Indications, limitations, and outcomes of clear aligners in orthodontic treatment
Keywords:Orthodontics, Orthodontic treatment, Cosmetic, Clear aligners
Clear aligners have gained popularity in orthodontic treatment as a comfortable and aesthetically pleasing alternative to traditional braces. The use of clear aligners has increased due to their advantages, including improved aesthetics, easy removability, and minimal soft tissue irritation. The treatment process involves sequential aligners custom-made for each patient, using computer-aided design and manufacturing technology. Clear aligners employ controlled forces to gradually move teeth into proper alignment. However, clear aligners have limitations, such as the need for patient compliance and their effectiveness in addressing complex malocclusions. Clinical considerations include thorough assessment, regular follow-up visits, and patient education. Treatment outcomes vary depending on the specific malocclusion characteristics. Clear aligners have demonstrated benefits in treating mild malocclusions, spacing issues, and certain types of malocclusion corrections. Treatment duration may be shorter compared to fixed appliances in mild cases. Stability and periodontal health can be influenced by clear aligner therapy, which has effects on plaque levels and gingival inflammation. Root resorption is a concern, but aligners have shown a lower prevalence compared to fixed appliances. Compliance, eruption of permanent teeth, and limitations in visualizing hard and soft tissues are important considerations. Overall, clear aligners offer an aesthetic orthodontic treatment option for a variety of dental abnormalities and mild to moderate orthodontic issues.
Meier B, Wiemer KB, Miethke RR. Invisalign--patient profiling. Analysis of a prospective survey. J Orofacial Orthopedics. 2003;64(5):352-8.
Cardoso PC, Espinosa DG, Mecenas P, Flores-Mir C, Normando D. Pain level between clear aligners and fixed appliances: a systematic review. Progress Orthodontics. 2020;21(1):3.
Jiang Q, Li J, Mei L. Periodontal health during orthodontic treatment with clear aligners and fixed appliances: A meta-analysis. J Am Dent Assoc. 2018;149(8):712-720.
Zhang B, Huang X, Huo S. Effect of clear aligners on oral health-related quality of life: A systematic review. Orthodontics Craniofacial Res. 2020;23(4):363-70.
Tamer İ, Öztaş E, Marşan G. Orthodontic Treatment with Clear Aligners and The Scientific Reality Behind Their Marketing: A Literature Review. Turkish J Orthodontics. 2019;32(4):241-6.
Zheng M, Liu R, Ni Z, Yu Z. Efficiency, effectiveness and treatment stability of clear aligners: A systematic review and meta-analysis. Orthodont And Craniofacial Res. 2017;20(3):127-33.
Rossini G, Parrini S, Castroflorio T, Deregibus A, Debernardi CL. Efficacy of clear aligners in controlling orthodontic tooth movement: a systematic review. Angle Orthodontist. 2015;85(5):881-9.
Buschang PH, Shaw SG, Ross M, Crosby D, Campbell PM. Comparative time efficiency of aligner therapy and conventional edgewise braces. Angle Orthodontist. 2014;84(3):391-396.
Shetty S, Shaikh N. Clear aligner therapy-A review. J Dental Specialities. 2021;9:46-52.
Varshini GN, Kannan MS. Clear aligner therapy- a review. Eur J Molecular Clin Med. 2020;7(4):1689-1693.
Clements KM, Bollen AM, Huang G, King G, Hujoel P, Ma T. Activation time and material stiffness of sequential removable orthodontic appliances. Part 2: Dental improvements. Am J Orthodontics Dentofacial Orthop. 2003;124(5):502-8.
Kassas W, Al-Jewair T, Preston CB, Tabbaa S. Assessment of Invisalign treatment outcomes using the ABO Model Grading System. J World Federation Orthodontists. 2013;2:e61-4.
Krieger E, Seiferth J, Marinello I. Invisalign® treatment in the anterior region: were the predicted tooth movements achieved? J Orofacial Orthopedics. 2012;73(5):365-76.
