Iran J Ortho. In Press(In Press):e90579.
Published online 2019 March 28.
Possible Advantages of Self-Ligating Brackets: From Claims to
Evidence, a Literature Review
Homa Farhadifard 1, Mohammad Ali Keshvad 2, Aryan Hesamareﬁ 2and Elahe Soltan Mohammadi 3,*
1Department of Orthodontics, School of Dentistry , Hamedan University of Medical Sciences, Hamedan, Iran
2Department of Orthodontics, Tehran University of Medical Sciences, Tehran, Iran
3Department of Orthodontics, School of Dentistry, Qom University of Medical Sciences, Qom, Iran
*Corresponding author: Assistant Professor, Orthodontic Department, School of Dentistry, of Qom University of Medical Sciences, Saheli St., Qom, Iran. Tel: +98-9123058172,
Received 2019 February 12; Accepted 2019 March 06.
Self-ligating brackets are ligature-less brackets with the mechanical device built into them to close edgewise slot. It was claimed
that self-ligating brackets (SLBs) have advantages over conventional-ligating brackets brackets (CLBs). The most claimed advanta-
geous feature is reduced friction between the archwire and the bracket and full archwire engagement, resulting in faster alignment
and space closure. Greater arch expansion with less incisor proclination, also faster ligation, reduced number of visits and less pain
is mentioned as the beneﬁcial features of SLBs in diﬀerent articles. In this review article, we compared SLBs with CBs in aspect of
resistance to sliding, speed of archwire ligation, quality of alignment and amount of pain during treatment base on the most re-
cent articles published in literature. We concluded that although self-ligating brackets are proved to have some advantages over
conventional brackets, but more studies are needed to discard doubts about using them, routinely.
Keywords: Self-Ligating Brackets, Review, Friction, Alignment, Pain, Ligation, Engagement
Traditionally wire or elastomeric ligatures are used to
engage the archwire in the bracket slot. These conven-
tional ligation systems have limitations with respect to
ergonomics, eﬃcacy, discoloration, plaque accumulation,
and friction. Self-ligation has been developed to overcome
these deﬁcits. Self-ligating brackets (SLBs) are ligature-less
brackets with the mechanical device built into them to
close edgewise slot (1).
Self-ligation is not a new concept. The ﬁrst self-
ligating bracket, the Russell attachment, was introduced
by Stoltenberg in the early 1930s and during the past sev-
eral decades, interest in SLBs has been remarked (2). SLBs
are divided into 2 groups according to their mechanisms
of closure: active and passive. Active SLBs like in-ovation,
SPEED, and time, have a spring clip that stores energy to
press against the arch- wire for rotation and torque con-
trol. Passive SLBs usually have a slide that can be closed to
the slot lumen, so they exert no active force on the arch-
wire (Damon and Smart Clip) (3). It was claimed that SLBs
have advantages over conventional brackets (CB). The most
advantageous feature is reduced friction between the arch-
wire and the bracket and full archwire engagement, result-
ing in faster alignment and space closure. Greater arch ex-
pansion with less incisor proclination (4). Also, faster liga-
tion with reduced number of visits and less pain are men-
tioned as the beneﬁts of SLBs (5).
2. Evidence Acquisition
In order to compare diﬀerent allegations around
these kind of brackets we searched databases including:
PubMed, Google Scholar, Scopus and Medline. Two or-
thodontic experts reviewed articles in English language
only and those published from 2010 to 2018. Our keywords
were: “self-ligate AND orthodontic” - “ligation method AND
orthodontic “-“active self-ligated AND brackets” -“passive
self-ligated AND brackets”. Clinical trials (randomized or
non-randomized), systematic reviews and meta-analysis
on patients with no anomalies like syndrome or lip and
palate cleft and experimental in vitro studies were chosen
In this review we compared SLBs with CBs in aspect of
resistance to sliding, speed of archwire ligation, quality
Copyright © 2019, Iranian Journal of Orthodontics. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0
International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the
original work is properly cited.
Farhadifard H et al.
of alignment (arch expansion and incisor pro-inclination)
and amount of pain during treatment by using newest pa-
pers according to the criteria mentioned earlier.
