Chewing Efficiency Test in Subjects with Clear Aligners

The aim of this study was to evaluate the masticatory function of subjects with clear aligners and to propose a simple and repeatable method for the clinical and experimental evaluation of masticatory function. For the testing we used almonds, a natural substance that can be easily found and stored, has intermediate consistency and hardness, is insoluble in saliva, and has the ability easily lose the moisture absorbed in the mouth. Thirty-four subjects using the Invisalign^® (Align Technology, Santa Clara, CA, USA) protocol were randomly selected. This was an "intercontrol test", i.e., all subjects under the same conditions acted as controls but also as cases whilst wearing the clear aligners. Patients were asked to chew an almond for 20 s, once with aligners and once without aligners. The material was then dried, sieved, and weighted. Statistical analysis was performed to investigate any significative differences. In all our subjects, the efficiency of chewing with clear aligners was found to be comparable to the efficiency of chewing without clear aligners. In detail, the average weight after drying was 0.62 g without aligners and 0.69 g with aligners, while after sieving at 1 mm, the average weight was 0.08 g without aligners and 0.06 g with aligners. The average variation after drying was of 12%, and after sieving at 1 mm, it was 25%. In summary, there was no substantial difference between chewing with or without clear aligners. Despite some discomfort in chewing, the clear aligners were well tolerated by most subjects, who wore them without difficulty even during meals.