## 4 Discussion
### Chair Time, Treatment Duration  
Various old studies have stated that the Damon system (PSLB) could treat patients more quickly and with fewer appointments compared to traditional braces. According to a study by [PERSON] and [PERSON] (2007) [PERSON] and [PERSON] (2007), the type of bracket and the wire size statistically impact the speed of ligation and chairside time. The Damon system was stated to offer faster and more efficient wire removal and placement for most orthodontic treatment stages. The study also revealed that the Damon method greatly reduced the mean archwire ligation time compared to the traditional elastomeric system when inserting and removing wires.  
In fact, the self-ligating mechanism made ligating an archwire about twice as quick, and opening a Damon slide and closing one took around one second less time per bracket on average than removing an elastic from a mini-twin bracket. For bigger wire sizes used in later treatment stages, the difference in ligation time between the Damon and traditional mini-twin brackets became more pronounced. Several studies, including one by [PERSON] (2000) [12], have reported that PSLBs provide greater patient comfort, shorter treatment times, reduced chair time, and more precise control of tooth translation. The reduction in friction demonstrated by self-ligating brackets can help shorten overall treatment time, especially in extraction cases.  
According to [PERSON], [PERSON], and [PERSON]'s study [4], the Damon system produced significantly faster, better, and more consistent treatment results, with higher patient satisfaction than conventional braces. Damon patients experienced an average treatment time 6.33 months shorter than those treated using conventional twin brackets and required seven appointments less. Similarly, [PERSON]'s [5] study found that the Damon treatment was faster, required fewer appointments, and was more comfortable than conventionally ligated straight-wire appliances. Patients treated using Damon brackets required 30% fewer appointments and experienced significantly faster slide opening and closing than conventional ligation. In [PERSON]'s [58] comparative study, Damon treatment was found to be faster, requiring an average of 7.2 months less time than conventional braces and resulting in an average of 47.8% fewer appointments. The time required for leveling and aligning with conventional braces was 6.0 months versus just 3.2 months for Damon, representing a difference of 46.7%.  
The study conducted by [PERSON] et al. (2010) [67] compared the effectiveness of two different kinds of orthodontic appliances for treatment: self-ligating (SmartClip) and conventional fixed (Victory) appliances. The study found that there was no significant difference between the two types of appliances in terms of treatment duration or the number of visits required. However, the duration of treatment was slightly longer (by three months) in the group treated using SmartClip compared to the group treated using Victory. In another study by [PERSON] et al. (2016) [56], a multicenter randomized controlled trial was conducted in the UK population, research showed no clinically meaningful difference between a self-ligating bracket system (3M SmartClip) and a traditional ligation method (3M Victory) in terms of how effectively patients were treated.  
However, studies of this nature are invariably compromised by the compelling possibility of selection bias, observer bias, and confounding, including susceptibility to uncontrolled factors, varying operator experience and preference, differing archwires and sequences, and inconsistent appointment intervals. These studies were more notable for the large discrepancy in treatment duration between conventional brackets and PSLB. The discrepancy suggests that any advantage attributable to bracket type is likely to be dwarfed by extraneous factors, including the operator's skills, standards, and ability.