47- Do Laceback Ligatures Really Work
Show notes
Key Findings on Laceback Ligatures:
- Lacebacks are not effective in controlling incisor position.
- Resulted in more anchorage loss; 0.8 mm mesial movement of lower first molars. -No significant difference in incisor proclination between groups with and without lacebacks.
In summary, using laceback ligatures in extraction cases may lead to unwanted side effects, especially anchorage loss.
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Show transcript
00:00:00: Hey everyone, let's talk about something that seems small but can make a big difference.
00:00:04: Layspec ligatures.
00:00:06: are they really effective in controlling anterior tooth movement or just another orthodontic tradition we follow without evidence?
00:00:16: Today will break down what randomized controlled clinical trial found their actual effectiveness.
00:00:28: When we talk about anchorage control in extraction cases, laceback ligatures often come up as a routine step.
00:00:35: Many of us were taught that tying a lacebag from molar to canine would help prevent lower incisor proclination during alignment.
00:00:44: but what if it's just orthodontic folklore?
00:00:48: A randomized controlled clinical trial by Irvine Power and McDonald set out to test exactly that.
00:00:55: They studied sixty-two adolescents, treated with standard preadjusted edgewise appliances after four first premolar extractions.
00:01:05: Half received lacebacks the other half did not.
00:01:08: The results were clear!
00:01:10: The lower incisors retroclined slightly.
00:01:12: in both groups No difference at all.
00:01:15: But the laceback group lost significantly more anchorage.
00:01:20: The lower first molars moved about zero point eight millimeters more measually.
00:01:27: So lace backs didn't prevent proclination, but they did waste anchorage.
00:01:33: that's clinically relevant especially when Anchorage preservation is critical.
00:01:37: the study design was sound proper randomization matched groups reproducible cephalometric methods and a strong statistical power.
00:01:46: The only limitation was that it covered only the initial leveling phase, around seven months.
00:01:52: In clinical practice this means we may need to rethink their use of lacebacks.
00:01:57: They don't seem to control incisor position and they maybe even introduce unwanted side effects Anchorage loss or possibly plaque retention.
00:02:06: in summary in extraction cases with fixed appliances Lacebacks are not a protective tool.
00:02:12: We thought there were.
00:02:14: Sometimes doing less, leaving them out actually preserves more anchorage.
00:02:20: Thanks for watching!
00:02:21: I'm Dr.
00:02:21: Martin Baxman and let's bring science back to orthodontics.
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