Self-Ligating Brackets: To Use or Not to Use?
Although self-ligating brackets (SLBs) have been around for many years, they have only recently been in the spotlight. Modern self-ligation first occurred with the Edgelock® bracket, introduced by Ormco™ in the 1970s. It was big, difficult to open, and was welded to a band. In the early 1980s, Orec produced the Speed bracket, developed by Dr Herbert Hanson. It was, and is, a very aesthetic metal bracket. However, its small mesio-distal width makes it difficult to place precisely, and corrections of rotations are a problem.
Other SLB brackets came to market, and several of them hit big time. These include the Damon® bracket in several forms, and the In-Ovation brackets. Various companies produced their versions of “passive” and “interactive” brackets (more on that later): Forestadent® (BioQuick® and QuicKlear®), 3M™ Unitek™ (SmartClip™), and American Orthodontics (Empower®) being the most noteworthy.
So what is it about these brackets that provoke controversy? Are SLBs, in general, any better than traditional twin brackets? Are there any differences between “passive,” “active,” and “interactive”? Which is better, if any?
The great thing about orthodontics is that we can all have our opinions and treat with different brackets and different mechanics. So, what follows is the opinion of one orthodontist based on the use of many traditional, and most SLBs.
To get started, let’s look at the claims made about SLBs:
- Treat patients more quickly.
- Allow longer intervals be-tween patient appointments.
- Allow fewer patient visits.
- Treat patients to a better result.
- Eliminate the need for ex-pansion appliances.
- The reduction in friction causes teeth to move faster.
It is my opinion, all of these claims are unjustified.