• Kevin O'Brien.
• School of Dentistry, University of Manchester, UK.
• Evid Based Dent. 2014 Sep 1; 15 (3): 92.

Data SourcesThe Medline, Cochrane Library, Biomed Central, BBO including LILACS, Ind Med, Sceilo, Clinical trials.gov, Conference paper Index, Digital Dissertations, German National Library of Medicine (ZB MED), Google Scholar, ISI Web of Knowledge, metaRegister of Controlled Trials, OpenSIGLE and Scirus databases were searched.Study SelectionRandomised controlled trials (RCTs) and quasi-RCTs in patients having fixed-appliance orthodontic treatments were considered.Data Extraction And SynthesisStudy assessment data extraction and risk of bias assessment was carried out independently by two reviewers. Overall quality of evidence was based on the Grades of Recommendation Assessment, Development and Evaluation (GRADE) approach. Random-effects meta-analyses were performed where data could be pooled.ResultsTwenty five trials (1321 patients) were included. The majority (24) compared self-ligated (SL) and conventional brackets (CL). No trials primarily investigated the effect of bracket material and no indirect comparison was possible. Two trials assessed the bracket slot size but found no consistent difference between 0.022'' and 0.018'' brackets. Four studies contributed to a meta-analysis that showed overall duration of the orthodontic treatment be significantly longer in the SL group by 2.01 months (95%CI; 0.45 to 3.57).ConclusionsBased on existing evidence, no clinical recommendation can be made regarding the bracket material or different ligation modules. For Sl brackets, no conclusive benefits could be proven, while their use was associated with longer treatment durations.

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