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      The Effect of Treatment With Clear Aligners Versus Fixed Appliances on Oral Health-Related Quality of Life in Patients With Severe Crowding: A One-Year Follow-Up Randomized Controlled Clinical Trial

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          Abstract

          Objective

          To compare the level of oral health-related quality of life (OHRQoL) between patients receiving clear aligners or fixed appliances within one year of follow-up using Oral Health Impact Profile 14 (OHIP-14), a validated self-administered questionnaire.

          Materials and methods

          A single-centered, two-arm parallel-group randomized controlled clinical trial was conducted on 36 adult patients (19 females, 17 males; age range: 18 to 25 years) who had severe crowding and require orthodontic treatment with first premolars extraction. The patients were equally and randomly divided into two groups: The clear aligners (CA) group and the fixed appliances (FA) group. OHRQoL was assessed using the OHIP-14 tool at various times during comprehensive orthodontic therapy: baseline (T0), one week (T1), two weeks (T2), one month (T3), 6 months (T4), and 12 months (T5) after starting the active orthodontic treatment. Mann-Whitney U test or Friedman test were used to detect significant differences. The level of significance was set at 5%. 

          Results

          All of the selected patients entered the statistical analysis stage. There were no significant differences between the CA and FA groups for the psychological discomfort, psychological disability, social disability, and handicap (P˃0.05) at almost all assessment times. For the functional limitation, physical pain, physical disability, and the overall score, there were significant differences between the studied groups (P˂0.05), with the FA group having higher mean scores than the CA group in all of the assessment times.

          Conclusion

          Patients' treatment with clear aligners has less impact on OHRQoL than those treated using conventional fixed appliances during the first year of treatment.

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          Most cited references39

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          A comparison of treatment effectiveness between clear aligner and fixed appliance therapies

          Background Align technology has developed greatly over past few years. Patients tended to prefer clear aligners over conventional brackets because of the superior comfort and esthetics, while the effectiveness of clear aligners was still controversial. The aim of this systematic review was to verify whether the treatment effectiveness of clear aligners was similar to the conventional fixed appliances. Methods A comprehensive search of the Pubmed, Web of Science, Embase, Scopus, and Cochrane Central Register of Controlled Clinical Trials Register databases for studies published through to August 20, 2018 was conducted. Comparative clinical studies assessing the effectiveness of clear aligners compared with braces were included. Results Eight papers were included in this study. Two of the included papers were randomized controlled trials and six were cohort studies. Clear aligners might not be as effective as braces in producing adequate occlusal contacts, controlling teeth torque, increasing transverse width and retention. While no statistically significant difference was found between two groups in Objective Grading System score (WMD = 8.38, 95% CI [− 0.17, 16.93]; P = 0.05). On the other hand, patients treated with clear aligners had a statistically significant shorter treatment duration than with braces (WMD = − 6.31, 95% CI [− 8.37, − 4.24]; P < 0.001). Conclusion Both clear aligners and braces were effective in treating malocclusion. Clear aligners had advantage in segmented movement of teeth and shortened treatment duration, but were not as effective as braces in producing adequate occlusal contacts, controlling teeth torque, and retention.
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            Braces versus Invisalign®: gingival parameters and patients’ satisfaction during treatment: a cross-sectional study

            Background Fixed orthodontic appliances (FOA) temporarily interfere with periodontal health of patients, as the appliance complicates oral hygiene. The use of aligners in orthodontic therapy increased strongly during the last decade. In the literature, the reports about effects of aligner treatment on oral hygiene and gingival conditions are scarce. This cross-sectional study evaluated oral hygiene and patient’s satisfaction during orthodontic treatment of patients with FOA or Invisalign®. Methods 100 patients (FOA = 50, Invisalign® = 50) were included who underwent orthodontic treatment for more than 6 months. Clinical examinations were performed to evaluate patients’ periodontal condition and were compared with clinical data at the beginning of the orthodontic treatment. Oral hygiene, patients’ satisfaction and dietary habits were documented by a detailed questionnaire. For statistical analysis, the Mann–Whitney U-Test and Fisher’s Exact Test were used; as multiple testing was applied, a Bonferroni correction was performed. Results At the time of clinical examinations, patients with FOA were in orthodontic therapy for 12.9 ± 7.2 months, whereas patients with Invisalign® were in orthodontic therapy for 12.6 ± 7.4 months. Significantly better gingival health conditions were recorded in Invisalign® patients (GI: 0.54 ± 0.50 for FOA versus 0.35 ± 0.34 for Invisalign®; SBI: 15.2 ± 7.6 for FOA versus 7.6 ± 4.1 for Invisalign®), whereas the amount of dental plaque was also less but not significantly different (API: 37.7 % ± 21.9 for FOA versus 27.8 % ± 24.6 for Invisalign®). The evaluation of the questionnaire showed greater patients’ satisfaction in patients treated with Invisalign® than with FOA. Conclusion Patients treated with Invisalign® have a better periodontal health and greater satisfaction during orthodontic treatment than patients treated with FOA. Electronic supplementary material The online version of this article (doi:10.1186/s12903-015-0060-4) contains supplementary material, which is available to authorized users.
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              A comparison of treatment impacts between Invisalign aligner and fixed appliance therapy during the first week of treatment.

              The aim of this study was to evaluate the differences in quality of life impacts between subjects treated with Invisalign aligners (Align Technology, Santa Clara, Calif) and those with fixed appliances during the first week of orthodontic treatment.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                30 May 2022
                May 2022
                : 14
                : 5
                : e25472
                Affiliations
                [1 ] Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, SYR
                [2 ] Department of Internal Medicine, University of Damascus Faculty of Medicine, Damascus, SYR
                Author notes
                Mohammad Y Hajeer myhajeer@ 123456gmail.com
                Article
                10.7759/cureus.25472
                9156343
                35663697
                3ae571e1-1326-45ce-a683-1cda743914e9
                Copyright © 2022, Jaber et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 29 May 2022
                Categories
                Dentistry
                Oral Medicine

                psychological disability,physical disability,psychological discomfort,physical pain,functional limitation,oral health impact profile,crowding,oral health-related quality of life,clear aligners,class i malocclusion

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