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Self-Ligation in the Year 2000, a Comparative Assessment of Conventional Ligation and Self-Ligation Bracket Systems

Berger J. Journal of Clinical Orthodontics 2000.

Objective

A retrospective assessment of clinical studies relating to the effectiveness and efficiencies of self-ligating brackets as compared with conventionally ligated straightwire appliances.

Objective

More than twenty published articles/clinical studies were analyzed.

A total of 215 patients were treated at three different sites — one university and two private practices. Out of those patients, 108 were treated with the Damon System and 107 with conventional braces. Damon and non-Damon treatments were analyzed for frequency of appointments, treatment duration and quality of treatment outcome as determined by the ABO grading criteria. Additionally, patients in both groups were surveyed to assess their level of satisfaction with their treatment.

Findings
  • Self-ligating brackets were found to provide greater patient comfort, shorter treatment time, reduced chair time, and more precise control of tooth translation.
  • Self-ligating brackets demonstrate dramatically less friction. Such reduction in friction can help shorten overall treatment time, especially in extraction cases.
  • The authors of several studies reported an average of four months' reduction in treatment time and a significant savings of chair time in changing archwires.
  • Self-ligation reduces the risks of percutaneous injury. It also protects the patient from soft-tissue lacerations and possible infections from the cut ends of steel ligatures.
  • Elastomeric ligatures not only show a rapid rate of decay and deformation but they are often associated with poor oral hygiene. With the elimination of ligatures, self-ligating appliances can significantly improve the hygiene of all patients.
Conclusion

"As more orthodontic practices embrace the concept of self-ligation, it is becoming apparent that stainless steel and elastomeric ligatures will eventually be as outdated as full banding is today. Considering the advantages of self-ligating brackets for the clinician, staff, and patient, they (self-ligating appliances) may well become the 'conventional' appliance systems of the 21st century."