Treatment Outcome and Efficiency of Aligners Compared with Conventional Fixed Appliances: A Systematic Review

Abstract

Background: Over the years, aligner therapy has undergone a great evolution. The use of aligners is now an alternative to braces for aesthetic reasons. Their effectiveness and impact have yet to be evaluated. Objective: The objective of this study was to compare the effectiveness of dental movements with aligners versus the use of conventional appliances, as well as the effectiveness and impact on periodontal health and root resorption. Materials and Methods: A systematic search of PubMed, Ebsco Host and Scopus was performed using a well-designed formula. Articles published in the last 10 years in English and French were included after filtering the titles, abstracts then full texts. Results: Twenty-six records were deemed suitable for the objectives of our systematic review. All records focused on the comparison of treatment with aligners and fixed appliances. The difference in treatment and time efficiency was assessed in 17 papers, 6 papers evaluated the impact of orthodontic appliances on periodontal health, and the remaining 3 records focused on the occurrence of root resorption. Conclusion: Clear aligners produce clinically acceptable outcomes that could be comparable to fixed appliance therapy. Aligners facilitate oral hygiene practices which results in better periodontal health. However, it appears that Invisalign may not be as effective as fixed appliances in achieving certain tooth movements like vertical, radicular and rotational movements.