Microbial species associated with dental caries found in saliva and in situ after use of self-ligating and conventional brackets.

OBJECTIVES: Enamel demineralization is among the main topics of interest in the orthodontic field. Self-ligating brackets have been regarded as advantageous in this aspect. The aim of this study was to evaluate the break homeostasis in the oral environment and the levels of microorganisms associated with dental caries among the different types of brackets. MATERIAL AND METHODS: Twenty patients received two self-ligating brackets: In-Ovation®R, SmartClipTM, and one conventional GeminiTM. Saliva was collected before bonding (S0), 30 (S1) and 60 (S2) days after bonding. One sample of each bracket was removed at 30 and 60 days for the in situ analysis. Checkerboard DNA-DNA Hybridization was employed to evaluate the levels of microbial species as-sociated with dental caries. Data were evaluated by nonparametric Friedman and Wilcoxon tests at 5% significance level. RESULTS: The salivary levels of L. casei (p=0.033), S. sobrinus (p=0.011), and S. sanguinis (p=0.004) increased in S1. The in situ analyses showed alteration in S. mutans (p=0.047), whose highest levels were observed to the In-Ovation®R. CONCLUSIONS: The orthodontic appliances break the salivary homeostasis of microorganisms involved in dental caries. The contamination pattern was different between self-ligating and conventional brackets. The In-Ovation®R presented worse performance considering the levels of cariogenic bacterial species.

Microbial species associated with dental caries found in saliva and in situ after use of self-ligating and conventional brackets

Abstract Objectives Enamel demineralization is among the main topics of interest in the orthodontic field. Self-ligating brackets have been regarded as advantageous in this aspect. The aim of this study was to evaluate the break homeostasis in the oral environment and the levels of microorganisms associated with dental caries among the different types of brackets. Material and Methods Twenty patients received two self-ligating brackets: In-Ovation®R, SmartClipTM, and one conventional GeminiTM. Saliva was collected before bonding (S0), 30 (S1) and 60 (S2) days after bonding. One sample of each bracket was removed at 30 and 60 days for the in situ analysis. Checkerboard DNA-DNA Hybridization was employed to evaluate the levels of microbial species as-sociated with dental caries. Data were evaluated by nonparametric Friedman and Wilcoxon tests at 5% significance level. Results The salivary levels of L. casei (p=0.033), S. sobrinus (p=0.011), and S. sanguinis (p=0.004) increased in S1. The in situ analyses showed alteration in S. mutans (p=0.047), whose highest levels were observed to the In-Ovation®R. Conclusions The orthodontic appliances break the salivary homeostasis of microorganisms involved in dental caries. The contamination pattern was different between self-ligating and conventional brackets. The In-Ovation®R presented worse performance considering the levels of cariogenic bacterial species.

Initial arch wires used in orthodontic treatment with fixed appliances.

