Patient satisfaction and quality of life status after 2 treatment modalities: Invisalign and conventional fixed appliances

Am J Orthod Dentofacial Orthop. 2018 Nov;154(5):639-644. doi: 10.1016/j.ajodo.2018.01.013.


Introduction: Our objectives were to assess patient satisfaction and quality of life among adults via 2 validated comprehensive questionnaires and to compare patient satisfaction and status in oral health-related quality of life immediately after orthodontic treatment in patients treated with Invisalign (Align Technology, San Jose, Calif) and those who received standard bracket-based treatment.

Methods: Adult patients (n = 145) treated with bracket-based or Invisalign therapy were recruited from several private practices and a university clinic. The survey comprised a combination of the Dental Impacts on Daily Living index and the Patient Satisfaction Questionnaire. This 94-question assessment focused on various dimensions of satisfaction and quality of life. Multivariate analysis of variance and the bootstrap test were applied. A reliability analysis was used to assess responses at a 6-month follow-up for a small sample of patients.

Results: Finally, 122 patients were assessed. The multivariate analysis of variance analysis showed that the eating and chewing dimension was significantly different between the 2 groups (Invisalign, 49%; bracket based, 24%; P = 0.047). No significant difference in any other satisfaction factors (all, P > 0.05) was identified. The follow-up assessment was only possible in a small sample of the bracket group; it showed adequate reliability values on the categories of oral comfort (intraclass correlation coefficient [ICC], 0.71), general performance (ICC, 0.755), situational (ICC, 0.80), and doctor-patient relationship (ICC, 0.75).

Conclusions: Of the patients surveyed to assess their satisfaction and oral health-related quality of life immediately after completion of their orthodontic treatment, both the bracket-based and Invisalign treated patients had statistically similar satisfaction outcomes across all dimensions analyzed, except for eating and chewing: the Invisalign group reported more satisfaction. Patient satisfaction remained relatively similar 6 months later for the bracket-type treatment.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Dentist-Patient Relations
  • Eating
  • Esthetics, Dental
  • Female
  • Humans
  • Male
  • Mastication
  • Orthodontic Appliance Design*
  • Orthodontics, Corrective / instrumentation*
  • Orthodontics, Corrective / methods*
  • Patient Satisfaction*
  • Quality of Life*
  • Surveys and Questionnaires
  • Young Adult