Periodontal health status, oral microbiome, white-spot lesions and oral health related to quality of life-clear aligners versus fixed appliances: A systematic review, meta-analysis and meta-regression

Objective: : Assess and evaluate the different indicators of oral health-related quality of life (OHRQoL) among patients treated with clear aligners (CAs) versus those treated with conventional fixed orthodontics (FAs). Methods: : An electronic search was performed on the database is Web of Science, Scopus, and Embase databases. Randomized and non-randomized control trials, cross-sectional, prospective cohort and retrospective trials were included. Quality was assessed with risk of bias tool and risk of bias in non-randomised studies. Meta-analyses were performed with random effects models, estimating the standardized and non-standardized mean differences, odds ratio and risk ratio as the measure of effect. The effect on time was determined using a meta-regression model. Results: bacteria. The risk of white spot lesion onset is ten times lower in carriers of CAs. Conclusions: : Patients wearing CAs show better periodontal indicators, less risk of white spot development, less biofilm mass and a better QoL than patients with FAs.