Bakgraund: External apical root resorption is a common side effect of fixed appliance orthodontic therapy. The most
susceptible teeth are maxillary and mandibular incisors. Recently, the demand for self-ligating brackets has increased,
and the effect of these bracket systems on EARR compared with conventional brackets has been a subject of clinical
trials.
Materials and Methods: Studies comparing external apical root resorption between passive self-ligating and
conventional bracket systems were identified through an electronic search in databases including PubMed, Cochrane
Library, Google Scholar, and Scopus until September 2024. Risk of bias assessment was done using the Cochrane risk
of bias tool with Review Manager 5.4.
Results: After data extraction and removal of duplicates, four randomized controlled studies and two controlled clinical trials were included in the review. Three studies were of high risk, 2 studies were of fair risk of bias, and one was of low risk of bias. The value of EARR of mandibular incisors in the passive self- ligating bracket group was observed to be lower than that in the conventional bracket group. However, no statistically significant differences were observed with EARR between passive self-ligating and conventional brackets.
Conclusion: Based on the currently available literature, the use of passive self- ligating brackets doesn't provide
any advantage over conventional brackets in terms of EARR. However, passive self-ligating brackets appear to protect
mandibular incisors from EARR, which still needs to be substantiated with more high-quality randomized controlled
studies. There was no statistically significant difference in EARR in passive self-ligating brackets and conventional
bracket.
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