Study weighs use of self-ligating vs. conventional brackets

Do orthodontists perceive significant clinical differences between self-ligating brackets (SLB) and conventional brackets (CB) during treatment?

That was the question posed by a team of researchers from Virginia Commonwealth University in a new study in The Angle Orthodontist (March 12, 2012).

The authors developed and distributed a survey (n = 430) to evaluate how SLB compared to CB in terms of orthodontists' perceptions.

They found that the majority of the practitioners (73%) had been using SLB for two to 10 years, and most (76%) became comfortable with them after treating fewer than 30 cases. However, 36% of the respondents who had used SLB reported that they no longer use them or were planning on discontinuing their use of SLB. Of those who had stopped using SLB, the majority indicated that this was due to the lack of noticeable advantages compared to justifying the expanded inventory and increased costs.

The study authors found that more orthodontists preferred SLB during the initial stage of treatment based on the shorter adjustment appointments and faster initial treatment progress they provided (p < .0001).

However, 64% of respondents preferred CB during the finishing and detailing stages of treatment (p < .0001). In addition, in terms of cost-effectiveness, 68% preferred CB over SLB because they were cheaper and resulted in fewer emergency appointments.

"The orthodontists participating in this study reported a perceived clinical difference between SLB and CB with regard to orthodontic treatment," the researchers wrote. "SLB were preferred by orthodontists more often than CB for the majority of the treatment factors evaluated."

The survey respondents' preferences were "significantly influenced" by the proportion of patients treated with SLB (p < .0001), the number of cases it took them to become accustomed to SLB (p < .0001), and the average appointment intervals associated with SLB (p < .0001), the study authors noted.

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