Systematic review on self-ligating vs. conventional brackets: initial pain, number of visits, treatment time

  • A.G. ČelarEmail author
  • M. Schedlberger
  • P. Dörfler
  • M.H. Bertl
Original article



Meta-analysis of differences between conventional and self-ligating brackets concerning pain during tooth movement, number of patient visits, total treatment duration, and ligation times.

Materials and methods

Online search in Medline, Embase, and Central focused on randomized clinical trials and controlled clinical studies published between 1996 and 2012.


Four studies on pain met our inclusion criteria, two on the number of appointments, two on overall treatment time but none on ligation times. Pain levels did not differ significantly between patients treated with conventional or self-ligating brackets after 4 h, 24 h, 3 and 7 days. The number of appointments and total treatment times revealed no significant differences between self-ligating and conventional brackets.


The lack of significant overall effects apparent in this meta-analysis contradicts evidence-based statements on the advantages of self-ligating brackets over conventional ones regarding discomfort during initial orthodontic therapy, number of appointments, and total treatment time. Due to the limited number of studies included, further randomized controlled clinical trials are required to deliver more data and to substantiate evidence-based conclusions on differences between the two bracket types considering orthodontic pain, number of visits, treatment, and ligation times.


Systematic review Meta-analysis Self-ligating bracket Number of appointments Treatment time Orthodontic pain 

Systematisches Review über ligaturfreie und konventionelle Brackets: initiale Schmerzen, Anzahl der Behandlungstermine, Therapiedauer



Metaanalyse zu Unterschieden zwischen selbstligierenden und konventionellen Brackets hinsichtlich der Schmerzen bei Zahnbewegung, Behandlungsfrequenz, Behandlungsdauer und Ligationszeit.

Material und Methode

Onlinesuche in Medline, Embase und Central nach randomisierten klinischen und kontrollierten klinischen Studien der Jahre 1996–2012.


Den Einschlusskriterien entsprachen vier Schmerzstudien, zwei über die Anzahl an Behandlungsterminen, zwei zur Gesamttherapiedauer, aber keine Publikationen zur Dauer des Ein- und Ausligierens. Bei den Schmerzangaben nach 4 h, 24 h, 3 Tagen und 7 Tagen festsitzender Kieferorthopädie bestanden keine signifikanten Unterschiede zwischen selbstligierenden und konventionellen Brackets. Die Metaanalyse zeigte auch bei der Terminfrequenz und Gesamtbehandlungsdauer keine signifikant unterschiedlichen Gesamteffekte zwischen beiden Bracketarten.


Das Fehlen signifikanter Gesamteffekte in der Metaanalyse erlaubt keine evidenzbasierten Aussagen, dass selbstligierende Brackets geringere Schmerzen in der ersten Behandlungswoche, weniger Behandlungstermine oder kürzere Gesamtbehandlungsdauern bewirkten. Aufgrund der geringen Zahl brauchbarer Arbeiten bedarf es weiterer randomisierter, kontrollierter Studien, um mehr Daten und damit substanzielle, evidenzbasierte Konklusionen über Unterschiede zwischen selbstligierenden und konventionellen Brackets hinsichtlich Schmerz und zeitlicher Aspekte zu erlangen.


Systematisches Review Metaanalyse Selbstligierende Brackets Anzahl von Terminen Behandlungszeit Kieferorthopädisch bedingte Schmerzen 


Conflict of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.


Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • A.G. Čelar
    • 1
    Email author
  • M. Schedlberger
    • 1
  • P. Dörfler
    • 1
  • M.H. Bertl
    • 1
  1. 1.Division of OrthodonticsBernhard Gottlieb University Clinic of Dentistry, Medical University of ViennaViennaAustria

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