**3.7. Plaque accumulation**

Limited information is available about which bracket material (ceramic versus metal brackets) is less prone to the adhesion of bacteria and plaque accumulation. A clinical study performed by Lindel et al. [25] concluded that ceramic brackets exhibit less long-term biofilm accumulation than metal brackets. It was emphasized that future research should aim to determine whether the difference in biofilm accumulation between ceramic and metal brackets has a clinically significant effect on the development of decalcifications. Lindel et al. [25] pointed out that the results obtained from this type of future research might have a strong effect when choosing bracket material in patients with insufficient oral hygiene habits.

**Figure 4.** Intraoral image of monocrystalline (A) and polycrystalline (B) ceramic brackets.
