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Treatment outcome with orthodontic aligners and fixed appliances: a systematic review with meta-analyses.
- Source :
-
European journal of orthodontics [Eur J Orthod] 2020 Jun 23; Vol. 42 (3), pp. 331-343. - Publication Year :
- 2020
-
Abstract
- Background: The use of orthodontic aligners to treat a variety of malocclusions has seen considerable increase in the last years, yet evidence about their efficacy and adverse effects relative to conventional fixed orthodontic appliances remains unclear.<br />Objective: This systematic review assesses the efficacy of aligners and fixed appliances for comprehensive orthodontic treatment.<br />Search Methods: Eight databases were searched without limitations in April 2019.<br />Selection Criteria: Randomized or matched non-randomized studies.<br />Data Collection and Analysis: Study selection, data extraction, and risk of bias assessment was done independently in triplicate. Random-effects meta-analyses of mean differences (MDs) or relative risks (RRs) with their 95% confidence intervals (CIs) were conducted, followed by sensitivity analyses, and the GRADE analysis of the evidence quality.<br />Results: A total of 11 studies (4 randomized/7 non-randomized) were included comparing aligners with braces (887 patients; mean age 28.0 years; 33% male). Moderate quality evidence indicated that treatment with orthodontic aligners is associated with worse occlusal outcome with the American Board of Orthodontics Objective Grading System (3 studies; MD = 9.9; 95% CI = 3.6-16.2) and more patients with unacceptable results (3 studies; RR = 1.6; 95% CI = 1.2-2.0). No significant differences were seen for treatment duration. The main limitations of existing evidence pertained to risk of bias, inconsistency, and imprecision of included studies.<br />Conclusions: Orthodontic treatment with aligners is associated with worse treatment outcome compared to fixed appliances in adult patients. Current evidence does not support the clinical use of aligners as a treatment modality that is equally effective to the gold standard of braces.<br />Registration: PROSPERO (CRD42019131589).<br /> (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Details
- Language :
- English
- ISSN :
- 1460-2210
- Volume :
- 42
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- European journal of orthodontics
- Publication Type :
- Academic Journal
- Accession number :
- 31758191
- Full Text :
- https://doi.org/10.1093/ejo/cjz094