PCA ceramic brackets, whose slot surface is covered with an yttria-stabilized zirconia-based coating exhibited frictional properties similar to those of metal brackets. Frictional resistance resulted in an over 60 % loss of the applied force due to the use of elastic ligatures.

Lingual bracket systems showed higher forces compared to labial bracket systems that might be of clinical concern. We recommend highly flexible nickel titanium arch wires lower than 0.013-in for the initial levelling and alignment especially with lingual appliances.