Abstract

Objectives: Our objective was to test the hypothesis that thermoplastic clear aligners (Invisalign®; Align Technology, Santa Clara, CA, USA) are more pleasant for patients than conventional fixed orthodontic appliances.

Subjects and methods: This was an observational retrospective study in which subjects were matched for age, treatment modality, and the treating orthodontist. A total of 60 adult patients (30 in the Invisalign group and 30 in the conventional buccal fixed appliance group) who met the inclusion criteria completed a validated self-reporting questionnaire, rating their experience after appliance activation in regard to oral impact experience and satisfaction of both treatment modalities. Categorical variables were compared using the χ2 test, Fisher's exact test, and the Z test. Continuous variables such as pain level and age were analyzed using the 2-sample t test.

Results: Patients on clear aligner therapy reported significantly more difficulty in speech (p = 0.035) necessitating change in speech delivery (p = 0.003). In addition, they reported better chewing ability (p < 0.001), no restrictions on amounts or types of food (p = 0.02), and less mucosal ulcerations (p = 0.01). Effects on daily routine, use of analgesics, and overall treatment satisfaction were not significantly different between the 2 groups.

Conclusion: Clear aligner therapy is not necessarily more pleasant, but it is more tolerable as it satisfies patient needs over food consumption and absence of mucosal ulcerations. However, clear aligners affect pronunciation and speech delivery in the short term.

Keywords: Braces; Dentistry; Fixed appliance therapy; Invisalign; Oral health-related quality of life; Oral impacts; Orthodontics; Patients.