Abstract
Self-ligation shortens chair time and compounds savings, with external bracket hygiene compared to conventional ligation: Systematic review with meta-analysis of randomized controlled trials
Highlights
Why do seasoned orthodontists continue to apply selfligating brackets internationally? Self-ligation (SL) proponents and manufacturers of SL systems have made clinical claims of their effectiveness and efficiency over conventional ligation (CL), but the scientific evidence for several clinically relevant assertions appears to remain inconclusive
The inclusion criteria were satisfied by a total of ten randomized controlled trials (RCTs) studies, six of which were matched for meta-analysis of three popular clinical claims
A few published systematic reviews (SRs), including one SR of in vitro studies, tried to address many of these questions, but there was a lack of high quality evidence available at the time of their publication, a chronic problem with the extremely high-bars to reach in SRs
Summary
Why do seasoned orthodontists continue to apply selfligating brackets internationally? Self-ligation (SL) proponents and manufacturers of SL systems have made clinical claims of their effectiveness and efficiency over conventional ligation (CL), but the scientific evidence for several clinically relevant assertions appears to remain inconclusive. There has been a significant five-fold increase in the number of randomized controlled trials (RCTs) on SL compared to CL, that were suggested to be employed exclusively for meta-analysis (MA), and to prevent statistical errors [1] It may have been in 1935 that the first SL, single-wing bracket design was introduced, but SL for the most commonly used type of orthodontic brackets, like the siamese twin bracket design, was only developed recently within the last 18 years. This appears to be a central inflection point because it coincides with an increased frequency of use for twin SL and the associated claim of chair time efficiency. There have been two SL bracket mechanisms and schools of siamese twin philosophies: the interactive (ISL) or active, and the passive (PSL) as 2 different groups for SL investigations
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