Comparing Outcomes in Orthognathic Surgery Using Clear Aligners Versus Conventional Fixed Appliances

Area of Science:

• Oral and Maxillofacial Surgery
• Orthodontics
• Plastic Surgery

Background:

• Orthognathic surgery corrects dentofacial deformities, typically requiring pre- and post-operative orthodontic treatment.
• Conventional fixed orthodontic appliances are standard for dental movement and stabilization.
• Clear-aligner therapy offers an aesthetic alternative, but its use in complex triple-jaw orthognathic surgery is not well-documented.

Purpose of the Study:

• To evaluate perioperative outcomes in patients undergoing triple-jaw orthognathic surgery with clear-aligner therapy (Invisalign).
• To quantify and compare postoperative edema in Invisalign patients versus those with conventional fixed appliances.
• To outline the surgical approach for clear-aligner patients undergoing these complex procedures.

Main Methods:

• Retrospective chart review and 3-dimensional morphometric analysis of patients undergoing triple-jaw surgery (LeFort I osteotomy, bilateral sagittal split osteotomy, genioplasty).
• Comparison between a group of 13 Invisalign patients and a demographically matched group of 20 patients with conventional fixed appliances.
• Volumetric analysis of postoperative edema using 3-dimensional imaging for a subset of patients.

Main Results:

• No significant differences were found in operating time, concurrent tooth extractions, fat grafting, hospital stay, diet advancement, or narcotic analgesic use between the Invisalign and conventional fixed appliance groups.
• Postoperative edema measurements showed no significant difference between groups (Invisalign: 37.36 ± 31.19 cm³ vs. conventional: 44.29 ± 23.16 cm³).
• The study included 33 patients, with a mean age of 19.99 years.

Conclusions:

• Complex multiple-jaw orthognathic procedures can be successfully performed using clear-aligner therapy (Invisalign).
• Perioperative and short-term clinical outcomes are not compromised when using Invisalign compared to conventional fixed appliances.
• The findings support the use of Invisalign as a viable orthodontic option for patients undergoing extensive orthognathic surgery.