3.1. Resistance to Sliding
Friction is deﬁned as resistance to motion when one
surface attempts to slide over another, which has contact
with (6). It has been proposed that approximately 50%
of the force applied to slide a tooth through an archwire
is used up to overcome friction (7). There is lots of as-
sertions considering this factor in self ligating and con-
ventional brackets and sometimes contradicting conclu-
sions (8). Ehsani et al. reported that SLBs maintain lower
friction than CBs when engaged with small round arch-
wires in the absence of tipping and/or torque in an ide-
ally aligned arch. Also, they announced that as the arch-
wire size increased, friction of both self-ligated and con-
ventional brackets increased (1). Harradine concluded that
for self-ligation, lower resistance to sliding is one of 3 main
features that are increasingly supported by valid studies
(9). Thapa and Wu reported that major portion of the resis-
tance is because of the ligation forces applied to the arch-
wire and self-ligation decreases the amount of friction due
to binding but only when thin archwires are used along
with it (10). Rinchuse and Miles reported that SLBs showed
good performance in vitro with smaller wires that are used
during early stages of treatment. But when larger wires
are used (like 0.016 ×0.022 and 0.019 ×0.025 nickel- ti-
tanium), no diﬀerences were found between SLBs and CBs
(11). Pillai et al. by evaluating frictional resistance gener-
ated by conventional stainless steel, radiance ceramic, self-
ligating and composite brackets concluded that SLB has
the least friction among these four types of brackets (12).
Leite et al. also conﬁrmed this ﬁnding in his research in
2014. According to him, SLBs had lesser frictional resis-
tance than steel or elastomeric-tied conventional brackets
(13). Other studies also found the same conclusion (8,14-
18). In an in-vitro study by Vinay K which assessed fric-
tion in diﬀerent combinations of wire, bracket and lig-
ation method, it was concluded that self-ligating brack-
ets oﬀered least friction followed by conventional stain-
less steel brackets, ceramic with metal insert bracket and
ceramic brackets (19). In spite of these articles, Pliska et
al. found that with the exception of CL monocrystalline
bracket, CBs & SLBs displayed comparable amounts of re-
sistance to sliding regardless of ligation method or bracket
slot material (20).
Saporito et al. compared the eﬀectiveness of space clo-
sure of CBs & SLBs. No signiﬁcant diﬀerence was seen in
the eﬃciency of space closure between the self-ligating
bracket and conventional bracket tied with stainless steel
Karim Soltani et al. compared the resistance to slid-
ing in 4 subgroups of brackets including: metallic and
clear Damon brackets and metallic and clear conventional
brackets in a wet condition resembling oral cavity environ-
ment. Statistically, there was no signiﬁcant diﬀerence ob-
served between either of the subgroups in resistance to
sliding and static frictional forces meaning that neither
the type of bracket materials (clear and metal) nor their
type of ligation made any diﬀerence in resistance to slid-
ing and static friction (22).
Muguruma et al. investigated the eﬀects of torque on
frictional properties of SLBs. He founded that in most sit-
uations, increasing the torque produced a signiﬁcant in-
crease in static friction but most SLB-wire combinations at
all torques produced less friction than that of the conven-
tional bracket. Active-type SLB-wire combinations showed
higher friction than passive-type SLB-wire combinations in
most conditions (23). Huang et al. (24) and Oliver et al. (25)
also conﬁrmed this ﬁnding.
3.2. Pain During the Treatment
The belief that treatment with SLBs is less painful may
be because of the lighter archwires that can be used with
equal eﬀectiveness with these brackets; so forces on the
teeth are lower and also the teeth move more readily in
response to the applied forces because of decreased re-
sistance to sliding (25,26). Celar et al. in their meta-
analysis announced that there were no signiﬁcant diﬀer-
ences in perceived pain between self-ligating and conven-
tional brackets during the ﬁrst week of treatment (27,28).
Fleming and Johal declared that analysis of the eﬀect of
bracket type on pain experience conﬁrmed that SLBs do
not have a clinically signiﬁcant stance on pain experience
(29). Othman et al. found the same conclusion in their
randomized clinical trial (30). Zhou et al. found that Pa-
tients with self-ligating brackets were associated with less
pain and discomfort at any intervals compared with con-
ventional brackets but no signiﬁcant diﬀerence of overall
oral health-related quality of life (OHRQoL) scores could be
found between two groups (31).
