Clear Aligners – Fact or Fiction
Unley Orthodontics
Efficiency, effectiveness and treatment stability of clear aligners: A systematic review and meta‐analysis
Zheng M, et al.
Orthodontics and Craniofacial Research 2017
Background
Clear aligners, such as Invisalign or Spark, are plastic trays that fit closely to the surfaces of the teeth. By changing the aligners once or twice per fortnight, the teeth are slowly moved into the desired position to create a straight smile and functional bite. Clear aligners are one of the greatest innovations in orthodontics over the past 20 years and have encouraged millions of patients to have their teeth straightened without the need for metal braces. As exciting as this technology is, it is important to separate some common facts from fiction. A recent systematic review and meta-analysis sheds some light on the topic.
Fact or fiction
Clear aligners are faster than metal or ceramic braces.
FACT. The total treatment time for clear aligners can be anywhere from three to five months shorter than braces. However, most orthodontists treat their “easier”, non-extraction cases with clear aligners. More difficult cases involving the extraction of teeth usually require more time with clear aligners when compared to braces.
Clear aligners achieve a better final smile and bite.
FICTION. For mild to moderate malocclusions (crooked teeth and bite), there is little difference in the final result that can be achieved by either clear aligners or braces. More severe malocclusions, especially when removal of teeth is required, are harder to correct with clear aligners and, according to an American Grading System, do not correct malocclusions as well as braces.
Braces create a more stable final smile and bite.
FACT. Although this fact is based on a single study, it was found that patients treated by Invisalign relapsed (teeth moved back) more than those treated with traditional braces. However, the factors that contribute to relapse after orthodontic treatment are complex and it is important to remember that retention, with removable or fixed (bonded) wire retainers, is one of the most important factors in maintaining a long-term smile and bite.
Clear aligners have fewer appointments and emergencies than braces.
FACT. Most clear aligner appointments take half the time of a regular braces adjustment because there are no wires to change. Furthermore, clear aligner patients generally require fewer overall appointments. Those with good compliance (wearing aligners for 22 hours per day consistently with excellent oral hygiene) can be seen at 10—12-week intervals rather than the regular 8-week interval. Emergency visits are not as common with clear aligners as there are fewer parts that can break and no bands or brackets that can come loose. Clear aligners must be removed for eating, which negates the risk of breaking something whilst chewing.
Summary
The main advantages for clear aligners over braces are shorter treatment time, fewer emergencies and less office visits. However, this is only significant when mild-to-moderate malocclusions are treated. More severe malocclusions are usually treated more efficiently with braces.
Dr Jensen