Objective: To analyse through a systematic review the effectiveness of clear aligners by assessing: (a) predictability of clear aligners and (b) treatment outcome comparison of clear aligner therapy with fixed appliance therapy.
Methods: An electronic search was made from January 2014 to April 2019 using MEDLINE, Embase, Web of Science and LILACS databases without any limitations on language. Three reviewers independently assessed the articles. Quality assessment of observational studies and randomized control trial was done by using the ROBINS tool and Cochrane risk of bias tool, respectively. GRADE instrument was used to assess certainty level for each identified outcome.
Results: Seven eligible articles (one randomized controlled trial and six retrospective cohort) were included in our systematic review. Most of the studies (six out of seven) had a moderate risk of bias and one had a high risk of bias.
Conclusions: 'Low to moderate level' of certainty in regard to specific clear aligner therapy tooth movements' efficiency was identified. Clear aligners may produce clinically acceptable outcomes that could be comparable to fixed appliance therapy for buccolingual inclination of upper and lower incisors in mild to moderate malocclusions. However, not all potential clinical scenarios have been assessed in the included studies. Most of the tooth movements may not be predictable enough to be accomplished with only one set of trays with clear aligners despite the recent advances in technology.
Keywords: clear aligner; predictability; systematic review; treatment outcome.
© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Efficacy of Clear Aligners in Controlling Orthodontic Tooth Movement: A Systematic ReviewG Rossini et al. Angle Orthod 85 (5), 881-9. PMID 25412265. - ReviewCAT aligns and levels the arches; it is effective in controlling anterior intrusion but not anterior extrusion; it is effective in controlling posterior buccolingual incl …
Efficiency, Effectiveness and Treatment Stability of Clear Aligners: A Systematic Review and Meta-AnalysisM Zheng et al. Orthod Craniofac Res 20 (3), 127-133. PMID 28547915. - ReviewDespite claims about the effectiveness of clear aligners, evidence is generally lacking. Shortened treatment duration and chair time in mild-to-moderate cases appear to b …
A Comparison of Treatment Effectiveness Between Clear Aligner and Fixed Appliance TherapiesY Ke et al. BMC Oral Health 19 (1), 24. PMID 30674307.Both clear aligners and braces were effective in treating malocclusion. Clear aligners had advantage in segmented movement of teeth and shortened treatment duration, but …
Root Resorption in Orthodontic Treatment With Clear Aligners: A Systematic Review and Meta-AnalysisX Fang et al. Orthod Craniofac Res 22 (4), 259-269. PMID 31323701. - Meta-AnalysisThe aim of this study was to investigate the external root resorption in participants receiving clear aligners and compare it with those treated with fixed appliances. Sy …
Forces and Moments Generated by Aligner-Type Appliances for Orthodontic Tooth Movement: A Systematic Review and Meta-AnalysisA Iliadi et al. Orthod Craniofac Res 22 (4), 248-258. PMID 31237410. - ReviewThe aim of this review was to systematically appraise the evidence on aligner mechanics and forces and moments generated across difference types of aligners. In vitro- la …