scholarly journals Does Clear Aligner Treatment Result in Different Patient Perceptions of Treatment Process and Outcomes Compared to Conventional/Traditional Fixed Appliance Treatment: A Literature Review

Author(s):  
Afnan A. Ben Gassem

AbstractThis study sought to systematically review the literature to determine whether clear aligner treatment results in different patient perceptions of treatment process and outcomes compared with conventional fixed appliance treatment. A systematic review was conducted to identify studies that examined differences in patient perceptions between clear aligners and conventional fixed appliance treatment. Studies were identified through searching relevant terms using PubMed and Embase. Following review of identified articles, key information about the studies including study design, setting, comparison groups, sample size/response rate, study location, primary outcomes, and statistical tests used were extracted. A total of 13 articles were identified that met the inclusion criteria for this study. These studies described a variety of outcomes which were divided into two broad categories: treatment process (pain, chewing, speech, daily routine, etc.) and treatment outcomes (satisfaction level, smile outcome perceptions, etc.). There was the strongest evidence that clear aligners had a positive impact with respect to treatment process compared with fixed orthodontic appliances. This study highlights that clear aligners may be effective for improving treatment-process-related outcomes among orthodontic patients. More studies need to be conducted to determine whether clear aligners have a beneficial impact with respect to treatment outcomes.

2021 ◽  
Vol 11 (23) ◽  
pp. 11216
Author(s):  
Chiho Moon ◽  
George K. Sándor ◽  
Edward Chengchuan Ko ◽  
Yong-Deok Kim

Backgrond: Until now, there have been many studies on the postoperative stability of orthognathic patients treated with traditional fixed orthodontic appliances. Recently, the use of clear aligners as orthodontic appliances has increased in orthodontic treatment for aesthetic and patient convenience. The aim of this preliminary study was to investigate the stability and characteristics of patients undergoing orthognathic surgery using clear aligners. Patients and Methods: This study was performed on patients who underwent orthognathic surgery by one surgeon at Pusan National University Dental Hospital from April 2017 to August 2021. A comparative study was conducted on five patients treated with clear aligners during orthodontic treatment and ten patients treated with traditional fixed appliances as a control group. Postoperative skeletal changes and recurrence were evaluated by cone beam computed tomography and lateral cephalometric radiographs taken two days postoperatively and six months postoperatively. Several measurement variables were used to confirm the presence or absence of recurrence, preoperative and postoperative orthodontic treatment period, and the number of extracted teeth. Results: Postoperative stability for six months after surgery was not significantly different between the clear aligner group and the traditional fixed appliance group. The preoperative orthodontic treatment period was also shorter in the clear aligner group, and the number of extracted premolar teeth and impacted teeth were also fewer in the clear aligner group, but there was no significant difference. Conclusions: Orthodontic treatment using clear aligners continues to develop, and it is believed that there is no limit to what can be accomplished during orthodontic surgery accompanied by clear aligners.


2020 ◽  
Vol 25 (5) ◽  
pp. 30-37
Author(s):  
Daniela Lasmar de Mendonça ◽  
Renata Rodrigues Almeida-Pedrin ◽  
Nayara Caldas Pereira ◽  
Paula Vanessa Pedron Oltramari ◽  
Thaís Maria Freire Fernandes ◽  
...  

ABSTRACT Objective: This prospective study aimed at assessing the effects of anxiety and a follow-up text message on pain perception after the installation of fixed orthodontic appliances and its impact on the patients’ routine. Methods: The sample of this study consisted of 103 orthodontic patients, 40 males and 63 females (mean age 20.5 years), distributed in two groups: G1 (n=51), including control patients that did not receive any post-procedure communication; and G2 (n=52), including patients that received a structured text message. In baseline phase, the patients completed a questionnaire to assess their level of anxiety prior to treatment. Pain was assessed by using 100-mm visual analog scale (VAS) in baseline and ten times prospectively in predetermined time points. VAS was also applied to assess the patient’s routine alterations caused by the pain. All data were analyzed using ANOVA, Tukey, Mann-Whitney, t-test, chi-square and Spearman’s correlation tests. All statistical tests were performed with significance level of 5%. Results: Low-level and high-level anxiety was observed in 42.7% and 7.8% of the patients, respectively. Statistically significant correlation was observed between anxiety and pain (p< 0.05). Maximum mean pain intensity was detected in the second treatment day (G1=36.9mm and G2=26.2mm) and was significantly higher in G1. Nearly 53% of the patients in G1 reported alterations in the routine (18.8mm), while in G2 the percentage rate reached 28.8% (9.9mm) (p=0.013). Conclusions: Anxious patients report more pain after the installation of orthodontic appliances. Text messages were effective to reduce pain levels and to decrease the negative effects on patients’ daily routine.


