title: Differences between active and passive self-ligating brackets for orthodontic treatment : Systematic review and meta-analysis based on randomized clinical trials.
abstract: OBJECTIVE
  In orthodontic treatment, the effects of differences in the design between active and passive self-ligating bracket (ASLB and PSLB, respectively) are usually neglected. This study investigated differences in effectiveness and efficiency between ASLBs and PSLBs.
  
  
  METHODS
  To identify randomized, controlled clinical trials (RCTs) comparing ASLB with PSLB, the electronic databases Medline, Embase, Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and Chinese Medical Journal Database were searched without language or time limits. Relevant available dental journals and reference lists from included studies were manually searched for applicable reports. Meta-analyses were conducted with the Review Manager program. Two independent reviewers performed all search processes; disagreements were discussed with a third reviewer.
  
  
  RESULTS
  Eight studies were included in the systematic review, of which six were included in the meta-analysis due to the data consistency. Three had a low risk of bias, four had an unclear risk of bias, and one had a high risk of bias. With regard to alignment efficiency, meta-analysis favors ASLB [mean difference (MD) -10.24 days, 95% confidence interval (CI) -17.68 to -2.80]. However, the same analysis does not favor either design in terms of width change due to treatment for intercanine (MD -0.49 mm, 95% CI -1.10 to 0.13 mm) interfirst premolar (MD -0.07 mm, 95% CI -0.69, 0.56 mm) intersecond premolar (MD -0.58 mm, 95% CI -1.25 to 0.08 mm) and intermolar (MD 0.10 mm, 95% CI -0.82 to 1.02 mm) width.
  
  
  CONCLUSIONS
  Based on current clinical evidence from RCTs, ASLB appears to be more efficient for alignment, while neither design shows an advantage for width change. Further research is needed to confirm present results.
authors.affiliation: Department of Orthodontics, West China School of Stomatology, Sichuan University, 3rd Section of Renmin South Road, Chengdu, 610041, Sichuan, China.
authors.forename: Xianrui
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Orthodontics, West China School of Stomatology, Sichuan University, 3rd Section of Renmin South Road, Chengdu, 610041, Sichuan, China.
authors.forename: Yiruo
authors.initials: Y
authors.lastname: He
authors.affiliation: Department of Orthodontics, West China School of Stomatology, Sichuan University, 3rd Section of Renmin South Road, Chengdu, 610041, Sichuan, China.
authors.forename: Tian
authors.initials: T
authors.lastname: Chen
authors.affiliation: Department of Orthodontics, West China School of Stomatology, Sichuan University, 3rd Section of Renmin South Road, Chengdu, 610041, Sichuan, China.
authors.forename: Mengyuan
authors.initials: M
authors.lastname: Zhao
authors.affiliation: Department of Orthodontics, West China School of Stomatology, Sichuan University, 3rd Section of Renmin South Road, Chengdu, 610041, Sichuan, China.
authors.forename: Yinqiu
authors.initials: Y
authors.lastname: Yan
authors.affiliation: Department of Orthodontics, West China School of Stomatology, Sichuan University, 3rd Section of Renmin South Road, Chengdu, 610041, Sichuan, China.
authors.forename: Hongzhe
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Orthodontics, West China School of Stomatology, Sichuan University, 3rd Section of Renmin South Road, Chengdu, 610041, Sichuan, China. baiding@scu.edu.cn.
authors.forename: Ding
authors.initials: D
authors.lastname: Bai
mesh_terms: D000293:Adolescent; D017267:Dental Prosthesis Design; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000453:epidemiology* / Q000628:therapy*; D016910:Orthodontic Brackets / Q000145:classification* / Q000706:statistics & numerical data*; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data*; D012307:Risk Factors; D014087:Tooth Movement Techniques / Q000295:instrumentation* / Q000706:statistics & numerical data; D016896:Treatment Outcome
keywords: Active self-ligating bracket; Alignment; Efficacy; Passive self-ligating bracket; Randomized controlled clinical trial