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Self-ligating bracket systems are popular and seem to demonstrate lesser friction, allowing tooth movement without exerting unwanted forces on surrounding structures. This umbrella review aimed to compare self-ligating and conventional bracket systems for treatment efficiency.Methods   An electronic search in 8 databases was performed for literature published between January 1, 1990, and October 1, 2021, with manual hand-searching of references of retrieved articles. Quality assessment was performed using the risk of bias in a systematic tool by 2 independent reviewers. Data were extracted using a prepiloted form (Joanna Briggs Institute) for evidence synthesis. Corrected covered area was calculated to quantify study overlaps across systematic reviews with or without meta-analysis.Results   605 articles were retrieved, of which 16 were selected. Most included studies had a low risk of bias, except for 6 that showed an unclear risk of bias. Data analysis revealed a reduction in lower incisor proclination, bacterial accumulation, and oral malodor using self-ligating appliances.Conclusions   Self-ligating systems reduce mandibular incisor proclination, bacterial accumulation, external apical root resorption, chairside time, and oral malodor. No other differences could be demonstrated in comparison with conventional appliance systems.

An Umbrella Review of Systematic Reviews With or Without Meta-Analysis Assessing Treatment Outcomes and Efficiency of Self-Ligating Brackets