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Introduction: This pilot two-arm, parallel group, randomized clinical trial aimed to compare the efficacy of tooth movement and patient comfort during orthodontic leveling and alignment with the BRIUS™ lingual system (BR) versus labial full fixed appliances (LFFAs). Methods: Patients in the permanent dentition with mild to moderate crowding were recruited at the University at Buffalo and randomly assigned into the BR group (seven patients) or LFFAs group (six patients). The patients' dental arches were scanned before bonding (T1) and after 18 weeks (T2). Digital dental model superimpositions were performed to three-dimensionally evaluate tooth movement. Changes between T1 and T2 were measured in the x, y, and z planes. Little's Irregularity Index (LII) was also assessed at T1 and T2. An electronic questionnaire was completed daily for 7 days after T1 to evaluate the patients' comfort levels. Results: After 18 weeks, similar displacements were observed for all teeth in both groups except for the lower left second premolar (LL5) in the x-axis which showed greater displacement in the BR group ( p = 0.016). Groups showed similar changes in LII. Discomfort during the first week after bonding was greater on the tongue in the BR group and on the lips and cheeks in the LFFAs group. Tongue discomfort caused by the BR lasted for around 3 days. Conclusion: The BR and LFFAs showed similar teeth displacements and therefore were equally effective at leveling and aligning teeth. LFFAs caused cheek- and lip-borne discomfort while the BR caused tongue-borne discomfort during the first week after bonding. Larger studies with longer follow-ups are needed to obtain more definitive results.