What do systematic reviews say?

Clear aligners (Invisalign / thermoformed aligners) vs Conventional orthodontic appliance treatment

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 to fixed… 2023 All outcomes

  Range 1 to 18 months (maximum time-point per study) · University/hospital orthodontic clinics and private practice (multiple countries) · Study design: randomized controlled trials
  SMD -1.79 [-3.63, 0.04]
  3 studies · 111 participants
  Moderate
• White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared to fixed… 2023 All outcomes

  6 months · University/hospital orthodontic clinics and private practice (multiple countries) · Follow-up: 6 months
  SMD -2.04 [-3.37, -0.70]
  5 studies · 253 participants
  GRADE not reported
• White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared to fixed… 2023 All outcomes

  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
  SMD -1.46 [-2.77, -0.15]
  5 studies · 246 participants
  Moderate

Carboxymethylcellulose (CMC) spray vs Salinum linseed oil spray

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Mean plaque and gingival indices were reduced during the Salinum (linseed) period; incomplete comparative data.
  1 study · 20 participants
  GRADE not reported