Title	Advantages Of Self-Ligating Bracket Systems
Clinical Question	Are self-ligating bracket systems truly an improvement in orthodontic treatment when compared to conventional edgewise bracket systems?
Clinical Bottom Line	Orthodontic treatment objectives can be successfully attained regardless of bracket system used. Diagnosis and treatment planning with competent execution of treatment is more important than any specific bracket system used in treating the orthodontic patient. (See Comments on the CAT below)
Best Evidence
PubMed ID Author / Year Patient Group Study type (level of evidence) 20685517 Chen/2010 Sixteen studies were reviewed, including 2 randomized controlled trials with low risk of bias, 10 cohort studies with moderate risk of bias, and 4 cross-sectional studies with moderate to high risk of bias Systematic review with meta-analysis Key results There are many claims stating the superiority of self-ligating bracket systems over conventional bracket systems. Although supporting evidence is generally lacking to support these claims, several recent studies have found a small but statistically significant difference in mandibular incisor position. These studies have found 1.5 degrees less mandibular incisor proclination with self ligating brackets compared with conventional bracket systems. No other supporting evidence regarding treatment time or occlusal characteristics after treatment has been found.
Evidence Search	"self"[All Fields] AND ligating[All Fields] AND brackets[All Fields] AND conventional[All Fields] AND brackets[All Fields] AND ("review"[Publication Type] OR "review literature as topic"[MeSH Terms] OR "review"[All Fields])
Comments on The Evidence	The exclusion of certain studies from this systematic review due to a high risk of bias appears to be subjective in approach. This subjective exclusion of certain studies will result in a conclusion where not one bracket system favors another, thus allowing this study to be non-committal in its results.
Applicability	A competent orthodontist is a greater predictor in achieving optimal results in treatment rather than using a specific bracket system over another.
Specialty	(General Dentistry) (Orthodontics) (Pediatric Dentistry)
Keywords	Self ligating brackets, conventional brackets, edgewise
ID#	743
Date of submission	11/16/2010
E-mail	riveraj7@uthscsa.edu
Author	Jaime Rivera, DDS
Co-author(s)
Co-author(s) e-mail
Faculty mentor
Faculty mentor e-mail
Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) by Kaveh Najibfard (San Antonio, TX) on 07/09/2012 A PubMed search on this topic in July 2012 showed that the answer to the clinical question addressed in this CAT is still valid, and the article listed contains the highest level of evidence.