Lactobacilli presence (CFU > 10^5) · Adults undergoing orthodontic treatment
Aligners probably lower the risk of high lactobacilli counts versus fixed appliances in adults at 3 months (RR 0.09, 95% CI 0.02 to 0.47; low certainty).
2 findings from 1 review
S. mutans presence (CFU > 10^5) · Adults undergoing orthodontic treatment
Aligners probably lower the risk of high S. mutans counts versus fixed appliances in adults at 3 months (RR 0.07, 95% CI 0.01 to 0.49; low certainty).
2 findings from 1 review
S. mutans presence · Adolescents/teenagers undergoing orthodontic treatment
A single study found no significant difference in S. mutans presence between aligners and fixed appliances in adolescents at 1 month (RR 0.86, 95% CI 0.64 to 1.14; ungraded).
1 finding from 1 review
RR 0.86 [0.64, 1.14]
1 study
GRADE not reported
Plaque · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)
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).
6 findings from 1 review
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White spot lesion incidence · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)
Most studies reported a lower incidence of white spot lesions with clear aligners than fixed appliances, but heterogeneous assessment methods precluded meta-analysis (ungraded).
1 finding from 1 review
Severity of white spot lesions (surface area and depth) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)
White spot lesion severity was assessed narratively in a small number of studies and not meta-analyzed; evidence is limited (ungraded).
1 finding from 1 review
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)
Both included studies reported higher salivary caries-associated bacteria (S. mutans and Lactobacilli) with fixed appliances than clear aligners; not meta-analyzed (ungraded).
1 finding from 1 review