Arch perimeter changes with passive self-ligating bracket system: a systematic review and meta analysis

To determine and compare arch perimeter changes obtained with and between passive self-ligating bracket systems and conventional bracket systems.

A thorough search in six databases up to January 11th, 2025 was done with no restriction of date. Prospective and retrospective studies that evaluated the arch perimeter changes with and between passive self-ligating (PSL) and conventional brackets. Quality assessment was done using the ROB 2.0 and ROBINS-I tools. A standard random-effects model was used in this review for analysis.

Search identified twelve studies on arch perimeter changes with and between passive self-ligating (PSL) and conventional brackets. Eight studies were included in the quantitative analysis. Qualitative analysis indicated that arch perimeter increase was achieved with both conventional and passive self-ligating systems with no significant difference between the two. Meta-analysis indicates that there was an arch perimeter increase of 2.57 mm (0.29, 4.85) in the maxilla and 1.57 mm (-0.27, 3.41) in the mandible with passive self-ligation. However, when compared with the conventional system, the difference in arch perimeter gain was 0.09 mm (mean - 1.69, SD -1.88) in the maxillary arch and - 0.5 mm (-3.47, 2.43) in the mandibular arch. The difference was not significant.

Both conventional and self-ligation systems increased arch perimeter. However, the arch perimeter changes between the two bracket systems were not clinically or statistically significant. The hypothesis that self-ligating systems have a greater increase in arch perimeter is not based on evidence.

Not applicable.