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Limited evidence on differences between fixed appliances and clear aligners regarding pain level
Samer Mheissen1, Haris Khan2, Mays Aldandan3
1Former instructor in Orthodontic Department, Syrian Ministry of Health, Private Practice, Damascus, Syria. Mheissen@yahoo.com.
Evidence-Based Dentistry
|December 19, 2020
Summary
Patients undergoing orthodontic treatment with clear aligners may experience less pain initially compared to those with traditional fixed braces. However, pain levels appear similar between the two methods after the initial treatment phase.
Area of Science:
- Orthodontics
- Dental Pain Management
Background:
- Orthodontic treatment commonly involves fixed appliances or clear aligners.
- Patient-reported pain is a significant factor influencing treatment satisfaction and adherence.
Purpose of the Study:
- To systematically review and synthesize evidence comparing pain levels between clear aligners and fixed orthodontic appliances in adult patients.
Main Methods:
- Systematic review of randomized and non-randomized controlled trials, and cross-sectional studies.
- Searched eight electronic databases and included hand-searching.
- Assessed risk of bias using established tools (ROB.2, ROBINS-I, Newcastle-Ottawa scale).
Main Results:
- Seven studies were included (1 RCT, 5 non-RCTs, 1 cross-sectional).
- Higher pain was reported with fixed appliances in the first 24 hours and days 3-4.
- No significant pain differences were found by day 14 or up to three months.
Conclusions:
- Clear aligners may offer reduced initial pain perception compared to fixed appliances.
- Long-term pain differences are not evident.
- Study limitations include variability in fixed appliance types and lack of detailed malocclusion description.
