Authors :
Dr. Padmashri Narayanan; Dr. Shailaja A. M.; Dr. Madhusudhan V.; Dr. Chethan Kumar D.; Dr. Pachaiyappan G.
Volume/Issue :
Volume 10 - 2025, Issue 10 - October
Google Scholar :
https://tinyurl.com/ysu64m4k
Scribd :
https://tinyurl.com/47dmre4t
DOI :
https://doi.org/10.38124/ijisrt/25oct241
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Note : Google Scholar may take 30 to 40 days to display the article.
Abstract :
Fixed orthodontic mechanotherapy has become a cornerstone in achieving predictable tooth movement and
functional occlusion. The MBT system, although widely adopted, presents limitations due to its standardized bracket
prescriptions that may not accommodate individual anatomical variations. Challenges such as incomplete torque
expression, reliance on precise bracket placement, and increased friction with conventional ligatures often necessitate
additional adjustments, thereby extending treatment time and compromising efficiency. These drawbacks have driven the
exploration of alternative strategies that extend beyond MBT. Contemporary approaches emphasize reduced friction
mechanics, digital customization, and patient-centered treatment planning. Advances in computer-aided design and
manufacturing enable custom brackets and archwires tailored to specific tooth morphology, while integration of three-
dimensional imaging improves diagnostic accuracy and precision in appliance placement. Innovations such as self-ligating
systems, digitally guided workflows, and bioadaptive force concepts are reshaping clinical practice by enhancing comfort,
efficiency, and treatment predictability. Looking forward, the incorporation of artificial intelligence, smart materials, and
real-time monitoring technologies is expected to further individualize orthodontic care. This review critically evaluates the
shortcomings of MBT mechanotherapy and highlights the transition toward innovative, technology-driven systems that
promise to redefine fixed orthodontics in the future.
Keywords :
Fixed Mechanotherapy; MBT System; Orthodontic Biomechanics; Digital Orthodontics; Customized Appliances; Future Perspectives.
References :
- J. Liu, C. Zhang, and Z. Shan, “Application of artificial intelligence in orthodontics: current state and future perspectives,” Healthcare (Basel), vol. 11, no. 20, p. 2760, Oct. 2023. doi: 10.3390/healthcare11202760. Available: https://doi.org/10.3390/healthcare11202760
- N. F. Nordblom, M. Büttner, and F. Schwendicke, “Artificial intelligence in orthodontics: critical review,” J. Dent. Res., vol. 103, no. 6, pp. 577–584, Jun. 2024. doi: 10.1177/00220345241235606.
- B. A. Mendes, R. A. Neto Ferreira, M. M. Pithon, M. C. Horta, and D. D. Oliveira, “Physical and chemical properties of orthodontic brackets after 12 and 24 months: in situ study,” J. Appl. Oral Sci., vol. 22, no. 3, pp. 194–203, Jun. 2014. doi: 10.1590/1678-775720130528.
- R. Srinidhi, S. Dilip, A. Gopinath, R. Kannan, S. Chakravathi, and D. Davis, “Orthodontic bracket materials – an up-to-date review,” Int. J. Chem. Biochem. Sci., vol. 24, no. 6, pp. 45–54, 2023.
- C. Gioka, C. Bourauel, S. Zinelis, T. Eliades, N. Silikas, and G. Eliades, “Titanium orthodontic brackets: structure, composition, hardness and ionic release,” Dent. Mater., vol. 20, no. 7, pp. 693–700, Sep. 2004. doi: 10.1016/j.dental.2004.02.008.
- C. Park, H. V. Giap, J. S. Kwon, K. H. Kim, S. H. Choi, J. S. Lee, and K. J. Lee, “Dimensional accuracy, mechanical property, and optical stability of zirconia orthodontic bracket according to yttria proportions,” Sci. Rep., vol. 13, no. 1, p. 20418, Nov. 2023.
