Question · asked by 1 review
Clear aligners (Invisalign / thermoformed aligners) vs Conventional orthodontic appliance treatment: Plaque
- 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
- Plaque
In randomized trials, clear aligners probably reduce plaque accumulation versus fixed appliances, though the subgroup estimate is imprecise and its CI crosses no effect (SMD -1.79, 95% CI -3.63 to 0.04; moderate certainty).
What each review found
Current versions onlyNo studies found 0 · 0%GRADE not reported 4 · 66.7%Very low 0 · 0%Low 0 · 0%Moderate 2 · 33.3%High 0 · 0%
| Finding | Effect | Studies | GRADE certainty |
|---|---|---|---|
Clear aligners (CA) vs Conventional fixed orthodontic appliances (CF) Plaque accumulation (Plaque Index) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries) · Range 1 to 18 months (maximum time-point per study), University/hospital orthodontic clinics and private practice (multiple countries), Study design: randomized controlled trials In randomized trials, clear aligners probably reduce plaque accumulation versus fixed appliances, though the subgroup estimate is imprecise and its CI crosses no effect (SMD -1.79, 95% CI -3.63 to 0.04; moderate certainty). White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared… (2023) All outcomes | SMD -1.79 [-3.63, 0.04] | 3 studies · 111 participants | Moderate |
Clear aligners (CA) vs Conventional fixed orthodontic appliances (CF) Plaque accumulation (Plaque Index) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries) · 6 months, University/hospital orthodontic clinics and private practice (multiple countries), Follow-up: 6 months At 6 months, clear aligners were associated with significantly less plaque accumulation than fixed appliances (SMD -2.04, 95% CI -3.37 to -0.70; ungraded). White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared… (2023) All outcomes | SMD -2.04 [-3.37, -0.70] | 5 studies · 253 participants | GRADE not reported |
Clear aligners (CA) vs Conventional fixed orthodontic appliances (CF) Plaque accumulation (Plaque Index) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries) · Range 1 to 12 months (maximum time-point per study), University/hospital orthodontic clinics and private practice (multiple countries), Study design: non-randomized studies of interventions In non-randomized studies, clear aligners probably reduce plaque accumulation versus fixed appliances (SMD -1.46, 95% CI -2.77 to -0.15; moderate certainty). White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared… (2023) All outcomes | SMD -1.46 [-2.77, -0.15] | 5 studies · 246 participants | Moderate |
Clear aligners (CA) vs Conventional fixed orthodontic appliances (CF) Plaque accumulation (Plaque Index) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries) · 3 months, University/hospital orthodontic clinics and private practice (multiple countries), Follow-up: 3 months At 3 months, clear aligners were associated with significantly less plaque accumulation than fixed appliances (SMD -1.08, 95% CI -1.93 to -0.24; ungraded). White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared… (2023) All outcomes | SMD -1.08 [-1.93, -0.24] | 5 studies · 211 participants | GRADE not reported |
Clear aligners (CA) vs Conventional fixed orthodontic appliances (CF) Plaque accumulation (Plaque Index) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries) · Maximum reported time-point per study (range 1-18 months), University/hospital orthodontic clinics and private practice (multiple countries) Clear aligners are associated with significantly less plaque accumulation than conventional fixed appliances (pooled SMD -1.58, 95% CI -2.57 to -0.58); certainty graded moderate within study-design subgroups. White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared… (2023) All outcomes | SMD -1.58 [-2.57, -0.58] | 8 studies · 357 participants | GRADE not reported |
Clear aligners (CA) vs Conventional fixed orthodontic appliances (CF) Plaque accumulation (Plaque Index) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries) · 12 months, University/hospital orthodontic clinics and private practice (multiple countries), Follow-up: 12 months At 12 months, clear aligners were associated with significantly less plaque accumulation than fixed appliances (SMD -2.14, 95% CI -3.64 to -0.64; ungraded). White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared… (2023) All outcomes | SMD -2.14 [-3.64, -0.64] | 3 studies · 113 participants | 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 |
Related questions
The same intervention and outcome, asked in another population or against another comparator.
- Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances · Adolescents/teenagers undergoing orthodontic treatment · 1 review
- Clear aligners (Invisalign / thermoformed aligners) vs Fixed appliances · Adults undergoing orthodontic treatment · 1 review
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.
- The impact of fixed orthodontic appliances and clear aligners on the oral microbiome and the association with clinical parameters: A… · 2022 · included by 1 of these review
- Impact of Fixed Orthodontic Appliance and Clear Aligners on the Periodontal Health: A Prospective Clinical Study. · 2020 · included by 1 of these review
- Which orthodontic appliance is best for oral hygiene? A randomized clinical trial. · 2018 · included by 1 of these review
- Periodontal health in teenagers treated with removable aligners and fixed orthodontic appliances. · 2015 · included by 1 of these review
- Periodontal health status in patients treated with the Invisalign(®) system and fixed orthodontic appliances: A 3 months clinical and… · 2015 · included by 1 of these review
- Assessment of the periodontal health status in patients undergoing orthodontic treatment with fixed or removable appliances. A… · 2013 · included by 1 of these review
- Periodontal status of adult patients treated with fixed buccal appliances and removable aligners over one year of active orthodontic… · 2013 · included by 1 of these review
- A comparison of the periodontal health of patients during treatment with the Invisalign system and with fixed orthodontic appliances. · 2005 · 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.