Efficacy of self-ligating versus conventional brackets in maxillary transverse development: A systematic review and meta-analysis

Introduction: Self-ligating brackets (SLB) have been promoted as superior to conventional brackets (CB) in maxillary arch development, though clinical evidence remains inconsistent. Objective: To evaluate the comparative efficacy of SLB versus CB systems in maxillary arch dimensional changes through systematic review and meta-analysis. Method: A systematic search was conducted in PubMed, Scopus, and ClinicalKey through December 2024. Randomized controlled trials and controlled clinical trials comparing SLB versus CB were included. Studies were assessed using Cochrane and JBI tools. A random-effects model was employed. Results: Six studies met criteria (353 participants). The meta-analysis revealed significant differences favoring SLB for maxillary intercanine width (MD = 0.83 mm, 95%CI 0.33-1.33, p=0.001), with no differences for mandibular intercanine width (MD = -0.38 mm, 95%CI -1.17-0.41, p=0.35). SLB d was associated with less incisor inclination (MD = -2.28°, 95%CI -4.56-0.00, p=0.05). Conclusions: SLB produced greater maxillary transverse expansion with less proclination. Longitudinal studies are needed to evaluate stability and cost-effectiveness.