Review Article

An updated systematic review on the effectivity of clear aligner therapy: A review

Abstract

Introduction: Several studies have evaluated the strengths and weaknesses of orthodonthic aligners however, the results are still uncertain. In the current study, we aimed to systematically review the literature and provide updates on the efficacy and effectivity of orthodontic therapy using aligners. Materials and Methods: PubMed, Web of Science and Cochrane Oral Health Group’s Trials Register databases were systematically searched for relevant literature up to December 2020. All studies reporting aligner therapy in management of dental misalignment were included. The quality was assessed using the methodological index for non-randomized studies (MINORS) criteria and Jadad scale for randomized controlled trials. Results: Of the initial 550 articles, 18 studies were ultimately included representing a total of 637 patients who were treated with clear aligners. Of the 18 studies, 15 had a retrospective design, one was an observational study, one was conducted as a prospective clinical trial, and one study was a randomized controlled trial. Due to the design and methodology of the studies the quality assessment revealed a high risk of bias. Significant diversity among the outcomes of the studies was observed; however, an underlying consistency was detected within the included studies with regards to the effectivity of aligner therapy in alignment of the anterior teeth, while the pretreatment predictive rates were not significantly different to treatment outcomes. In addition, despite comparable treatment outcomes between aligner therapy and conventional appliance technique, aligner therapy resulted in increased rates of patient satisfaction. Conclusion: Aligner therapy seems to be a viable alternative to conventional orthodontictherapy for correction of mild to moderate malocclusions in non-growing nonextraction patients. However, it should be taken into consideration that due to the high risk of bias, results should be interpreted with caution. Keywords: Orthodontics; Aligner; Tooth movement; Clinical effectivity.
References:
1. Kesling HD. The philosophy of the tooth positioning appliance. American Journal of Orthodontics and Oral Surgery. 1945;31(6):297-304.
2. Lagravere MO, Flores-Mir C. The treatment effects of Invisalign orthodontic aligners: a systematic review. The Journal of the American Dental Association. 2005;136(12):1724-9.
3. Vlaskalic V, Boyd R. Orthodontic treatment of a mildly crowded malocclusion using the Invisalign System. Australian orthodontic journal. 2001;17(1):41-6.
4. Djeu G, Shelton C, Maganzini A. Outcome assessment of Invisalign and traditional orthodontic treatment compared with the American Board of Orthodontics objective grading system. American journal of orthodontics and dentofacial orthopedics. 2005;128(3):292-8.
5. Mortazavi, M., Chalipa, J., Entezari Mogadam, N., Kamali Hakim, L., & Tavakol Davani, S. (2019). Face Vertical Dimension Change and Incisors Position Following Orthodontic Treatment with Extraction of Four First Premolars. Journal of "Regeneration, Reconstruction & Restoration" (Triple R), 4(3), 117-120. https://doi.org/10.22037/rrr.v4i3.29580
6. Krieger E, Seiferth J, Marinello I, Jung BA, Wriedt S, Jacobs C, et al. Invisalign® treatment in the anterior region. Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopädie. 2012;73(5):365-76.
7. Krieger E, Seiferth J, Saric I, Jung BA, Wehrbein H. Accuracy of invisalign® treatments in the anterior tooth region. Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopädie. 2011;72(2):141-9.
8. Kravitz ND, Kusnoto B, BeGole E, Obrez A, Agran B. How well does Invisalign work? A prospective clinical study evaluating the efficacy of tooth movement with Invisalign. American Journal of Orthodontics and Dentofacial Orthopedics. 2009;135(1):27-35.
9. Elhaddaoui R, Qoraich HS, Bahije L, Zaoui F. Orthodontic aligners and root resorption: A systematic review. International orthodontics. 2017;15(1):1-12.
10. Rossini G, Parrini S, Castroflorio T, Deregibus A, Debernardi CL. Efficacy of clear aligners in controlling orthodontic tooth movement: a systematic review. The Angle Orthodontist. 2015;85(5):881-9.
11. Iliadi A, Koletsi D, Eliades T. Forces and moments generated by aligner‐type appliances for orthodontic tooth movement: A systematic review and meta‐analysis. Orthodontics & Craniofacial Research. 2019;22(4):248-58.
12. Zheng M, Liu R, Ni Z, Yu Z. Efficiency, effectiveness and treatment stability of clear aligners: A systematic review and meta‐analysis. Orthodontics & craniofacial research. 2017;20(3):127-33.
13. Robertson L, Kaur H, Fagundes NCF, Romanyk D, Major P, Flores Mir C. Effectiveness of clear aligner therapy for orthodontic treatment: A systematic review. Orthodontics & craniofacial research. 2019.
14. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. 2010.
15. Dent O. Methodological index for non‐randomized studies. ANZ journal of surgery. 2003;73(9):675-6.
