Comparison of efficacy and accuracy of tooth movements in optimized and conventional attachments of clear aligners - A systematic review and meta-analysis

Q1 Medicine

Journal of oral biology and craniofacial research Pub Date : 2025-07-29 DOI:10.1016/j.jobcr.2025.07.019

Srirengalakshmi Muthuswamy Pandian, Aravind Kumar Subramanian, Nikhillesh Vaiid

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引用次数: 0

Abstract

Aim

This systematic review and meta-analysis aimed to compare the efficacy and accuracy of optimized versus conventional attachments in clear aligner treatment using Invisalign.

Materials and methods

Adhering to the ‘Preferred Reporting Items for Systematic Review and Meta-analysis’ (PRISMA) 2020 guidelines¹², the review obtained 6 retrospective cohort studies and one randomized controlled trial, sourced from databases such as PubMed, SCOPUS, Web of Science, Cochrane Library, Google Scholar, and clinical trial registries. Four studies were included for meta-analysis. Data was pooled for mean percentage accuracy of various tooth movements and corresponding Forest plots were generated.

Results

Most of the studies included showed a good methodological quality with a low risk of bias. No significant differences in the accuracy of tooth movement between conventional attachments and optimized attachments were noted for canine derotation, anterior extrusion, and root angulation changes in canine, premolar, and molar (p > 0.05). The studies however exhibited high heterogeneity (I² = 75 %). The pooled accuracy for canine derotation was 61.2 % and 71.5 % for conventional and optimized rotations respectively. Similarly, 57.5 % and 62.4 % were the pooled accuracy for conventional and optimized attachments in anterior extrusion. None of the attachments produced the expected tooth movement as predicted by the ClinCheck program.

Conclusion

There was a non-significant difference in accuracy between optimized and conventional attachments for most orthodontic movements. While optimized attachments may offer improved control for specific movements like upper lateral incisor rotation, and conventional attachments potentially enhance anterior extrusion, their overall superiority remains inconclusive. Further high-quality research is needed to validate the hypothesized biomechanical advantages of optimized attachments.

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优化后的牙齿矫正器与传统的牙齿矫正器附着物牙齿移动的有效性和准确性的比较-一项系统回顾和荟萃分析

目的：本系统综述和荟萃分析旨在比较优化的附着体与传统附着体在使用Invisalign治疗透明矫正器时的疗效和准确性。材料和方法根据“系统评价和荟萃分析的首选报告项目”（PRISMA） 2020指南12，本综述获得了6项回顾性队列研究和1项随机对照试验，来源数据库包括PubMed、SCOPUS、Web of Science、Cochrane Library、谷歌Scholar和临床试验注册库。四项研究纳入meta分析。将数据汇总为各种牙齿运动的平均百分比准确度，并生成相应的Forest图。结果纳入的大多数研究方法学质量良好，偏倚风险低。传统附着体和优化附着体在犬齿旋转、前牙挤压和犬齿、前磨牙和磨牙牙根角度变化方面的牙齿运动精度无显著差异(p >；0.05)。然而，这些研究显示出高度的异质性（I2 = 75%）。在常规旋转和优化旋转中，犬类旋转的综合精度分别为61.2%和71.5%。同样，常规附着体和优化附着体在前牙挤压中的总准确率分别为57.5%和62.4%。没有一个附着物产生ClinCheck程序所预测的牙齿运动。结论优化后的附着体与常规附着体在大多数正畸运动中的准确性无显著差异。虽然优化的附着体可以改善对特定运动的控制，如上侧切牙旋转，而传统的附着体可能会增强前牙挤压，但它们的整体优势仍不确定。需要进一步的高质量研究来验证优化后的附着体的生物力学优势。

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来源期刊

Journal of oral biology and craniofacial research Medicine-Otorhinolaryngology

CiteScore

4.90

自引率

0.00%

发文量

133

审稿时长

167 days

期刊介绍： Journal of Oral Biology and Craniofacial Research (JOBCR)is the official journal of the Craniofacial Research Foundation (CRF). The journal aims to provide a common platform for both clinical and translational research and to promote interdisciplinary sciences in craniofacial region. JOBCR publishes content that includes diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the mouth and jaws and face region; diagnosis and medical management of diseases specific to the orofacial tissues and of oral manifestations of systemic diseases; studies on identifying populations at risk of oral disease or in need of specific care, and comparing regional, environmental, social, and access similarities and differences in dental care between populations; diseases of the mouth and related structures like salivary glands, temporomandibular joints, facial muscles and perioral skin; biomedical engineering, tissue engineering and stem cells. The journal publishes reviews, commentaries, peer-reviewed original research articles, short communication, and case reports.