Non-Cochrane · intervention · PM42356103
Comparative Impact of Clear Aligners and Traditional Fixed Appliances on Oral Health-Related Quality of Life: A Systematic Review and Meta-Analysis.
Lalli Elisabetta, Caramaschi Elena, Nieri Agnese, et al. · Medicina (Kaunas, Lithuania) · 2026 · PubMed · doi:10.3390/medicina62061090
Findings
Population Adults with Angle class I malocclusion needing non-extraction orthodontic treatment
8 findings
| Clear aligners | Conventional fixed appliances | Handicap (OHIP-14) Change in score from baseline to 1 month (T1-T0) · Orthodontic treatment, short-term early phase | WMD -0.21 [-0.93, 0.51] Moderate Downgraded: imprecision 2 studies · 74 participants |
| Clear aligners | Conventional fixed appliances | Overall OHIP-14 score Change in score from baseline to 1 month (T1-T0) · Orthodontic treatment, short-term early phase | WMD -5.27 [-12.86, 2.32] GRADE not reported 2 studies · 74 participants |
| Clear aligners | Conventional fixed appliances | Psychological discomfort (OHIP-14) Change in score from baseline to 1 month (T1-T0) · Orthodontic treatment, short-term early phase | WMD -1.28 [-2.21, -0.35] Moderate Downgraded: imprecision 2 studies · 74 participants |
| Clear aligners | Conventional fixed appliances | Physical pain (OHIP-14) Change in score from baseline to 1 month (T1-T0) · Orthodontic treatment, short-term early phase | WMD -0.66 [-3.23, 1.9] Low Downgraded: imprecision, inconsistency 2 studies · 74 participants |
| Clear aligners | Conventional fixed appliances | Social disability (OHIP-14) Change in score from baseline to 1 month (T1-T0) · Orthodontic treatment, short-term early phase | WMD -0.52 [-1.08, 0.05] Moderate Downgraded: imprecision 2 studies · 74 participants |
| Clear aligners | Conventional fixed appliances | Physical disability (OHIP-14) Change in score from baseline to 1 month (T1-T0) · Orthodontic treatment, short-term early phase | WMD -1.29 [-3.4, 0.81] Low Downgraded: imprecision, inconsistency 2 studies · 74 participants |
| Clear aligners | Conventional fixed appliances | Psychological disability (OHIP-14) Change in score from baseline to 1 month (T1-T0) · Orthodontic treatment, short-term early phase | WMD -1.63 [-2.51, -0.74] Low Downgraded: imprecision, inconsistency 2 studies · 74 participants |
| Clear aligners | Conventional fixed appliances | Functional limitation (OHIP-14) Change in score from baseline to 1 month (T1-T0) · Orthodontic treatment, short-term early phase | WMD 0.04 [-1.76, 1.84] Low Downgraded: imprecision, inconsistency 2 studies · 74 participants |
Included primary studies 2
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Alhafi 2024 The Impact of Non-Extraction Orthodontic Treatment on the Oral-Health-Related Quality of Life between a Modified Aligner Appliance with… PMID:39064568 | 2024 | 2 other reviews | not stated | not extracted yet |
| Borsato 2025 Impact of orthodontic treatment with aligners and fixed appliances on OHRQoL: a randomized clinical trial. PMID:39936711 | 2025 | 1 other review | 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 | Adult patients in permanent dentition with Angle class I malocclusion requiring non-extraction orthodontic treatment without orthognathic surgery or TADs | Adults with Angle class I malocclusion with mild to moderate crowding (n=74) |
| Intervention | Orthodontic treatment with clear aligners | Clear aligners (Invisalign; modified aligner with Ni-Ti springs) (n=37) |
| Comparison | Traditional fixed orthodontic appliances | Conventional fixed appliances (n=37) |
| Outcomes | OHRQoL (OHIP-14 overall and domain scores): pain, discomfort, functional limitation, speech, psychological impact, social well-being | OHIP-14 overall and seven domain scores (functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, handicap) |
| Study designs | Randomized controlled trials | 2 RCTs |
| Timing | Baseline to earliest comparable follow-up (about 1 month) | Baseline, 2 weeks to 12 months; meta-analysis on change from baseline to about 1 month |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | Yes | Yes | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | No | No | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Yes | no |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |