Efficiency of treatment mechanics has been a major focus throughout the history of orthodontics. Self-ligating brackets were developed on the premise that elimination of ligature ties creates a friction-free environment and allows for better sliding mechanics. It is expected that the self-ligating bracket will reduce the treatment time. This study was designed to compare the effectiveness and efficiency of Damon self-ligating (SL) brackets to those brackets ligated with either steel ligatures or elastomeric 'O' rings. Not only treatment time and the number of appointments needed were addressed, but the quality of the treatment outcome was also assessed. American Board of Orthodontics (ABO) grading criteria for models and panoramic radiographs were employed. Additionally, a nine-question survey was sent to the 215-patients in this study (108 Damon, 107 conventionally-ligated) to elicit their perceptions of how their orthodontic treatment progressed and finished. The results showed that patients treated with Damon SL brackets had significantly lower treatment times, required significantly fewer appointments, and had significantly higher ABO scores than those treated with conventionally-ligated edgewise brackets. There were no significant differences in Damon or non-Damon ABO scores with respect to gender. Damon patients over the age of 21 had significantly higher ABO scores. Conversely, the non-Damon patients under the age of 21 had significantly higher ABO scores. For pre-treatment Angle classification, no significant differences were noted. Patient responses showed that Damon patients perceived their treatment time as being shorter than expected. It appears that faster orthodontic treatment can be better as measured by the ABO criteria.

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