ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Efficacy Of Tooth Movement Of Clear Plastic Aligners Vs. Traditional Brackets And Archwires
Clinical Question In an orthodontic patient, will a clear plastic aligner move teeth as well as traditional orthodontic treatment with brackets and arch wires?
Clinical Bottom Line Clear plastic aligners can accomplish some malocclusion well, but the evidence does not support that clear plastic aligners can accomplish all tooth movements as accurately as brackets and arch wires can.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 19121497Kravitz/200937 patients in need of clear plastic aligner treatmentClinical Trial
Key resultsClear plastic aligners can efficiently move teeth, but the clinician must understand the limitations that clear plastic aligners have, particularly in the accuracy of tooth movement. This can often be overcome by over correction, however. Clear plastic aligners move canines with the lowest efficiency out of all anterior teeth.
#2) 16168325Djeu/2005Two groups of 48 patients – one Invisalign and one braces group Retrospective Cohort Analysis
Key resultsInvisalign did not correct malocclusions as well as braces, especially in large anteroposterior discrepancies and occlusal contact deficiencies. However, Invisalign did close spaces, approximate marginal ridge heights, and correct anterior rotations well.
Evidence Search invisalign[All Fields] AND "humans"[MeSH Terms]
Comments on
The Evidence
The Kravitz evidence was from a clinical trial that had 37 patients. This is a sufficient number of patients for the trial, but it’s possible that this cohort may not be representative for the population at whole. Also, a clinical trial is not an exceptionally strong form of evidence. The Djeu evidence was a retrospective cohort analysis. There were a sufficient number of patients in each group (forty-eight), but a cohort analysis is not an exceptionally strong form of evidence.
Applicability Clear plastic aligners can be a great addition to a dentist’s malocclusion and malalignment treatment options, but the individual practitioner must keep in mind the limitations that they present. These limitation include, but are not limited to: difficulty correcting large anteroposterior discrepancies, difficulty establishing proper occlusal contacts, difficulty rotating maxillary and mandibular canines, difficulty with extrusion, and difficulty with labial crown tipping.
Specialty/Discipline (General Dentistry) (Orthodontics)
Keywords Invisalign, malocclusion, orthodontic brackets
ID# 2254
Date of submission: 04/19/2012spacer
E-mail BurtonCR@livemail.uthscsa.edu
Author Christopher R. Burton
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Clarence C. Bryk, DDS, MS
Faculty mentor/Co-author e-mail BRYKC@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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