Comparison of anchorage loss between conventional and self-ligating brackets during canine retraction – A systematic review and meta-analysis Durr E. Shahwar Malik, Mubassar Fida, Erum Afzal, Sarah Irfan The Aga Khan University Hospital, Department of Surgery, Section of Dentistry, P.O Box 3500, Stadium Road, Karachi 74800, Pakistan Correspondence: Mubassar Fida, The Aga Khan University Hospital, Department of Surgery, Section of Dentistry, P.O Box 3500, Stadium Road, Karachi 74800, Pakistan. mubassar.fida@aku.edu ORTHO-443 Available online: Keywords Anchorage Conventional brackets Self-ligating brackets Canine retraction Summary Introduction > Anchorage is defined as the resistance to unwanted tooth movement. In orthodon- tics, loss of anchorage can be detrimental to treatment. The proponents of orthodontic self-ligating brackets (SLB) advocate the use of extremely light forces thereby reducing anchorage burden. Therefore, the aim of this study was to compare anchorage loss during canine retraction between conventional brackets (CB) and self-ligating brackets. Methods > An electronic search was conducted on the Cochrane database, Scopus, Web of Science, PubMed, Dental & Oral Science and CINAHL, along with handsearching Google Scholar and clinicaltrials.gov. Randomized or non-randomized clinical trials published in the English language on human subjects were included. Orthodontic patients undergoing canine retraction after premolar extraction bonded with self-ligating brackets as the intervention and conventional brackets as the control group in a split mouth design were included. Primary outcome studied was anchorage loss; secondary outcomes were retraction velocity and total amount of canine retraction. Two researchers carried out data extraction and study selection independently. The risk of bias was calculated using the Cochrane's Risk of Bias Assessment tool. The RevMan software was used for quantitative synthesis of data. Effect estimate of the primary and secondary outcomes was expressed using weighted mean difference and 95% confidence intervals (CIs). Heterogeneity of the studies was evaluated using the Cochrane's test for heterogeneity (I 2 Test); subgroup and sensitivity analyses were performed to investigate sources of heterogeneity among the studies. Results > Results of the literature search across all databases yielded 10,439 hits, out of which five studies were included in the qualitative synthesis that met the inclusion criteria. Four studies were randomized control trials (RCTs) where as one was a non-randomized control trial, with 100 sub- jects included in this systematic review. All studies used a split mouth design. Of the five studies included, only one reported significant differences between CB and SLB for anchorage loss, retraction velocity and total amount of canine retraction (P-value  0.001). Four studies were included in the meta-analysis, which showed no difference in the amount of anchorage between To cite this article: Malik DES, et al. Comparison of anchorage loss between conventional and self-ligating brackets during canine retraction – A systematic review and meta-analysis. International Orthodontics (2019), https://doi.org/10.1016/j. ortho.2019.11.002 tome xx > 000 > xx 2019 https://doi.org/10.1016/j.ortho.2019.11.002 © 2019 Published by Elsevier Masson SAS on behalf of CEO. 1 Systematic review and meta-analysis International Orthodontics 2019; //: /// Websites: www.em-consulte.com www.sciencedirect.com