Comparative Impact of Clear Aligners and Traditional Fixed Appliances on Oral Health-Related Quality of Life: A Systematic Review and Meta-Analysis
Abstract
Background and Objectives: The impact of orthodontic appliances on oral health-related quality of life (OHRQoL) has gained increasing attention, particularly in relation to patient-centered outcomes. Clear aligners (CAs) are often perceived as more comfortable than fixed appliances (FAs), although evidence remains limited and heterogeneous. This systematic review and meta-analysis aimed to compare the effects of CAs and FAs on OHRQoL in patients with Angle class I malocclusion and to further evaluate the reliability of the findings using trial sequential analysis (TSA). Materials and Methods: This review followed PRISMA guidelines and was registered in PROSPERO (CRD420251051003). A comprehensive search of PubMed, Scopus, Web of Science, Embase, and Cochrane CENTRAL was conducted. Only randomized controlled trials comparing CAs and FAs and reporting OHRQoL outcomes (OHIP-14) were included. Random-effects meta-analyses were performed on early changes in OHRQoL. TSA was applied to control for type I and II errors and to evaluate the sufficiency of the cumulative evidence. Results: Two randomized controlled trials (n = 74) were included in the quantitative synthesis. Both treatments were associated with a transient deterioration in OHRQoL after appliance placement. Meta-analysis showed statistically significant improvements favoring CAs in psychological discomfort (p = 0.007) and psychological disability (p Conclusions: Clear aligners may provide a modest short-term advantage…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 74 participants or records.
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