Comparison of outcomes in adolescents treated with aligners versus fixed appliances

To compare treatment efficacy and efficiency, presence and extent of new white spot lesions (WSL), and quality of life in adolescent patients treated with aligners vs fixed appliances (FA) in an academic clinic.

This cohort study included 29 adolescents (18 male and 11 female; mean age: 14) treated with aligners who were matched with 29 adolescents treated with FA. Pretreatment characteristics were collected, and consented subjects completed a modified OHIP-14 (Oral Health Impact Profile) questionnaire. Treatment efficacy was assessed comparing the peer-assessment rating (PAR) and efficiency was assessed comparing emergency visits, debonded appliances, appointments, and treatment time. Maxillary incisors were assessed for presence and extent of new WSLs.

Both groups had similar demographic, pretreatment parameters, post-treatment PAR scores, and treatment time, while having a trend for less debonded appliances in the aligner group (P = .07). However, aligner patients had significantly less appointments (mean A = 15.7 vs FA = 21.3 visits; P < .001), emergency visits (mean A = 0.4 vs FA = 1.0 visits; P = .01), new or larger WSLs (P = .021), and oral hygiene counselling (mean A = 0.9 vs FA = 3.2 times; P = .006). The two groups also had similar OHIP-14 scores, but only 26% of aligner patients reported interruption of meals vs 70% of FA patients (P = .015).

Both groups had similar PAR outcomes and treatment times. However, aligner patients had fewer emergency visits, appointments, debonded appliances, new or larger WSLs, and interruption of meals compared to FA patients.