Bertl et al. in their study declared that engagement
and disengagement of rigid rectangular archwires caused
more pain with Smart Clip self-ligating brackets than con-
ventional ones (32). In a randomized clinical trial by Rah-
man et al. with the aim of comparing pain perception
between self-ligating and conventional preadjusted edge-
wise brackets, it was concluded that patients treated with
self-ligating brackets reported more pain perception but
statistically it was not signiﬁcant and was higher in day 1
compared to day 3 and 5 after bonding brackets (33) which
is conﬁrmed by the work of Scott et al. who did not report
2Iran J Ortho. In Press(In Press):e90579.
Farhadifard H et al.
any signiﬁcant diﬀerences in pain perception during ini-
tial alignment between patients who randomly were pre-
scribed by self-ligating and conventional brackets (34). Dis-
cussing active or passive self-ligating brackets Kohli and
his colleagues in 2012 stated that patients with active self-
ligating brackets experienced more pain in the ﬁrst 2 days
after bonding which was signiﬁcant (35).
3.3. Quality of Alignment
It is believed that with self-ligation mechanics,
lesser incisor proclination and greater arch expansion
is achieved, and so fewer extractions are required to pro-
vide space to do aligning of teeth (3). Chen et al. stated
that there was no signiﬁcant diﬀerence between the
SLB and CB for intercanine and intermolar widths. For
incisor proclination, their meta-analysis indicated that
self-ligating brackets resulted in slightly lesser incisor
proclination (1.5° leser proclination with SLBs versus CBs)
(3). Prettyman et al. declared that the use of SLB and
CB does not cause diﬀerences in incisor proclination and
intercanine expansion (4). Songra et al. concluded that the
time of initial alignment was signiﬁcantly shorter in the
conventional bracket than for either the active or passive
self-ligating brackets. There was no statistically signiﬁcant
diﬀerence in passive, active, or total space-closure times
among the 3 brackets under investigation (36). Pandis et
al. found that use of conventional or self-ligating brackets
did not seem to be a signiﬁcant indicator of mandibular
intermolar width in non-extraction patients when the
same wire sequence is used (37). Celikoglu et al. found
that bracket type has little inﬂuence on improvement in
anterior ambiguity during initial mandibular alignment
(38). Wahab and his colleagues compared the aligning
eﬃcacy of damon self-ligating brackets and mini-diamond
conventional brackets at each appointment and showed
that in the ﬁrst month of therapy CLB group lead to sig-
niﬁcantly faster alignment compared with SLB group but
there were no signiﬁcant diﬀerences in the alignment
speed between the second and third month and third and
fourth month. After four month of alignment, CLB group
showed 98 percent of alignment which was signiﬁcantly
more than 67 percent of SLB group (39).
3.4. Sped of Archwire Ligation
The initial motivation of developing self-ligating
brackets was to speed up the process of archwire ligation.
Several authors have reported that self-ligating brackets
save of up to nine minutes per visit compared with wire
ligation and approximately two minutes compared with
elastomeric ligation (9). In the study of Chen et al. results
showed a mean saving of 20 seconds per arch for opening
the slides of SLB compared with removing the ligatures of
CB, but there was no signiﬁcant diﬀerences between the
time needed for closing the slides of SLBs and replacing
the ligatures of CBs and self-ligation does appear to have a
signiﬁcant advantage in aspect of chair time (5). Paduano
et al. revealed that SLB had signiﬁcantly shorter ligation
time compared with elastomeric or stainless steel liga-
tions in both arches. He also claimed that speed of arch
wire ligation in SLB was dependent to self-ligating bracket
As shown in a recent systematic review by Dehbi and
colleagues which evaluated the tooth alignment, space clo-
sure, treatment duration, arch expansion and patient dis-
comfort in SLB and CB systems, and found no signiﬁcant
diﬀerences (41). Evidence shows that self-ligating brackets
can have little advantages over conventional ones. But as
the results of articles are contradictory, more studies are
needed to survey diﬀerent aspects of these brackets, more
Authors’ Contribution: Study concept and design:
Homa Farhadifard; acquisition of data: Mohammad Ali
Keshvad; drafting of the manuscript: Elahe Soltan Moham-
madi; critical revision of the manuscript for important in-
tellectual content: Aryan Hesamareﬁ; study supervision:
Elahe Soltan Mohammadi.
Conﬂicts of Interests: The authors have no conﬂicts of
interest to disclose.
