Review found little difference in orthodontic bonding failure rates with different types of curing lights

iStock_000002551343XSmall colourful braces on teeth

Light systems to cure orthodontic bonding materials to attach orthodontic brackets have been in use for many years. In recent years, alternatives to halogen lights, including light emitting diodes (LEDs) and plasma lights, have been developed. The aims of this review was to compare bracket failure risks and times taken to place attachments with 3 light curing systems (halogen, LED, and plasma) during bonding of orthodontic brackets

A wide range of databases were searched; Medline, Embase, Cochrane Oral Health Group’s Trials Register and Cochrane Central Register of Controlled Trials (CENTRAL), ( ,the National Research Register ( and Pro-Quest Dissertation Abstracts and Thesis. No language restrictions were applied.

Study selection, assessment of risk of bias, and extraction of data were performed independently and in duplicate by 2 investigators.  Randomised and controlled clinical trials, with split-mouth designs with follow-up of more than 6 months were included.   The main outcome was initial bond failure with placement time being a secondary outcome.

  • Ten studies (all split-mouth studies) met the inclusion criteria.  Eight studies were included in a meta- analysis, five compared plasma arc and halogen lights the other three    focused on LEDs and conventional light curing systems. One study was judged to be at low risk of bias, and seven studies had unclear risks of bias.
  • Comparing the bond failure risk with halogen lights and plasma arc lights, 1851 brackets were included in both groups.  There was no statistical difference in bond failure risk between the groups (OR, 0.92; 95% CI, 0.68-1.23; prediction intervals, 0.54, 1.56).
  • No statistical difference in bond failure risk was seen in the meta-analysis comparing halogen lights and LEDs (OR, 0.96; 95% CI, 0.64-1.44; prediction intervals, 0.07, 13.32).
  • The pooled estimates from both comparisons were OR, 0.93; 95% CI, 0.74-1.17; and prediction intervals, 0.69, 1.17.

The authors concluded

There was no evidence to suggest any significant differences in the risks of bond failure with conventional halogen, plasma arc, or LED curing light systems.


Fleming PS, Eliades T, Katsaros C, Pandis N. Curing lights for orthodontic bonding: a systematic review and meta-analysis. Am J Orthod Dentofacial Orthop. 2013 Apr;143(4 Suppl):S92-103. doi: 10.1016/j.ajodo.2012.07.018. Review. PubMed PMID: 23540642

 Protocol for review as registered on PROSPERO

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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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