Pain perception and sEMG of masticatory muscle in clear aligners vs. conventional orthodontics: A systematic review and meta-analysis.

Background: Clear aligner therapy (CAT) has gained popularity as an alternative to Conventional Orthodontic Treatments (COT) for its potential to reduce pain and discomfort. This systematic review and meta-analysis aimed to compare pain perception and surface electromyography (sEMG) in masticatory muscles between CAT and COT groups.

Materials and methods: A comprehensive search of multiple electronic databases was conducted to identify relevant studies. The PRISMA guidelines were employed to ensure transparency and completeness in reporting and was registered in PROSPERO (CRD42024556800).

Results: Nine studies were considered for inclusion. The meta-analysis revealed a nonsignificant difference in Visual Analog Scale scores between CAT and COT groups, with a mean difference (MD) of -2.77 (95% confidence interval [CI]: -7.25, 1.71), P = 0.23. The heterogeneity test revealed significant heterogeneity among studies (I² = 100%). In contrast, the sEMG activity scores showed a nonsignificant difference between CAT and COT groups (MD = -0.80, P = 0.60). In addition, the odds ratio for patients requiring analgesics was 0.23 (95% CI: 0.08, 0.65), P = 0.005, suggesting a significant difference between CAT and COT groups.

Conclusion: The results suggest that CAT may be associated with improved patient outcomes, including reduced pain and discomfort, as well as lower analgesic consumption. However, the evidence is not conclusive, and further research is needed to fully understand the differences between CAT and COT.