2021 ◽  
Vol 10 (23) ◽  
pp. 5638
Author(s):  
Urszula Kozak ◽  
Agnieszka Lasota ◽  
Renata Chałas

Good oral hygiene is an important factor in oral and general health, especially in orthodontic patients, because fixed appliances might impede effective oral hygiene and thus increase the risks of tooth decay, periodontal disease and general health complications. This study investigated the impact of fixed orthodontic appliances on the distribution of dental biofilm in teenagers. Supragingival plaque was assessed at T0, T1 and T2. The distribution of the biofilm was analyzed. Approximal Plaque Index (API) and Bonded Bracket Index (BBI) were used to measure the presence of dental plaque. After insertion of the fixed appliance, the dental plaque indices values in the orthodontically treated group were significantly higher (p < 0.05) than in the control group. Fixed orthodontic appliances caused significant changes in the distribution of the biofilm. This was characterized by the change of location of the dental plaque. In the orthodontic group, we observed an increase in the amount of the supragingival plaque on the vestibular surface of the teeth.


2014 ◽  
Vol 85 (3) ◽  
pp. 434-439 ◽  
Author(s):  
Reem Sh. Abdelrahman ◽  
Kazem S. Al-Nimri ◽  
Emad F. Al Maaitah

ABSTRACT Objectives:  To clinically evaluate the effectiveness of three orthodontic aligning archwires in relation to tooth alignment speed during the initial alignment stage of treatment. Materials and Methods:  A consecutive sample of 74 patients requiring lower only or upper and lower fixed orthodontic appliances were randomly allocated into three different archwires (0.014-inch superelastic nickel-titanium [NiTi], 0.014-inch thermoelastic NiTi, or 0.014-inch conventional NiTi). Good quality impressions were taken of the lower arch before archwire placement (T0) and at designated serial stages of alignment (every 2 weeks: T2, T4, T6, …, T16). The change in tooth alignment was measured in millimeters from the resultant casts using Little's irregularity index. Demographic and clinical differences among the three groups were compared with the chi-square or analysis of variance (ANOVA) test. The difference in the change of lower anterior tooth alignment over time among the three groups was explored with a Split Plot ANOVA (SPANOVA, or within- and between-groups ANOVA). The Kruskal-Wallis nonparametric test was used when data were not normally distributed. Results:  The SPANOVA and Wilks Lambda Multivariate test confirmed that the wire type had no influence on the rate of change in alignment (P  =  .98). Conclusion:  The three forms of NiTi wires were similar in terms of their alignment efficiency during the initial aligning stage of orthodontic fixed appliance therapy.


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Anand Marya ◽  
Adith Venugopal ◽  
Nikhilesh Vaid ◽  
Mohammad Khursheed Alam ◽  
Mohmed Isaqali Karobari

Fixed orthodontic treatment has been compromised at many levels during the pandemic period, as clinics underwent a prolonged lockdown and patients could not be treated regularly. With the end of the pandemic nowhere in sight, may be it is time to put newer tools, such as clear aligner therapy, for better use. Fixed orthodontic appliances by nature are not always self-limiting, which, if left unmonitored over a long period may cause undesirable side effects, pain, and discomfort. The undesired tooth movements that may occur with arch wire-guided mechanics in addition to problems with cut wires or removed brackets may be minimized with the use of aligners. While the benefits of using aligners are for all to see, they do require extensive planning and careful evaluation of the progress. This article reviews the advantages of using aligners during the pandemic period and how it can be beneficial in helping orthodontists resume their practice.


2018 ◽  
Vol 52 (4) ◽  
pp. 272-278 ◽  
Author(s):  
Lídia Lipták ◽  
Krisztina Szabó ◽  
Gábor Nagy ◽  
Sándor Márton ◽  
Melinda Madléna

The aim of this study was to investigate the effects of Cervitec Plus® on the level of mutans streptococcus (SM) and lactobacillus (LB) colonies and the development of white spot lesions (WSLs) in patients with fixed orthodontic appliances. Informed consent was obtained from 32 volunteers (age 16.5 ± 2.75 years). At baseline, levels of the bacterial colonies were determined in saliva and plaque using a chairside test (CRT Bacteria, Ivoclar-Vivadent, Schaan, Liechtenstein), and the number of WSLs was registered. After placing the fixed appliance, Cervitec Plus® or placebo varnishes (Ivoclar-Vivadent, Schaan, Liechtenstein) were applied monthly around the brackets and tubes, randomly in the right or left (test and placebo) quadrants of the same dental arch. SM and LB colonies in saliva and the SM colonies in plaque were determined on 11–21, 13–23, 15–25, and 16–26 teeth monthly over a 6-month period. At the sixth month, the number of new WSLs was determined. By the end of the study, compared with baseline, the ratio of saliva samples belonging to the low-risk category was significantly higher (p ≤ 0.01) from the 2nd month regarding the SM (76 vs. 52%) and LB (69 vs. 52%); reduction of SM in plaque was significantly greater on the test than placebo sides (6.69 ± 1.71 and 4.45 ± 1.60, respectively; p ≤ 0.01). The mean number of new WSLs was significantly lower in the test (0.06 ± 1.60) than in the placebo quadrants (1.13 ± 1.50, p ≤ 0.01). Conclusion: Monthly use of Cervitec Plus® could result in a significant improvement in oral health of orthodontic patients.


2017 ◽  
Vol 87 (6) ◽  
pp. 801-808 ◽  
Author(s):  
David W. White ◽  
Katie C. Julien ◽  
Helder Jacob ◽  
Phillip M. Campbell ◽  
Peter H. Buschang

ABSTRACT Objective: To evaluate differences in discomfort levels between patients treated with aligners and traditional fixed orthodontic appliances. Materials and Methods: This blinded, prospective, randomized equivalence two-arm parallel trial allocated 41 adult Class I nonextraction patients to either traditional fixed appliance (6 males and 12 females) or aligner (11 males and 12 females) treatment. Patients completed daily discomfort diaries following their initial treatment appointment, after 1 month and after 2 months. They recorded their levels of discomfort at rest, while chewing, and while biting, as well as their analgesic consumption and sleep disturbances. Results: Both treatment modalities demonstrated similar levels of initial discomfort. There were no significant sex differences. Patients in the traditional fixed appliances group reported significantly (P &lt; .05) greater discomfort than patients in the aligner group during the first week of active treatment. There was significantly more discomfort while chewing than when at rest. Traditional patients also reported significantly more discomfort than aligner patients after the first and second monthly adjustment appointments. Discomfort after the subsequent adjustments was consistently lower than after the initial bonding or aligner delivery appointments. A higher percentage of patients in the fixed-appliance group reported taking analgesics during the first week for dental pain, but only the difference on day 2 was statistically significant. Conclusions: Patients treated with traditional fixed appliances reported greater discomfort and consumed more analgesics than patients treated with aligners. This trial was not registered.


Author(s):  
Laila Fawzi Baidas ◽  
Lubna Faleh Alfaleh

Introduction: The evaluation of changes in orthodontic practice over the years, is essential for defining treatment efficacy. Accordingly, shedding light on the profile of orthodontic practice in Saudi Arabia is crucial. Aim: To investigate current trends in orthodontic practice in Saudi Arabia and the factors affecting choices regarding materials and techniques among orthodontists. Materials and Methods: This cross-sectional study was conducted from July 2019 to December 2019 at the College of Dentistry, King Saud University, Riyadh, Saudi Arabia. An electronic survey of 29 objective questions was sent to 1,500 orthodontic members of the Saudi Orthodontic Society. The survey collected demographic data, diagnostic records and information on the fixed orthodontic appliances used by the respondents. Frequency and percentages were calculated for all variables. Chi-square test was used to determine the effects of factors, including years of experience and place of work, on the choice of diagnosis protocol and fixed appliance material, with the significance set at p-value ≤0.05. Results: Two hundred and nine respondents completed the survey. The respondents reported a highly significant use of computers for digitising cephalometric analysis, with the traditional method of obtaining study models reported as highly significant (p<0.001). Orthodontists routinely used the MBT preadjusted bracket system (52.6%) and performed direct bonding of the bracket (91.4%). Bonding of the first molars was preferred by 36.4% of the clinicians. Glass ionomer cement was the most frequently used band cement (55.5%), and the most popular archwire material was nickel–titanium shape memory. Clinicians with less than five years of experience used significantly more postcephalometric radiographs (p=0.006) and postorthodontic treatment models (p=0.028). Senior orthodontists (10-15 years of experience) had a higher use of indirect bonding techniques (p=0.05). Conclusion: This study provides information on the relevant aspects of orthodontists in Saudi Arabia in terms of their individuality, training and techniques used. The findings can be used as a reference for future national surveys to evaluate changes in orthodontic practice in Saudi Arabia.


