Skip to main content
SpringerLink
Log in

Differences between active and passive self-ligating brackets for orthodontic treatment

Systematic review and meta-analysis based on randomized clinical trials

Unterschiede zwischen aktiven und passiven selbstligierenden Brackets bei der kieferorthopädischen Behandlung

Systematisches Review und Metaanalyse auf der Basis randomisierter klinischer Studien

  • Original Article
  • Published:
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Purpose

In orthodontic treatment, the effects of differences in the design between active and passive self-ligating bracket (ASLB and PSLB, respectively) are usually neglected. This study investigated differences in effectiveness and efficiency between ASLBs and PSLBs.

Methods

To identify randomized, controlled clinical trials (RCTs) comparing ASLB with PSLB, the electronic databases Medline, Embase, Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and Chinese Medical Journal Database were searched without language or time limits. Relevant available dental journals and reference lists from included studies were manually searched for applicable reports. Meta-analyses were conducted with the Review Manager program. Two independent reviewers performed all search processes; disagreements were discussed with a third reviewer.

Results

Eight studies were included in the systematic review, of which six were included in the meta-analysis due to the data consistency. Three had a low risk of bias, four had an unclear risk of bias, and one had a high risk of bias. With regard to alignment efficiency, meta-analysis favors ASLB [mean difference (MD) −10.24 days, 95% confidence interval (CI) −17.68 to −2.80]. However, the same analysis does not favor either design in terms of width change due to treatment for intercanine (MD −0.49 mm, 95% CI −1.10 to 0.13 mm) interfirst premolar (MD −0.07 mm, 95% CI −0.69, 0.56 mm) intersecond premolar (MD −0.58 mm, 95% CI −1.25 to 0.08 mm) and intermolar (MD 0.10 mm, 95% CI −0.82 to 1.02 mm) width.

Conclusions

Based on current clinical evidence from RCTs, ASLB appears to be more efficient for alignment, while neither design shows an advantage for width change. Further research is needed to confirm present results.

Zusammenfassung

Ziel

Bei der kieferorthopädischen Behandlung werden die Effekte von Unterschieden im Design zwischen aktiv und passiv selbstligierenden Brackets (ASLB bzw. PSLB) in der Regel nicht berücksichtigt. Ziel der Studie war die Erforschung möglicher Unterschiede zwischen ASLB und PSLB hinsichtlich Effektivität und Effizienz.

Methoden

Um randomisierte kontrollierte klinische Studien (RCT) zum Vergleich von ASLB und PSLB zu ermitteln wurde in elektronischen Datenbanken – Medline, Embase, Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Database, China National Knowledge Infrastructure und Chinese Medical Journal Database – ohne sprachliche oder zeitliche Restriktionen gesucht. Relevante zur Verfügung stehende zahnärztliche Periodika und Literaturverzeichnisse von in die Analyse aufgenommenen Studien wurden manuell durchsucht. Für die Metaanalysen wurde die Software Review Manager (RevMan) eingesetzt. Alle Suchprozesse wurden von 2 unabhängigen Forschern durchgeführt, Uneinigkeiten wurden mit einem dritten Forscher diskutiert.

Ergebnisse

In den systematischen Review eingeschlossen wurden 8 Studien, bedingt durch die Datenkonsistenz gingen 6 dieser Studien in die Metaanalyse ein. Bei 3 Studien bestand ein geringes Bias-Risiko, bei 4 ein unklares und bei einer Studie ein hohes Bias-Risiko. Hinsichtlich der Alignment-Korrektur wies die Metaanalyse eine Überlegenheit der ASLB nach [durchschnittliche Differenz (“mean difference”, MD) -10,24 Tage; 95%-Konfidenzintervall (KI) -17,68 bis -2,80]. Die gleiche Analyse zeigte allerdings keinen Vorteil für eines der beiden Verfahren hinsichtlich der therapeutischen Breitenänderungen [intercanine Distanz (MD -0,49 mm, 95%-KI -1,10 bis 0,13 mm), Distanz zwischen ersten Prämolaren (MD -0,07 mm, 95%-KI -0,69, 0,56 mm), zweiten Prämolaren (MD -0,58 mm, 95%-KI -1,25 bis 0,08 mm) und Molaren (MD 0,10 mm, 95%-KI -0,82 bis 1,02 mm)].

