The influence of attachments on the adaptability and quality of life of patients using Invisalign

To evaluate patients' adaptability to attachments and their quality of life during the use of Invisalign®. 25 patients (mean age: 32.3 years) beginning treatment with Invisalign using attachments were evaluated. A questionnaire containing questions regarding comfort, esthetic, and Ohip-14 was applied in 4 stages: the same-day attachments were installed 15, 45, and 90 days after installation. Intragroup comparison between the evaluated stages was performed using repeated measures ANOVA. The correlation between the number of attachments and discomfort was assessed using Pearson's correlation test. The day the attachments were bonded was considered the most uncomfortable for patients to cheek adaptation (7.52 ± 2.87). There were no differences in aesthetic appearance and quality of life concerning the patient's perception of the attachments during the first 3 months of treatment. On the installation day, the maxillary attachments were more uncomfortable for the lips, cheeks, and tongue (p = 0.043; 0.013 and 0.004, respectively), while the mandibular attachments were for the lips and tongue (p = 0.004 and 0.029, respectively). There was a positive correlation between anterior attachments and the tongue on the first day (p = 0.010). For posterior attachments, this correlation occurred with the lips, cheeks, and tongue on the installation day (p = 0.002; 0.039 and 0.031, respectively), remaining significant at all stages only regarding lips (T1: p = 0.022; T2: p = 0.032 and T3: p = 0.017). There was some discomfort in the cheeks when the attachments were bonded. However, after 15 days, there was an improvement in adaptability and quality of life. The number of anterior and posterior attachments was correlated with the lips, cheeks, and tongue discomfort at installation, and the number of posterior attachments, with lips discomfort during all stages evaluated. Orthodontists may guide their patients regarding adaptation to the attachments. Additionally, the orthodontist may base their treatment plans on using the fewest attachments possible.