- R. Pandey, R. Kamble, and H. Kanani, “Revolutionizing smiles: advancing orthodontics through digital innovation,” Cureus, vol. 16, no. 7, p. e64086, Jul. 2024. doi: 10.7759/cureus.64086.
- X. Guo, M. Zhao, Y. Li, and H. Wang, “AI-driven dynamic orthodontic treatment management,” Front. Dent. Med., vol. 6, p. 1612441, 2025. doi: 10.3389/fdmed.2025.1612441.
- N. Wahl, “Orthodontics in 3 millennia. Chapter 1: antiquity to the mid-19th century,” Am. J. Orthod. Dentofacial Orthop., vol. 127, no. 2, pp. 255–259, 2005. doi: 10.1016/j.ajodo.2004.11.013. Available: https://doi.org/10.1016/j.ajodo.2004.11.013
- W. A. Andrews,“The straight-wire appliance: individualization versus customization,” J. World Fed. Orthod., vol. 12, no. 4, pp. 166–172, 2023. doi: 10.1016/j.ejwf.2023.06.004.Available:https://doi.org/10.1016/j.ejwf.2023.06.004
- E. L. Dellinger, “A scientific assessment of the straight-wire appliance,” Am. J. Orthod., vol. 73, no. 3, pp. 290–299, 1978. doi: 10.1016/0002-9416(78)90135-5. Available: https://doi.org/10.1016/0002-9416(78)90135-5
- T. D. Creekmore and R. L. Kunik, “Straight wire: the next generation,” Am. J. Orthod. Dentofacial Orthop., vol. 104, no. 1, pp. 8–20, 1993. doi: 10.1016/0889-5406(93)70023H.Available:https://doi.org/10.1016/0889-5406(93)70023-H
- Y. A. Yassir, M. K. Sofar, G. T. McIntyre, and D. R. Bearn, “Clinical effectiveness of customized versus noncustomized orthodontic appliances: a systematic review,” J. Orthod. Sci., vol. 13, article 26, 2024. doi: 10.4103/jos.jos_46_24.Available:https://doi.org/10.4103/jos.jos_46_24
- R. P. McLaughlin and J. C. Bennett, “The transition from standard edgewise to preadjusted appliance systems,” J. Clin. Orthod., vol. 23, no. 3, pp. 142–153, 1989.Available:https://www.jcoonline.com/archive/1989/03/142-the-transition-from-standard-edgewise-to-preadjusted-appliance-systems/
- Amurdhavani B.S. “A review on MBT system in orthodontics.” Research J. Pharm. Technol., vol. 9, no. 9, pp. 1529–1532, 2016. doi: 10.5958/0974-360X.2016.00299.7.Available:https://doi.org/10.5958/0974-360X.2016.00299.7
- P. Namdar, E. Bardideh, F. Lal Alizadeh, A. Jahanbin, and N. Eslami, “Comparison of Roth and McLaughlin-Bennet-Trevisi prescriptions as two popular pre-adjusted orthodontic bracket systems: a systematic review,” Orthod. Waves, vol. 79, nos. 2–3, pp. 65–75, 2020. doi: 10.1080/13440241.2020.1777798.Available:https://doi.org/10.1080/13440241.2020.1777798
- M. Jain, J. Varghese, R. Mascarenhas, S. Mogra, S. Shetty, and N. Dhakar, “Assessment of clinical outcomes of Roth and MBT bracket prescription using the American Board of Orthodontics Objective Grading System,” Contemp. Clin. Dent., vol. 4, no. 3, pp. 307–312, 2013. doi: 10.4103/0976-237X.118361. Available: https://doi.org/10.4103/0976-237X.118361
- B. Moesi, F. Dyer, and P. E. Benson, “Roth versus MBT: does bracket prescription have an effect on the subjective outcome of pre-adjusted edgewise treatment?,” Eur. J. Orthod., vol. 35, no. 2, pp. 236–243, 2013. doi: 10.1093/ejo/cjr126. Available: https://doi.org/10.1093/ejo/cjr126
- J. J. Eberting, S. R. Straja, and O. C. Tuncay, “Treatment time, outcome, and patient satisfaction comparisons of Damon and conventional brackets,” Clin. Orthod. Res., vol. 4, no. 4, pp. 228–234, 2001. doi: 10.1034/j.1600-0544.2001.40407.x.Available:https://doi.org/10.1034/j.1600-0544.2001.40407.x
