Clinical Effectiveness of Clear Aligners (CAT) vs. Fixed Appliances (FAT)

Review: Clin Oral Investig. 2022;26(3):2353-2370.
Authors: Yassir A Yassir, Sarah A Nabbat, Grant T McIntyre, David R Bearn

Key Findings

1. Effectiveness & Indications:
   CAT is effective for:
   Mild-to-moderate malocclusions.
   Relapse cases, periodontal patients, and patients with social/emotional preferences.
   FAT is superior for:
   Complex cases (e.g., large extractions, severe root/bodily movements).

2. Treatment Duration:
   CAT may achieve shorter treatment times for mild-moderate cases.

3. Periodontal Health:
   CAT shows better periodontal outcomes (easier cleaning, smoother surfaces, fewer plaque traps).

4. Root Resorption:
   Potential lower risk with CAT, but further studies needed.

5. Limitations of CAT:
   Higher relapse potential (overcorrection recommended).
   Challenges in achieving solid occlusal contacts and precise root control.

Author Recommendations

• For Clinicians:
  Master IPR (Interproximal Reduction), attachments, and staging for optimal CAT outcomes.
  Consider overcorrection to mitigate relapse.

• For Research:
  More studies needed to evaluate next-generation aligners and long-term stability.

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Takeaway

• CAT excels in simplicity, aesthetics, and periodontal health.

• FAT remains gold-standard for complex movements.

• Hybrid approaches may be ideal for certain cases.