Funding/Support: No funding support was needed.
1. Ehsani S, Mandich MA, El-Bialy TH, Flores-Mir C. Frictional resis-
tance in self-ligating orthodontic brackets and conventionally lig-
ated brackets. A systematic review. Angle Orthod. 2009;79(3):592–601.
doi: 10.2319/060208-288.1. [PubMed: 19413397].
2. Stolzenberg J. The Russell attachment and its improved advan-
tages. Int J Orthod Dent Child. 1935;21(9):837–40. doi: 10.1016/s0097-
3. Chen SS, Greenlee GM, Kim JE, Smith CL, Huang GJ. System-
atic review of self-ligating brackets. Am J Orthod Dentofa-
cial Orthop. 2010;137(6):726 e1–726 e18. discussion 726-7. doi:
10.1016/j.ajodo.2009.11.009. [PubMed: 20685517].
4. Prettyman C, Best AM, Lindauer SJ, Tufekci E. Self-ligating vs con-
ventional brackets as perceived by orthodontists. Angle Orthod.
2012;82(6):1060–6. doi: 10.2319/101311-640.1. [PubMed: 22409395].
5. Johansson K, Lundstrom F. Orthodontic treatment eﬃciency with
self-ligating and conventional edgewise twin brackets: A prospec-
tive randomized clinical trial. Angle Orthod. 2012;82(5):929–34. doi:
10.2319/101911-653.1. [PubMed: 22397386].
Iran J Ortho. In Press(In Press):e90579. 3
Farhadifard H et al.
6. Pizzoni L, Ravnholt G, Melsen B. Frictional forces related
to self-ligating brackets. Eur J Orthod. 1998;20(3):283–91. doi:
10.1093/ejo/20.3.283. [PubMed: 9699406].
7. Proﬃt WR. Contemporary orthodontics. 3rd ed. Louis, Mo: Mosby; 2000.
8. Araujo RC, Bichara LM, Araujo AM, Normando D. Debris and friction
of self-ligating and conventional orthodontic brackets after clinical
use. Angle Orthod. 2015;85(4):673–7. doi: 10.2319/012914-80.1. [PubMed:
9. Harradine N. Self-ligating brackets increase treatment eﬃ-
ciency. Am J Orthod Dentofacial Orthop. 2013;143(1):10–8. 11-9. doi:
10.1016/j.ajodo.2012.10.011. [PubMed: 23273355].
10. Thapa B, Wu LP. Self-ligating brackets in perspective of friction: A Re-
view.Orthod J Nepal. 2013;3(2):40–3.
11. Rinchuse DJ, Miles PG. Self-ligating brackets: Present and fu-
ture. Am J Orthod Dentofacial Orthop. 2007;132(2):216–22. doi:
10.1016/j.ajodo.2006.06.018. [PubMed: 17693372].
12. Pillai AR, Gangadharan A, Kumar S, Shah A. Comparison of the
frictional resistance between archwire and diﬀerent bracket sys-
tem: An in vitro study. J Pharm Bioallied Sci. 2014;6(Suppl 1):S150–5.
doi: 10.4103/0975-7406.137429. [PubMed: 25210359]. [PubMed Central:
13. Leite VV, Lopes MB, Gonini Junior A, Almeida MR, Moura SK, Almeida
RR. Comparison of frictional resistance between self-ligating and
conventional brackets tied with elastomeric and metal ligature in
orthodontic archwires. Dental Press J Orthod. 2014;19(3):114–9. doi:
10.1590/2176-94188.8.131.52-119.oar. [PubMed: 25162575]. [PubMed Cen-
14. Jakob SR, Matheus D, Jimenez-Pellegrin MC, Turssi CP, Amaral FL. Com-
parative study of friction between metallic and conventional inter-
active self-ligating brackets in diﬀerent alignment conditions. Dental
Press J Orthod. 2014;19(3):82–9. doi: 10.1590/2176-9451.19.3.082-089.oar.
[PubMed: 25162570]. [PubMed Central: PMC4296631].
15. Kumar S, Singh S, Hamsa PRR, Ahmed S, Bhatnagar A; Prasan-
thma, et al. Evaluation of friction in orthodontics using various
brackets and archwire combinations-an in vitro study. J Clin Diagn
Res. 2014;8(5):ZC33–6. doi: 10.7860/JCDR/2014/7990.4364. [PubMed:
24995241]. [PubMed Central: PMC4080062].
