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

Abstract

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 selfligating 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.

An Umbrella Review of Systematic Reviews With or Without Meta-Analysis Assessing Treatment Outcomes and Efficiency of Self-Ligating Brackets

“…Studies were scrutinized by applying inclusion criteria, and 25 systematic reviews were found eligible for full-text assessment (Figure 1). Following full text assessment, 16 articles were included, 9-24 and 8 were excluded. Out of 17 studies, 12 performed a quantitative analysis, 9, 10, 11, 12, 14, 15, 16, 18, 21, 22, 23 and 5 performed a qualitative analysis.…”

“…Following full text assessment, 16 articles were included, 9-24 and 8 were excluded. Out of 17 studies, 12 performed a quantitative analysis, 9, 10, 11, 12, 14, 15, 16, 18, 21, 22, 23 and 5 performed a qualitative analysis. 13, 17, 19, 20, 24…”

“…Rate of alignment efficiency was evaluated by 5 studies, 9,10,11,18,20 space closure was evaluated by 7 studies, 9,10,11,14,18,20,23 pain and discomfort were reported by 3 studies 9,10,20 and periodontal condition and oral hygiene were evaluated by 7 studies. 10,11,13,17,19,21,22 Transverse arch dimensional changes were evaluated by 4 studies 10,17,18,24 and 1 study reported external apical resorption. 15 Methodological quality of all studies was positive to the following questions: The protocol provided a priori, had an adequate selection of studies by 2 independent reviewers, had a comprehensive search strategy, and provided characteristics of included studies.…”

“…The risk of bias in 10 studies was low, [9][10][11]14,15,[17][18][19]21,23 while it was unclear in 6. 12,13,16,20,22,24 The methodological quality of almost all studies was positive to signaling questions in domains 1 and 4 of phase 2 of ROBIS. However, Celar et al and Malik et al placed language restrictions on English and German, 12,23 and Arbildo et al placed restrictions on the time.…”

An Evaluation of Microbial Flora, Alkaline Phosphatase and IL-8 Levels in GCF of Orthodontic Patients with Self-Ligating and Conventional Brackets

“…These findings are in contrast to other investigations that declared no differences in the periodontal status in patients who were treated with either SLB or conventional brackets. 39–42 This difference can be explained by the following aspects: variation in baseline confounders, observation timepoints, methodological design, the population studied, units of assessment, statistical analyses, and differences in manufacturer of the brackets. Additionally, meta-analyses described in the literature have expressed the issue of low quality of evidence in studies that evaluated the difference of periodontal status in patients who were treated with SLB or conventional brackets.…”