Non-Cochrane · intervention · PM41464384
Oral Health-Related Quality of Life (OHRQoL), Pain and Side Effects in Adults Undergoing Different Orthodontic Treatment Modalities: A Systematic Review and Meta-Analysis.
Johal Ama, Dunne Brian, Bolooki Honieh, et al. · Healthcare (Basel, Switzerland) · 2025 · PubMed · doi:10.3390/healthcare13243317
Findings
Population Adults undergoing orthodontic treatment
10 findings
| Clear aligners | Within-group change, 7 days versus 24 hours after appliance fit | Pain (VAS) 24 hours to 7 days | SMD -10.02 [-11.13, -8.91] GRADE not reported 2 studies · 88 participants |
| Fixed labial appliances | Within-group change, 7 days versus 24 hours after appliance fit | Pain (VAS) 24 hours to 7 days | SMD -6.40 [-10.42, -2.38] GRADE not reported 5 studies · 176 participants |
| Aligners and fixed labial appliances (combined) | Within-group change, 7 days versus 24 hours after appliance fit | Pain (VAS) 24 hours to 7 days Unresolved: the two extractors disagree on this row. | SMD -7.45 [-11.28, -3.62] GRADE not reported 5 studies · 264 participants |
| Clear aligners | Fixed labial (straight wire) appliances | Oral health-related quality of life (OHIP-14 score) Pre-treatment | MD -0.3 [-1.7, 1.1] GRADE not reported 2 studies · 80 participants |
| Clear aligners | Fixed labial (straight wire) appliances | Oral health-related quality of life (OHIP-14 score) 1 week | MD -10.9 [-13.0, -8.7] GRADE not reported 2 studies · 80 participants |
| Clear aligners | Fixed labial (straight wire) appliances | Oral health-related quality of life (OHIP-14 score) 6 months | MD -4.2 [-6.6, -1.7] GRADE not reported 2 studies · 80 participants |
| Clear aligners | Fixed labial (straight wire) appliances | Oral health-related quality of life (OHIP-14 score) 1 month | MD -6.3 [-7.8, -4.7] GRADE not reported 2 studies · 80 participants |
| Fixed labial appliances | Pre-treatment (before-after comparison) | Rosenberg self-esteem score Post-treatment versus pre-treatment | SMD 0.13 [-0.46, 0.73] GRADE not reported 2 studies · 113 participants |
| Fixed labial appliances | Pre-treatment (before-after comparison) | Aesthetic concern (PIDAQ domain) score Post-treatment versus pre-treatment | SMD -1.71 [-3.46, 0.04] GRADE not reported 2 studies · 471 participants |
| Fixed labial appliances | Pre-treatment (before-after comparison) | Dental self-confidence (PIDAQ domain) score Post-treatment versus pre-treatment | SMD 2.18 [0.87, 3.50] GRADE not reported 2 studies · 471 participants |
Included primary studies 35
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Alfawal et al. 2022 The impact of non-extraction orthodontic treatment on oral health-related quality of life: clear aligners versus fixed appliances-a… PMID:35395075 | 2022 | 3 other reviews | Pain (VAS) | not extracted yet |
| Antonio-Zancajo et al. 2020 Pain and Oral-Health-Related Quality of Life in Orthodontic Patients During Initial Therapy with Conventional, Low-Friction, and Lingual… PMID:32635196 | 2020 | 2 other reviews | not stated | not extracted yet |
| Gao et al. 2021 Comparison of pain perception, anxiety, and impacts on oral health-related quality of life between patients receiving clear aligners and… PMID:32613250 | 2021 | 2 other reviews | Pain (VAS) | not extracted yet |
| Miller et al. 2007 A comparison of treatment impacts between Invisalign aligner and fixed appliance therapy during the first week of treatment. PMID:17346581 | 2007 | 2 other reviews | Pain (VAS) | not extracted yet |
| Al Nazeh et al. 2020 Relationship between oral health impacts and personality profiles among orthodontic patients treated with Invisalign clear aligners. PMID:33235288 | 2020 | 1 other review | not stated | not extracted yet |
| Almasoud 2018 Pain perception among patients treated with passive self-ligating fixed appliances and Invisalign® aligners during the first week of… PMID:30206531 | 2018 | 1 other review | not stated | not extracted yet |
| Choi et al. 2017 Changes in psychological health, subjective food intake ability and oral health-related quality of life during orthodontic treatment. PMID:28853165 | 2017 | 1 other review | Rosenberg self-esteem score | not extracted yet |
| Diddige et al. 2020 Comparison of pain levels in patients treated with 3 different orthodontic appliances - a randomized trial. PMID:32133451 | 2020 | 1 other review | not stated | not extracted yet |
| Flores-Mir et al. 2018 Patient satisfaction and quality of life status after 2 treatment modalities: Invisalign and conventional fixed appliances. PMID:30384934 | 2018 | 1 other review | not stated | not extracted yet |
| Fujiyama et al. 2014 Analysis of pain level in cases treated with Invisalign aligner: comparison with fixed edgewise appliance therapy. PMID:25416143 | 2014 | 1 other review | not stated | not extracted yet |
| Gibreal et al. 2019 Evaluation of the levels of pain and discomfort of piezocision-assisted flapless corticotomy when treating severely crowded lower anterior… PMID:30991984 | 2019 | 1 other review | Pain (VAS) | not extracted yet |
| Jaber et al. 2022 The Effect of Treatment With Clear Aligners Versus Fixed Appliances on Oral Health-Related Quality of Life in Patients With Severe… PMID:35663697 | 2022 | 1 other review | Pain (VAS) | not extracted yet |
| Johal et al. 2018 Pain experience in adults undergoing treatment: A longitudinal evaluation. PMID:29509026 | 2018 | 1 other review | Pain (VAS) | not extracted yet |