BACKGROUND: Initial arch wires are the first arch wires to be inserted into the fixed appliance at the beginning of orthodontic treatment and are used mainly for the alignment of teeth by correcting crowding and rotations. With a number of different types of orthodontic arch wires available for initial tooth alignment, it is important to understand which wire is most efficient, as well as which wires cause least amount of root resorption and pain during the initial aligning stage of treatment. This is an update of the review entitledInitial arch wires for alignment of crooked teeth with fixed orthodontic braces, which was first published in 2010. OBJECTIVES: To assess the effects of initial arch wires for the alignment of teeth with fixed orthodontic braces, in terms of the rate of tooth alignment, amount of root resorption accompanying tooth movement, and intensity of pain experienced by patients during the initial alignment stage of treatment. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 5 October 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2017, Issue 9), MEDLINE Ovid (1946 to 5 October 2017), and Embase Ovid (1980 to 5 October 2017. The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: We included randomised controlled trials (RCTs) of initial arch wires to align teeth with fixed orthodontic braces. We included only studies involving participants with upper or lower, or both, full arch fixed orthodontic appliances. DATA COLLECTION AND ANALYSIS: Two review authors were responsible for study selection, 'Risk of bias' assessment and data extraction. We resolved disagreements by discussion between the review authors. We contacted corresponding authors of included studies to obtain missing information. We assessed the quality of the evidence for each comparison and outcome as high, moderate, low or very low, according to GRADE criteria. MAIN RESULTS: For this update, we found three new RCTs (228 participants), bringing the total to 12 RCTs with 799 participants. We judged three studies to be at high risk of bias, and three to be at low risk of bias; six were unclear. None of the studies reported the adverse outcome of root resorption. The review assessed six comparisons.1. Multistrand stainless steel versus superelastic nickel-titanium (NiTi) arch wires. There were five studies in this group and it was appropriate to undertake a meta-analysis of two of them. There is insufficient evidence from these studies to determine whether there is a difference in rate of alignment between multistrand stainless steel and superelastic NiTi arch wires (mean difference (MD) -7.5 mm per month, 95% confidence interval (CI) -26.27 to 11.27; 1 study, 48 participants; low-quality evidence). The findings for pain at day 1 as measured on a 100 mm visual analogue scale suggested that there was no meaningful difference between the interventions (MD -2.68 mm, 95% CI -6.75 to 1.38; 2 studies, 127 participants; moderate-quality evidence).2. Multistrand stainless steel versus thermoelastic NiTi arch wires. There were two studies in this group, but it was not appropriate to undertake a meta-analysis of the data. There is insufficient evidence from the studies to determine whether there is a difference in rate of alignment between multistrand stainless steel and thermoelastic NiTi arch wires (low-quality evidence). Pain was not measured.3. Conventional NiTi versus superelastic NiTi arch wires. There were three studies in this group, but it was not appropriate to undertake a meta-analysis of the data. There is insufficient evidence from these studies to determine whether there is any difference between conventional and superelastic NiTi arch wires with regard to either alignment or pain (low- to very low-quality evidence).4. Conventional NiTi versus thermoelastic NiTi arch wires. There were two studies in this group, but it was not appropriate to undertake a meta-analysis of the data. There is insufficient evidence from these studies to determine whether there is a difference in alignment between conventional and thermoelastic NiTi arch wires (low-quality evidence). Pain was not measured.5. Single-strand superelastic NiTi versus coaxial superelastic NiTi arch wires. There was only one study (24 participants) in this group. There is moderate-quality evidence that coaxial superelastic NiTi can produce greater tooth movement over 12 weeks (MD -6.76 mm, 95% CI -7.98 to -5.55). Pain was not measured.6. Superelastic NiTi versus thermoelastic NiTi arch wires. There were three studies in this group, but it was not appropriate to undertake a meta-analysis of the data. There is insufficient evidence from these studies to determine whether there is a difference in alignment or pain between superelastic and thermoelastic NiTi arch wires (low-quality evidence). AUTHORS' CONCLUSIONS: Moderate-quality evidence shows that arch wires of coaxial superelastic nickel-titanium (NiTi) can produce greater tooth movement over 12 weeks than arch wires made of single-strand superelastic NiTi. Moderate-quality evidence also suggests there may be no difference in pain at day 1 between multistrand stainless steel arch wires and superelastic NiTi arch wires. Other than these findings, there is insufficient evidence to determine whether any particular arch wire material is superior to any other in terms of alignment rate, time to alignment, pain and root resorption.

Enamel shear bond strength of different primers combined with an orthodontic adhesive paste.

AIM: The aim of this study was a comparison of shear bond strength (SBS) on tooth enamel of different primers combined with the adhesive paste Transbond XT. MATERIALS AND METHODS: Forty bovine teeth were used in order to create 40 test blocks. The blocks were divided into four groups of 10 blocks each: group A - sample primer (SP); group B - Opal Seal (OS); group C - Transbond Plus SEP (TSEP); group D - Transbond XT Primer (TXT). After surface preparation and application of the primer, respectively, two stainless steel brackets were fixed on each tooth by using Transbond XT. Accordingly, 80 brackets were debonded (n=20). Shear bond strength and adhesive remnant index (ARI) scores were evaluated. Statistical analyses were performed by using the Student's t-test and Mann-Whitney U test. RESULTS: All tested groups revealed high shear bond strength in a similar size range. There were no significant differences between the groups concerning shear bond strength. The ARI scores of group C showed significantly lower ARI scores (0 and 1) than that of group D. Apart from that there was no statistical difference. CONCLUSION: In combination with the adhesive paste Transbond XT, all tested primers were suitable for fixing orthodontic brackets. The primers could be changed according to the clinical situation.

A comparative assessment of enamel mineral content and Streptococcus mutans population between conventional composites and composites containing nano amorphous calcium phosphate in fixed orthodontic patients: a split-mouth randomized clinical trial.

