Self‑Ligating Versus Conventional Orthodontic Brackets - A Review of Treatment Efficiency and Adverse Effects

AIM: To compare clinical outcomes of orthodontic treatment with self-ligating and conventional brackets by reviewing high-quality clinical studies in human subjects, with assessment of treatment efficiency, root resorption, pain and periodontal status. METHODS: An electronic and manual literature search of MEDLINE–PubMed was conducted for the period January 2003 to March 2023. The initial search retrieved 157 records; 57 were screened and 36 met predefined inclusion criteria. Data were extracted and synthesised for outcomes relating to treatment efficiency, root resorption, patient-reported pain and periodontal parameters. RESULTS: Across the selected studies no statistically significant differences were observed between self-ligating and conventional bracket systems for treatment efficiency, degree of root resorption, pain levels or periodontal status. Nevertheless, several studies reported numerical trends favouring self-ligating brackets for some outcomes. Heterogeneity in study design, outcome measurement and follow-up duration limited direct comparability. CONCLUSION: Current clinical evidence is insufficient to conclude that orthodontic treatment is more or less efficient with self-ligating brackets compared with conventional brackets. Well designed, adequately powered randomised trials with standardised outcome measures are required to determine any clinically relevant differences.