Characteristics and Dental Indices of Orthodontic Patients Using Aligners or Brackets

Abstract

Background. Clear aligners have become a treatment alternative to metal brackets in recent years due to the advantages of aesthetics, comfort, and oral health improvement. Nevertheless, few studies have analyzed the clinical characteristics and dental indices of orthodontic patients using aligners or brackets. Methods. A total of 170 patients received orthodontic treatment at Chang Gung Memorial Hospital in 2021. Patients were stratified by types of treatment (Invisalign® clear aligner (n = 60) or metal bracket (n = 110). Results: Patients were aged 26.1 ± 7.2 years, and most were female (75.0%). The Invisalign® group was older than the bracket group (p = 0.003). The skeletal relationships were mainly Class I (49.4%), followed by Class II (30.0%) and Class III (20.6%). The molar relationships were primarily Class I (38.8%), followed by Class II (37.1%) and Class III (24.1%). The decayed, missing, and filled tooth (DMFT) index was 9.9 ± 6.0, including 2.1 ± 2.9 for decayed teeth, 0.5 ± 1.1 for missing teeth, and 7.3 ± 4.3 for filled teeth. There were no significant differences in the DMFT index or skeletal and molar relationships between the groups (p > 0.05). The index of complexity outcome and need (ICON) was 56.8 ± 13.5, and the score was lower in the Invisalign® group than in the bracket group (p = 0.002). Among the variables included in the ICON assessment, only the aesthetic variable was lower in the Invisalign® group than in the bracket group (p < 0.001). The Frankfort-mandibular plane angle was 27.9 ± 5.1 degrees. Finally, the E-line of the lower lip was lower in the Invisalign® group than in the bracket group (1.5 ± 2.4 versus 2.8 ± 3.1, p = 0.005). Conclusions. Older patients showed a greater intention to choose Invisalign® treatment for improving the appearance of their teeth than younger patients, who chose metal bracket treatment. The demand for Invisalign® aligner treatment for aesthetic reasons was substantial. A soft tissue profile with more protrusive lower lips and a greater need for orthodontic treatment was found in the bracket group.