Porcelain brackets during initial alignment: are self-ligating cosmetic brackets more efficient?

Abstract Objective To compare the effectiveness of a self-ligating (SL) porcelain bracket with a conventional porcelain (CP) bracket tied with ligatures for initial alignment in the upper arch, to compare the discomfort of both bracket – archwire combinations and to compare the times taken (both assisted and unassisted) to untie and ligate both bracket – archwire combinations. Methods Sixty nonextraction patients were randomly assigned to either a group with CP brackets on the upper six anterior teeth and conventional metal brackets on the premolars and first molars, or a group with SL porcelain brackets on the anterior teeth and SL metal brackets on the posterior teeth. The CP brackets were tied with coated ligatures. The irregularity index was measured at the start of treatment and at the first recall 10.7 weeks later. Discomfort was recorded over the first week with a Likert scale and the times to untie and ligate the six anterior porcelain brackets (assisted and unassisted) were recorded. Results There were no differences in irregularities at the start of treatment ( p = 0.91) or 10.7 weeks later ( p = 0.12). No significant difference in discomfort was found between the bracket types ( p = 0.90). The porcelain SL brackets were significantly faster ( p < 0.001) to untie and ligate than the CP brackets with ligatures. Conclusion Porcelain SL brackets were faster to untie and ligate by 22 seconds per bracket, but there were no significant differences in the alignment achieved or discomfort experienced.