Comparing the periodontal clinical effect between conventional and self-ligating brackets: Systematic review and meta-analysis.

  • Heber Arbildo Escuela de Estomatología, Universidad Señor de Sipán. Chiclayo, Perú. Escuela de Odontología, Universidad Particular de Chiclayo. Chiclayo, Perú. Centro de Salud Odontológico San Mateo. Trujillo, Perú.
  • Luis Gamarra Escuela de Estomatología, Universidad Privada Antonio Guillermo Urrelu. Cajamarca, Perú. Facultad de Estomatología, Universidad Nacional de Trujillo. Trujillo, Perú. Escuela de Estomatología, Universidad César Vallejo. Piura, Perú.
  • Sandra Rojas Facultad de Estomatología, Universidad Nacional de Trujillo. Trujillo, Perú.
  • Edward Infantes Escuela de Estomatología, Universidad Señor de Sipán. Chiclayo, Perú. Escuela de Estomatología, Universidad César Vallejo. Piura, Perú.
  • Fredy Cruzado Escuela de Odontología, Universidad Particular de Chiclayo. Chiclayo, Perú.
  • Hernán Vásquez Facultad de Odontología, Universidad San Martín de Porres. Lima, Perú.


Introduction: Orthodontists constantly seek to reduce the duration of their provided treatments and the patient's time in the office. For this reason, different bracket systems are currently used in orthodontics; an example is self-ligating brackets (SLB) which are believed to offer advantages over conventional brackets (CB). Objective: To evaluate and compare the clinical periodontal effect of CB and SLB through a systematic review and a meta-analysis. Material and Method: A search of the literature was carried out until December 2017, in the biomedical databases: PubMed, Embase, SciELO, ScienceDirect, SIGLE, LILACS, BBO, Google Scholar and the Cochrane Central Register of Controlled Trials.  The selection criteria of the studies were defined as such: randomized clinical trials, up to 5 years old and that report the clinical effects (probing depth, bleeding on probing, gingival index and plaque index) from the use of CB and SLB. The risk of study bias was analyzed through the Cochrane Handbook of systematic reviews of interventions. Results: The search strategy resulted in 12 articles, eight of which reported no difference in the reduction in probing depth, bleeding on probing, gingival index and plaque index (p>0.05) between CB and SLB. Conclusion: The literature reviewed suggests that there are no differences in the periodontal clinical effect among patients who received orthodontic treatment with CB or SLB.