Djeu G, Shelton C, Maganzini A. Outcome assessment of Invisalign and traditional orthodontic treatment compared with the American Board of Orthodontics objective grading system. Am J Orthodontics Dentofacial Orthop. 2005;128(3):292-8.
Li W, Wang S, Zhang Y. The effectiveness of the Invisalign appliance in extraction cases using the the ABO model grading system: a multicenter randomized controlled trial. Int J Clin Experim Med. 2015;8(5):8276-82.
Grünheid T, Gaalaas S, Hamdan H, Larson BE. Effect of clear aligner therapy on the buccolingual inclination of mandibular canines and the intercanine distance. Angle Orthodontist. 2016;86(1):10-16.
Gu J, Tang JS, Skulski B. Evaluation of Invisalign treatment effectiveness and efficiency compared with conventional fixed appliances using the Peer Assessment Rating index. Am J Orthodontics Dentofacial Orthop. 2017;151(2):259-266.
Simon M, Keilig L, Schwarze J, Jung BA, Bourauel C. Treatment outcome and efficacy of an aligner technique-regarding incisor torque, premolar derotation and molar distalization. BMC Oral Health. 2014;14(1):68.
Ravera S, Castroflorio T, Garino F, Daher S, Cugliari G, Deregibus A. Maxillary molar distalization with aligners in adult patients: a multicenter retrospective study. Progress Orthodontics. 2016;17:12.
Kravitz ND, Kusnoto B, BeGole E, Obrez A, Agran B. How well does Invisalign work? A prospective clinical study evaluating the efficacy of tooth movement with Invisalign. Am J Orthodontics Dentofacial Orthop. 2009;135(1):27-35.
Morales-Burruezo I, Gandía-Franco JL, Cobo J, Vela-Hernández A, Bellot-Arcís C. Arch expansion with the Invisalign system: Efficacy and predictability. PLoS One. 2020;15(12):e0242979.
Garnett BS, Mahood K, Nguyen M. Cephalometric comparison of adult anterior open bite treatment using clear aligners and fixed appliances. Angle Orthodontist. 2019;89(1):3-9.
Kuncio D, Maganzini A, Shelton C, Freeman K. Invisalign and traditional orthodontic treatment postretention outcomes compared using the American Board of Orthodontics objective grading system. Angle Orthodontist. 2007;77(5):864-9.
Han JY. A comparative study of combined periodontal and orthodontic treatment with fixed appliances and clear aligners in patients with periodontitis. J Periodontal Implant Sci. 2015;45(6):193-204.
Abbate GM, Caria MP, Montanari P. Periodontal health in teenagers treated with removable aligners and fixed orthodontic appliances. J Orofacial Orthop. 2015;76(3):240-50.
Karkhanechi M, Chow D, Sipkin J. Periodontal status of adult patients treated with fixed buccal appliances and removable aligners over one year of active orthodontic therapy. Angle Orthodontist. 2013;83(1):146-51.
Türkkahraman H, Sayin MO, Bozkurt FY, Yetkin Z, Kaya S, Onal S. Archwire ligation techniques, microbial colonization, and periodontal status in orthodontically treated patients. Angle Orthodontist. 2005;75(2):231-6.
Tieu LD, Saltaji H, Normando D, Flores-Mir C. Radiologically determined orthodontically induced external apical root resorption in incisors after non-surgical orthodontic treatment of class II division 1 malocclusion: a systematic review. Progress Orthodontics. 2014;15(1):48.
Roscoe MG, Meira JB, Cattaneo PM. Association of orthodontic force system and root resorption: A systematic review. Am J Orthodontics Dentofacial Orthop. 2015;147(5):610-26.
Gay G, Ravera S, Castroflorio T. Root resorption during orthodontic treatment with Invisalign®: a radiometric study. Progress Orthodontics. 2017;18(1):12.