Clear aligners (Invisalign / thermoformed aligners) vs Conventional orthodontic appliance treatment: Salivary caries-associated bacteria (S. mutans and Lactobacilli, subjects with >10^5 CFU/mL)
- Population
- Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)
- Intervention
- Clear aligners (Invisalign / thermoformed aligners)
- Comparison
- Conventional orthodontic appliance treatment
- Outcome
- Salivary caries-associated bacteria (S. mutans and Lactobacilli, subjects with >10^5 CFU/mL)
Both included studies reported higher salivary caries-associated bacteria (S. mutans and Lactobacilli) with fixed appliances than clear aligners; not meta-analyzed (ungraded).
What each review found
Include earlier review versions| Finding | Effect | Studies | GRADE certainty |
|---|---|---|---|
Clear aligners (CA) vs Conventional fixed orthodontic appliances (CF) Salivary caries-associated bacteria (S. mutans and Lactobacilli, subjects with >10^5 CFU/mL) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries) · 3 and 6 months, University/hospital orthodontic clinics and private practice (multiple countries) Both included studies reported higher salivary caries-associated bacteria (S. mutans and Lactobacilli) with fixed appliances than clear aligners; not meta-analyzed (ungraded). White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared… (2023) All outcomes | Not meta-analyzed (insufficient number of studies). Both included observational studies (Mummolo 2020 [19]; Mummolo 2020 [25]) reported a higher number of subjects with S. mutans and Lactobacilli >10^5 CFU/mL in the… | 2 studies | GRADE not reported |
Findings are shown side by side, never pooled across reviews.
The reviews
| Review | Searched up to | Included studies | AMSTAR 2 |
|---|---|---|---|
| White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared to fixed orthodontic treatment.… 2023 All outcomes | May 2023 (searched January 2022 to May 2023; literature 1990-May 2023) | 14 | Critically Low / Low |
Studies behind the findings
The primary studies the full-text reviews tie to this outcome. Reviews with headline outcomes only do not list them here.
- Enamel demineralization during clear aligner orthodontic treatment compared with fixed appliance therapy, evaluated with quantitative… · 2020 · included by 1 of these review
- Influence of orthodontic appliance type on salivary parameters during treatment. · 2020 · included by 1 of these review
- Incidence of white spot lesions among patients treated with clear aligners and traditional braces. · 2019 · included by 1 of these review
- International exercise on 124Sb photon emission intensities determination. · 2010 · included by 1 of these review
How reviews are matched to this question
Reviews word the same question differently. Four decision models (TypeSafe's Jev, Liquid AI's d1-ultra, SubQ Snap and Baseten's Elephant) judged each wording of the population, intervention, comparator and outcome against the others; two wordings count as the same when at least three of them agree and none clearly disagrees, and findings count as this question only when all four elements match. Timing, setting and subgroup never split a question: they are shown on each finding.