OBJECTIVES: The aim of this 'split-mouth design' trial was to evaluate the effect of the nano amorphous calcium phosphate (NACP) containing composite on enamel mineral contents and streptococcus mutans population in fixed orthodontic patients. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTION: Randomized, prospective, single-center controlled trial. Twenty-four patients between the ages of 13-18 years participated in this study. The control and test sides were randomly selected by a coin toss (1:1 ratio). On the control side orthodontic brackets were bonded on the buccal surfaces of upper premolars and laterals using an orthodontic composite (Transbond XT), and on the study side NACP-containing composite was used. Outcome measures were the mineral content around the brackets and S.mutans count. The later were calculated in the plaque around the brackets by real-time PCR at 3 months, and 6 months after the initiation of treatment. All stages of the study were blind using coding system. Paired t-test and repeated measurements were used for data analysis. RESULTS: In the third and sixth month, the bacterial population was significantly lower in the study side than the control side (P = 0.01 and 0.000).The mineral content of the study side was significantly higher than the controls, 6 months after brocket bonding (P = 0.004). There were no significant differences between the premolars and lateral teeth for all measurements. LIMITATIONS: This research was performed in a single-center by one experienced clinician. CONCLUSION: NACP-containing composites have the potential to inhibit mineral content loss and S.mutans colonization around orthodontic brackets during fixed orthodontic treatments. TRIAL REGISTRATION: This trial was not registered. PROTOCOL: The protocol was not published before trial commencement.

Effects of fixed orthodontic treatment using conventional (two-piece) versus metal injection moulding brackets on hair nickel and chromium levels: a double-blind randomized clinical trial.

INTRODUCTION: Although nickel and chromium are known as allergen and cytotoxic orthodontic metals, very few and controversial studies have assessed the effect of orthodontic treatment on their systemic levels especially those reflected by their best biomarker of exposure, hair. Additionally, metal injection moulding (MIM) brackets are not studied, and there is no study on systemic ion changes following their usage. METHODS: In this double-blind randomized clinical trial, scalp hair samples of 24 female and 22 male fixed orthodontic patients [as two groups of conventional (two-piece) versus MIM brackets, n = 23×2] were collected before treatment and 6 months later. Randomization was carried out using a computer-generated random number table. The patients, laboratory expert, and author responsible for analyses were blinded of the bracket allocations. Hair nickel and chromium levels were measured using atomic absorption spectrophotometry. The effects of treatment, bracket types, gender, and age on hair ions were analysed statistically (α = 0.05, ß ≤ 0.02). RESULTS: In both groups combined (n = 46), nickel increased from 0.1600±0.0890 µg/g dry hair mass (pre-treatment) to 0.3199±0.1706 (6th month). Chromium increased from 0.1657±0.0884 to 0.3066±0.1362 µg/g. Both of these increases were significant (paired t-test, P = 0.0000). Bracket types, age, and gender had no significant influence on ion levels (P > 0.05). ANCOVA indicated different patterns of chromium increases in different genders (P = 0.033) and ages (P = 0.056). LIMITATIONS: Sample size determination should have accounted for the grouping as well. CONCLUSION: Hair nickel and chromium levels might increase about 185-200% after 6 months. They might not be affected by bracket types. Gender and age might not influence the baseline or 6th-month levels of both metals. Gender might however interact with orthodontic treatment, only in the case of chromium. REGISTRATION: The research is registered offline (thesis) and online (IR.AJUMS.REC.1394.516). PROTOCOL: The protocol was pre-determined before any experiments begin. FUNDING: The study was self-funded by the authors.

In vitro analysis of shear bond strength and adhesive remnant index of different metal brackets

ABSTRACT Introduction: There is a great variety of orthodontic brackets in the Brazilian market, and constantly evaluating them is critical for professionals to know their properties, so as to be able to choose which product best suits their clinical practice. Objectives: To evaluate the bond strength and the adhesive remnant index (ARI) of different brands of metal brackets. Material and Methods: A total of 105 bovine incisors were used, and brackets of different brands were bonded to teeth. Seven different bracket brands were tested (MorelliTM, American OrthodonticsTM, TP OrthodonticsTM, Abzil-3MTM, OrthometricTM, TecnidentTM and UNIDENTM). Twenty-four hours after bonding, shear bond strength test was performed; and after debonding, the ARI was determined by using an optical microscope at a 10-fold increase. Results: Mean shear bond strength values ranged from 3.845 ± 3.997 (MorelliTM) to 9.871 ± 5.106 MPa (TecnidentTM). The majority of the ARI index scores was 0 and 1. Conclusion: Among the evaluated brackets, the one with the lowest mean shear bond strength values was MorelliTM. General evaluation of groups indicated that a greater number of bond failure occurred at the enamel/adhesive interface.