- J. Harradine, “Self-ligating brackets: Where are we now?,” J. Orthod., vol. 30, no. 3, pp. 262–273, 2003. doi:10.1093/ortho/30.3.262.Available:https://pubmed.ncbi.nlm.nih.gov/14530482/
- C. Fontinha, P. M. Cattaneo, and M. A. Cornelis, “How efficient is customized lingual orthodontics? an assessment of treatment outcome,” Orthod. Craniofac. Res., 2022. doi: 10.1111/ocr.12494. Available: https://doi.org/10.1111/ocr.12494
- R. Sachdeva, “SureSmile technology in a patient–centered orthodontic practice,” J. Clin. Orthod., vol. 35, no. 4, pp. 245–253, 2001. Available: https://www.jco-online.com/archive/2001/04/245-suresmile-technology-in-a-patient-centered-orthodontic-practice/
- V. V. Mundhada, V. V. Jadhav, and A. Reche, “A review on orthodontic brackets and their application in clinical orthodontics,” Cureus, vol. 15, no. 10, e46615, Oct. 2023. doi: 10.7759/cureus.46615. Available: https://doi.org/10.7759/cureus.46615
- J. Hegele, L. Seitz, C. Claussen, U. Baumert, H. Sabbagh, and A. Wichelhaus, “Clinical effects with customized brackets and CAD/CAM technology: a prospective controlled study,” Prog. Orthod., vol. 22, no. 1, p. 40, Dec. 2021. doi: 10.1186/s40510-021-00386-0.
- C. Fontinha, P. M. Cattaneo, and M. A. Cornelis, “How efficient is customized lingual orthodontics? an assessment of treatment outcome,” Orthod. Craniofac. Res., 2022. doi: 10.1111/ocr.12494. Available: https://doi.org/10.1111/ocr.12494
- R. K. Satapathy, S. Verma, J. Sowmya, and P. Chitra, “Torque moments and stress analysis in two passive self-ligating brackets across different incisor inclinations: a 3-dimensional finite element study,” J. Oral Biol. Craniofac. Res., vol. 14, no. 5, pp. 487–493, 2024. doi: 10.1016/j.jobcr.2024.06.002.
- S. J. Bowman and A. Carano, “The Butterfly System,” J. Clin. Orthod., vol. 38, no. 5, pp. 274–287, 2004. doi: 10.1681/clinorthod.2004.38.5.274. Available: https://pubmed.ncbi.nlm.nih.gov/15178882/
- E. M. F. Franco, F. P. Valarelli, J. B. Fernandes, R. H. Cançado, and K. M. S. de Freitas, “Comparative study of torque expression among active and passive self-ligating and conventional brackets,” Dental Press J. Orthod., vol. 20, no. 6, pp. 68–74, 2015. doi: 10.1590/2177-6709.20.6.068074.oar.Available:https://doi.org/10.1590/2177-6709.20.6.068-074.oar
- K. H. Attia, S. A. Elkordy, M. ElKoussy, and A. M. Abouelezz, “Are self-ligating brackets’ slots dimensions accurate?,” Int. Orthod., vol. 16, no. 4, pp. 613–622, 2018. doi: 10.1016/j.ortho.2018.09.001. Available: https://doi.org/10.1016/j.ortho.2018.09.001
- A. Aiyar, G. Scuzzo, G. Scuzzo, and C. Verna, “Hybrid orthodontics for aesthetic deep bite correction—case series and general clinical considerations,” Oral, vol. 4, no. 2, pp. 126–147, 2024. doi: 10.3390/oral4020011. Available: https://doi.org/10.3390/oral4020011
- A. Auluck, “Lingual orthodontic treatment: what is the current evidence base?,” J. Orthod., vol. 40, suppl. 1, pp. S27S33,2013.doi:10.1179/1465313313Y.0000000073.Available:https://doi.org/10.1179/1465313313Y.0000000073
