Self-ligating brackets do not reduce discomfort or pain when compared to conventional orthodontic appliances in Class I patients: a clinical study

Objectives: To compare the intensity, location, and short-term impact of the periodontal discomfort/ pain, as well as the related functional parameters of bite force and masticatory efficiency, between self-ligating and conventional orthodontic appliances. Materials and Methods: In 20 patients referred for orthodontic treatment, samples were collected from the gingival sulcus to evaluate the level of substance P using enzyme-linked immunosorbent assay. Orthodontic devices were randomly bonded, with self-ligating appliances on one side and conventional brackets on the contralateral side. Pain threshold (PT), maximal bite force (MBF), and masticatory efficiency (ME) were assessed using standard validated techniques at the beginning of the treatment and 24 hours post-orthodontic activation with an 0.016-inch nickel-titanium wire. Results: There were no significant differences (P . .05) in the substance P levels, PT, MBF, and ME between the self-ligating and conventional orthodontic appliances. Conclusions: There was no difference between conventional and self-ligating appliances in the parameters of pain: substance P and pressure. Functional aspects, such as pain, discomfort, and masticatory efficiency, should not be considered when making a therapeutic decision regarding the use of self-ligating vs conventional orthodontic appliances. (Angle Orthod. 2023;93:398-402.)