Comparison of active self-ligating brackets and conventional pre-adjusted brackets.

Background: Active self-ligating brackets may be more efficient than conventional pre-adjusted brackets.
Aims: To determine if self-ligating brackets are more efficient than conventional pre-adjusted brackets when used in a specialist practice setting.
Methods: Seven hundred and sixty two patients, consecutively treated with fixed appliances, were evaluated retrospectively. All patients were treated by one orthodontist in a private orthodontic practice. Three hundred and eighty three patients were treated using a conventional pre-adjusted bracket system and 379 patients were treated with active self-ligating brackets. The total treatment time, number of appointments, appointment intervals, number of bracket breakages and number of unscheduled emergency appointments were recorded. Pretreatment characteristics identified by the ICON were related to these variables.
Results: The average treatment duration was 15.7 months (Range: 4.1-40.5 months; SD: 5.6 months). Comparable amounts of time were spent in rectangular and round archwires by both appliances. Overall, there was no statistically significant difference between the durations of treatment with active self-ligating brackets and conventional pre-adjusted brackets. The number of debonded brackets and other emergency visits was significantly higher in patients treated with active self-ligating brackets. The treatment characteristics associated with prolonged treatment were: extraction of teeth, a Class II molar relationship and the degree of maxillary crowding or spacing.
Conclusions: Active self-ligating brackets appear to offer no measurable advantages in orthodontic treatment time, number of treatment visits and time spent in initial alignment over conventional pre-adjusted orthodontic brackets.