Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

33 questions · 38 findings · 4 reviews · Orthodontics

No studies found 9 · 23.7%GRADE not reported 22 · 57.9%Very low 5 · 13.2%Low 0 · 0%Moderate 2 · 5.3%High 0 · 0%

Schwarz appliance vs No active treatment (control)

Lower incisors to mandible (position, mm) at 9 months · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

Schwarz appliance led to higher lower incisors to mandible (position, mm) at 9 months compared with no active treatment (control); GRADE not reported.

1 finding from 1 review

Lower lingual arch vs No active treatment (control)

Lower molars to mandible (relationship of lower back teeth to the mandible) · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth

Lower lingual arch led to lower lower molars to mandible at 1 year compared with no active treatment (control); GRADE not reported.

1 finding from 1 review

Any intervention to manage relapse: fixed options (labial braces, lingual braces, fixed lingual wire) or removable options (Hawley's retainer with spring elastomeric module, Bloore removable aligner, other Hawley's retainer modifications, Invisalign, Clearstep) vs no intervention or another intervention

Cost-benefit consideration · Participants who previously underwent orthodontic treatment, with subsequent crowding (relapse) of the lower front teeth (lower incisors…

The review found no eligible studies for this question.

1 finding from 1 review

Any intervention to manage relapse: fixed options (labial braces, lingual braces, fixed lingual wire) or removable options (Hawley's retainer with spring elastomeric module, Bloore removable aligner, other Hawley's retainer modifications, Invisalign, Clearstep) vs no intervention or another intervention

Patient discomfort · Participants who previously underwent orthodontic treatment, with subsequent crowding (relapse) of the lower front teeth (lower incisors…

The review found no eligible studies for this question.

1 finding from 1 review

Any intervention to manage relapse: fixed options (labial braces, lingual braces, fixed lingual wire) or removable options (Hawley's retainer with spring elastomeric module, Bloore removable aligner, other Hawley's retainer modifications, Invisalign, Clearstep) vs no intervention or another intervention

Stability of the correction · Participants who previously underwent orthodontic treatment, with subsequent crowding (relapse) of the lower front teeth (lower incisors…

The review found no eligible studies for this question.

1 finding from 1 review

Any intervention to manage relapse: fixed options (labial braces, lingual braces, fixed lingual wire) or removable options (Hawley's retainer with spring elastomeric module, Bloore removable aligner, other Hawley's retainer modifications, Invisalign, Clearstep) vs no intervention or another intervention

Quality of life · Participants who previously underwent orthodontic treatment, with subsequent crowding (relapse) of the lower front teeth (lower incisors…

The review found no eligible studies for this question.

1 finding from 1 review

Any intervention to manage relapse: fixed options (labial braces, lingual braces, fixed lingual wire) or removable options (Hawley's retainer with spring elastomeric module, Bloore removable aligner, other Hawley's retainer modifications, Invisalign, Clearstep) vs no intervention or another intervention

Adverse effects including pain, gingivitis, enamel decalcification and root resorption · Participants who previously underwent orthodontic treatment, with subsequent crowding (relapse) of the lower front teeth (lower incisors…

The review found no eligible studies for this question.

1 finding from 1 review

Any intervention to manage relapse: fixed options (labial braces, lingual braces, fixed lingual wire) or removable options (Hawley's retainer with spring elastomeric module, Bloore removable aligner, other Hawley's retainer modifications, Invisalign, Clearstep) vs no intervention or another intervention

Aesthetics · Participants who previously underwent orthodontic treatment, with subsequent crowding (relapse) of the lower front teeth (lower incisors…

The review found no eligible studies for this question.

1 finding from 1 review

Any intervention to manage relapse: fixed options (labial braces, lingual braces, fixed lingual wire) or removable options (Hawley's retainer with spring elastomeric module, Bloore removable aligner, other Hawley's retainer modifications, Invisalign, Clearstep) vs no intervention or another intervention

Assessment of the alignment of the lower front teeth using any method or index · Participants who previously underwent orthodontic treatment, with subsequent crowding (relapse) of the lower front teeth (lower incisors…

The review found no eligible studies for this question.

1 finding from 1 review

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
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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

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

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