Defense Date


Document Type


Degree Name

Master of Science



First Advisor

Eser Tufekci

Second Advisor

Steven Lindauer

Third Advisor

Al Best


Introduction: Within the past decade, significant developments, new designs, and numerous proposed advantages of self-ligating (SL) brackets have caused them to gain great popularity among practicing orthodontists. The purpose of this study was to determine if there are significant clinical differences between SL and conventional brackets on orthodontic treatment as perceived by practicing orthodontists, and more specifically, if the proposed advantages of SL brackets are evident in clinical practice. Methods: A survey was developed to evaluate how SL brackets compare to conventional brackets when perceived by practicing orthodontists (n=430). The initial series of questions focused on individual practitioner characteristics and the clinician’s experience with SL brackets, while the second part of the survey allowed the orthodontists to indicate a preference for either SL or conventional brackets in regard to a variety of treatment factors. Results: Most of the responding orthodontists (90%) had experience using SL brackets in clinical practice. SL brackets were preferred for the majority of orthodontic treatment factors, and were most significantly indicated as having shorter adjustment appointments (P <0.0001), providing faster initial treatment progress (P <0.0001), and were the most preferred bracket during the initial alignment stage of treatment (P <0.0001). On the other hand, practitioners reported a stronger preference for conventional brackets during the finishing and detailing stages of treatment (P <0.0001), and regarded conventional brackets as being significantly more cost effective than SL brackets (P <0.0001). Less emergency appointments were also reported with conventional brackets compared to SL brackets (P <0.0001). Despite the perceived overall preference for SL brackets, more than one-third of practitioners no longer use or are planning on discontinuing use of SL brackets. In many circumstances, the orthodontists’ bracket preference was significantly influenced by the proportion of patients they treated with SL brackets (P <0.0001), the number of cases it took them to become accustomed to SL brackets (P <0.0001), and their average appointment intervals for both SL brackets (P <0.0001) and conventional brackets (P = 0.0002). Conclusion: Overall, the orthodontists participating in this study reported a perceived difference between SL brackets and conventional brackets on orthodontic treatment. SL brackets were found to be preferred for the majority of the treatment factors, while there were a few situations in which conventional brackets were preferred. Ultimately, due to the lack of high-quality evidence supporting SL brackets, more objective, evidence-based research is essential in order to evaluate definitively the clinical differences of SL and conventional brackets on orthodontic treatment.


© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

May 2010