Point- counterpoint session focused on expansion with self ligation brackets Risk and benefit of arch expansion in growing and non-growing patients. Self-ligation, the claims and the evidence

When the self-ligating brackets were introduced the scope was first and foremost to facilitate the daily work for the orthodontist and their staff members. The development within fixed appliances had focused on other aspect of the facilitation by the introduction of prescription brackets making first , second and third order bend superfluous and although there was a pronounced difference between what the individual clinician considered the optimal prescription it was still only a help to reach what was considered an optimal treatment goal . However, orthodontics has, over the past decennia, been dominated by outsourcing and delegating all or parts of treatment and orthodontists are no more considered as wirer benders. The role of the orthodontist in relation to the fast food orthodontist has decreased With the introduction of the Damon bracket the brackets were no longer just handles used for the application of the force systems but “sold “ as an important component of a special philosophy supported by a number of claims regarding not only chair time and treatment time but also the biological reaction to the wire bracket combination recommended , the latter leading to a dramatic drop in the number of extractions. Unfortunately the claims remained claims for a long period but now after 15 years the time to test the validity of these claims has come. It is obvious that the number of extractions has been reduced, but to what degree can the specific Brackets be held responsible. The intention with this point/counterpoint session is to illustrate the impact of these new brackets on the orthodontic profession and the reaction of the clinician to the gradually appearing evidence supporting or rejecting the claims. The type of marketing seem to be more relevant than the product “Event economy”-. Do we have to belong to a special club when choosing our treatment approach? We have to be aware of the influence of marketing strategy. Is it focused on the patient or the doctor? It is crucial for the orthodontist to have a critical attitude both to marketing material and the design of the orthodontic research reported in the literature.