16. Pasha A, Vishwakarma S, Narayan A, Vinay K, Shetty SV, Roy PP. Com-
parison of frictional forces generated by a new ceramic bracket with
the conventional brackets using unconventional and conventional
ligation system and the self-ligating brackets: An in vitro study. J Int
Oral Health. 2015;7(9):108–13. [PubMed: 26435628]. [PubMed Central:
17. Ben Rejeb Jdir S, Tobji S, Turki W, Dallel I, Khedher N, Ben Amor A.
[Brackets and friction in orthodontics: experimental study]. Orthod
Fr. 2015;86(3):255–64. French. doi: 10.1051/orthodfr/2015026. [PubMed:
18. Monteiro MR, Silva LE, Elias CN, Vilella Ode V. Frictional resistance
of self-ligating versus conventional brackets in diﬀerent bracket-
archwire-angle combinations. J Appl Oral Sci. 2014;22(3):228–34. doi:
10.1590/1678-775720130665. [PubMed: 25025564]. [PubMed Central:
19. Vinay K, Venkatesh MJ, Nayak RS, Pasha A, Rajesh M, Kumar P. A com-
parative study to evaluate the eﬀects of ligation methods on fric-
tion in sliding mechanics using 0.022" slot brackets in dry state: An
In-vitro study. J Int Oral Health. 2014;6(2):76–83. [PubMed: 24876706].
[PubMed Central: PMC4037790].
20. Pliska BT, Beyer JP, Larson BE. A comparison of resistance to sliding
of self-ligating brackets under an increasing applied moment. Angle
Orthod. 2011;81(5):794–9. doi: 10.2319/111510-666.1. [PubMed: 21568646].
21. Saporito I, Butti AC, Salvato A, Biagi R. A "typodont" study of rate of
orthodontic space closure: Self-ligating systems vs. conventional sys-
tems. Minerva Stomatol. 2011;60(11-12):555–65. [PubMed: 22210459].
22. Karim Soltani M, Golfeshan F, Alizadeh Y, Mehrzad J. Resistance to slid-
ing in clear and metallic damon 3 and conventional edgewise brack-
ets: An in vitro study. J Dent (Shiraz). 2015;16(1 Suppl):15–20. [PubMed:
26106630]. [PubMed Central: PMC4476125].
23. Muguruma T, Iijima M, Brantley WA, Ahluwalia KS, Kohda N, Mi-
zoguchi I. Eﬀects of third-order torque on frictional force of self-
ligating brackets. Angle Orthod. 2014;84(6):1054–61. doi: 10.2319/111913-
845.1. [PubMed: 24738791].
24. Huang TH, Luk HS, Hsu YC, Kao CT. An in vitro comparison of
the frictional forces between archwires and self-ligating brackets
of passive and active types. Eur J Orthod. 2012;34(5):625–32. doi:
10.1093/ejo/cjr065. [PubMed: 21765175].
25. Oliver CL, Daskalogiannakis J, Tompson BD. Archwire depth is a signif-
icant parameter in the frictional resistance of active and interactive,
but not passive, self-ligating brackets. Angle Orthod. 2011;81(6):1036–
44. doi: 10.2319/122810-751.1. [PubMed: 21699367].
26. Heo W, Baek SH. Friction properties according to vertical and hori-
zontal tooth displacement and bracket type during initial leveling
and alignment. Angle Orthod. 2011;81(4):653–61. doi: 10.2319/072310-
431.1. [PubMed: 21306223].
27. Baccetti T, Franchi L, Camporesi M, Defraia E, Barbato E. Forces
produced by diﬀerent nonconventional bracket or ligature sys-
tems during alignment of apically displaced teeth. Angle Orthod.
2009;79(3):533–9. doi: 10.2319/050508-249.1. [PubMed: 19413392].
28. Celar A, Schedlberger M, Dorﬂer P, Bertl M. Systematic review on
self-ligating vs. conventional brackets: Initial pain, number of visits,
treatment time. J Orofac Orthop. 2013;74(1):40–51. doi: 10.1007/s00056-
012-0116-x. [PubMed: 23299650].
