Title: Covid 19: The impact of the new non-AGP protocol on the bracket failure rate in the Orthodontic Department at Dumfries and Galloway Royal Infirmary
AIM: This project looks at the impact of the new non-AGP protocol on the bracket failure rate in the Orthodontic Department at Dumfries and Galloway Royal Infirmary. Literature search and previous audit looking at bracket failure rate was taken into account to agree
GOLD STANDARD: Gold standard was set at no more than 6%. This project consists of retrospective audit and first cycle of prospective audit. In the retrospective audit bracket bonding failure rate was analysed while using protocol that strictly follows manufacturer instructions, thus generating aerosols. Prospective audit analyses bracket bonding
failure with amended bond-up protocol which avoids creating aerosols.
MATERIALS AND METHODS: All patients with full or sectional bond-ups in the analysed period oftime were included in the audit 22 patients who had full or sectional bond-ups provided between 01/09/2019 to 31/12/2019 wereincluded in the retrospective audit cycle.24 patients with full or sectional bond-ups provided between 01/09/2020 and 31/12/2020 wereincluded in the first prospective audit cycle.Patients in both audit cycles were followed up for 3 months.
RESULTS: Retrospective audit-The Gold Standard was met in the retrospective audit. 290 brackets were bonded in the retrospective audit cycle. 15 brackets debonded within the first 3 months following bond-up. This gives bracket failure rate at 5.2% in 3 months following bond-up when using AGP protocol.
1st cycle of prospective audit-The Gold Standard wasn’t met in the first cycle of the prospective audit 231 brackets were bonded using amended bond-up protocol between September and December 2020. 17 brackets debonded within the first 3 months following bond-up. This gives bracket failure rate at 7.4%, which exceeds Gold Standard figure.
CONCLUSION: Although we cannot be absolutely certain that patients' compliance hasn’t contributed to the results due to the incomplete data, an increase in bracket failure was observed when Covid-19 pandemic led bond-up protocol, avoiding aerosol generating procedures was introduced.