3D predictability assessment of clear aligners versus fixed appliances using CBCT

Area of Science:

• Orthodontics
• Dental Imaging
• Biomechanical Engineering

Background:

• Limited three-dimensional (3D) comparative evidence exists for orthodontic tooth movement predictability between clear aligners and fixed appliances, especially in complex cases.
• Understanding modality-specific accuracy is crucial for optimizing treatment outcomes in orthodontics.

Purpose of the Study:

• To prospectively compare the 3D predictability of orthodontic tooth movement between clear aligners and fixed appliances in complex cases.
• To quantify accuracy across three planes of space using cone-beam computed tomography (CBCT) superimposition.

Main Methods:

• A prospective randomized study involving 60 complex orthodontic patients (30 clear aligners, 30 fixed appliances).
• CBCT scans were taken at baseline, planned, and post-treatment.
• Superimposition of CBCT scans quantified tooth movement accuracy in three planes.

Main Results:

• Clear aligners demonstrated higher accuracy in incisor torque (87.3% vs. 82.2%) and anterior intrusion (91.2% vs. 82.8%).
• Fixed appliances were superior for canine/premolar rotation (88.9% vs. 78.6%) and anterior extrusion (85.7% vs. 76.2%).
• Overall treatment predictability was comparable (clear aligners: 84.6% ± 7.8%; fixed appliances: 82.3% ± 8.9%).

Conclusions:

• Both clear aligners and fixed appliances have modality-specific strengths for different orthodontic tooth movements.
• CBCT-based evidence supports informed modality selection in complex orthodontic cases for enhanced precision.
• This study provides valuable data for clinicians planning orthodontic treatment.