External Apical Root Resorption Following Orthodontic Treatment with Clear Aligners Versus Fixed Appliances: A...

Area of Science:

• Orthodontics
• Dental Research
• Biomaterials Science

Background:

• Clear aligners (CAs) offer a popular alternative to traditional fixed appliances (FAs) in orthodontic treatment.
• External apical root resorption (EARR) is a potential side effect of orthodontic tooth movement.
• Comparing EARR between CAs and FAs is crucial for patient outcomes.

Purpose of the Study:

• To systematically review and compare the incidence of external apical root resorption (EARR) in incisor teeth treated with clear aligners (CAs) versus fixed appliances (FAs).

Main Methods:

• A systematic electronic literature search identified comparative studies.
• Risk of bias was assessed using Cochrane RoB 2.0 and ROBINS-I tools.
• Random-effects meta-analysis quantified EARR differences in maxillary and mandibular incisors.

Main Results:

• Ten studies (1 RCT, 2 prospective, 7 retrospective) were included, with varying risk of bias.
• Clear aligners (CAs) demonstrated significantly lower EARR than fixed appliances (FAs) for maxillary central, maxillary lateral, and mandibular central incisors.
• Mean differences favoring CAs ranged from -0.64 mm (maxillary central) to -0.26 mm (mandibular central), with high heterogeneity except for mandibular central incisors.

Conclusions:

• External apical root resorption (EARR) at incisor teeth is generally reduced with clear aligners (CAs) compared to fixed appliances (FAs).
• Further high-quality, evidence-based studies are warranted to validate these findings and ascertain the clinical relevance of EARR differences.