Different bracket types have been introduced as orthodontics has evolved over the past 125 years. Some vary in material they are constructed from, often for aesthetics (metal vs. ceramic). Some vary in the bracket prescription, often named after the orthodontist or group of orthodontists who popularized the individual tooth movement of each bracket in a set (Roth vs. MBT, etc.).  Other types of brackets vary by how the wire is held into the bracket. This article is about this last category. The two main types are traditional braces and self-ligating braces.

The original type of brace is called a traditional, edgewise, or twin brace. Elastic color ties or steel ties hold the wire into the braces. This is the most common type of brace and the most familiar to patients.

Self-ligating braces have been around for several decades, with their initial development dating back to the 1930s. Just like traditional braces, self-ligating braces align your teeth using the interaction of the brace (glued to a specific place on the tooth) and the wire. 

Self-ligating and traditional braces are marketed by many different companies, hence a list of every brand and type would be nearly impossible. However, several popular types of self-ligating braces today include Ormco Damon®, Ormco In-Ovation®, 3M SmartClip®, 3M Clarity Ultra®, GC Orthodontics Gemini™, and American Orthodontics Empower™.

In this article, we’ll go into greater depth about how traditional braces work, how self-ligating braces work, the pros and cons of each, how they compare to each other, and key factors to consider when deciding on the best option for your orthodontic needs.

What Are Self-Ligating Braces and How Do They Work?

Self-ligating braces are similar to traditional braces in that they both help align teeth. The principal difference is that while traditional braces use elastic color ties (ligatures) to hold the archwire in place, self-ligating braces utilize a clip attached to the bracket to secure the wire. In both cases, the wire’s interaction with the bracket is what moves the teeth. 

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Pros of Self-Ligating Braces

Self-ligating braces are often heavily marketed to doctors and patients by bracket manufacturing companies. These companies claim their particular bracket, or self-ligating brackets in general, offer benefits that traditional braces do not. These claimed benefits are usually linked to the absence of color ties. Claims include faster orthodontic appointments, less friction allowing for better sliding mechanics, less frequent appointments, better oral hygiene, and even the ability to grow bone, leading to wider smiles and no need for palatal expander appliances.

The claim of faster appointments is mixed. Self-ligating braces may still require power chains like traditional brackets (i.e., interconnected color ties that close spaces between teeth). Additionally, if a patient wants color ties for aesthetic reasons, both the clip on the self-ligating brace and the power chain or color ties will need to be added. This results in additional work for the orthodontic staff and a slightly longer appointment than with traditional braces.

Another suggested benefit of self-ligating braces—whether active or passive self-ligating braces—is a reduced amount of friction between the wire and brace, which has been claimed to accelerate tooth movement. While it’s true that self-ligating braces in some situations can speed up the alignment of teeth during the initial unraveling of the crowded teeth phase in the first few months, studies have shown no clinically significant difference in overall treatment times when compared to traditional braces. This may be because the final stage of braces treatment, the detailing stage, can be more difficult with self-ligating braces. This is because it can be more difficult to do detail wire bends with self-ligating brackets and keep the doors closed than with traditional braces.

Some proponents of self-ligating braces also claim that self-ligating braces reduce appointment frequency because colored ties need to be changed with traditional braces whereas the self-ligating clip can hold the wire indefinitely. However, research studies on this subject show that there is no significant difference in the number of appointments required between self-ligating braces and traditional braces. 

Finally, another claimed benefit of self-ligating braces is reduced plaque buildup, with the claim being that color ties accumulate more plaque than the self-ligating clip. However, as mentioned previously, many patients still require power chains or elect for color ties. Additionally, research on the actual impact of self-ligating braces on plaque buildup has shown no significant difference from traditional braces.

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Cons of Self-Ligating Braces

Self-ligating braces also come with several potential drawbacks. One of these is that the clips on these braces can get stuck, break off, or open spontaneously, which might cause issues during treatment. When this happens, many types of self-ligating braces can’t simply revert to regular color ties. Instead, the braces may need to be fitted with steel ties on each tooth with a broken clip every visit.

Steel ties, while effective, are more time-consuming to apply. They can also create a poking annoyance, as the tail end of the steel tie can be dislodged while eating. If a self-ligating door opens spontaneously, it may not cause any problems, but it may also set the treatment back several months in a worst-case scenario. For this reason, some orthodontists prefer to take off a bracket with a broken clip and replace it with a new one. This comes with additional time requirements and costs that aren't a concern with traditional braces.

Another challenge with self-ligating braces is that their design can limit the amount of room available for wire detail bends, which is critically important during the final stage of orthodontic treatment. In this stage, the orthodontist makes subtle aesthetic adjustments to the wire to customize the result to the patient’s own unique smile and teeth. This step can be more difficult to perfect with self-ligating braces, requiring smaller bends and more appointments than with traditional braces, especially with stiff, full-sized stainless steel finishing wires.

Additionally, the more complex manufacturing process of self-ligating braces results in higher costs. These increased supply expenses are passed on to patients through higher treatment fees. 

When balancing the pros of faster initial alignment vs. the difficulties of the detailing phase, each orthodontist makes their own choice. Many orthodontists prefer traditional brackets because the detailing stage is universally considered to be more difficult than the initial alignment phase. This allows them to use a tool that is better suited for the more challenging part of the treatment. Conversely, some may opt for self-ligating braces or use a combination of both types, sometimes even on the same patient, depending on individual treatment needs.

Ultimately, the choice of braces often comes down to the orthodontist’s personal preference and the unique needs of each patient.

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Below is a side-by-side comparison of self-ligating braces and traditional braces, including the points previously discussed:

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Which Type of Bracket Is Right for You?

Just as the skill of a builder is more important than the specific tools a builder uses when constructing a house, the most important factor in orthodontic treatment is the expertise of the orthodontist.

In reality, orthodontists have varying opinions on the effectiveness of self-ligating braces versus traditional braces—some believe self-ligating braces offer additional benefits, others argue that traditional braces provide better control, and others don't believe there is a significant difference. Ultimately, the quality of care your orthodontist provides will have a greater impact on your results than the kind of braces you choose!

Orthodontists are dentists who excelled in their dental school programs and applied to highly competitive orthodontic residencies. Over the course of an additional 2-3 years, they immerse themselves exclusively in orthodontics, gaining extensive theoretical knowledge and hands-on experience by managing numerous cases under the mentorship of multiple seasoned orthodontic specialists. Once they complete their residency, they limit their practice exclusively to orthodontics, refining their skills every day through continuous practice.

In contrast, while general dentists are also highly skilled professionals, their focus is broader, covering areas such as restorative procedures, extractions, and overall oral health. Some general dentists offer orthodontic treatment, but their training and daily experience in orthodontics are more limited compared to orthodontists, who devote their entire practice to the field. This dedicated focus results in a much more in-depth understanding, benefiting their patients who require expert orthodontic care.

Thus, the best approach when deciding to straighten your smile and bite is to get a consultation with an orthodontic specialist. They can provide personalized advice on your best treatment options, including whether self-ligating braces or traditional braces are the most suitable option for you.

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CONTACT US

At Orem Orthodontics, we provide a variety of tooth and bite alignment options. Schedule your complimentary consultation with us and you’ll be on your way to achieving your ideal smile!