- Abdullah M. Koaban, Joharah M. Alwadai, Aseel M. Alghamdi, Faisal J. Alsiwat, Almiqdad I. Dashti, Mohammad M. Nasser, Mohammed A. Alhazmi, Essa M. Aljaroudi, Salem B. Alanazi, Waleed A. Almanjhi, “Recent Advances in Orthodontic Brackets: From Aesthetics to Smart Technologies,” Cureus, vol. 17, no. 6, 2025. doi: 10.7759/cureus.85385. Available: https://doi.org/10.7759/cureus.85385
- G. Rossini, S. Parrini, T. Castroflorio, A. Deregibus, and C.L. Debernardi, “Diagnostic accuracy and measurement sensitivity of digital models for orthodontic purposes: a systematic review,” Am. J. Orthod. Dentofacial Orthop., vol. 149, no. 2, pp. 161–170, 2016. doi: 10.1016/j.ajodo.2015.06.029.Available:https://doi.org/10.1016/j.ajodo.2015.06.029
- T. Grünheid, S.D. McCarthy, and B.E. Larson, “Clinical use of a direct chairside oral scanner: An assessment of accuracy, time, and patient satisfaction,” Am. J. Orthod. Dentofacial Orthop., vol. 146, no. 5, pp. 673–682, 2014. doi: 10.1016/j.ajodo.2014.07.023. Available: https://pubmed.ncbi.nlm.nih.gov/25439218/
- K. Johansson, H. Christell, A. Brechter, and L. Paulsson, “Evaluation of external apical root resorption and the relevance of intermediate radiography in non-extraction treatment with fixed appliances for adolescents with crowding: a multicenter randomized controlled trial using CBCT,” Orthod. Craniofac. Res., 2025. doi: 10.1111/ocr.12903.Available:https://doi.org/10.1111/ocr.12903
- K.H. Yu, A.L. Beam, and I.S. Kohane, “Artificial intelligence in healthcare,” Nat. Biomed. Eng., vol. 2, no. 10, pp. 719–731, 2018. doi: 10.1038/s41551-018-0305-z. Available: https://pubmed.ncbi.nlm.nih.gov/31015651/
Fixed orthodontic mechanotherapy has become a cornerstone in achieving predictable tooth movement and
functional occlusion. The MBT system, although widely adopted, presents limitations due to its standardized bracket
prescriptions that may not accommodate individual anatomical variations. Challenges such as incomplete torque
expression, reliance on precise bracket placement, and increased friction with conventional ligatures often necessitate
additional adjustments, thereby extending treatment time and compromising efficiency. These drawbacks have driven the
exploration of alternative strategies that extend beyond MBT. Contemporary approaches emphasize reduced friction
mechanics, digital customization, and patient-centered treatment planning. Advances in computer-aided design and
manufacturing enable custom brackets and archwires tailored to specific tooth morphology, while integration of three-
dimensional imaging improves diagnostic accuracy and precision in appliance placement. Innovations such as self-ligating
systems, digitally guided workflows, and bioadaptive force concepts are reshaping clinical practice by enhancing comfort,
efficiency, and treatment predictability. Looking forward, the incorporation of artificial intelligence, smart materials, and
real-time monitoring technologies is expected to further individualize orthodontic care. This review critically evaluates the
shortcomings of MBT mechanotherapy and highlights the transition toward innovative, technology-driven systems that
promise to redefine fixed orthodontics in the future.
Keywords :
Fixed Mechanotherapy; MBT System; Orthodontic Biomechanics; Digital Orthodontics; Customized Appliances; Future Perspectives.