Adverse effects of clear aligner orthodontic treatment – a literary review

Abstract

Background and aim: Orthodontic treatment with clear aligners has been increasingly popular since introduction in the late 1990 ́s. This literary review is aimed to study the adverse effects in connection to clear aligner treatment regarding white spot lesions, root resorption, periodontal status, pain and discomfort. Material and methods: Search in the PubMed, Cochrane Library and Embase databases gave 1144 initial titles, and after removal of duplicates and reviewing for exclusion criteria resulted in a final amount of 30 articles. Inclusion criteria were healthy patients with aligner treatment. Keywords were: clear aligner (CA), Invisalign, white spot lesions (WSL), root resorption (RR), periodontal status (PERIO), pain and discomfort (P&D). Endnote was used for organizing articles and excluding duplicates. Results: Clear aligner treatment was presented to generate significantly less lesions (compared to fixed appliances treatment (6.2 vs. 8.3 lesions/patient); p < 0.05)). However, CA lesions were larger in area but shallower. Prevalence of root-resorption was significantly lower in a CA group compared to a fixed appliance group (56% vs. 82%; p < 0.001). Periodontal pocket depth was found to be significantly less on average in CA patients compared to FA patients in 5/6 articles. Pain and discomfort levels were significantly lower among CA patients than FA patients during the first week after initiation of treatment. Conclusion: This literary review clearly indicates that clear aligner treatment has less adverse effects regarding white spot lesions, root resorption, periodontal risk factors, and pain and discomfort compared to conventional fixed appliance treatment.