29. Fleming PS, Johal A. Self-ligating brackets in orthodontics. A system-
atic review.Angle Orthod. 2010;80(3):575–84. doi: 10.2319/081009-454.1.
30. Othman SA, Mansor N, Saub R. Randomized controlled clinical trial
of oral health-related quality of life in patients wearing conven-
tional and self-ligating brackets. Korean J Orthod. 2014;44(4):168–76.
doi: 10.4041/kjod.2014.44.4.168. [PubMed: 25133131]. [PubMed Central:
31. Zhou Y, Zheng M, Lin J, Wang Y, Ni ZY. Self-ligating brackets and
their impact on oral health-related quality of life in Chinese adoles-
cence patients: A longitudinal prospective study. ScientiﬁcWorldJour-
nal. 2014;2014:352031. doi: 10.1155/2014/352031. [PubMed: 25202720].
[PubMed Central: PMC4151365].
32. Bertl MH, Onodera K, Celar AG. A prospective randomized split-mouth
study on pain experience during chairside archwire manipulation in
self-ligating and conventional brackets. Angle Orthod. 2013;83(2):292–
7. doi: 10.2319/042312-338.1. [PubMed: 22827479].
33. Rahman S, Spencer RJ, Littlewood SJ, O’Dywer L, Barber SK, Russell JS.
A multicenter randomized controlled trial to compare a self-ligating
bracket with a conventional bracket in a UK population: Part 2: Pain
perception. Angle Orthod. 2016;86(1):149–56. doi: 10.2319/112414-838.1.
34. Scott P, Sherriﬀ M, Dibiase AT, Cobourne MT. Perception of discom-
fort during initial orthodontic tooth alignment using a self-ligating
or conventional bracket system: A randomized clinical trial. Eur J Or-
thod. 2008;30(3):227–32. doi: 10.1093/ejo/cjm131. [PubMed: 18339656].
35. Kohli SS, Kohli VS. Patient pain experience after placement of initial
aligning archwire using active and passive self-ligating bracket sys-
tems: A randomized clinical trial. Orthodontics (Chic.). 2012;13(1):e58–
65. doi: 10.1016/j.ajodo.2013.12.024. [PubMed: 22567655].
36. Songra G, Clover M, Atack NE, Ewings P, Sherriﬀ M, Sandy JR, et al.
Comparative assessment of alignment eﬃciency and space closure
of active and passive self-ligating vs conventional appliances in ado-
lescents: A single-center randomized controlled trial. Am J Orthod
Dentofacial Orthop. 2014;145(5):569–78. doi: 10.1016/j.ajodo.2013.12.024.
37. Pandis N, Polychronopoulou A, Katsaros C, Eliades T. Comparative as-
sessment of conventional and self-ligating appliances on the eﬀect
of mandibular intermolar distance in adolescent nonextraction pa-
4Iran J Ortho. In Press(In Press):e90579.
Farhadifard H et al.
tients: A single-center randomized controlled trial. Am J Orthod Dento-
facial Orthop. 2011;140(3):e99–e105. doi: 10.1016/j.ajodo.2011.03.019.
38. Celikoglu M, Bayram M, Nur M, Kilkis D. Mandibular changes dur-
ing initial alignment with SmartClip self-ligating and conventional
brackets: A single-center prospective randomized controlled clinical
trial. Korean J Orthod. 2015;45(2):89–94. doi: 10.4041/kjod.2015.45.2.89.
[PubMed: 25798415]. [PubMed Central: PMC4367136].
39. Wahab RM, Idris H, Yacob H, Ariﬃn SH. Comparison of self- and
conventional-ligating brackets in the alignment stage. Eur J Orthod.
2012;34(2):176–81. doi: 10.1093/ejo/cjq179. [PubMed: 21478298].
40. Paduano S, Cioﬃ I, Iodice G, Rapuano A, Silva R. Time eﬃciency of
self-ligating vs conventional brackets in orthodontics: eﬀect of ap-
pliances and ligating systems. Prog Orthod. 2008;9(2):74–80. [PubMed:
41. Dehbi H, Azaroual MF, Zaoui F, Halimi A, Benyahia H. Therapeu-
tic eﬃcacy of self-ligating brackets: A systematic review. Int Or-
thod. 2017;15(3):297–311. doi: 10.1016/j.ortho.2017.06.009. [PubMed:
Iran J Ortho. In Press(In Press):e90579. 5