Schlussfolgerungen

Auf der Grundlage aktueller klinischer Evidenz aus RCTs scheinen ASLB für das initiale Alignment effizienter zu sein. Für Korrekturen der Breiten dagegen erweist sich kein Design als überlegen. Zur Bestätigung der vorgestellten Ergebnisse sind weitere Untersuchungen notwendig.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Cattaneo PM, Treccani M, Carlsson K, Thorgeirsson T, Myrda A, Cevidanes LH, Melsen B (2011) Transversal maxillary dento-alveolar changes in patients treated with active and passive self-ligating brackets: a randomized clinical trial using CBCT-scans and digital models. Orthod Craniofac Res 14:222–233

    Article  PubMed  Google Scholar 

  2. Cattaneo PM, Salih RA, Melsen B (2013) Labio-lingual root control of lower anterior teeth and canine obtained by active and passive self-ligating brackets. Angle Orthod 83:691–697

    Article  PubMed  Google Scholar 

  3. Damon D (2004) Damon system: the workbook. Ormco: Orange: Calif

  4. Drescher D, Bourauel C, Schumacher HA (1989) Frictional forces between bracket and arch wire. Am J Orthod Dentofac Orthop 96:397–404

    Article  Google Scholar 

  5. Fleming PS, Lee RT, Marinho V, Johal A (2013) Comparison of maxillary arch dimensional changes with passive and active self-ligation and conventional brackets in the permanent dentition: a multicenter, randomized controlled trial. Am J Orthod Dentofac Orthop. 144:185–193

    Article  Google Scholar 

  6. Franchi L, Baccetti T (2006) Forces released during alignment with a preadjusted appliance with different types of elastomeric ligatures. Am J Orthod Dentofac Orthop 129:687–690

    Article  Google Scholar 

  7. Higgins JPT, Altman DG (2008) Assessing risk of bias. In: Higgins JPT, Green S (eds) Cochrane handbook for systematic reviews of interventions. Wiley, Chichester, pp 8.1–8.44

    Chapter  Google Scholar 

  8. Liu Z, McGrath C, Hagg U (2011) Associations between orthodontic treatment need and oral health-related quality of life among young adults: does it depend on how you assess them? Community Dent Oral Epidemiol 39:137–144

    Article  PubMed  Google Scholar 

  9. Maijer R, Smith DC (1990) Time savings with self-ligating brackets. J Clin Orthod 24:29–31

    PubMed  Google Scholar 

  10. Matarese G, Nucera R, Militi A, Mazza M, Portelli M, Festa F, Cordasco G (2008) Evaluation of frictional forces during dental alignment: an experimental model with 3 nonleveled brackets. Am J Orthod Dentofac Orthop 133:708–715

  11. Mezomo M, de Lima ES, de Menezes LM, Weissheimer A, Allgayer S (2011) Maxillary canine retraction with self-ligating and conventional brackets. Angle Orthod 81:292–297

    Article  PubMed  Google Scholar 

  12. Miles PG (2007) Self-ligating vs conventional twin brackets during enmasse space closure with sliding mechanics. Am J Orthod Dentofac Orthop 132:223–225

    Article  Google Scholar 

  13. Ong E, McCallum H, Griffin MP, Ho C (2010) Efficiency of self-ligating vs conventionally ligated brackets during initial alignment. Am J Orthod Dentofac Orthop 138:e1–e7