| Shalish et al. 2012 Adult patients' adjustability to orthodontic appliances. Part I: a comparison between Labial, Lingual, and Invisalign™. PMID:21750242 | 2012 | 1 other review | not stated | not extracted yet |
| White et al. 2017 Discomfort associated with Invisalign and traditional brackets: A randomized, prospective trial. PMID:28753032 | 2017 | 1 other review | not stated | not extracted yet |
| Wu et al. 2010 A comparison of pain experienced by patients treated with labial and lingual orthodontic appliances. PMID:20018798 | 2010 | 1 other review | not stated | not extracted yet |
| Zamora-Martínez et al. 2021 Comparative Study of Oral Health-Related Quality of Life (OHRQL) between Different Types of Orthodontic Treatment. PMID:34356964 | 2021 | 1 other review | not stated | not extracted yet |
| AlSeraidi et al. 2021 The effect of vestibular, lingual, and aligner appliances on the quality of life of adult patients during the initial stages of… PMID:33458787 | 2021 | this review only | not stated | not extracted yet |
| Antonio-Zancajo et al. 2021 Comparative Analysis of Periodontal Pain According to the Type of Precision Orthodontic Appliances: Vestibular, Lingual and Aligners. A… PMID:33924818 | 2021 | this review only | not stated | not extracted yet |
| Chen et al. 2015 Impact of malocclusion on oral health-related quality of life in young adults. PMID:25531421 | 2015 | this review only | not stated | not extracted yet |
| González et al. 2019 Psychosocial dental impact in adult orthodontic patients: what about health competence? PMID:31242920 | 2019 | this review only | Dental self-confidence (PIDAQ domain) score; Aesthetic concern (PIDAQ domain) score | not extracted yet |
| Grewal et al. 2019 Psychological impact of orthodontic treatment on quality of life - A longitudinal study. PMID:31028017 | 2019 | this review only | Dental self-confidence (PIDAQ domain) score; Aesthetic concern (PIDAQ domain) score | not extracted yet |
| Hohoff et al. 2003 Speech performance in lingual orthodontic patients measured by sonagraphy and auditive analysis. PMID:12594420 | 2003 | this review only | not stated | not extracted yet |
| Hohoff et al. 2003 Comparison of 3 bonded lingual appliances by auditive analysis and subjective assessment. PMID:14666090 | 2003 | this review only | not stated | not extracted yet |
| Johal et al. 2015 The impact of orthodontic treatment on quality of life and self-esteem in adult patients. PMID:25214505 | 2015 | this review only | Rosenberg self-esteem score | not extracted yet |
| Kara-Boulad et al. 2022 Evaluation of the Oral Health-Related Quality of Life (OHRQoL) in Patients Undergoing Lingual Versus Labial Fixed Orthodontic Appliances:… PMID:35371870 | 2022 | this review only | not stated | not extracted yet |
| Krishnamurthy et al. 2022 Quality of Life Before and After Orthodontic Treatment in Adult Patients with Malocclusion: A Quasi-experimental Study DOI:10.7860/jcdr/2022/56888.17054 | 2022 | this review only | not stated | not extracted yet |
| Lau et al. 2023 Minimally important differences in oral health-related quality of life after fixed orthodontic treatment: a prospective cohort study. PMID:36370121 | 2023 | this review only | not stated | not extracted yet |
| Pacheco-Pereira et al. 2018 Patient satisfaction and quality of life changes after Invisalign treatment. PMID:29853241 | 2018 | this review only | not stated | not extracted yet |
| Prado et al. 2016 Prospective evaluation of the psychosocial impact of the first 6 months of orthodontic treatment with fixed appliance among young adults. PMID:26574928 | 2016 | this review only | not stated | not extracted yet |
| Romero-Maroto et al. 2015 The impact of dental appearance and anxiety on self-esteem in adult orthodontic patients. PMID:25809714 | 2015 | this review only | not stated | not extracted yet |
| Shen et al. 2016 Fixed orthodontic appliances cause pain and disturbance in somatosensory function. PMID:26715259 | 2016 | this review only | Pain (VAS) | not extracted yet |
| Varela & Garciacamba 1995 Impact of orthodontics on the psychologic profile of adult patients: a prospective study. PMID:7625386 | 1995 | this review only | not stated | not extracted yet |
| Wong et al. 2018 Factors influencing satisfaction with the process of orthodontic treatment in adult patients. PMID:29501111 | 2018 | this review only | not stated | not extracted yet |
| Wu et al. 2008 A comparison of pain experienced by patients treated with labial and lingual orthodontic appliances. PMID:22073476 | 2008 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults (older than 18 years) requiring orthodontic treatment | Adults, 2611 independent participants (n=35 studies) |
| Intervention | Fixed (labial or lingual) or removable clear aligner appliances | Aligners (n=513), fixed labial (n=1816), lingual (n=218), combined appliances (n=64) |
| Comparison | Comparison group not essential for inclusion | Fixed labial vs aligners vs lingual appliances; single-arm studies |
| Outcomes | OHRQoL and self-esteem; pain or discomfort; other side effects and complications including function | OHRQoL (OHIP-14, PIDAQ), self-esteem (Rosenberg), pain VAS, speech and other side effects |
| Study designs | RCTs, non-randomized controlled trials, cohort, cross-sectional, prospective case series, qualitative studies | 6 RCTs, 1 CCT, 1 quasi-experimental, 23 prospective cohort, 2 cross-sectional, 1 longitudinal observational, 1 qualitative (n=35); 9 in meta-analysis |
| Timing | Not specified | Up to 12 months |