1. Capistrano A, Cordeiro A, Siqueira DF, Capelozza Filho L, Cardoso Mde A, Almeida-Pedrin RR. From conventional to self-ligating bracket systems: is it possible to aggregate the experience with the former to the use of the latter? Dental Press J Orthod. 2014;19(3):139–57.
2. Fleming PS, O'Brien K. Self-ligating brackets do not increase treatment efficiency. Am J Orthod Dentofacial Orthop. 2013;143(1):11–9.
3. Prettyman C, Best AM, Lindauer SJ, Tufekci E. Self-ligating vs conventional brackets as perceived by orthodontists. Angle Orthod. 2012;82(6):1060–6.
4. Arteche P, Echandia GO, Sierra Á, Aristizábal JF, Rey D. Consideraciones importantes de la ortodoncia con brackets de autoligado versus ligado convencional. Rev Esp Ortod. 2015;45(2):93–100.
5. Liu Y, Wang PJ, Zhou S, Bai XF. Comparative study of self-ligating brackets and conventional brackets: direction and progress. Chin J Tissue Eng Res. 2014;18(25):4068–72.
6. Al-Thomali Y, Mohamed RN, Basha S. Torque expression in self-ligating orthodontic brackets and conventionally ligated brackets: A systematic review. J Clin Exp Dent. 2017;9(1):e123–8.
7. Muguruma T, Iijima M, Brantley WA, Ahluwalia KS, Kohda N, Mizoguchi I. Effects of third-order torque on frictional force of self-ligating brackets. Angle Orthod. 2014;84(6):1054–61.
8. Yang X, Xue C, He Y, Zhao M, Luo M, Wang P, Bai D. Transversal changes, space closure, and efficiency of conventional and self-ligating appliances : A quantitative systematic review. J Orofac Orthop. 2018;79(1):1–10.
9. Čelar A, Schedlberger M, Dörfler P, Bertl M. Systematic review on self-ligating vs. conventional brackets: initial pain, number of visits, treatment time. J Orofac Orthop. 2013;74(1):40–51.
10. Zhou Q, Ul Haq AA, Tian L, Chen X, Huang K, Zhou Y. Canine retraction and anchorage loss self-ligating versus conventional brackets: a systematic review and meta-analysis. BMC Oral Health. 2015;15(1):136.
11. Urrútia G, Bonfill X. [PRISMA declaration: a proposal to improve the publication of systematic reviews and meta-analyses]. Med Clin . 2010;135(11):507–11.
12. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0. The Cochrane: The Cochrane Collaboration; 2011.
13. Bergamo AZ, Nelson-Filho P, Romano FL, da Silva RA, Saraiva MC, da Silva LA, Matsumoto MA. Gingival crevicular fluid volume and periodontal parameters alterations after use of conventional and self-ligating brackets. J Orthod. 2016;43(4):260–7.
14. Cardoso Mde A, Saraiva PP, Maltagliati LÁ, Rhoden FK, Costa CC, Normando D, Capelozza Filho L. Alterations in plaque accumulation and gingival inflammation promoted by treatment with self-ligating and conventional orthodontic brackets. Dental Press J Orthod. 2015;20(2):35–41.
15. Kaygisiz E, Uzuner FD, Yuksel S, Taner L, Çulhaoğlu R, Sezgin Y, Ateş C. Effects of self-ligating and conventional brackets on halitosis and periodontal conditions. Angle Orthod. 2015;85(3):468–73.
16. Shrestha B, Jin X, Chen L, Shrestha R. Comparative Study of Periodontal Status of Early Orthodontic. Subjects treated with Self-ligating Brackets vs Conventional Edgewise Brackets. J Ind Orthod Soc. 2014;48(4):365–9.
17. Uzuner FD, Kaygisiz E, Cankaya ZT. Effect of the bracket types on microbial colonization and periodontal status. Angle Orthod. 2014;84(6):1062–7.
18. Folco AA, Benítez-Rogé SC, Iglesias M, Calabrese D, Pelizardi C, Rosa A, Brusca MI, Hecht P, Mateu ME. Gingival response in orthodontic patients: Comparative study between self-ligating and conventional brackets. Acta Odontol Latinoam. 2014;27(3):120–4.
19. Atik E, Ciğer S. An assessment of conventional and self-ligating brackets in Class I maxillary constriction patients. Angle Orthod. 2014;84(4):615–22.
20. Nalçacı R, Özat Y, Çokakoğlu S, Türkkahraman H, Önal S, Kaya S. Effect of bracket type on halitosis, periodontal status, and microbial colonization. Angle Orthod. 2014;84(3):479–85.
21. Baka ZM, Basciftci FA, Arslan U. Effects of 2 bracket and ligation types on plaque retention: a quantitative microbiologic analysis with real-time polymerase chain reaction. Am J Orthod Dentofacial Orthop. 2013;144(2):260–7.
22. Mummolo S, Marchetti E, Giuca MR, Gallusi G, Tecco S, Gatto R, Marzo G. In-office bacteria test for a microbial monitoring during the conventional and self-ligating orthodontic treatment. Head Face Med. 2013;9:7.
23. Pejda S, Varga ML, Milosevic SA, Mestrovic S, Slaj M, Repic D, Bosnjak A. Clinical and microbiological parameters in patients with self-ligating and conventional brackets during early phase of orthodontic treatment. Angle Orthod. 2013;83(1):133–9.
24. Shi J, Liu Y, Hou J, Yan Z, Peng H, Chang X. [Comparison of periodontal indices and Porphyromonas gingivalis between conventional and self-ligating brackets]. Hua Xi Kou Qiang Yi Xue Za Zhi. 2013;31(3):228–31.
25. Davis SM, Plonka AB, Fulks BA, Taylor KL, Bashutski J. Consequences of orthodontic treatment on periodontal health: Clinical and microbial effects. Semin Orthod. 2014;20:139.
26. Akgun OM, Altug H, Karacay S, Guven Polat G, Duyan S, Bedir O. Effect of 2 elastomeric ligatures on microbial flora and periodontal status in orthodontic patients. Am J Orthod Dentofacial Orthop. 2014;145(5):667–71.
27. Arnold S, Koletsi D, Patcas R, Eliades T. The effect of bracket ligation on the periodontal status of adolescents undergoing orthodontic treatment. A systematic review and meta-analysis. J Dent. 2016;54:13–24.
28. Koletsi D, Fleming PS, Eliades T, Pandis N. The evidence from systematic reviews and meta-analyses published in orthodontic literature. Where do we stand? Eur J Orthod. 2015;37(6):603–9.
29. Migliorati M, Isaia L, Cassaro A, Rivetti A, Silvestrini-Biavati F, Gastaldo L, Piccardo I, Dalessandri D, Silvestrini-Biavati A. Efficacy of professional hygiene and prophylaxis on preventing plaque increase in orthodontic patients with multibracket appliances: a systematic review. Eur J Orthod. 2015;37(3):297–307.
30. Yang X, Su N, Shi Z, Xiang Z, He Y, Han X, Bai D. Effects of self-ligating brackets on oral hygiene and discomfort: a systematic review and meta-analysis of randomized controlled clinical trials. Int J Dent Hyg. 2017;15(1):16–22.
31. Cobos-Carbó A, Augustovski F. [CONSORT 2010 Declaration: updated guideline for reporting parallel group randomised trials]. Med Clin. 2011;137(5):213–5.
How to Cite
ARBILDO, Heber et al. Comparing the periodontal clinical effect between conventional and self-ligating brackets: Systematic review and meta-analysis.. Journal of Oral Research, [S.l.], v. 7, n. 4, p. 155-161, apr. 2018. ISSN 0719-2479. Available at: <>. Date accessed: 28 feb. 2020. doi:


elf-ligating bracket; conventional bracket; periodontal health; review; meta-analysis.