What do systematic reviews say?

4 questions · 9 findings · 1 reviews · Periodontology

Sort:Best matchNewest Highest certainty Download CSV

No studies found 0 · 0%GRADE not reported 7 · 77.8%Very low 0 · 0%Low 0 · 0%Moderate 2 · 22.2%High 0 · 0%

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

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

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

Show 3 more findings

White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared to fixed… 2023 All outcomes
3 months · University/hospital orthodontic clinics and private practice (multiple countries) · Follow-up: 3 months
SMD -1.08 [-1.93, -0.24]
5 studies · 211 participants
GRADE not reported
White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared to fixed… 2023 All outcomes
Maximum reported time-point per study (range 1-18 months) · University/hospital orthodontic clinics and private practice (multiple countries)
SMD -1.58 [-2.57, -0.58]
8 studies · 357 participants
GRADE not reported
White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared to fixed… 2023 All outcomes
12 months · University/hospital orthodontic clinics and private practice (multiple countries) · Follow-up: 12 months
SMD -2.14 [-3.64, -0.64]
3 studies · 113 participants
GRADE not reported

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

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

White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared to fixed… 2023 All outcomes
End of orthodontic treatment (varying) · University/hospital orthodontic clinics and private practice (multiple countries)
Not meta-analyzed (heterogeneous methods; tooth-based vs patient-based incidence). 4 studies assessed WSL incidence; 3 (Albhaisi 2020 [12]; Buschang 2019 [29]; Dallel 2020 [30]) reported a lower risk of developing WSLs…
4 studies
GRADE not reported

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

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

White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared to fixed… 2023 All outcomes
Baseline to end of treatment (varying) · University/hospital orthodontic clinics and private practice (multiple countries)
Not meta-analyzed. 2 RCTs assessed WSL severity by lesion surface area (Albhaisi 2020 [12]; Alshatti 2017 [31]) and 1 (Albhaisi 2020 [12]) also by lesion depth; reported narratively with differing methods, generally…
2 studies
GRADE not reported

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

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

White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared to fixed… 2023 All outcomes
3 and 6 months · University/hospital orthodontic clinics and private practice (multiple countries)
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