Comparison of orthodontic adverse effects: braces versus clear aligners

Background: The aim of the study is to compare the potential side effects of fixed orthodontic treatment (FOT) and clear aligner therapy (CAT). Methods: 27 individuals who were treated with clear aligners (20 Female, 7 Male; mean age: 22.57 ± 7.37) and 22 patients treated with braces (14 Female, 8 Male; mean age: 17.05 ± 4.51) formed the study group. The periodontal statuses of the patients were evaluated before treatment (T0), 3 months (T1) after, and at 6th month (T2) following the beginning of the treatment. The amount of root resorption in maxillary & mandibular incisors was evaluated using the ImageJ software on periapical radiographies taken with the paralleling technique. Pain experience and chewing function were also recorded during treatment. Results: The root lengths showed a significant decrease from T0 to T2 in both groups. Compared to CAT, greater amount of root resorption was noted with FOT (p < 0.05). The highest degrees of pain and the highest chewing difficulty scores were recorded at the 24th hour for both groups. The pain scores after the 2nd week in CAT were similar to those before the orthodontic treatment, while this amelioration occurred after the 1st month in FOT. Chewing function improved after the 2nd week in CAT and after the 1stweek in FOT. Periodontal status evaluation showed that there was no significant difference in probing depth between the groups for the maxillary teeth. However, higher probing depth values were observed for all mandibular teeth in FOT. The change in the plaque index and the levels of bleeding were higher for FOT at all time points. Conclusions: CAT has some advantages in terms of protecting periodontal health and controlling root resorption during orthodontic treatment. In terms of the patients’ treatment experience, while the pain levels felt by the patients in the CAT group decreased faster, chewing performance improved more rapidly in the FOT group. Clinical Trial Registration: The study was registered with ClinicalTrials.gov as NCT06709287.

Clear aligners; Fixed orthodontic treatment; Adverse effects; Root resorption; Periodontal status

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