Self-ligating brackets in orthodontics. A systematic review.

OBJECTIVE To evaluate the clinical differences in relation to the use of self-ligating brackets in orthodontics. MATERIALS AND METHODS Electronic databases were searched; no restrictions relating to publication status or language of publication were applied. Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) investigating the influence of bracket type on alignment efficiency, subjective pain experience, bond failure rate, arch dimensional changes, rate of orthodontic space closure, periodontal outcomes, and root resorption were selected. Both authors were involved in study selection, validity assessment, and data extraction. Disagreements were resolved by discussion. RESULTS Six RCTs and 11 CCTs were identified. Meta-analysis of the influence of bracket type on subjective pain experience failed to demonstrate a significant advantage for either type of appliance. Statistical analysis of other outcomes was unfeasible because of inadequate methodological design and heterogenous designs. CONCLUSIONS At this stage there is insufficient high-quality evidence to support the use of self-ligating fixed orthodontic appliances over conventional appliance systems or vice versa.