Self‐ligating brackets in orthodontics: do they deliver what they claim?

Abstract

Self-ligating brackets have enjoyed recent popularity in the orthodontic marketplace with various claims made including faster ligation, lower friction, faster treatment, less pain, waking up the tongue, and fewer appointments. Although various designs of self-ligating brackets have been available for many years they have only recently surged in popularity on the back of these claims but what evidence is there to support these claims? This review article examines the current available evidence regarding treatment duration, influence on archform, and the speed of tying and untying self-ligating brackets compared with conventional brackets and methods of ligation.

Root resorption, treatment time and extraction rate during orthodontic treatment with self-ligating and conventional brackets

“…Still they have undergone a revival in the recent years with a variety of new features being developed and advanced. A host of advantages such as shorter treatment time, higher rate of tooth movement and fewer appointments have been claimed relating to reduced frictional resistance of these brackets [29]. …”

Transversal maxillary dento‐alveolar changes in patients treated with active and passive self‐ligating brackets: a randomized clinical trial using CBCT‐scans and digital models

“…However, it was with the SPEED brackets in the 70s and later on with the In‐Ovation bracket and the Damon SL, that the interest for SLBs increased (2), as they were promoted as a system rather than a bracket (3). This happened because of the claims of higher treatment efficiency and less chair time associated with SLBs (4, 5), although these allegations are not unanimously accepted (6, 7). The combination of SLBs with high‐tech and high‐resilient copper–nickel–titanium wires is supposed to deliver light forces and low friction (3, 8).…”

Orthodontic treatment efficiency with self-ligating and conventional edgewise twin brackets

“…2 When compared with conventional brackets, several advantages of self-ligating brackets have been claimed, including faster ligation, reduced friction, and faster treatment time with reduced number of visits and less pain. [3][4][5][6] In laboratory setups, self-ligating brackets have demonstrated reduced friction compared with conventional brackets tied with modules. 7,8 In other studies, however, reduced frictional resistance with self-ligating brackets compared with conventional brackets was found only in combination with certain wires.…”

“…17,18 There is still controversy and limited knowledge regarding the evidence for reduced overall treatment time with self-ligating brackets, and the need for prospective randomized studies is obvious. [3][4][5] Recent prospective randomized studies have shown that selfligating brackets do not reduce overall treatment time, neither in terms of number of visits nor treatment outcome. 19,20 The need for further evaluation of the overall efficiency of self-ligating brackets in daily orthodontic clinical work is thus important.…”