Comparative Assessment of the Clinical Outcomes of Clear Aligners Compared to Fixed Appliance in Class II Malocclusion

Overview

Journal Clin Oral Investig

Specialty Dentistry

Date 2024 Jul 25

PMID 39052179

Authors

Ruwa Irsheid

Lucas Da Cunha Godoy

Chia-Ling Kuo

John Metz

Calogero Dolce

Sarah Abu Arqub

Affiliations

Soon will be listed here.

Abstract

Objective: This study compared clinical outcomes between aligners and fixed appliances in class II adolescent patients.

Materials And Methods: Records of 31 aligners and 35 fixed class II patients, aged 13.5 ± 1.6 years were compared. Class II elastics was the mechanism employed for correcting the malocclusion. DI scores were used to compare initial complexity, and the PAR index scores were used to compare the clinical outcomes. Data on demographics, treatment and finishing durations, number of visits and refinements, duration of class II correction, and changes in the IMPA were collected.

Results: The mean pre-, post-treatment, and overall reduction in PAR index scores between the groups were not significantly different (P > 0.05). The clear aligners group had significantly shorter treatment duration (20.0 ± 11.6 months) than the fixed group (27.4 ± 9.1 months) (P < 0.001). The number of visits for the aligners' group was significantly less (12.7 ± 6.2) than in the fixed group (17.8 ± 5.8) (P < 0.001). Duration for class II correction was significantly shorter for clear aligners (13.3 ± 10.0 months) compared to the fixed group (17.4 ± 9.0 months) (P = 0.026). A smaller post-treatment change in IMPA (2 ± 6°) was detected in the aligners group compared to the fixed group (5 ± 6°) (P < 0.05).

Conclusions: Treatment outcomes for aligners in class II adolescent patients were comparable to those achieved in fixed appliances. Shorter treatment and class II correction durations, fewer visits, and better control for the IMPA were noticed in the aligners' group.

Clinical Relevance: Treating class II adolescent patients with aligners seems promising and demands shorter treatment time and fewer visits.

Citing Articles

Clear Aligner Treatment: Indications, Advantages, and Adverse Effects-A Systematic Review.

Hartogsohn C, Sonnesen L Dent J (Basel). 2025; 13(1).

PMID: 39851616 PMC: 11764167. DOI: 10.3390/dj13010040.

References

Lanteri V, Farronato G, Lanteri C, Caravita R, Cossellu G . The efficacy of orthodontic treatments for anterior crowding with Invisalign compared with fixed appliances using the Peer Assessment Rating Index. Quintessence Int. 2018; 49(7):581-587. DOI: 10.3290/j.qi.a40511. View

Rongo R, Dianiskova S, Spiezia A, Bucci R, Michelotti A, DAnto V . Class II Malocclusion in Adult Patients: What Are the Effects of the Intermaxillary Elastics with Clear Aligners? A Retrospective Single Center One-Group Longitudinal Study. J Clin Med. 2022; 11(24). PMC: 9782913. DOI: 10.3390/jcm11247333. View

Lin E, Julien K, Kesterke M, Buschang P . Differences in finished case quality between Invisalign and traditional fixed appliances. Angle Orthod. 2022; 92(2):173-179. PMC: 8887409. DOI: 10.2319/032921-246.1. View

Buschang P, Shaw S, Ross M, Crosby D, Campbell P . Comparative time efficiency of aligner therapy and conventional edgewise braces. Angle Orthod. 2014; 84(3):391-6. PMC: 8667515. DOI: 10.2319/062113-466. View

Harradine N . Self-ligating brackets and treatment efficiency. Clin Orthod Res. 2001; 4(4):220-7. DOI: 10.1034/j.1600-0544.2001.40406.x. View

Ireland A, Sherriff M, McDonald F . Effect of bracket and wire composition on frictional forces. Eur J Orthod. 1991; 13(4):322-8. DOI: 10.1093/ejo/13.4.322. View

Borda A, Garfinkle J, Covell D, Wang M, Doyle L, Sedgley C . Outcome assessment of orthodontic clear aligner vs fixed appliance treatment in a teenage population with mild malocclusions. Angle Orthod. 2020; 90(4):485-490. PMC: 8028462. DOI: 10.2319/122919-844.1. View

Richmond S, Shaw W, OBrien K, Buchanan I, Jones R, Stephens C . The development of the PAR Index (Peer Assessment Rating): reliability and validity. Eur J Orthod. 1992; 14(2):125-39. DOI: 10.1093/ejo/14.2.125. View

10.

Gera A, Gera S, Dalstra M, Cattaneo P, Cornelis M . Validity and Reproducibility of the Peer Assessment Rating Index Scored on Digital Models Using a Software Compared with Traditional Manual Scoring. J Clin Med. 2021; 10(8). PMC: 8070578. DOI: 10.3390/jcm10081646. View

11.

Joss-Vassalli I, Grebenstein C, Topouzelis N, Sculean A, Katsaros C . Orthodontic therapy and gingival recession: a systematic review. Orthod Craniofac Res. 2010; 13(3):127-41. DOI: 10.1111/j.1601-6343.2010.01491.x. View

12.

Rozzi M, Mucedero M, Pezzuto C, Lione R, Cozza P . Long-term stability of curve of Spee levelled with continuous archwires in subjects with different vertical patterns: a retrospective study. Eur J Orthod. 2018; 41(3):286-293. DOI: 10.1093/ejo/cjy065. View

13.

Baysal A, Ucar F, Buyuk S, Ozer T, Uysal T . Alveolar bone thickness and lower incisor position in skeletal Class I and Class II malocclusions assessed with cone-beam computed tomography. Korean J Orthod. 2013; 43(3):134-40. PMC: 3694205. DOI: 10.4041/kjod.2013.43.3.134. View

14.

Hennessy J, Garvey T, Al-Awadhi E . A randomized clinical trial comparing mandibular incisor proclination produced by fixed labial appliances and clear aligners. Angle Orthod. 2016; 86(5):706-12. PMC: 8600838. DOI: 10.2319/101415-686.1. View

15.

Holman J, Hans M, Nelson S, Powers M . An assessment of extraction versus nonextraction orthodontic treatment using the peer assessment rating (PAR) index. Angle Orthod. 1998; 68(6):527-34. DOI: 10.1043/0003-3219(1998)068<0527:AAOEVN>2.3.CO;2. View