    Google Scholar 

  14. Othman SA, Mansor N, Saub R (2014) Randomized controlled clinical trial of oral health-related quality of life in patients wearing conventional and self-ligating brackets. Korean J Orthod. 44:168–176

    Article  PubMed  PubMed Central  Google Scholar 

  15. Pandis N, Polychronopoulou A, Eliades T (2010) Active or passive self-ligating bracket? A randomized controlled trial of comparative efficiency in resolving maxillary anterior crowding in adolescents. Am J Orthod Dentofac Orthop 137:121–126

    Google Scholar 

  16. Pandis N, Polychronopoulou A, Eliades T (2007) Self-ligating vs. conventional brackets in the treatment of mandibular crowding: a prospective clinical trial of treatment duration and dental effects. Am J Orthod Dentofac Orthop 132:208–215

    Article  Google Scholar 

  17. Pandis N, Polychronopoulou A, Makou M, Eliades T (2010) Mandibular dental arch changes associated with treatment of crowding using self-ligating and conventional brackets. Eur J Orthod 32:248–253

    Article  PubMed  Google Scholar 

  18. Papageorgiou SN, Sifakakis I, Doulis I, Eliades T, Bourauel C (2016) Torque efficiency of square and rectangular archwires into 0.018 and 0.022 in conventional brackets. Progress Orthod 17:5

    Article  Google Scholar 

  19. Reddy VB, Kumar TA, Prasad M, Nuvvula S, Patil RG, Reddy PK (2014) A comparative in vivo evaluation of the alignment efficiency of 5 ligation methods: a prospective randomized clinical trial. Eur J Dent. 8:23–31

    Article  PubMed  PubMed Central  Google Scholar 

  20. Rinchuse DJ, Miles PG (2007) Self-ligating brackets: present and future. Am J Orthod Dentofac Orthop 132:216–222

    Article  Google Scholar 

  21. Songra G, Clover M, Atack NE, Ewings P, Sherriff M, Sandy JR, Ireland AJ (2014) Comparative assessment of alignment efficiency and space closure of active and passive self-ligating vs conventional appliances in adolescents: a single-center randomized controlled trial. Am J Orthod Dentofac Orthop. 145:569–578

    Article  Google Scholar 

  22. Thorstenson GA, Kusy RP (2002) Comparison of resistance to sliding between different self-ligating brackets with second-order angulation in the dry and saliva states. Am J Orthod Dentofac Orthop 121:472–482

    Article  Google Scholar 

  23. Turnbull NR, Birnie DJ (2007) Treatment efficiency of conventional vs self-ligating brackets: effects of archwire size and material. Am J Orthod Dentofac Orthop 131:395–399

    Article  Google Scholar 

  24. Wang D, Bakhai A (2006) Clinical trials. A practical guide to design, analysis, and reporting. London: Remedica, pp 15–21

  25. Ying C, Hui C, Xiang W (2014) Comparative evaluation of arch width changes treated with active and passive self-ligating systems. Stomatology. 34:618–620 [in Chinese]

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthodontics, West China School of Stomatology, Sichuan University, 3rd Section of Renmin South Road, Chengdu, 610041, Sichuan, China

    Xianrui Yang, Yiruo He, Tian Chen, Mengyuan Zhao, Yinqiu Yan, Hongzhe Wang & Ding Bai

Authors
  1. Xianrui Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yiruo He
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tian Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mengyuan Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yinqiu Yan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hongzhe Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ding Bai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ding Bai.

Ethics declarations

Conflict of interest

X Yang, Y. He, T. Chen, M. Zhao, Y. Yan, H. Wang, and D. Bai declare that they have no conflict of interest.

This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Dr.: Ding Bai.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yang, X., He, Y., Chen, T. et al. Differences between active and passive self-ligating brackets for orthodontic treatment. J Orofac Orthop 78, 121–128 (2017). https://doi.org/10.1007/s00056-016-0059-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00056-016-0059-8

Keywords

Schlüsselwörter

Search

Navigation