RESUMO Introdução: atualmente, há uma grande diversidade de braquetes ortodônticos no mercado brasileiro, e a avaliação desses é fundamental para que os profissionais conheçam suas propriedades e possam qualificar a sua escolha. Objetivo: avaliar o desempenho de diferentes braquetes metálicos - com diferentes características de base -, por meio da resistência de união e do Índice de Adesivo Remanescente (IAR). Material e Métodos: braquetes de sete marcas distintas foram testados (Morelli®, American Orthodontics®, TP Orthodontics®, Abzil-3M®, Orthometric®, Tecnident® e UNIDEN®). Os braquetes foram colados em incisivos bovinos totalizando 105 corpos de prova. O teste de resistência ao cisalhamento foi realizado 24h após a colagem e, em seguida, foi avaliado o IAR, por meio do uso de um microscópio óptico, em aumento de 10 vezes. Resultados: a média dos valores de resistência de união variou entre 3,845 ± 3,997 MPa (Morelli®) e 9,871 ± 5,106 MPa (Tecnident®). A maioria dos escores do IAR foi de 0 e 1. Conclusão: entre os braquetes avaliados, o que obteve a menor média de resistência de união foi o Morelli®. A avaliação geral dos grupos indicou maior número de falhas de colagem na interface esmalte/adesivo.

Analysis on the precision of the dimensions of self-ligating brackets.

OBJECTIVE: The present study aimed to evaluate the precision of the torque applied by 0.022" self-ligating brackets of different brands, the precision of parallelism between the inner walls of their slots, and precision of their slot height. Eighty brackets for upper central incisors of eight trademarked models were selected: Abzil, GAC, American Orthodontics, Morelli, Orthometric, Ormco, Forestadent, and Ortho Organizers. Images of the brackets were obtained using a scanning electron microscope (SEM) and these were measured using the AutoCAD 2011 software. The tolerance parameters stated in the ISO 27020 standard were used as references. The results showed that only the Orthometric, Morelli, and Ormco groups showed results inconsistent with the ISO standard. Regarding the parallelism of the internal walls of the slots, most of the models studied had results in line with the ISO prescription, except the Morelli group. In assessing bracket slot height, only the Forestadent, GAC, American Orthodontics, and Ormco groups presented results in accordance with the ISO standard. The GAC, Forestadent, and American Orthodontics groups did not differ in relation to the three factors of the ISO 27020 standard. Great variability of results is observed in relation to all the variables.

In vitro analysis of shear bond strength and adhesive remnant index of different metal brackets.

INTRODUCTION:: There is a great variety of orthodontic brackets in the Brazilian market, and constantly evaluating them is critical for professionals to know their properties, so as to be able to choose which product best suits their clinical practice. OBJECTIVES:: To evaluate the bond strength and the adhesive remnant index (ARI) of different brands of metal brackets. MATERIAL AND METHODS:: A total of 105 bovine incisors were used, and brackets of different brands were bonded to teeth. Seven different bracket brands were tested (MorelliTM, American OrthodonticsTM, TP OrthodonticsTM, Abzil-3MTM, OrthometricTM, TecnidentTM and UNIDENTM). Twenty-four hours after bonding, shear bond strength test was performed; and after debonding, the ARI was determined by using an optical microscope at a 10-fold increase. RESULTS:: Mean shear bond strength values ranged from 3.845 ± 3.997 (MorelliTM) to 9.871 ± 5.106 MPa (TecnidentTM). The majority of the ARI index scores was 0 and 1. CONCLUSION:: Among the evaluated brackets, the one with the lowest mean shear bond strength values was MorelliTM. General evaluation of groups indicated that a greater number of bond failure occurred at the enamel/adhesive interface.

Factors Affecting the Shear Bond Strength of Orthodontic Brackets - a Review of In Vitro Studies.

