ABSTRACT

Objective

To assess the efficacy and efficiency of treatment in adolescents presenting with mild malocclusions, comparing outcomes using clear aligners to fixed appliances.

Materials and Methods

Patients identified retrospectively and consecutively from one private practice had been treated with either clear aligners (Invisalign, Align Technology, Santa Clara, Calif) or fixed appliances (0.022 Damon, Ormco, Orange, Calif; n = 26/group). Assessments of occlusion were made using the American Board of Orthodontics Discrepancy Index (DI) for initial records and Cast-Radiograph Evaluation (CRE) for final records. Number of appointments, number of emergency visits, and overall treatment time were determined from chart reviews. Data were analyzed using Pearson's correlation, Wilcoxon rank tests, unpaired t-tests, and Chi-square tests, with significance set to P ≤ .05.

Results

Pretreatment, the aligner and fixed groups showed no significant difference in overall severity (DI: 11.9 ± 5.3 vs 11.6 ± 4.8) or in any individual DI category. Posttreatment scores showed finishes for the aligner group had fewer discrepancies from ideal relative to the fixed appliance group (CRE: 30.1 ± 8.3 vs 37.0 ± 9.3; P < .01). Patients treated with aligners had fewer appointments (13.7 ± 4.4 vs 19.3 ± 3.6; P < .0001), fewer emergency visits (0.8 ± 1.0 vs 3.6 ± 2.5; P < .0001), and shorter overall treatment time (16.9 ± 5.7 vs 23.4 ± 4.4 months; P < .0001).

Conclusions

Outcomes for treatment of mild malocclusions in adolescents showed equivalent effectiveness of clear aligners compared to fixed appliances, with significantly improved results for clear aligner treatment in terms of tooth alignment, occlusal relations, and overjet. Assessment of the number of appointments, number of emergency visits, and overall treatment time showed better outcomes for treatment with clear aligners.

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Author notes

a

Private Practice, Seattle, Wash.

b

Adjunct Associate Professor, Plastic and Reconstructive Surgery; and Director of Craniofacial Orthodontics, Oregon Health & Science University; and Private Practice, Portland, Oreg.

c

Professor and Chair, Department of Orthodontics, State University of New York at Buffalo, Buffalo, NY.

d

Biostatistician II, Medical Data Research Center, Providence Health Services, Portland, Oreg.

e

Assistant Professor and Graduate Program Director, Department of Orthodontics, Oregon Health & Science University, Portland, Oreg.

f

Professor and Chair, Department of Endodontology; and Interim Chair, Department of Orthodontics, Oregon Health & Science University, Portland, Oreg.