2019 ◽  
Vol 42 (3) ◽  
pp. 223-230 ◽  
Author(s):  
Yassir A Yassir ◽  
Grant T McIntyre ◽  
David R Bearn

Summary Background Patient perception with fixed appliance orthodontic treatment is important to improve oral health-related quality of life. Objective The main objective of this study was to evaluate the impact of labial fixed appliance orthodontic care on patient perception before, during, and after the treatment. Search methods Relevant systematic reviews investigating patient perception with fixed appliance orthodontic treatment were identified by searching electronic databases: MEDLINE via OVID (1946 to 31 December 2018), EMBASE (1974 to 31 December 2018), AMED (Allied and Complementary Medicine Database; 1985 to November 2018), PubMed (inception to 31 December 2018), Web of Science (1900 to 2018), and PsychINFO (1806 to 31 December 2018). Ongoing systematic reviews were searched using Prospero and a grey literature search was undertaken using Google Scholar and OpenGrey (www.opengrey.eu/). No language restriction was applied. Selection criteria Only studies investigating patient perception of fixed appliance orthodontic treatment were included. Data collection and analysis Screening, quality assessment [using the AMSTAR 2 tool (A Measurement Tool to Assess Systematic Reviews)], and data extraction were performed by two authors independently. Information was categorized and narratively synthesized for the key findings. Results A total of 163 articles investigating patient expectation, experience, and satisfaction with conventional ligation labial fixed orthodontic appliances were obtained. Of these, 152 observational or interventional studies were excluded, resulting in 11 eligible systematic reviews. Two were excluded as earlier reports of a Cochrane review. The quality of the reviews was variable (critically low, low, and moderate). The findings were as follows: aesthetics represents a primary motive for orthodontic treatment; a temporary deterioration in the quality of life occurs during the initial phases of treatment; gender and ethnicity factors do not have an impact on patient perception of treatment; and a positive relationship between orthodontist–patient–parent is important to achieve patient compliance and satisfaction. Conclusions There is a lack of high-quality studies in terms of systematic reviews and meta-analyses for assessing patient perception with fixed appliance orthodontic treatment. The aesthetic impact of malocclusion is the main motive for seeking orthodontic treatment. Quality of life reduces during the initial stages of orthodontic treatment but improves in the later stages of treatment. Assessment before, during, and after orthodontic treatment is necessary to comprehensively assess patient perception at all stages of care. Trial registration CRD42019122653. Conflict of Interest None to declare.


2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Agnieszka Machorowska-Pieniążek ◽  
Tadeusz Morawiec ◽  
Anna Mertas ◽  
Marta Tanasiewicz ◽  
Arkadiusz Dziedzic ◽  
...  

The aim of this study was to evaluate the influence of 3% ethanol extract of propolis (EEP) on hygiene, gingival and microbiological status of oral cavity in patients with cleft lip and palate treated with fixed orthodontic appliances. The study included forty-one nonsyndromic complete unilateral of bilateral cleft lip and palate subjects with fixed appliance on at least 10 teeth. Twenty-one subjects were instructed to brush their teeth three times a day using toothpaste with propolis. Control group included twenty subjects who were asked to brush their teeth three times a day using a toothpaste without propolis. API, OPI, GI, and supragingival bacterial plaque were taken from each subject twice: baseline and after using the toothpaste for 35 days. The final examinations showed statistically significant decrease in OPI, GI, and the percentage of theActinomycesspp. andCapnocytophagaspp. compared with baseline in propolis group subjects. The improvement in oral health in these patients confirms antibacterial, anti-inflammatory, and regenerative properties of propolis.


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