The adhesive material used to bond orthodontic brackets to teeth should neither fail during the treatment period, resulting in treatment delays, untoward expenses or patient inconvenience nor should it damage the enamel on debonding at the end of the treatment. Although the effectiveness of a bonding system and any unfavorable effects on the enamel may be studied by conducting in-vivo studies, it is nearly impossible to independently analyze different variables that influence a specific bonding system in the oral environment. In-vitro studies, on the other hand, may utilize more standardized protocols for testing different bonding systems and materials available. Thus, the present review focused attention on in-vitro studies and made an attempt to discuss material-related, teeth-related (fluorotic vs non-fluorotic teeth) and other miscellaneous factors that influences the shear bond strength of orthodontic brackets. Within the limitations of this review, using conventional acid-etch technique, ceramic brackets and bonding to non-fluorotic teeth was reported to have a positive influence on the shear bond strength of orthodontic brackets, but higher shear bond strength found on using ceramic brackets can be dangerous for the enamel.

Development of a standardized testing system for orthodontic sliding mechanics.

BACKGROUND: The primary objective of this study was to develop a computer-controlled three-dimensional friction measuring system, the orthodontic friction simulator (OFS). A clinically-based in vitro experiment considering wet and dry friction for conventionally and self-ligated brackets is presented to elucidate debate surrounding sliding mechanics and illustrate capabilities of the OFS. METHODS: The OFS was designed and manufactured using sound engineering principles and with the primary concern of being able to measure all forces and moments generated during sliding mechanics. This required the implementation of a six-axis load cell. A variety of translation and rotation stages were also incorporated to allow for precise positioning of the bracket relative to the archwire. Once designed and built, the OFS was then used to compare conventional and self-ligation methods in both the wet and dry state. Damon Q brackets and 0.018″ × 0.025″ stainless steel wires were used for all tests with a sample size of n = 65 for each ligation method. Archwires were pulled at a speed of 0.1 mm/s in 11 increments of 0.1 mm. At each increment, the bracket would be rotated 0.5° resulting in a total archwire travel of 1.1 mm and a second-order bracket angle range of 0°-5°. A repeated measures ANOVA was conducted to determine if ligation method and/or addition of moisture effected resulting orthodontic loads. RESULTS: The developed equipment for studying orthodontic sliding mechanics was able to measure forces and moments in all three directions; a capability not previously realized in the literature. Additionally, it was found that passive ligation significantly reduced resistance to sliding, P ≤ 0.05, while the dry/wet state did not. CONCLUSIONS: The OFS certainly proved to be an adequate instrument for the scientific evaluation of orthodontic sliding mechanics. It is capable of measuring loads generated in all directions and is a fully automated apparatus allowing for simple and repeatable friction tests to be conducted. Furthermore, the addition of saliva was not found to significantly influence the loads generated during sliding mechanics regardless of ligation method.

Dez anos trabalhando com braquetes autologáveis. Vantagens e desvantagens no consultório particular / Ten years working with self-ligating brackets: advantages and disadvantages in private clinical practice

Introdução: o aparelho ortodôntico autoligável está no mercado há mais de uma década, sendo frequentemente usado nos consultórios particulares de todo o Brasil. Método: o método desse trabalho foi a seleção retrospectiva baseada na resposta de tratamentos e experiências. Propósito: avaliar o real impacto dos braquetes autoligáveis dentro do consultório particular, assim como enumerar e discutir as vantagens e desvantagens da utilização desse acessório, ressaltando características importantes nos quesitos clínicos, científico e gerencial. Conclusão: a literatura atual não suporta a eficiência superior dessa modalidade de aparelho, quando comparada aos braquetes convencionais, porém esse acessório pode oferecer grande impacto dentro de um consultório ortodôntico, favorecendo o aumento da produtividade e da qualidade de vida do profissional.

