White spot lesion in self-ligating versus conventional ligating bracket systems: A systematic review.

BackgroundWhite spot lesion formation around orthodontic brackets is a major complication associated with fixed orthodontic treatment.ObjectiveThis review aimed to evaluate the current evidence regarding the differences in white spot lesion formation between self-ligating and conventional ligating brackets.MethodsEleven bibliographic databases were searched until January 2025. This review covered parallel-group and split-mouth randomized controlled trials, controlled clinical trials, and cross-sectional studies that investigated the differences in white spot lesion formation between self-ligating and conventional ligating brackets.ResultsThree randomized controlled trials, one controlled clinical trial, and one cross-sectional study were included in this systematic review. Among these, three studies were classified as having a low risk of bias. Four of the five included studies showed no statistically significant difference in white spot lesion formation between the two types of bracket systems (p < 0.05).ConclusionThere are no potential differences in white spot lesion formation between self-ligating and conventional ligating bracket systems. However, orthodontists must be aware of the other factors affecting white spot lesion formation, with oral hygiene being the most critical factor. The protocol was registered in the PROSPERO database (CRD42022353478) on 25 August 2022.