Conventional braces (CB) require a wire ligature or plastic O-ring to engage and hold the archwires in place while self ligating braces (SLB) have an internal locking mechanism replacing the need to change O’s at each appointment. Much continues to be made in the popular literature and on the Internet about the increased efficiency and speed of SLB therapy as well as the decreased duration as compared to CB therapy.

Most bracket manufacturers have both types of bracket lines to sell . A randomized controlled study appearing in the June 2010 American Journal of Orthodontics by Fleming, DiBiase and Lee appears to set this notion to rest. 66 consecutively treated patients were randomly assigned to one of two such systems (CB or SLB) marketed by 3M Unitek. Results were analyzed for several parameters including speed, accuracy and efficiency of each approach. The conclusion: SLB’s “neither improved the efficiency…nor resulted in fewer treatment visits” as compared to CB’s. Several other recent studies support these findings. We note that the cost of SLB’s is 5-10 times greater per bracket than CB’s and users report trouble finishing cases due to failures or jamming of the locking mechanism for the archwire in the latter stages of therapy.