Self-Ligating Brackets and "The Frankel like Effect": A Systematic Review

Objectives: The aim of this Systematic review was to compare the effect of Self-Ligating Brackets (SLB) and conventional brackets (CB) on buccal bone (height & thickness), transverse dental dimensions, and incisal inclinationin adult orthodontic patients with mild to moderate crowding. Methods: A systematic search was conducted on May 2016 and updated on May 2017, in PubMed, CENTRAL, Lilacs, and Embase. Date or language restrictions were not applied. Hand search was performed too. Search was performed on orthodontic patients receiving treatment using SLB compared to (CB).The Primary outcomes of interest were the changes in alveolar bone thickness and height and changes in the arch width and incisor inclination. Studies which fulfilled the selection criteria were assessed for methodological quality using validated checklists. Studies of moderate and high quality were included. Results: Out of 930 initially retrieved articles, 8 articles were included in this review for qualitative and quantitative analysis. There was noevidence for the difference in alveolar bone changes foreitherintervention. Both interventions demonstrated no difference in arch width expansion except for maxillary inter-canine width and mandibular inter-molar width. There was no difference in maxillary incisor inclination between both interventions. However, CB showed more mandibular incisor inclination. Conclusion: There is no conclusiveevidence to confirm or refute the claims that SLB produce superior physiologic tooth movement with more bone deposition. Both SLB and CB produce statistically and clinically significant dental expansion. SLB produce less proclination. Rigorous randomized clinical trials are needed to investigate alveolar bone changes between SLB and CB.