A, Bourauel C. Numeric

modeling of torque capabilities of self-ligating and conventional brackets. Am J Orthod
Dentofacial Orthop. 2009 Nov 1;136(5):638-43.

17. Mathew, A., Kumar, H. K., & Shetty, S. (2020). A Comparative Study of the InBuilt
Torque and Slot Size of MBT Prescription Bracket of Different Manufacturing Companies:
A Stereo-Microscopic Study. J. Indian Orthod. Soc. 54(4), 297–303.

18. Flores DA, Choi LK, Caruso JM, Tomlinson JL, Scott GE, Jeiroudi MT. Deformation of
metal brackets: a comparative study. The Angle Orthod. 1994 Aug;64(4):283-90.

19. Kusy RP, Whitley JQ. Influence of archwire and bracket dimensions on sliding mechanics:
derivations and determinations of the critical contact angles for binding. Eur. J. Orthod.
1999 Apr 1;21(2):199-208.

20. Peck S. Orthodontic slot size: it's time to retool. Angle Orthod. 2001 Oct;71(5):329-30.

21. Epstein MB. Benefits and rationale of differential bracket slot sizes: the use of 0.018-inch
and 0.022-inch slot sizes within a single bracket system. Angle Orthod. 2002
Oct;70(5):326-30.

22. Kang BS, Baek SH, Mah J, Yang WS. Three-dimensional relationship between the critical
contact angle and the torque angle. Am J Orthod Dentofacial Orthop. 2003 Jan
31;123(1):64-73.

12
23. Sernetz F. Standardization of Orthodontic Products—Does it Make Sense? J Orofac
Orthop /Fortschritte der Kieferorthopädie. 2005 Jul 1;66(4):307-18.

24. Demling A, Dittmer MP, Schwestka-Polly R. Comparative analysis of slot dimension in

lingual bracket systems. Head Face Med. 2009 Dec 15;5(1):27.

25. Major TW, Carey JP, Nobes DS, Major PW. Orthodontic Bracket Manufacturing
Tolerances and Dimensional Differences between Select Self-Ligating Brackets. J Dent
Biomech. 2010 Jun 27;2010:781321

26. Joch A, Pichelmayer M, Weiland F. Bracket slot and archwire dimensions: manufacturing
precision and third order clearance. Journal of orthodontics. 2010 Dec 1;37(4):241-9.
27. Arreghini A, Lombardo L, Mollica F, Siciliani G. Torque expression capacity of 0.018 and
0.022 bracket slots by changing archwire material and cross section. Prog Orthod. 2014
Dec 1;15(1):53.
28. Dolci GS, Spohr AM, Zimmer ER, Marchioro EM. Assessment of the dimensions and
surface characteristics of orthodontic wires and bracket slots. Dental Press J Orthod. 2013
Apr;18(2):69-75.

29. Díaz RD, Díaz RR, Botello GR, Olvera SP. Tolerance in a 0.022” x 0.025” bracket slot
from three commercial brands used in the Department of Orthodontics of the National
Autonomous University of Mexico. Revista Mexicana de Ortod. 2014 Sep 30;2(3): e188-
91.

30. Ancona MA, Díaz RR, Rodríguez FM, Olvera SP. Variations in slot size of selfligating
brackets. Revista Mexicana de Ortod. 2015 Dec 31;3(4):e224-7.

31. Dalstra M, Eriksen H, Bergamini C, Melsen B. Actual versus theoretical torsional play in
conventional and self-ligating bracket systems. J orthod. 2015 Jun 1;42(2):103-13.

32. Lee Y, Lee DY, Kim YJ. Dimensional accuracy of ceramic self-ligating brackets and
estimates of theoretical torsional play. Angle Orthod. 2016 Sep;86(5):804-9.

13
33. Radhakrishnan PD, Varma NS, Ajith VV. Assessment of bracket surface morphology and
dimensional change Contemp. Clin. Dent. 2017 Jan;8(1):71.

34. Silver M, Griffin Jr AC, Azzopardi L, Masoud MI, Tokede O, Griffin III AC. Novel
methods reveal that parallelism contributes to the functional vertical slot dimension in
ceramic and metal brackets. Angle Orthod. 2018 Nov;88(6):812-8.

35. Lefebvre C, Saadaoui H, Olive JM, Renaudin S, Jordana F. Variability of slot size in
orthodontic brackets. Clin. Exp. Dent. Res. 2019 Oct;5(5):528-33.

14