O benefício da utilização dos braquetes autoligáveis em tratamentos com atresia mandibular e com mordida aberta anterior / The benefit of using self-ligating brackets in cases of narrow mandibule and anterior open bite

Introdução: Tratando-se de novos protocolos ortodônticos, os braquetes autoligáveis estão entre as mais recentes evoluções tecnológicas, atraindo cada vez mais a a atenção dos ortodontistas, com inúmeras vantagens sendo atribuídas, em muitos artigos científicos, a esse novo sistema de ligação. Objetivo: o presente artigo objetiva avaliar os resultados clínicos do uso de braquetes autoligáveis em pacientes com arcada inferior triangular (atrésica) e em casos de mordida aberta, sendo observadas algumas das principais ações desses braquetes, que são os efeitos de redução de atrito e da melhor leitura da prescrição de torque dos aparelhos programados. Conclusão: a utilização de braquetes autoligáveis nos casos de arcada inferior triangular apresentou importante efeito expansivo de mordida aberta anterior, também foi observada grande eficiência na correção, com uma biomecânica simples e rápida, proporcionada pelo baixo atrito e pela ótima ação de torque desses braquetes. No entanto, para se obter bons resultados com esse ou qualquer outro tipo de aparato ortodôntico, é imprescindível um correto diagnóstico.

Ortodontia de precisão / Accuracy Orthodontics

A prática clínica contemporânea da Ortodontia apresenta novas desmandas por parte dos cliente, relacionadas ao tempo de tratamento, redução do número de consultas e aparelhos estéticos. O profissional dispões, hoje, de aparelhos que podem ser combinados na customização e construção de sistemas de forças específicos, dentro de um ambiente de baixo atrito, possibilitando uma considerável redução do tempo de cadeira e no número de consultas, tendo um impacto positivo na produtividade do consultório e qualidade de vida do profissional. Os braquetes autoligáveis, dentro de uma plataforma digital, trazem uma nova filosofia para facilitar a prática e realizar uma Ortodontia de precisão.

Tratamento ortodôntico com aparelho autoligável / Orthodontic treatment with self-ligating appliance

Várias inovações tecnológicas são introduzidas com frequência no mercado ortodôntico. entre elas, podemos destacar os aparelhos autoligáveis, que prometem encurtar o tempo de tratamento, pois têm como característica a baixa fricção, que facilita o início do movimento dentário, pela diminuição da resistência inicial à movimentação. Essa característica de autoligação, comum a todos os braquetes dessa geração, desperta bastante interesse entre os ortodontistas, pois esses acreditam que os tratamentos ortodônticos tornam-se mais fáceis e rápidos. Durante a movimentação dentária, o atrito pode ser estático ou dinâmico, e está intimamente relacionado com o material do braquete, com o contato de arco com o braquete e, principalmente, com o sistema de amarração. Devido à possibilidade de ter controle sobre essas variáveis que influenciam na movimentação ortodôntica, a escolha do sistema de braquetes deverá estar relacionada com os objetivos do tratamento, ou seja, em casos que demandam grandes movimentações por meio do deslizamento, onde o controle de torque não é relevante, braquetes autoligáveis terão melhor desempenho do que os convencionais.

Braquetes autoligáveis alinham os dentes mais rapidamente? / Self-ligating brackets align teeth faster?

É impressionante como os fabricantes fazem alegações sem confirmação aparente sobre a validação ou veracidade de suas declarações, ao mesmo tempo que lutamos por apoio à pesquisa científica.

Braquetes autoligáveis: por que sim, por que não? / Self-ligating brackets: to use it or not to use it?

A utilização dos braquetes autoligáveis vem crescendo na Ortodontia clínica. A vantagem propagada pela indústria ortodôntica e por alguns membros da comunidade ortodôntica é a da redução do tempo de tratamento, consequência de um menor atrito observado nesse sistema de braquetes . Essa observação é baseada em ensaios in vitro e confirmada por diversos estudos. Entretanto, revisões sistemáticas, obtidas por meio da compilação e análise de estudos clínicos controlados, têm reportado que não existe vantagens ao se utilizar braquetes autoligáveis com a finalidade de reduzir o tempo do tratamento ortodôntico, os riscos clínicos controlados, têm reportado que não existe vantagens ao se utilizar braquetes autoligáveis com a finalidade de reduzir o tempo do tratamento ortodôntico, os riscos de doença periodontal e de reabsorção radicular, o número de fraturas de colagens dos acessórios ortodônticos e o desconforto do paciente durante o alinhamento dos dentes. As vantagens cientificamente comprovadas parecem estar restritas à redução do tempo de cadeira do paciente e ao emprego dos braquetes estéticos, evitando-se a pigmentação que ocorre nas ligaduras estéticas necessárias no sistema convencional. Em contrapartida, estudos clínicos reportam um maior desconforto, provocado por uma maior experiência de dor durante a manipulação do sistema de abertura e fechamento das caneletas dos aparelhos autoligáveis.