16. Jadad Alejandro R, MD, Dphil, Moore R Andrew, DPhil, Carroll Dawn, RGN, Jenkinson Crispin, DPhil, Reynolds D John M, DPhil, Gavaghan DavidJ, DPhil, Henry J, McQuay DM. Assessing the Quality of Reports of Randomized Clinical Trials: Is Blinding Necessary? Controlled Clinical Trials. 1996;17:1–12.
17. Chisari JR, McGorray SP, Nair M, Wheeler TT. Variables affecting orthodontic tooth movement with clear aligners. American Journal of Orthodontics and Dentofacial Orthopedics. 2014;145(4):S82-S91.
18. Simon M, Keilig L, Schwarze J, Jung BA, Bourauel C. Treatment outcome and efficacy of an aligner technique–regarding incisor torque, premolar derotation and molar distalization. BMC Oral Health. 2014;14(1):68.
19. Zhang X-J, He L, Guo H-M, Tian J, Bai Y-X, Li S. Integrated three-dimensional digital assessment of accuracy of anterior tooth movement using clear aligners. The korean journal of orthodontics. 2015;45(6):275-81.
20. Charalampakis O, Iliadi A, Ueno H, Oliver DR, Kim KB. Accuracy of clear aligners: A retrospective study of patients who needed refinement. American Journal of Orthodontics and Dentofacial Orthopedics. 2018;154(1):47-54.
21. Grünheid T, Loh C, Larson BE. How accurate is Invisalign in nonextraction cases? Are predicted tooth positions achieved? The Angle Orthodontist. 2017;87(6):809-15.
22. Tepedino M, Paoloni V, Cozza P, Chimenti C. Movement of anterior teeth using clear aligners: a three-dimensional, retrospective evaluation. Progress in orthodontics. 2018;19(1):9.
23. Duncan LO, Piedade L, Lekic M, Cunha RS, Wiltshire WA. Changes in mandibular incisor position and arch form resulting from Invisalign correction of the crowded dentition treated nonextraction. The Angle Orthodontist. 2016;86(4):577-83.
24. Houle J-P, Piedade L, Todescan R, Jr, Pinheiro FHSL. The predictability of transverse changes with Invisalign. The Angle Orthodontist. 2016;87(1):19-24.
25. Lombardo L, Arreghini A, Ramina F, Ghislanzoni LTH, Siciliani G. Predictability of orthodontic movement with orthodontic aligners: a retrospective study. Progress in orthodontics. 2017;18(1):35.
26. Dai F-F, Xu T-M, Shu G. Comparison of achieved and predicted tooth movement of maxillary first molars and central incisors: First premolar extraction treatment with Invisalign. The Angle Orthodontist. 2019;89(5):679-87.
27. Grünheid T, Gaalaas S, Hamdan H, Larson BE. Effect of clear aligner therapy on the buccolingual inclination of mandibular canines and the intercanine distance. The Angle Orthodontist. 2016;86(1):10-6.
28. Gu J, Tang JS, Skulski B, Fields Jr HW, Beck FM, Firestone AR, et al. Evaluation of Invisalign treatment effectiveness and efficiency compared with conventional fixed appliances using the Peer Assessment Rating index. American Journal of Orthodontics and Dentofacial Orthopedics. 2017;151(2):259-66.
29. Lanteri V, Farronato G, Lanteri C, Caravita R, Cossellu G. The efficacy of orthodontic treatments for anterior crowding with Invisalign compared with fixed appliances using the Peer Assessment Rating Index. Quintessence Int. 2018;49(7):581-7.
30. Hennessy J, Garvey T, Al-Awadhi EA. A randomized clinical trial comparing mandibular incisor proclination produced by fixed labial appliances and clear aligners. The Angle Orthodontist. 2016;86(5):706-12.
31. Sfondrini MF, Gandini P, Castroflorio T, Garino F, Mergati L, D’Anca K, et al. Buccolingual inclination control of upper central incisors of aligners: a comparison with conventional and self-ligating brackets. BioMed research international. 2018;2018.
32. Issa FHKM, Issa ZHKM, Rabah AF, Hu L. Periodontal parameters in adult patients with clear aligners orthodontics treatment versus three other types of brackets: A cross-sectional study. Journal of Orthodontic Science. 2020;9.
33. Alajmi S, Shaban A, Al-Azemi R. Comparison of short-term oral impacts experienced by patients treated with Invisalign or conventional fixed orthodontic appliances. Medical Principles and Practice. 2019.
34. Kankam H, Madari S, Sawh-Martinez R, Bruckman KC, Steinbacher DM. Comparing outcomes in orthognathic surgery using clear aligners versus conventional fixed appliances. Journal of Craniofacial Surgery. 2019;30(5):1488-91.
35. Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non‐randomized studies (MINORS): development and validation of a new instrument. ANZ journal of surgery. 2003;73(9):712-6.
36. Mortazavi, M., Chalipa, J., Entezari Mogadam, N., Kamali Hakim, L., & Tavakol Davani, S. (2019). Face Vertical Dimension Change and Incisors Position Following Orthodontic Treatment with Extraction of Four First Premolars. Journal of "Regeneration, Reconstruction & Restoration" (Triple R), 4(3), 117-120. https://doi.org/10.22037/rrr.v4i3.29580
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IssueVol 7, No 4 (Autumn 2020) QRcode
SectionReview Article(s)
Published2021-02-20
DOI https://doi.org/10.18502/jcr.v7i4.5552
Keywords
Orthodontics; Aligner; Tooth movement; Clinical effectivity.

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How to Cite
1.
Mortazavi M, Naeim M, Badri A, Sharifi R, Hasheminasab M. An updated systematic review on the effectivity of clear aligner therapy: A review. J Craniomaxillofac Res. 2021;7(4):165-177.