Comparison of Outcomes between Conventional Fixed Appliance and Clear Aligners in Orthodontic Treatment

AIM: This study compared the effectiveness of fixed appliances (FA) and clear aligner treatment (CAT) in the management of malocclusion, with a particular focus on crowding, pain, treatment duration, and root resorption. METHODS: A systematic review was conducted using PubMed and Google Scholar to identify studies published in English between 2003 and 2021. Data were extracted on malocclusion correction, root resorption, treatment duration, pain perception, and quality of life. The included studies were synthesised to compare outcomes between treatment with FA and CAT. RESULTS: Twenty-three studies were included. Treatment with FA was found to be more effective for the correction of malocclusion, proclination, and proximal contact; however, both modalities were associated with mild root resorption of the maxillary and mandibular anterior teeth, with CAT showing less resorption. CAT was also associated with shorter treatment duration, lower pain perception, and better quality of life. CONCLUSION: Both modalities were effective in the treatment of malocclusion; however, CAT appeared to offer particular advantages in cases of mild crowding, including shorter treatment duration, improved quality of life, and reduced pain, whereas FA were more suitable for mild to severe cases. Both modalities resulted in mild root resorption of the anterior teeth, and treatment selection should therefore be individualised.